Asthma is a chronic lung disease characterized by the narrowing and inflammation of the airways in the lungs which results in a recurrent, reversible airway obstruction. Due to inflammation, the walls of the lung passages swell and the openings fill with mucus. This makes it difficult for a person to exhale. Asthma belongs to a class of lung conditions called the Chronic Obstructive Pulmonary Disease (COPD).
Causes and Risk Factors of Asthma
The exact cause of asthma is unknown. It is usually due to a combination of genetic and
environmental factors. People might be genetically predisposed to an asthma attack which makes them more susceptible to the disease. An asthma attack is a reaction to certain triggers. These include pollen, air pollution, tobacco smoke, dust mites, respiratory infections like cold, flu, sinusitis and bronchitis cold air, respiratory irritants like perfumes mold, allergic reactions to some foods and physical exertion. Some of the risk factors of asthma are:
1.Gender: In childhood, asthma is more common among the males, although adult asthma
is more common in females. The reason for this is unknown.
2.Family History: A person’s inherited genetic makeup makes him/her predisposed to
3.Environmental Factors: Certain factors such as cigarette smoke, mold, fumes from
household cleaners and paints, high humidity, cold temperatures, sulphur dioxide, nitrogen oxide, ozone etc., are known to trigger asthma in susceptible individuals.
4. Obesity: People who are overweight or obese are more susceptible to uncontrolled
asthma and are usually on medications for a longer duration.
5.Pregnancy: In some cases, pregnancy can aggravate the effects of asthma. This can
be due to a variety of reasons such as changing physiology, hormones and body shape and gastric reflux. It is important to watch out for the signs of worsening of asthma such as increased breathlessness and visit a doctor immediately.
Signs and Symptoms of Asthma:
The main symptoms of an impending asthma attack are:
1.Wheezing: A whistling sound that occurs usually during expiration (breathing out)
through the narrow, inflamed airways of the lungs.
2.Tightness in the chest
3.Persistent coughing, which is usually worse at night
4.Breathlessness due to excessive mucus secretion in the airways, due to which the air
tubes in the lungs get blocked and air is trapped in the lungs.
5.Difficulty in speaking
6.Pale, sweaty face
Diagnosis and Treatment:
Asthma is diagnosed based on the person’s medical and family history of asthma and
allergies and a physical examination. It may include a test called Spirometry, which
measures how much air the individual can exhale and how forcefully he/she can breathe
out. This is an accurate measurement of the person’s lung function. The severity of an attack can be monitored by a Peak Flow Meter, which is a less forceful manoeuvre than a spirometry. Another way is to perform a painless probe using a pulse oximeter which
measures the amount of oxygen in the bloodstream.
There is no known cure for asthma. The purpose of asthma therapy is so the patient
can be free of the symptoms. The treatment includes a lot of medications. The treatment is mainly in the form of inhaled medications, or inhalers. There are different types of inhalers such as puffers or metered dose inhalers and capsule-based or drug powder inhalers. Inhaled therapy includes long-acting drugs, for example, corticosteroids which reduce inflammation and swelling and bronchodilators, which are medications to relax the tubes.
These are typically taken twice a day and there are short acting relieving medicines, which can be carried around in the pocket for use during emergencies. In severe asthmatics, if it is not controlled with inhalers, the doctor may prescribe some tablets.
It is also advisable not to smoke, as it can aggravate the severity of asthma. Cough
medicines and non-prescription inhalers should be avoided as they may cause some
unwanted side-effects. The same goes for non-prescription preparations, herbs or dietary supplements. Patients who are taking long-term medications should not stop taking the medicines when they start feeling better, as the symptoms can return.
Prevention is always easier than treatment. The preventive measures are mainly by
taking inhalers on a regular basis as prescribed by the doctor. People must avoid any
precipitants such as dust and pollution and other allergens like pets, mites and smoking. It is recommended to undergo immunization for pneumonia and flu in order to prevent asthma attacks.
FREQUENTLY ASKED QUESTIONS
- What are the risks of uncontrolled asthma during pregnancy?
There are major risks to both the mother and the baby if the asthma is not controlled. If left untreated in pregnancy, asthma can progress to cause oxygen deficiency in the mother and the fetus. This lack of oxygen can cause intra-uterine growth retardation, or the slowing of the growth rate of the fetus leading to low birth weight and/or premature delivery. In extreme cases, it may even result in intra-uterine death. Therefore, it is very important that asthma is well-controlled in pregnancy.
2. What is the long-term health impact of Asthma?
Asthma is generally a reversible disease. But in cases of untreated or under-treated
patients, i.e. those who are not on inhalers or do no take the medications as prescribed by the doctors, they are likely to develop airway remodelling, where the lung tubes are irreversibly damaged and become permanently narrowed. These patients can get breathlessness which does not get better even with treatment. This is the main impact of untreated or chronic asthma. Therefore, it is important to start taking medications in order to stop the disease from progressing to that stage.
3. What are the side-effects of inhaled steroids?
The side-effects of inhaled steroids are minimal. It is common to see people getting worried about the systemic side-effects due to steroids, but all the side-effects that are described are due to taking tablets of steroids which affect the whole body. Inhaled steroids, on the other hand, are directly targeted at the lungs and very little amount is absorbed into the body. They are also taken in low doses and do not have any major side-effects. After using inhalers, it is important to gargle with water to remove any steroid deposition at the back of the throat.
4. What to do after an Asthma attack?
After the asthma attack has been treated, there is further risk of having an attack within the next one month, which is the highest risk period. Firstly, the patients should make sure they take the medications as prescribed by the doctor regularly. They should have frequent checks with the doctor during that one month. In case of any major symptoms such as increased breathlessness, they should immediately visit the hospital. There is a high possibility of a second asthma attack in the immediate aftermath of the first attack, so the patients must be careful for the first few weeks after the attack.
5. What is an Asthma flare-up?
Flare-ups are exacerbations or worsening of the symptoms like breathlessness beyond regular variations, increase in sputum production, difficulty in speaking. The patient should ask his/her doctor for an action plan in case of a flare-up. Minor flare-ups are usually managed by doubling the dose of the regular. In case of a major flare-up, the patient may need further medications, visit the doctor and, in severe cases, undergo hospitalization for nebulization and intravenous medications.