What’s asthma?
Asthma is a respiratory disorder of the lungs. Asthma affects normal breathing; routine physical activities become difficult or impossible for an asthma patient. Asthma can be life-threatening if proper treatment is delayed.
Due to factors such as increasing pollution, respiratory diseases such as asthma are becoming alarmingly prevalent. The World Health Organization estimates that India has approximately 20 million asthma patients. Asthma also strikes children usually aged between 5 to 11.
During respiration, the air that we breathe in goes through the nose, throat and into the lungs. Asthma occurs when the airways to the lungs enlarge and tighten the surrounding muscles. This causes mucus to block the airways which further blocks the supply of oxygen to the lungs. The result is the asthma attack of coughing, etc.
In this blog, we’ll be looking more into the asthma causes and treatment.
Asthma Symptoms:
Some of the symptoms of bronchial asthma are:
- Coughing – especially at night, when laughing or exertions such as exercising
- Wheezing – a whistling sound when breathing
- Shortness of breath and a feeling of tightness in the chest
- Fatigue – a feeling of tiredness
Different types of asthma have different symptoms. Persistent signs of the above symptoms indicate that a visit to the doctor is necessary – sooner the better.
Types of asthma:
Bronchial asthma is a more common type of asthma. It affects the bronchi (main air passages) in the lungs. Other types of asthma include childhood asthma, adult-onset asthma, allergic asthma, nocturnal asthma, etc.
Causes of asthma:
As yet medical science has not narrowed down any single cause for asthma. Studies point to some leading suspects:
- Genetics – a parent with asthma increases the chances of the child getting it too.
- Viral infections: those prone to viral infections during childhood have more risk of getting asthma.
- Hygiene hypothesis – babies not exposed sufficiently to good bacteria have weaker immune systems and become more vulnerable to asthma in the later years.
- Allergen exposure: regular contact with allergens, irritants increases the chances of asthma.
Risk Factors of Asthma
Although it can’t be said for sure what causes asthma in some people and not in others, however, there can be some triggers. One of the reasons for asthma can be being exposed to elements such as:
- Airborne allergens such as pollen or dust mites
- Respiratory infections such as common cold
- Chilly air
- Air pollutants and irritants
- Excessive physical activity
- Medications such as beta blockers, aspirin, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
- Stress and anxiety
- Preservatives and sulfites
- Gastroesophageal reflux disease (GERD)
Additionally, you’ll be at a greater risk for asthma if:
- You’re overweight
- You’re a smoker
- You have a family history of asthma
- You get exposed to passive smoking
- You have any form of allergy
- You are exposed to fumes and other types of pollutants
- You are exposed to harmful substances at work such as chemicals
Now that you’re aware of the causes of bronchial asthma, let’s look at the asthma symptoms and treatment.
Asthma triggers:
Specific conditions and environments can trigger or worsen the symptoms of asthma:
- Respiratory illnesses such as the flu and pneumonia.
- Increased activity may make respiration more difficult.
- Asthma patients are sensitive to chemical fumes, strong odours, smoke, and similar irritants.
- Extreme weather conditions such as high humidity or freezing weather.
- Loud laughing, shouting and any emotional outbreaks that increase the rate of breathing.
Asthma Diagnosis:
No single test or exam can detect asthma. A variety of criteria determines if asthma is the cause of respiratory problems:
Family medical history – family members with a breathing disorder increase the possibilities of another family member having asthma.
Physical examination – the doctor uses a stethoscope to examine breathing, conducts skin tests for allergic reactions such as hives or eczema. Allergies increase the risk of asthma.
Breathing tests: Pulmonary function tests such as spirometry is done to measure the airflow in and out of the lungs. In spirometry, the narrowing of your bronchial tubes is checked by observing the quantity of air you exhale and the speed with which you do it. Peak flow is another test that can also be done to check how strongly you can breathe out. If your peak flow reading is lower than usual, it means there may be a problem in your lungs.
There can be some other tests too such as:
- Methacholine Challenge – This involves checking whether methacholine, an asthma trigger, will narrow your lungs or not.
- Imaging tests – This can include X-rays to check for structural abnormalities and infections.
- Nitric oxide test – This involves testing the amount of nitric oxide in your breath. A higher content of nitric oxide in your lungs indicates asthma.
- Sputum eosinophils – This test checks for white blood cells in your saliva or mucus during coughing.
- Provocative testing – This test is done to check for cold-induced asthma and asthma from physical activity.
Treatment:
Asthma treatment may involve involves breathing exercises, rescue, or first aid treatments and asthma control medications for long-term treatment. The doctor decides on the appropriate treatment after taking into consideration the type of asthma, the patient’s age, medical history, etc.
Some of the methods for asthma prevention are:
- Breathing exercises increase the airflow in and out of the lungs – thereby neutralizing problems of asthma.
- Rescue or first aid treatments are the instant relief-providing medications used during an asthma attack. Options include rescue inhalers and nebulizers, bronchodilators (to relax tightened lung muscles), anti-inflammatory medications.
- Long-term asthma control medications are daily dosage that needs to be taken for years, to keep asthma under check.
- These include Inhaled corticosteroids such as fluticasone propionate (Flovent HFA), beclomethasone (Qvar Redihaler), and fluticasone furoate (Arnuity Ellipta), leukotriene modifiers such as montelukast (Singulair) and zafirlukast (Accolate), combination inhalers such as fluticasone-salmeterol (Airduo Digihaler) and formoterol-mometasone (Dulera), and theophylline. Some short-term medications include short-acting beta agonists such as albuterol (ProAir HFA) and levalbuterol (Xopenex), anticholinergic agents such as bronchodilators and ipratropium (Atrovent HFA), and oral and intravenous corticosteroids such as prednisone (Prednisone Intensol) and methylprednisolone (Medrol).
- Bronchial thermoplasty is used for severe asthma where medications don’t work. In this type of bronchial asthma treatment, the doctor will heat up the insides of your lungs with electrodes which will smoothen the muscle inside the airways and reduce their ability to tighten, making it easier to breathe and reduce asthma symptoms.
If asthmatic symptoms continue for more than 20 minutes even after using the above treatment then immediately seek medical help.
How to prevent asthma:
- Keep away from chemicals and products that have earlier caused breathing problems.
- Keep away from allergens such as dust or mould.
- Take allergy shots that protect the body against asthmatic triggers.
- Take preventive medication, as the doctor prescribes.
Dr. M. L. Ali, Senior Consultant Diabetology, Internal Medicine, Brahmananda Narayana Multispeciality Hospital, Jamshedpur