Asthma

Understanding Asthma

Asthma is a condition affecting your airways. Your airways are small tubes lined by living cells that carry oxygen and carbon dioxide out of the lungs. In a healthy person, oxygen-rich air goes from the nostrils to the windpipe. It goes inside the lungs from the windpipe through bronchioles and air tubules. It follows the same path during exhalation. During the attack of asthma, the inflammation of air passage takes place. The inflammation may be due to contact with some irritant or otherwise. Due to the hypersensitivity of air passage during an attack, mucous is secreted. All these factors combined result in the hampering of airflow. This phenomenon is reversible but chronic.

Are you suffering from asthma?

If having one or more of the below-given symptoms, chances are there that you have asthma, and you should see a doctor.

Key symptoms

1. Shortness of breath. In asthma, the airways are constricted due to inflammation. The mucus is secreted, and mucus plugs are formed. Reduced flow results in a shortage of oxygen supply to the body, resulting in difficulty breathing.
2. Wheezing. Wheezing is the whistle-like sound that occurs when you exhale air. The passage of air through constricted and narrow air tubes produces this sound. It is one of its characteristic features.
3. Cough. It is caused by the activation of the cough center, which is triggered by irritants and mucus in the airways. Cough in asthma is more persistent and may exacerbate during the night and after exercise.
4. The tightness of the chest. Contracting the chest and airway muscles gives a feeling of a tight chest.
5. Excessive mucus secretion. Due to the hyperactive immune system, the cells lining the airways secrete large amounts of mucus. It may result in a wet cough.
6. Nasal flaring in children. It is the expansion of the nostrils while the kid is breathing. It is a sign of difficult and labored breathing.

Signs of a severe Asthma attack

An attack of severe asthma is a medical emergency. Call for immediate medical help if you notice the following symptoms during an asthma episode.

1. Rapid breathing along with chest retraction. It occurs when the skin of the chest goes in between rib bones while you inhale.
2. Cyanosis is the bluish coloration of the skin on the lips, face, and fingernails caused by a shortage of oxygen in the body.
3. Permanent expansion of the chest. The chest does not go in while you exhale.
4. The kid’s inability to recognize parents. It occurs in infants having an attack.

Causes

• Genetic causes

Family history is one of the significant risk factors for the development of Asthma. If any of your parents suffered from Asthma, you are at a higher risk of having it.

• Environmental causes

Many environmental factors, such as air pollution and smoking allergens in the air, have been implicated in an increased risk of the development of Asthma.

• Hygiene hypothesis

It says the increased rate of asthma development is due to reduced early exposure to nonpathogenic bacteria and viruses.

Asthma triggers

These are the substances that may provoke an asthma attack. These vary from person to person. A trigger of Asthma for one person may not be a trigger for another person. Common asthma triggers include:

Allergens: If you are allergic to some substance, chances are there that it will act as a trigger for your asthma. Some of the common allergens include:

• Dust mites
• Pollen
• Cockroach
• Pet dander
• Molds
• Rodents

Atmospheric irritants: Irritants in the atmosphere can also provoke an asthma attack.

• Cigarette smoking
• Wooden fire smoke
• Air polluters  such as smog and ozone
• Dust particles
• Charcoal grills
• Strong fumes, vapors, or odors of paint or perfume

Respiratory infections: In children, they are the most common asthma trigger. Common infections include:

• Sore throats
• Pneumonia
• Colds
• Flu (influenza)

Exercise:  Exercise, especially in cold weather, is a common asthma trigger.

Weather: Cold wind, dry air, and sudden weather changes can sometimes trigger attacks.

Strong emotions: Expression of intense emotions like Anger, Fear, Excitement, Laughter, or Crying can trigger an attack.

Medicines: Medication such as Aspirin and other NSAIDs may trigger an attack.

How will your doctor diagnose Asthma?

If you suspect asthma, you should see a doctor who is a specialist in allergies or the immune system. In some countries, a doctor specializing in pulmonary or general medicine also treats asthma.

Detailed medical history

Your doctor will usually ask you questions about your symptoms and their occurrence. He will also ask about asthma in your family, your lifestyle, and any medicines you take.

Physical examination

Your doctor will generally use his stethoscope to listen to your breathing. He may also examine your chest.

Lung function test

These are also known as the breathing test or the pulmonary function test. These tests measure airflow in the airways. These are conducted before and after taking a medicine called a bronchodilator. Standard lung function tests include:

• Spirometry
• Peak airflow
• FeNO tests (exhaled nitric oxide)

Treatment

Treatment of asthma differs from person to person and depends upon the severity of the condition. The procedure generally consists of avoiding triggers and some necessary medication. The therapy usually continues lifelong.

Avoiding triggers

Avoiding triggers is one of the main strategies to manage asthma. Accurately identifying and avoiding your triggers can help prevent an episode’s onset.

Short-term quick-acting  medication

These medications help to control symptoms of attacks quickly. They help to relax the bronchial muscles and widen the airways. These include:

• Short-acting beta-agonists: They are inhaled and promptly relieve symptoms. They act to relax the smooth muscles around the bronchioles. They are the first choice for controlling symptoms of acute episodes.

• Anticholinergics: They are also inhaled but work slower than short-acting beta-agonists. These widen the constricted airways by relaxing the muscles.
• A combination of both a short-acting beta-agonist and an anticholinergic may also be used.

Long-term control medication

These medicines are indicated if attacks are more frequent and severe.  These include:

•  Inhaled corticosteroids
•  Inhaled long-acting beta-agonists 
• Biologics.
• Leukotriene modifiers a
• Cromolyn sodium
• Theophylline
• Oral corticosteroids

Breathing exercise

These exercises will help increase your lungs’ capacity. A healthy lung will lower the severity of asthma symptoms, and controlled symptoms will reduce your medication. You must talk to your doctor or an occupational therapist about these exercises.

Home remedies and herbal medicine

You may try some home remedies. They may be useful for some of the patients.

Coffee contains caffeine, which is related to the asthma drug theophylline. It widens constricted airways and may relieve asthma symptoms.

Mustard oil: Crushed mustard seeds are used to make this vegetable oil. It can be used to massage the chest and neck skin; it may help open airways.

Prevention

• Abstain from smoking. Smoking is one of the triggers for the onset of an episode of acute asthma. Try to abstain from it.
• Identify your triggers and avoid them. You are the best person to identify the triggers that cause an episode to onset in you. Avoid them as much as possible.
• Act on your asthma action plan. Discuss it with your doctor to formulate an Asthma Action Plan. Once written, rigorously follow it.
• Use a peak flow meter. Use a peak flow meter to measure your peak flow daily. You should record it on paper. A decrease in lung function may indicate an impending attack.
• Read about your symptoms. Know about the symptoms of the onset of an acute attack of asthma and try to control it early.

Sit and discuss with your doctor how to formulate an asthma action plan. 

Living Healthy with Asthma

• Get vaccinated. If you have asthma, you must get vaccinated for diseases like Influenza, Pneumococcal disease, Shingles, and Whooping cough. The occurrence of these respiratory infections in asthmatics may worsen the condition.
• Follow your medication schedule. Rigorously follow your medication schedule. Talk with your doctor if there is a worsening of any symptom for change in medication.
• Exercise regularly. It will help keep your body fit and healthy and your mind fresh. The disease should in no way deter you from living an active life. A healthy lung will help subside asthma symptoms.
• Stay relaxed. Having an attack may result in anxiety and panic attacks. Use the techniques of meditation and yoga to stay relaxed.
• Live life to the fullest. No matter what, have fun. Stay encouraged.