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Asthma is a condition in which bronchial tubes, the airways through which air enters and exits through lungs become thick and narrower causing difficulty in breathing, coughand wheezing. This airway obstruction is reversible which differentiates  it from other obstructive diseases. The severity of asthma ranges from very mild symptoms to serious attacks. About  26 million Americans are being affected of asthma of which 7 million are children and according to World Health Organization around 300 million people are diagnosed of asthma.

Types of Asthma

  • Allergic: These people are highly sensitive to allergens such as pollen, animal dander (skin particles) etc. Family history is present in most of the cases
  • Non- allergic: These people have no such history of sensitivity to such substances and still have asthmatic symptoms.

Symptoms of Asthma

  • Difficulty in breathing
  • Chest tightness
  • Rapid breathing
  • Recurrent cough frequently at night or early morning
  • Wheezing( whistling  sound is heard during exhalation)

Symptoms of Asthma

Causes of Asthma

Exactly we don’t  know why only some people have asthma but probably it is due to the combination of both the environmental as well as genetic factors. So there are several risk factors and triggers for asthma

Risk factors

  • Having some pre-existing allergic conditions such as hay fever
  • A family person having asthma
  • Being obese
  • Having exposure to occupational hazards such as chemicals.
  • Smoker

Triggers: These factors can trigger asthmatic symptoms in both types of people.

  • Allergens present in air such as pollen, fungal spores, animal dander,
  • Exercise or rapid breathing– more common in children
  • Stress
  • Irritants
  • Cold air
  • Respiratory infection such as self limiting common cold
  • Medications such as beta blockers, aspirin
  • Air pollutants such as oxides of sulphur and nitrogen

Complications of Asthma

  • Severe asthma attacks that are difficult to manage with basic medications.
  • Narrowing of bronchial tubes permanently
  • Increased frequency of symptoms such that it interferes with daily activities.

Diagnosis of Asthma

  • Physical examination – Your physician will listen to your lung sounds and based on your signs, symptoms and history, a probable diagnosis can be made though tests are still required to confirm the diagnosis
  • Laboratory tests

Lung function tests or Pulmonary Function tests: These test will measure the functioning of lung by manipulating the amount of air going in and out of your lungs

Spirometry: It simply measures that how much air you can exhale after a deep inspiration. Reduced values indicates the narrowing of the airway passages.

PEF:  It stands for peak expiratory flow. This test will measure how fast you can exhale, simply it will determine the lung strength. Values are reduced in an asthmatic patients.

Methacholine challenge test:  It is used only when lung function test are normal or to differentiate asthma from another medical condition called as a chronic cough

Blood tests: RAST can be done which is used to find out the nature of allergen in allergic asthmatic patients.

Imaging: A simple chest x- ray or a CT scan can be used to find out any complications or problems which can aggravate the asthmatic symptoms.

Treatment of Asthma

The basic approach of the treatment is to control the ongoing symptoms and to reduce the future episodes. So treatment comprises both the drug medications and behavioral changes.

Treatment of Asthma

Short term relief medications

These are used only to provide relief from the current symptoms, use of these do not control asthma. So, more usage of these means that your asthma is not under control

  • Short acting beta agonists: These are bronchodilators, which relieves the symptoms by dilating the airways. They are given through an inhaler
  • Anticholinergics: These also act as a bronchodilator, but act slowly and efficiency is lesser than beta agonists. Generally, ipratropium is given by inhaler device

Controller therapies

  • Inhaled corticosteroids: At present they are the most effective controllers for asthma. They are given through an inhaler. They act by reducing the inflammation of the airways thus reducing the response to a trigger.
  • Intravenous corticosteroids: Used only for sudden asthmatic attacks that are not relieved by the use of inhaled corticosteroids
  • Anti-leukotrienes: Leukotrienes are one of the molecules responsible for the constriction of the passages. Anti-leukotrienes such as Montelukast are added to the therapy for better controlling future episodes

Prevention of Asthma

It has an important role in controlling asthma. With the help of some changes in lifestyle and medication therapy, you can completely cure your asthma problems. It varies from person to person because all the risk factors and triggers are not shared by all people.

  • Avoid your asthmatic triggers such as allergen, stress, irritants in the most possible ways
  • If humid air affects you, use AC in your rooms
  • For cold air sensitive people, they can keep mask or cloth around the nose while going outside.
  • Exercising regularly and adopting a healthy lifestyle.

Prognosis of Asthma

Asthma is a chronic condition means life going, it cannot be cured but symptoms can be controlled through proper management to lead a normal life like others.

Reference

Pulmonary Disease, Asthma


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