Asthma

Asthma is a chronic disease caused by inflammation in the respiratory tract. This inflammation makes the respiratory tract swollen and very sensitive. As a result, the respiratory tract narrows, causing a lack of air flowing into the lungs.

Cells in the respiratory tract may also make more mucus than usual. This mucus can further narrow the respiratory tract.

There are five common types of asthma, including:

• Exercise-induced asthma
• Nocturnal asthma (night)
• Occupational asthma
• Cough-variant asthma
• Allergic asthma

Why can't asthma be considered trivial?

According to WHO,

• Asthma is one of the most important non-communicable diseases. This is a chronic disease of the respiratory tract from the inflamed lungs and makes it narrow.
• About 235 million people currently suffer from asthma. This is a common disease among children.
• Asthma has a relatively low mortality rate compared to other chronic diseases but most asthma-related deaths occur in low and middle income countries.
• Drugs cannot cure, but only control asthma.

What causes asthma?

The exact cause of asthma is unknown. The researchers think some interactions of genetic and environmental factors can cause asthma, most often at the beginning of life. These factors include:

• The tendency to develop allergies, called atopy (AT-o-pe)
• Parents who have asthma
• Certain respiratory tract infections during childhood
• Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system develops

If asthma or atopy is present in your family, exposure to irritants (for example, cigarette smoke) can make your respiratory tract more reactive to substances in the air. Asthma attacks can occur when you are exposed to "asthma triggers." Your triggers can differ from other asthmatics. Triggers may include:

• Allergens from dust, animal hair, cockroaches, fungi, and pollen from trees, grass, and flowers
• Irritants like cigarette smoke, air pollution, chemicals or dust in the workplace, compounds in home decoration products, and sprays (like hairspray)
• Drugs such as aspirin or other nonsteroidal anti-inflammatory drugs and nonselective beta-blockers
• Sulfite in food and drink
• Upper respiratory viral infections, such as a cold
• Physical activity, including sports

Who is at risk for asthma?

According to WHO, asthma is a common disease among children. Actually asthma affects people of all ages, but most often starts in childhood because:

• Has a respiratory infection (highest risk)
• Have allergies, eczema (allergic conditions on the skin)
• Parents have asthma

Among children, boys have a tendency to get asthma more often than girls. But among adults, women are more often affected by this disease than men. It is not clear how sex and sex hormones play a role in causing asthma.

Some people who are exposed to certain chemical irritants or industrial dust at work have a high risk of asthma. This type of asthma is called occupational asthma.

What are the characteristics and symptoms of asthma?

The characteristics and symptoms of asthma are:

• Asthma cough is often worse at night or morning, making it difficult to sleep.
• Wheezing is a high-pitched whistling sound that appears when you breathe.
• Chest tightness. This might feel like something is pressing against your chest.
• Hard to breathe. Some people who have asthma say they can't breathe or they feel out of breath. You might feel like you can't blow air from your lungs.

If you have these symptoms, it doesn't always mean you have asthma. The best way to diagnose asthma with certainty is to use lung function tests, medical history (including the type and frequency of symptoms), and physical examination.

Severe symptoms can be fatal so it is important to treat symptoms when you first notice them so they don't get worse.

How to diagnose asthma?

Your doctor will diagnose asthma based on:

• Medical and family history. Your doctor may ask about your family history of asthma and allergies. He may also ask if you have asthma symptoms and when and how often they occur. Let your doctor know whether your symptoms appear to occur only at certain times or in certain places, or if the symptoms worsen at night. Your doctor may also ask about health related conditions that can interfere with the treatment of asthma.
• Physical examination. The doctor will listen to your breathing and look for signs of asthma or allergies.
• Lung function tests. Your doctor will use a test called spirometry to check how your lungs work. This test measures how much air you can breathe and exhale. This test also measures how fast you can blow air out.

Other tests may include:

• An allergy test to find out allergens that affect you, if any.
• Test to measure how sensitive your respiratory tract is. This is called a bronchial test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive an increase in a dose of cold air or a special chemical to breathe.
• A test to show whether you have other conditions with the same symptoms as asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea.
• Chest X-ray or EKG (electrocardiogram). This test will help find out whether foreign objects or other diseases can cause your symptoms.

What asthma medications are often used?

Asthma is an incurable disease. However, various ways from using drugs to lifestyle changes can help control asthma symptoms and prevent relapse.

Asthma is treated with two types of drugs: long-term control and instant relief:

• Long-term control medication: Most people who suffer from asthma should take long-term control medication every day to help prevent symptoms. Long-term medications are the most effective at reducing airway inflammation, and help prevent symptoms. These drugs include: inhaled corticosteroids, Cromolyn, Omalizumab (anti-IgE). If you have severe asthma, you may need to use corticosteroid or liquid pills for the short term to keep your asthma under control.
• Instant reliever: Everyone who has asthma needs these drugs to help relieve symptoms of asthma that may recur. Inhalation of short-acting beta2-agonists (Albuterol, pirbuterol, levalbuterol or bitolterol) is the first choice for rapid relief. Other drugs are Ipratropium (anticholinergic), Prednisone, prednisolone (oral steroids). You should use a quick reliever when you have symptoms of asthma. If you use this drug more than 2 days a week, talk to your doctor about controlling your asthma. You may need to make changes to your asthma action plan.

What complications might occur due to asthma?

Bad control of asthma can have an adverse effect on the quality of your life. This condition can result in:

• Fatigue
• Can not move optimally
• Psychological problems including stress, anxiety and depression

If you feel that asthma seriously affects your quality of life, contact your doctor. The plan for your asthma action may need to be reviewed to better control the condition.

In rare cases, asthma can cause a number of serious respiratory complications, including:

• Pneumonia (lung infection)
• Partial or total damage to the lungs
• Respiratory failure, where oxygen levels in the blood become very low, or carbon dioxide levels become very high
• Status Asmatikus (severe asthma attack that does not respond to treatment)

All of these complications are life threatening and require medical treatment.

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