Asthma: Guidance and guidelines
The lungs are very important organs in the body. The blood is oxygenated in the lungs and then pumped throughout the body, reaching the various cells and tissues. When the lungs malfunction, it may lead to serious health problems, including death.
Oxygen is the fuel of life. This element is crucial for all body processes and it enters the lungs through the air we breathe. As the body uses oxygen, it also makes a waste product dubbed as carbon dioxide. As people inhale fresh air and oxygen, he or she exhales carbon dioxide. When this process is disrupted by abnormalities or illnesses in the lungs, it may take a toll on the overall health of a person.
One of the most common causes of lung problems is asthma. Asthma is a lung problem wherein there is occasional breathing problems or difficulties. In asthma, the airways start to narrow and become inflamed, making it hard to breathe. It can trigger various symptoms such as shortness of breath, wheezing and coughing.
There is no cure for asthma but its symptoms can be controlled. Asthma affects people of all ages and it can start during childhood. However, it can also affect adults. For some people, asthma is just a small nuisance but for others, it could signal a life-threatening condition.
In the United States, the number of individuals with asthma continues to grow. About one in 12 people had asthma in 2009 alone, which accounts for an estimated 25 million or 8 percent of the whole U.S, population. In 2001, the only people who had asthma was one in 14, which is about 20 million or 7 percent of the U.S. population.
The signs and symptoms of asthma differ from one person to another. You may find some attacks as infrequent while it can be continuous. Infrequent attacks usually happen during exercise or strenuous activities.
The main symptoms of asthma include:
- Shortness of breath
- Wheezing or a whistling sound in the lungs
- Tight chest
The signs and symptoms may indicate another lung problem, but it is asthma if these
- Occurs frequently and it keeps on coming back
- Tend to respond to certain triggers such as exposure to allergens, exercise and touching animals
- Become worse at night and early in the morning
Any asthma symptoms are serious and can become deadly if it’s left untreated. If a person is experiencing one or more of the symptoms, visit a doctor immediately.
It is still unclear why some people have asthma while others don’t. However, some scientists have linked a combination of genetic and environmental factors in the development of asthma.
Individuals with asthma have inflamed or swollen airways that can narrow and obstructed with sticky mucus when exposed to some asthma triggers.
The common triggers include:
- Allergens or airborne substances such as pollen, animal fur or dander, feathers, dust mites, particles of cockroach waste and mold spores. Other airborne irritants include fumes, pollution and cigarette smoke.
- Infections of the upper airways like flu and colds
- Physical activity i.e. exercise-induced asthma
- Cold air
- Certain medications like beta blockers and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, aspirin and naproxen.
- Food additives such as tartrazine (yellow food coloring) and sulfites (pickled products, beer, wine and dried fruits)
- Sudden changes in temperature, thunderstorms, hot and humid days, windy days
- Strong emotions and stress
- Indoor conditions like damp, chemicals in carpets, and molds
- Gastroesophageal reflux disease (GERD)
Since the exact cause of asthma is still unknown. Some factors may increase the risk of developing asthma, including:
Family history – Having a family member, parent or sibling who has asthma may increase the risk of the condition.
History of another allergic reaction – People with personal and family history of other allergic reactions such as allergic rhinitis, atopic dermatitis (eczema) and others, are at a higher risk of developing asthma.
Experienced bronchiolitis as a child – People who had bronchiolitis as an infant is at a higher risk of having asthma.
Exposure to tobacco – People who are exposed to tobacco, and those who are smoking are at a higher risk of asthma.
Other factors – The other risk factors include being overweight or obese, being a smoker, exposure to occupational triggers like chemicals, mother smoking during pregnancy, being born prematurely or being born low birth weight.
If left untreated, asthma could lead to serious complications such as:
- Fatigue and extreme weakness
- The signs and symptoms interfere with work, sleep, recreational activities and underperformance in school and work.
- Recurrent hospital visits for severe asthma attacks
- Psychological problems like anxiety, stress and depression
In severe and rare cases, asthma may lead to complications like atelectasis (collapsed lung), pneumonia, status asthmaticus (severe asthma attack that does not respond to treatment) and respiratory failure.
There is no single test for asthma but it can be diagnosed from the signs and symptoms reported by the patient.
Physical examination – The doctor can recommend a complete physical examination and a medical history interview. These tests will determine the patient’s risk factors and the signs and symptoms, to rule out other possible lung conditions.
Lung function tests – The doctor may recommend pulmonary function tests to determine how much air moves when the patient breathes. The common tests include a spirometry and peak flow test.
Additional tests – Other tests can be done to determine the risk of a person in developing asthma. These tests include methacholine challenge, wherein an asthma trigger is inhaled and would see if the airways would constrict, nitric oxide test, imaging tests such has CT scan and MRI, sputum eosinophils to determine if there is inflammation in the airways, provocative testing for exercise and cold-induced asthma and allergy testing.
At present, there is still no cure for asthma. However, prevention and long-term management or control of the symptoms is the key to reducing or stopping asthma attacks. These are important before the asthma attack would start or may lead to serious complications. Here are the treatment options for asthma.
Preventive and maintenance medications decrease the inflammation in the airways to reduce the occurrence of the symptoms.
Long-term asthma control medicines – These are taken daily and will prevent asthma attacks. These drugs include inhaled corticosteroids, leukotriene modifiers, combination inhalers and, theophylline, long-acting beta-agonists.
Rescue medications or quick-relief medications – These are needed for the rapid relief of an acute asthma attack. These include short-acting beta agonists, ipratropium (Atrovent), and oral or intravenous corticosteroids.
Allergy medications – Allergy medications may help if allergies trigger the condition. These include allergy shots, or omalizumab (Xolair).
Bronchial thermoplasty is a treatment which is not yet used by many patients. It’s usually used for individuals with severe asthma, especially when the condition does not respond to other treatments, like inhaled corticosteroids.
The best way to manage asthma is to avoid the known triggers. Also, there are ways to reduce the exposure to triggers such as:
- Use air conditioner – Using air conditioning reduces the amount of pollen and other airborne substances. Also, air conditioning decreases the humidity in the room, reducing the risk of an asthma attack.
- Prevent molds in the house – Clean moist and damp areas in the bath and kitchen. Get rid of damp firewood and other sources of possible mold infestation.
- Reduce pet dander – In some cases, pets may trigger an asthma attack. It’s better to avoid pets with fur or feather. If you have pets, clean or bathe them regularly.
- Cover the mouth and nose if it’s cold like during the winter – You could use a scarf or a face mask.
- Clean regularly – Make sure you clean your surroundings.
- Stay healthy by having regular exercise and eating a well-balanced diet.
- Avoid stressful events and strenuous activities.
Asthma can’t be prevented, especially if it’s inherited. However, the patient can prevent acute and frequent attacks through preventive measures such as:
- Taking the medications regularly
- Stopping smoking or avoiding secondhand smoke
- Exercising regularly
- Eating healthily
- Being aware of your triggers
- Getting vaccinated against infections that could trigger an asthma attack like a flu jab.
- Having adequate sleep
Asthma is a chronic disease but if it’s maintained and controlled properly, the disease will not lead to serious complications. The severe effects of asthma are commonly seen among smokers.