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What is Asthma?
It is a respiratory condition which mainly affects the airways causing them to narrow down. This makes breathing difficult and causes shortness of breath. 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.
Symptoms
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
Causes and triggers
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
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
Medicines such as NSAIDS (non-steroidal anti-inflammatory drugs such as ibuprofen), aspirin (blood thinning medicine) etc
Consuming food items that contain sulfite (food preservatives) such as certain pickles, bottled lemon juices, beer and wine
Risk factors
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
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 manged 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.
Diagnosis
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.
Treatment
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
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 inhaler and symptoms continue to get worse, the patient should be rushed to emergency department without losing any time.
Lifestyle modifications and home remedies
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.
Complications
If asthma is not effectively and timely managed, it can lead to serious medical complications over the period of time. These include-
Loss of pregnancy
Preterm delivery
Permanent narrowing of bronchial tubes
Lung collapse
Respiratory failure
Bronchial Asthma is the most common type of Asthma, which affects the bronchi in the lungs. Other Asthma includes childhood asthma and adult-onset asthma. In adult-onset asthma, symptoms will not appear until at least age 20.
Other specific types of Asthma are the following:
1. Allergic Asthma (extrinsic Asthma)
Allergens are the cause of this common type of Asthma. Allergic Asthma is quite often seasonal because it goes hand-in-hand with seasonal allergies.
These might include:
2. Nonallergic Asthma (intrinsic Asthma)
Irritants in the air but not related to particular allergies trigger this type of Asthma. These are:
3. Occupational Asthma
Occupational Asthma is caused by working in dangerous environmental conditions. These include:
4. Exercise-induced bronchoconstriction (EIB)
Exercise-induced bronchoconstriction (EIB) affects people within a few minutes of starting strenuous exercise.
5. Aspirin-induced Asthma
Aspirin-induced Asthma (AIA) is caused due to the intake of aspirin or another NSAID (a nonsteroidal anti-inflammatory drug), such as naproxen (Aleve) or ibuprofen (Advil).
6. Nocturnal Asthma
In this type of Asthma, symptoms develop at night.
Triggers that are thought to bring on symptoms are:
7. Cough-variant Asthma (CVA)
A persistent, dry cough characterizes Cough-variant Asthma (CVA). If not treated quickly, it can lead to full-blown asthma flares that include the other more common symptoms.
The doctor will conduct a variety of tests to determine if the symptoms are the result of Asthma.
The following tests can help diagnose Asthma:
Treatments for Asthma comprise of three primary categories:
Your doctor will determine and plan your treatment based on:
1. Breathing exercises
Breathing exercises will help you get more air into and out of your lungs. This will help you expand and increase lung capacity and cut down on severe asthma symptoms.
2. Quick-relief asthma treatments
These medications are prescribed by the doctor in the event of asthma symptoms or an attack. These medicines will provide you with quick relief and help you breathe again.
3. Long-term asthma control medications
Long-term asthma control medications include the following:
Prevention
The following strategies are included to hamper asthma attacks:
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