Asthma: Symptoms, Complications, and Treatment

Contents

In this article we will look at:

• What is asthma?
• How does asthma occur?
• What are the symptoms of asthma?
• How is asthma diagnosed?
• What are the complications of asthma?
• What is the treatment for asthma?

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What is asthma?

Asthma, also referred to as bronchial asthma, is a chronic lung condition caused by inflammation and narrowing of the bronchial tubes, or the passageways through which the air enters and leaves the lungs.

Asthma causes recurring episodes of wheezing (whistling sound while breathing), shortness of breath, chest tightness, and fits of coughing. The fits of coughing usually occur at night or early in the morning.
Asthma, it is observed, usually starts during childhood, but can affect people of any age.

If you, your child or family members suffer from breathing problems, you need to consult your family doctor immediately, who might refer you to an allergist (who can also be a paediatrician and is a specialist in allergies, and immunology), or in certain cases a pulmonologist, if he suspects asthma.

How does asthma occur?

Asthma occurs when an asthmatic's (a person suffering from asthma) air passages are inflamed or swollen. Due to the swelling, the air passages become narrow and less amount of air can pass to and from the lungs. The swelling also makes the air passages sensitive due to which you can become susceptible to allergies.

The narrowing of the air passages cause wheezing or a hissing sound while breathing, coughing, shortness of breath, chest constriction and chest pain.

There are two types of asthma:

• Extrinsic asthma which is an immune system’s response to allergens in the environment such as pollen, animal dander, dust, etc. Extrinsic asthma causes two types of reactions:
  • an instant hypersensitive response which occurs within 30 minutes of exposure to the allergen
  •  a delayed hypersensitive response which occurs 6-8 hours later
• Intrinsic asthma for which the causative agent is unknown. It is usually caused by sudden and extreme emotional reactions such as laughing, crying, anger, stress, or due to contact with certain chemicals like cigarette smoke, aspirin, cleaning agents. It can also be caused by chest infection or exercising

What are the causes of asthma?

Asthma triggers or causes vary from person to person. If you suffer from asthma, knowing its pattern, as well as what triggers it can be very useful for you.

For example, if you experience the symptoms at home, something in the home environment may be triggering it. If the symptoms flare up during the spring season an outdoor allergen is most likely to blame.

Some of the most common asthma triggers include:

• Allergies: An allergy is a damaging response of your immune system to substances, such as pollen grains, mold, or animal danders. The immune system treats these otherwise harmless substances, also known as allergens, as invaders and reacts in a way which disrupts the body’s natural functions. The most common irritants which cause allergic asthma are:
  • pollen
  • dust mites
  • mold
  • animal danders (tiny flakes from their skin, fur, feathers, or saliva)
  • cockroach droppings

        Allergic asthma, in fact, is the most common form of asthma.

• Irritants in the Air: Certain irritants in the air can also cause asthma attacks. Some of these outdoor and indoor irritants are:
  • cigarette smoke
  • air pollution (for e.g.  car exhaust, gas fumes, smog, ozone, etc.)
  • strong fumes, aerosol sprays, vapours, or odours (such as paint, gasoline, perfumes and scented soaps)
  • dust and particles in the air
  • chemicals
  • gas stoves, wood fires fireplace smoke, charcoal grills, and cooking odours
  • formaldehyde and volatile organic compounds
    
    
    
• Respiratory Illnesses: This is the most common trigger of asthma in children. Respiratory infections cause inflammation of the air passageways and cause severe asthma. They include:
  • colds
  • flu
  • throat infections
  • sinusitis
  • pneumonia
    
    
    
• Exercise: Exercising and any strenuous physical activity which leads you to breathe harder can be a trigger for asthma. This condition is also known as Exercise Induced Asthma ( EIA). With proper treatment, you can continue exercising without facing any repercussions.
  
  
  
• Expressing Emotions Strongly: Sudden emotional outbursts, can be a trigger for asthma such as:
  • anger
  • fear
  • excitement
  • laughter
  • yelling
  • crying

        Strong emotions change the breathing pattern and may cause wheezing and other asthma-related symptoms.

• Medicines: If you are sensitive to certain medicines, such as aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs) or beta blockers they may trigger asthma.
  
  
  
• Menstrual Cycle: Around 20% to 40% women complain of worsening asthma symptoms during the menstrual periods. This condition is also known as perimenstrual asthma and is said to be caused by hormonal changes in the body.
  
  
  
• Changes in the Weather: Sudden changes in weather, such as excess rainfall, extreme heat, dry winds, or cold winds can sometimes bring on asthma attacks.
  
  
  
• Food Additives: Sulfites are added to certain foods, (such as potatoes, shrimp, dried fruit, beer, wine, and vinegar) to prevent them from spoiling which can cause an allergic reaction in sensitive individuals.
  
  
  
• Obesity: Obese people with a  Body Mass Index ( BMI) of 30 or greater - have twice the risk of asthma.
  
  
  
• Stress: People who are constantly stressed have a higher risk of developing asthma.
  
  
  
• Babies born by Caesarean-Sections: have a 20% risk of developing asthma compared to babies born through normal delivery.
  37 per 1,000 babies born via C-section have asthma, compared to 34 per 1,000 in babies born vaginally.
  Experts believe that the immune system of the babies born through C -Section is weaker compared to the babies born vaginally. Expectant mothers who smoke during pregnancy put their babies at a risk of weaker pulmonary functions. Babies who are born prematurely too are at a risk of asthma.

• Genetics: Children born to parents who have asthma are at a higher risk of contracting asthma.

What are the symptoms of asthma? How is asthma diagnosed?

The symptoms of asthma include:

• coughing, especially at night or early morning
• wheezing
• laboured short breaths
• chest tightness and pain
• difficulty in walking or talking
• skin may become bluish color

Having these symptoms does not always mean you have asthma.

Diagnosis

To diagnose asthma, your doctor will ask you your medical history, including your family history, especially if anyone in your family has asthma. The doctor might also perform a general physical check-up and prescribe you to go for a lung function test, along with a sinus x-ray and chest x-ray.  

If you or your child are having problems breathing on a regular basis, don’t wait! Visit a doctor immediately. Knowing what to expect during the diagnostic process may help.

The lung function tests include:

• Spirometry
• Peak Airflow
• Trigger Tests

What are the complications of asthma?

Asthma which is not carefully managed can lead to:

• constant fatigue
• frequent leave from work or school due to constant asthma flare-ups
• pneumonia
• increased mucus production
• thickening and narrowing of bronchial tubes which can become permanent leading to respiratory failure
• respiratory failure
• severe chest pain

What is the treatment for asthma?

Medical treatments

To treat asthma effectively, an asthma action plan will help. That includes identifying and avoiding asthma triggers, identifying your level of asthma toleration, using drug therapies, and having an emergency action plan ready in case of severe attacks. You will need to proactively work with your doctor to find out which course of treatment works best for you.

Each case of asthma is different, therefore depending on your condition, your doctor will create an asthma treatment plan exclusively for you. The treatment plan will have directions on how to take your medicines as well as information about the specific asthma triggers you need to avoid. The initial asthma treatment provided will depend upon the severity of your condition. The follow-up treatment will depend upon your response to the initial treatment.

The severity of the asthma attacks will differ in different environments, and also over time.
The dosages of your medicines will also be changed accordingly by the doctor.
If you are able to control your symptoms efficiently, the doctor will reduce the dosage of your medicines.

Asthma is treated with two types of medicines -

• Long-term control medicines - which helps to reduce inflammation of the airway passages, thereby reducing the asthma symptoms.
  
  
• Quick-relief medicines -  which as the name suggests are emergency medicines to be taken during an asthma attack.
  
  

The asthma medicines can be taken in pill form, or by breathing them in using a nebulizer or an inhaler. An inhaler allows the medicine to go directly into the lungs.

Your level of asthma control can vary over time and with changes in your home, school, or work environments. These changes can alter how often you're exposed to the factors that can worsen your asthma.

Asthma treatment will vary for different groups of people. For example, the treatment for people suffering from allergic asthma will be different from those in whom exercise brings on asthma symptoms. Similarly, treatment for children will be different from the treatment given to pregnant women.