Overview – What is it?
Asthma is a condition that involves narrowing and swelling of the airways and production of excess mucus causing difficulty in breathing. This condition is mostly caused by a combination of genetic and environmental factors.
Some of its symptoms include chest tightness, shortness of breath and wheezing.
It can be diagnosed through tests like spirometry, peak flow and allergy testing.
The treatment of asthma is done using medication and bronchial thermoplasty, among other treatment options.
You can prevent yourself from getting asthma attacks by avoiding your triggers, getting vaccinated for pneumonia and influenza, and by monitoring your breathing.
Causes – What causes it?
What exactly causes asthma is not known, however, environmental factors and gene inheritance are seen to be the major risk factors.
Other risk factors for asthma are:
- Having another allergic condition such as hay fever (also known as allergic rhinitis)
- Being a second-hand smoker
- Being exposed to exhaust fumes and other types of pollution, especially air pollution
- Being overweight or obese
- Being exposed to occupational triggers such as those used in manufacturing industries and chemicals used in farming
Asthma is triggered by irritants and substances which the body’s immune system reacts to causing asthma attacks. These triggers are referred to as allergens and they include:
- Air pollutants such as smoke,
- Airborne substances like pollen, pet hair and feathers, mould spores and dust mites,
- Cold air,
- Respiratory infections such as the common cold,
- Physical activity such as exercise,
- Certain medications like aspirin and beta blockers,
- Preservatives and sulphites that are added to some foods and beverages
- like beer and wine,
- Gastroesophageal reflux disease (GERD) which is a condition that involves stomach acid moving back to the throat, and
- Strong emotions and stress.
Symptoms – What do you feel?
Different people experience different symptoms which are due to different factors. The common asthma symptoms include:
- Wheezing or whistling sound when exhaling
- Chest tightness
- Shortness of breath accompanied by coughing and wheezing making it difficult to sleep at night
- Symptoms made worse by a respiratory virus like flu or cold
These are the signs to look out for that may indicate your asthma is getting worse:
- Getting more frequent and bothersome asthma symptoms
- Having a need to use a quick relief more often
- Increased difficulty breathing
Diagnosis – How do you diagnose it?
The first step to diagnosing asthma is by having an initial consultation with a doctor who finds out your medical history and whether any of your family members have asthma after which a physical exam is done to rule out any other conditions such as chronic pulmonary obstructive disease (COPD).
The tests done to diagnose asthma include:
- Spirometry: This test is done to estimate the narrowing of the bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
- Peak flow: This device is used to measure how hard you can breathe out.
- Nitric oxide test: Measures the amount of nitric acid that you have in your breath. (A person with an inflamed airway may have a higher level of this gas).
- Allergy testing: It can be performed using a blood test or skin test to identify which allergy triggers affect you, to make it possible for you to avoid them.
- Methacholine challenge: In this test, methacholine which is a known asthma trigger is used. Once you have inhaled it, it can determine whether you have asthma or not as it causes mild constriction of your airways.
- Provocative testing for exercise and cold-induced asthma. This test involves having your airway obstruction measured before and after vigorous physical activity or after taking several breaths of cold air.
- Sputum eosinophils: Eosinophils (white blood cells) in a mixture of saliva and sputum (mucus) discharged through coughing are looked at using a rose-coloured dye (eosin).
Treatment – How do you treat it?
The treatment of asthma focuses on recognising your triggers, avoiding them and ensuring that you keep your symptoms under control using medications.
Asthma medications depend on your age, triggers, symptoms and what works for you. The different types are:
- Long-term asthma control medications which are taken daily to keep the asthma under control and reduce your chances of getting an asthma attack. Some of the types of long-term control medications are:
- Leukotriene modifiers such as zileuton which are taken orally to help relieve asthma symptoms for up to 24 hours.
- Inhaled corticosteroids which are used as anti-inflammatory medications such as budesonide.
- Combination inhalers like Symbicort and Dulera which contain long-acting beta agonists that may increase your risk of having severe asthma attacks.
- Quick relief medication used for rapid, short-term symptom relief when you are having an asthma attack or before exercising. The types of these medications are:
- Short-acting beta antagonists which are inhaled and act within minutes to ease asthma symptoms during an attack.
- Oral and intravenous corticosteroids which are used to relieve airway inflammation caused by severe asthma.
- Ipratropium which is used to immediately relax your airways making it easier to breathe.
- Allergy medications are used to treat asthma that is triggered or made worse by allergies. These medicines include:
- Allergy shots which gradually reduce the immune system’s reaction to specific allergens.
- Omalizumab which is given as an injection every 2 to 4 weeks to alter the immune system for people with allergies and severe asthma attacks.
- Bronchial thermoplasty: This treatment is used for asthma that does not improve with inhaled corticosteroids or long-term medications by heating the inside of the airways in the lungs using an electrode and reducing the smooth muscle inside the airways. It thereby reduces the ability of the airways to tighten and makes breathing easier possible, reducing asthma attacks
Prevention – How do you prevent it?
The best way to prevent asthma attacks is by knowing what your triggers are and taking the necessary steps to avoid them. You can avoid triggers by:
- Using air conditioners to reduce the amount of airborne pollen from trees, grasses and weeds. It can also lower indoor humidity and reduce exposure to dust mites. In the absence of an air conditioner, you should try to keep your windows closed during pollen season.
- Maintaining optimal humidity using a dehumidifier after consulting your doctor.
- Reducing pet danger by avoiding pets with fur or feathers, bathing and grooming your pets regularly.
- Cleaning your house regularly, at least once a week, and if dust is one of your triggers, wear a dust mask while doing the cleaning.
- Covering your mouth and nose using a face mask if cold triggers worsens your asthma.
- Preventing mould spores by cleaning damp areas in the bathroom, kitchen and getting rid of mouldy leaves and wet firewood around the house to keep mould spores from developing.
- Minimizing dust by using washable, wooden flooring instead of carpets and washing your beddings regularly.
Other ways to prevent asthma attacks are:
- Getting regular exercise,
- Maintaining a healthy body weight,
- Controlling heartburn and gastroesophageal reflux disease (GERD), and
- Not smoking.