Asthma Overview

Asthma is an ailment that impacts the breathing channels of the lungs known as bronchioles. Asthma occurs due to ongoing swelling of these passages causing these airways extremely susceptible to different prompts. The initial inflammation is triggered by variety of exterior as well as internal factors causing the airways to swell and fill with mucus. This is followed by bronchospasm where the muscles in the breathing passages contract causing narrowing. This narrowing creates trouble in exhaling air from the lungs. This problem of exhaling creates characteristic symptoms of an asthma attack. Asthma is also called an obstructive lung disease. The medical term is chronic obstructive pulmonary disease.
Asthma is not curable but it can be avoided. You can control this disease if it is diagnosed at an early stage and proper treatment is given. Without treatment, the attacks occur more frequently and the person can even die. Asthma is more common in African Americans as compared to other races. Asthma is more widespread in younger people. The intensity and frequency of attacks decrease with the age of the person. Asthma is the most frequent chronic disease of children.

Asthma Symptoms

Whenever an attack is triggered, the following symptoms appear:

• Wheezing: Wheezing is a musical or hissing sound that comes with breathing. It is present during exhalation and is the common symptom of asthma.  
• Coughing
• Breathlessness
• Tightness of chest
• Problem in speaking

Depending on the intensity, asthma attacks can be classified as

• Mild intermittent: The attacks occur not more than 2 times a week and the attacks last for few hours to days. The intensity varies and there are no symptoms between attacks.
• Mild but continuing: The attacks occur more than twice a week and the nighttime symptoms are there for more than 2 times a month. Attacks might be severe and cause trouble in regular activities.
• Moderate and enduring: It includes daily attacks and the symptoms at night occur for two to three times a week. Attack lasts for many days and they need rescue medication and cause alteration in daily activities.
• Severe persistent: Here recurrent critical attacks occur with persistent daytime symptoms and repeated night symptoms.

Asthma Causes

Though the exact cause of asthma is not known, the main research is focused on why some people develop asthma and others not. The probable causes can be:

• Some people are more prone to asthma by birth. This may be due to some specific genes.
• The living and working atmosphere is also partially responsible for this ailment.
• An asthma attack is basically a reaction to a trigger and is just like an allergic reaction. The triggers of asthma attack are different for each person and they are:
• Tobacco or wood smoke
• Inhaling polluted air
• Certain typical perfumes or cleaning products Air passage irritants particularly at the workplace
• Inhaling allergens like molds, dirt, or animal dander
• Respiratory tract infection caused by cold, flu or bronchitis
• Sulfites that used as additives to certain foods and wine
• Changing or dry weather
• In some women asthma symptoms come with menstrual cycle.
• Any kind of stress
• Physical exertion
• Gastroesophageal reflux

Risk factors for developing asthma

• The biggest risk factor for developing asthma is allergic rhinitis and other allergies
• Heredity
• A skin allergy called eczema can also cause asthma

Diagnosis

If you get an attack, your doctor will ask you about your symptoms, history and medications. Then they’ll examine you physically and perform certain tests:
The tests that involve how well you breathe are:

• Spirometer: This device checks the amount of air you can inhale and how powerfully you can exhale it. The test is performed previous to and after you intake the inhaled medication.  It is a method to check for breathing impairment in an attack.
• Peak flow meter: It is a method to measure how powerfully you can exhale in an attack.
• Oximetry: Here a probe called pulse oximeter is put on your fingertip to determine the quantity of oxygen in your blood.

There is no blood test to diagnose asthma. Your blood is tested for any infection causing an attack. In acute attacks, a blood sample from artery is taken to find out oxygen and carbon dioxide present in your body.

Asthma Treatment

Asthma is a chronic disease and the treatment is quite lengthy. Some people have to remain on medications for their whole lives. You can improve your quality of life by:

• Keeping good knowledge of resources and the data, education, and proficiency which they offer.
• You must be aware of the asthma triggers and the ways to avoid them.
• You must follow the treatment recommendations of your doctor and know about every drug.
• Any deterioration of your symptoms must be reported.

The main goal of treatment is to prevent bothersome symptoms and asthma attacks. 
When asthma is diagnosed, you’ll be put on medications and monitoring. There are 2 kinds of medications:

• Controller medications: These medications are for long-term management of continual asthma. They aid in decreasing swelling in the lungs caused by asthma attacks. They must be taken everyday.
• Rescue medications: These medicines help in controlling short-lived asthma attacks. You can take them whenever you are having symptoms of respiratory tract infection.

Medications

The controller medicines aid in reducing the swelling leading to acute asthma attack

• Long-acting beta-agonists: These drugs are based on adrenaline secreted by the adrenal glands. The inhaled long-acting beta-agonists keep the breathing passages open for 12 -15 hours. They loosen up the muscles of the airways by dilating them and reducing obstruction to exhaled airflow. They can decrease inflammation. Serevent and Foradil are examples of this kind.
• Corticosteroids(inhaled) are the major group of medications in this group. These medications act in the vicinity by focusing their effects within the breathing passages. Beclomethasone and triamcinolone are inhaled corticosteroids.
• Leukotrienes are influential chemicals causing inflammation as seen in an acute asthma attack. Leukotriene inhibitors decrease this inflammation by stopping these chemicals. Zileuton and montelukast belong to this category.
• Methylxanthines act as extended working bronchodilators. They are not used frequently as they have significant side effects. Examples of this category are Theophylline and aminophylline.
  Rescue medications are taken after onset of an asthma attack. The beta-agonists are the commonly used rescue medications. They act in very short durations to open the breathing passages and the effects last for 3 -5 hours. Proventil and Ventolin are commonly used short-acting beta-agonist medication.

Living and coping

Asthma is a chronic ailment but it can be cured by proper management. These steps can help you to decrease the frequency and severity of the attacks.

• Take both controller and rescue medications as prescribed by your doctor.
• Visit your doctor regularly.
• Stay away from known triggers.
• Quit smoking

Follow-up

If you were admitted for treatment in an emergency situation, you must take proper care once you are discharged. You must visit your health provider on the next day. If the symptoms return, you must contact your doctor for guidance.