Asthma

Asthma is a chronic breathing disorder that is characterized by recurrent attacks of breathlessness and wheezing which vary in severity and frequency from person to person.  During an asthma attack the lining of the bronchial tubes swells, causing the airways to narrow and reduce the flow of air into and out of the lungs.  Although the fundamental causes of asthma are not completely understood, the strongest risk factors for developing asthma are inhaled asthma triggers. WHO estimates 235 million people suffer from asthma globally.  There is no cure for asthma, but with proper management one can control the disorder.  Some Children with milder forms of asthma outgrow their symptoms with age.  Most asthma related deaths occur in low and lower income countries.

Symptoms of Asthma Attacks

Not all people who have asthma have these symptoms, and not all people who have these symptoms have asthma

• Coughing
• Wheezing ( whistling or squeaking sound when you breathe)
• Tightness in chest ( narrowing/ inflammation of airways which makes them swollen and sensitive)
• Shortness of breath

Types of Asthma

There are many different types of asthma that can arise from different situations including: Allergic asthma, exercise –induced asthma, cough-variant asthma, occupational asthma, nocturnal asthma, and health conditions that can mimic asthma.

Causes of Asthma Attacks

•  Allergens : house dust mites in bedding, carpets, and stuffed furniture, pet dander, pollens, mold
• Irritants: Tobacco Smoke, Chemical  Irritants in the workplace,  aerosol sprays, pollution
• Cold Air
• Extreme emotional arousal (anger, or fear)
• Certain medications (Asprin, NSAIDs, beta-blockers)
• Sulfites in food and drinks
• Viral upper respiratory infections, such as colds
• Physical activity

How is Asthma Diagnosed?

Physical Exam

Asthma is traditionally diagnosed from a physical exam which includes a detailed medical and family history. The doctor will ask the patient to describe their symptoms including when, and how often, they occur.

Diagnostic Tests

Lung Function Test spirometry to check how the lungs are working; this test will measure how much air the patient can breathe in and out.  It also measures how quickly the patient can expel air.

Allergy Testing to find out which allergies affect the patient

Bronchoprovocation Testing a test to measure how sensitive the airways are

How is Asthma Treated and Controlled?

Asthma is a long-term disease that has no cure.  The goal of asthma treatment is to control the disease. Good asthma control will:

• Prevent chronic and troublesome symptoms
• Reduce your need for quick relief medications
• Help maintain good lung function
• Let the patient maintain a normal activity level and sleep through the night

Taking an active role to control asthma involves:

• Treating other conditions that may interfere with asthma management
• Avoid asthma triggers; however, patients  should  not avoid physical activity
• Work with doctors to create and asthma action plan

Long-Term Control Medicines

Most people who have asthma need to take long-term control medicines daily to help prevent symptoms.  These medications do not give quick relief from symptoms. Inhaled corticosteroids are the preferred medicine for long term control of asthma.  This medication reduces the inflammation and swelling that makes airways sensitive to certain inhaled substances.  Reducing inflammation helps prevent the chain reaction that causes asthma symptoms.

Other long-term control medicines

• Cromolyn: taken with a nebulizer, fine mist of medicine
• Omalizumab: given via an injection one or two times a month, helps the body not respond to triggers
• Inhaled long-acting  beta2- agonists: These medicines open the airways, used in conjunction with low dose inhaled corticosteroids

Quick Relief Medicines

Everyone who has asthma needs quick relief medication to help relieve asthma symptoms as they flare up. Inhaled short-acting neta2-agonists are the first choice for quick relief.  This medication acts quickly to relax tight muscles around airways when the patient is having a flare-up.

sources: http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/

http://www.mayoclinic.com/health/asthma/DS00021