Asthma

Asthma

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Overview

It is a respiratory condition which mainly affects the airways causing them to narrow down. This makes breathing difficult and causes shortness of breath.

What is Asthma?

Patients with severe asthma may even have trouble talking. The airways also produce extra mucus which leads to a whistling sound (wheezing) while breathing.Asthma is common among all age groups; children, adults and elderly. There is no cure for asthma and effective management lies in preventing and relieving the symptoms.

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What are the symptoms of Asthma?

  • Shortness of breath
  • Chest tightness
  • Chest pain, especially while coughing
  • Easily gets tired (fatigue)
  • Wheezing (whistling sound) while breathing out (common in children)
  • Difficulty sleeping due to coughing, shortness of breath and wheezing
  • Coughing or wheezing attacks are worse when you catch cold or flu

What are the causes or triggers for Asthma?

  • Respiratory tract infections such as sinusitis
  • Allergens such as pollens, molds, dust and dust mites
  • Pet danger (hair and skin shed by pets e.g., cats, dogs etc)
  • Strong odours from perfumes, paints or cleaning solutions
  • Air pollution
  • Tobacco smoke
  • Chemical fumes
  • Exercises
  • Cold air or changes in the weather conditions (temperature or humidity)
  • Gastroesophageal reflux disease (GERD is stomach acid regurgitating into the food pipe)
  • Emotional stress such as anxiety, sadness etc
  • Taking NSAIDS (non-steroidal anti-inflammatory drugs)
  • Consuming food items that contain sulfite (food preservatives) such as certain pickles, bottled lemon juices, beer and wine

What are the risk factors for Asthma?

The following factors increase the risk of developing asthma

  • Family history (parent, sibling or any blood relative with asthma)
  • Exposure to various triggers during childhood
  • Boys are more likely to develop asthma in comparison to girls
  • Having allergic condition, such as eczema (itchy inflammation of skin) also known as atopic dermatitis (young children with atopic dermatitis tend to develop asthma later in life)
  • Having underlying lung infections such as pneumonia or bronchitis
  • Obesity/ being overweight
  • Smoking cigarettes or cigars
  • Exposure to secondhand smoke
  • Exposure to exhaust fumes/gases
  • Occupational hazard such as exposure to chemicals used in farming or manufacturing

What are the types of asthma?

  • Mild intermittent asthma: mild symptoms less than 2 times a week. Night-time symptoms are less than twice a month. Can be managed with fewer medications.
  • Mild persistent asthma: symptoms occur 3 to 6 times a week. Night-time symptoms are around 3 to 4 times a month. Asthma attacks may affect normal daily activities.
  • Moderate persistent asthma: asthma symptoms occur daily. Night-time symptoms occur around 5 or more times a month. Symptoms affect normal daily activities and lifestyle modifications are required.
  • Severe persistent asthma: asthma symptoms occur daily and quite often. Symptoms affect normal daily activities and sleep. Activity restriction is required.

How is Asthma diagnosed ?

Your doctor may ask you to undergo any of the following tests to diagnose the type and severity of asthma.

  • Spirometry: it is a simple breathing test which measures the amount of air inhaled and exhaled by an individual.
  • Exhaled nitric oxide test: You will be asked to breathe into a tube that is connected to a machine. This machine measures the amount of nitric oxide in your breath. The levels of nitric oxide are higher if your airways are inflamed.
  • Chest X ray: this provides an image of the airways and the lungs. A chest x ray is helpful in identifying any structural abnormalities which may be causing airway obstruction.
  • Chest CT (computerized tomography): this is helpful in identifying any soft tissue abnormalities of the airways. It is very easy to diagnose chest infections on a CT scan.
  • Allergy tests: this can be either a blood or skin test. It is helpful in exactly pinpointing which allergen triggers an asthma attack.
  • Sputum test: this test looks for presence of red blood cells and/or white blood cells(eosinophils) in the sputum. Healthy sputum contains less than 1% eosinophils, if the count is higher, then probably you are suffering from asthma.

Also, presence of bacteria or any other micro-organism in the sputum that is causing lung infection also increases the risk of developing asthma.

How is Asthma treated ?

There is no definite cure for asthma. Symptomatic management with the help of inhalers and oral medicines is the treatment of choice. Your doctor will prescribe right medications depending on the type of asthma, severity of symptoms, age and allergens causing it. Your doctor will closely work with you and create an asthma action plan. He/she may ask you to track your symptoms and create your own list of triggers. The type, frequency and duration of the medicines will be altered depending on your progress. It is important to follow your doctor’s advice if you want to adequately control your asthma.

What is an asthma attack?

It is an episode of severe breathlessness which occurs due to marked constriction of the airway muscles (bronchospasm). Thick and more viscous mucus is produced which lines the inner walls of the airways making breathing very difficult. The condition is life threatening if not promptly treated. Other symptoms of an asthma attack include:

  • Severe wheezing while breathing
  • Severe coughing that won't stop
  • Rapid and shallow breathing
  • Pale and sweaty face
  • Bluish discoloration of lips and fingernails
  • Marked chest pain
  • Severe chest tightness or sense of pressure
  • Tightness of neck muscles (retractions)
  • Difficulty talking
  • Associated feelings of anxiety

The symptoms of an asthma attack can quickly worsen. It is important to immediately use an inhaler (bronchodilator) to ease breathing. If the patient is not responding to the inhaler and symptoms continue to get worse, the patient should be rushed to the emergency department without losing any time.

What are the complications of Asthma?

If asthma is not effectively and timely managed, it can lead to serious medical complications over the period of time. These include-

  • Pneumonia
  • Loss of pregnancy
  • Preterm delivery
  • Permanent narrowing of bronchial tubes
  • Lung collapse
  • Respiratory failure

Tips for prevention

  • Use an air conditioner: this will reduce the number of pollens, dust particles and dust mites in the indoor air.
  • Cleaning up your space: regularly clean your house, especially vacuum clean your bedroom pillows, mattresses and blankets to get rid of any allergens, bed bugs, dust mites etc.
  • Avoid having indoor plants: these will increase the level of indoor humidity and create a damp environment for molds to grow rapidly.
  • Reduce pet danger (dried skin or hairs): avoid pets with fur or feathers. Don’t allow the pet on your bed or in your personal space. If you have a pet, regularly get it groomed and clean the surroundings more frequently.
  • Avoid exposure to cold air or air pollutants: wear a face mask to cover your nose and mouth when outdoors to avoid inhaling any smoke or allergens.
  • Maintain a healthy body weight: asthma symptoms are worse and difficult to manage in obese patients
  • Breathing exercises: will help in managing episodes of breathlessness
  • Pace your activities: don’t exert yourself and take breaks/rest periods between your daily activities
  • Natural remedies: consuming ginger, garlic, omega-3 oils (present in fish and flax seeds), herbal teas etc. may help in managing asthma symptoms.
  • Alternate medicines: yoga, acupuncture, meditation etc. may also be effective in managing breathing difficulties.
  • Get those allergy shots: overtime allergy shots will reduce your immune system response to specific allergens. Shots are usually given over a period of few months to few years.
  • Vaccination: get vaccinated for COVID-19, flu, pneumonia, shingles, or whooping cough (pertussis). This lowers the risk of developing these conditions as well as asthma.

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