Asthma

15 May 2019

About: Asthma is a chronic inflammatory disease in which your airways narrow and swell and produce extra mucus, thus making the person difficult to breathe. It causes repeated episodes of wheezing, breathlessness, chest tightness, and night time or early morning coughing. It cannot be cured but it can be controlled.

  1. Asthma is clinically classified as:
  • Frequency of Symptoms
  • Forced expiratory volume in one second (FEV)
  • Peak expiratory Flow rate
  1. Asthma can also be classified as:
  • Atopic (Extrinsic)
  • Non-atopic (Intrinsic)

Causes: It is probably caused due to a combination of genetic and environmental factors.

  1. Asthma triggers: It is caused due to exposure to various substances that trigger allergies (allergens) and irritants like,
  • Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
  • Respiratory infections, such as the common cold
  • Physical activity (exercise-induced asthma)
  • Cold air
  • Air pollutants and irritants, such as smoke
  • Certain medications, including beta blockers, aspirin, ibuprofen and naproxen
  • Strong emotions and stress
  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
  • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
  • Menstrual cycle in some women
  1. RISK FACTORS: A number of factors are thought to increase your chances of developing asthma. These include:
  • Having a blood relative (such as a parent or sibling) with asthma
  • Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)
  • Being overweight
  • Being a smoker
  • Exposure to secondhand smoke
  • Having a mother who smoked while pregnant
  • Exposure to exhaust fumes or other types of pollution
  • Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing
  • Exposure to allergens, exposure to certain germs or parasites, and having some types of bacterial or viral infections also may be risk factors.
  1. COMPLICATIONS: Asthma complications include:
  • Symptoms that interfere with sleep, work or recreational activities
  • Sick days from work or school during asthma flare-ups
  • Permanent narrowing of the bronchial tubes (airway remodeling) that affects how well you can breathe
  • Emergency room visits and hospitalizations for severe asthma attacks
  • Side effects from long-term use of some medications used to stabilize severe asthma
  • Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

Signs and Symptoms: Asthma symptoms range from minor to severe and vary from person to person. The patient may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time. Symptoms are usually worse at night and in early morning. They include:

  • Shortness of breath
  • Chest tightness or pain
  • Trouble sleeping caused by shortness of breath, coughing or wheezing
  • A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)
  • Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is probably worsening include:

  • Asthma signs and symptoms that are more frequent and bothersome
  • Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)
  • The need to use a quick-relief inhaler more often

For some people, asthma symptoms flare up in certain situations:

  • Exercise-induced asthma, which may be worse when the air is cold and dry
  • Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
  • Allergy-induced asthma, triggered by particular allergens, such as pet dander, cockroaches or pollen

Diagnosis: There is no specific test for diagnosis of Asthma. A diagnosis of asthma should be suspected if there is a history of the symptoms. The tests for that includes:

  • Spirometry
  • Peak flow meter
  • Lung function test
  • Methacholine challenge
  • Nitric oxide test
  • Imaging tests
  • Allergy testing
  • Sputum eosinophils
  • Provocative testing

Treatments: Prevention and long term control are key in stopping asthma attacks.Treatment usually involves learning to recognize your triggers, taking steps to avoid them and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler (bronchodilators). Other ways to control Asthma are:

  • Lifestyle Modification
  • Medications
  • Oxygen to alleviate hypoxia
  • Bronchial thermoplasty
  • Acupuncture
  • Herbal and natural remedies
  • Breathing and relaxation techniques

Risk Factors: The major risk factors associated to Asthma are:

  • Infections
  • Exposure to endotoxins and allergens
  • Smoking
  • Diet and nutrition
  • Stress
  • Use of antibiotics

Statistics:

  • Mortality has decreased over the last few days due to better recognition, improvement in care and increased reach of medication.
  • Seen more in developed than developing countries
  • Twice as common in males than in females
  • More common in young than the old

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