ASTHMA
Asthma is also called bronchial asthma. It is a chronic condition that affects the lungs. Airways in the lungs become narrower, they swell and get blocked by excessive mucus. Asthma leads to bronchospasms, inflammation, thick mucus and airway constriction. It is therefore a life-threatening condition that can lead to death, but the good news is that it can be dealt with.
Asthma can occur across all age groups, children, adults and geriatrics.
For some people,asthma is not a big deal. It is just a sma;l nuisance, but for others it is a major struggle.
During a normal inspiration(breathing in) and expiration(breathing out), muscles surrounding the airways usually relax to allow in air without struggle.
In asthmatic attacks, bronchospasm, inflammation and mucus production occur.
Characteristics
- Bronchospasm- constriction of airway muscles. They become tight, narrow and free airflow is prevented. Tighter airways lead to production of a sound called wheezing when someone is breathing
- Mucus production- thick mucus is produced that blocks/ clogs these airways
- Inflammation- Swollen lining of airways. Sufficient inward and outward flow of air is prevented
Epidemiology & Prevalence
This condition affects >20 milllion people in the United States of America.
More than 5 million children are affected.
It is the most common chronic disease among children
Approximately, 5,000 people succumb to asthma every year in the United States. This figure may not include people who have developed severe chronic obstructive pulmonary disease(COPD) secondary to inadequately treated asthma
Types/ Forms
Asthma is characterized depending cause of symptoms and their severity.
Depending on cause;
- Allergic asthma- due to allergens such as molds, pollen grains from flowers, dust and pet dander
- Non-allergic- caused by factors such as exercise, stress, illnesses, and unfavourable weather
Depending on severity of symptoms;
- Intermittent asthma; attacks are resolved quickly. There is a normal feeling in between the flares.
- Persistent asthma; occurrence of symptoms is regular. Symptoms are mild, moderate or even sometimes, severe
Risk Factors
Note that any individual can develop asthma at any stage in their life.
Several factors increase chances of developing asthma.
Risk factors include;
- Tobacco smoking- active and passive smokers
- Sex- Females are at more risk than males
- Race- black people are more affected as compared to other races
- Obesity- overweight individual s are at risk of getting asthma
- Having any other allergic condition such as atopic dermatitis or hay fever
Causes
- Genetics- persons from families with history of asthma are more likely to develop the condition. If you have an asthmatic patient, you are 3-6 times more likely to develop the same condition as compared to a person whose parent does not have asthma.
- Allergens such as molds, pollen grains from flowers, dust and pet dander. Certain allergic conditions such as atopic dermatitis(eczema) and allergic rhinitis(hay fever) are connected to development of asthma.
- Unfavourable weather
- Exercise; exercise-induced asthma becomes worse when air is cold and dry
- Respiratory iIllnesses such as respiratory syncytial virus(RSV)
- Occupational exposures eg chemical fumes, industrial and wood dusts can lead to asthma on the very first exposure
- Smoking- tobacco smoking
Factors that can trigger an asthmatic attack include;
- Some medications such as beta-blockers(cause bronchial constriction), aspirin and Non-Steroidal Anti-Inflammatory Drugs(NSAIDS) such as ibuprofen
- Cold and dry air
- Dust mite
- Cockroach waste and other pests such as mice
- Pets
- Tobacco smoke
- Concentrated smells and odours
- GERD- Gastro-esophageal reflux disease, which is a condition whereby stomach contents including acids back up into the esophagus and throat
Signs & Symptoms
- Coughs
- Dyspnoea/ Shortness of breath
- Wheezing during exhalation/ breathing out. This is common in children
- Chest pain and tightness
- Troubled sleep/ Difficulty to sleep due to coughing and shortness of breath
- Swelling inside the airways
- Excess mucus that clogs airways
- A drop in peak flow reading
- Difficulty speaking
Diagnosis & Tests
- Medical history of allergies, eczema and other lung conditions
- Spirometry test to measure airflow in lungs
- Chest X-ray test
Management & Treatment
Asthma is not treatable, but it is manageable by medications. Health care providers prescribe medications to control the condition.
- Bronchodilators that relax muscles around the airways
- Anti-inflammatory drugs that reduce swelling and mucus production in the airways
- Biologic therapies for severe asthma
Asthma medications are taken using various ways, which include;
- Metered-dose inhaler
- Nebulizer
Prevention
- Avoid allergens such as dust
- Wear masks when working in environments that expose you to strong concentrated odours and chemicals
- Simply by avoiding triggers, one can prevent themselves form getting asthma
- Identify and manage attacks early
- Take medications as prescribed