Everything you should know about asthma or wheezing
What is the meaning of Asthma?
Asthma or Wheeze is a chronic disorder of the airways of the respiratory system that manifests as recurrent episodes of difficulty in breathing. Frequently, this is due to an allergic reaction against an inhaled foreign substance that is not pathogenic or toxic for the normal population. This abnormal tendency to produce allergic reactions against innocuous substances is called Atopy. Atopic individuals have a high probability to develop it. The prevalence of this disease, especially among the pediatric population has been rising during the recent past.
Pathophysiology of Asthma
The inhalation of the allergenic foreign substance triggers an inflammation of the airways. Consequently, the airways (bronchi) secrete a high amount of mucus, the wall enlarges due to edema and the smooth muscles in the walls contract. Collectively, these effects cause luminal narrowing. As a consequence, the person finds difficult to breath.
Symptoms and signs
- Sudden onset difficulty in breathing; particularly during the Dawn and morning.
- A wheezing sound during the expiration of air (That’s why it is called Wheeze among the general population)
- Chest tightness and pain
- Dry cough for a long period
- Increased respiratory rate (over 30 cycles per minute)
The symptoms appear only during an active episode of asthma which settles as the inflammation subsides. In-between the episodes, the person may be perfectly normal. However, chronic asthmatics tend to have a mild cough particularly during the morning or during exercises.
What is an asthma attack?
An asthma attack is a severe, acute asthma episode. It’s considered a medical emergency in medical practice. Unless promptly managed, the patient may even die of Oxygen deficiency and Carbon dioxide retention. About 250 000 people worldwide, die each year following severe attacks. The symptoms usually are at the maximal stage during the episode. However, the severity varies from a person to person.
It is classified depending on the etiological agents. The commonest type is allergen-induced, atopic asthma. This type begins during childhood. The person remains as an Asthmatic throughout his entire life. Atopic individuals tend to develop a set of allergic diseases that expresses a marching pattern (One after another). It includes Eczema, hay fever, allergic conjunctivitis, and urticaria.
Occupational irritants are also known to be associated with this disease. These are true toxins that damage the respiratory airways and lungs. Occupational Asthma usually occurs among the adult population due to a long term exposure to toxic substances like fumes, chemicals, or dust. Farming, painting, janitorial work, and plastics manufacturing occupations have the highest incidence of work-related asthma.
Exercise-induced asthma is a specific entity, that is triggered by exercises. This is thought to be due to the rapid inhalation of cold air.
Seasonal asthma is a type of it that varies in severity along with the seasonal changes of a year. Climate changes are thought to be the triggering factor in this type.
Common triggers of Asthma / Causes
- House and dust mites
- Animal hair and dander
- Viral respiratory tract infections
- Occupational exposures
- Tobacco smoking
- Long term use of certain drugs (NSAIDs like aspirin, β adrenoceptor blockers)
How to Treat Asthma
It is a lifelong disease. Therefore, adherence to the treatment plan is essential. Management of an asthma patient is done under several stages depending on its severity. The patients are given inhalers and drugs to prevent future attacks (preventers) and to relive the symptoms during an acute attack (relievers). In severe attacks, the patient may require artificial ventilation and intravenous medications with or without ICU admission.
Currently, it has no cure. But proper medications and lifestyle changes may completely recover the patient from the symptoms of Asthma.
Prevention of Asthma
Adherence to the medical therapy and follow-up monitoring is essential to prevent future attacks.
Yearly influenza vaccinations and pneumococci vaccination are indicated to prevent the bouts of asthma following respiratory tract infections.
Identification of the potential allergens has to be done in order to prevent future attacks. Most of the patients identify the triggering factors by themselves with time.
Keep a peak expiratory flow meter with you and monitor your peak expiratory flow daily. Your doctor will teach you how to use it.
Take relievers as soon as you feel an inbound asthma attack. You are allowed to double the dose if necessary.
Swimming is known to improve the ventilation of the lungs and to reduce the occurrence of asthma attacks. However, swimming should only be done during symptomless periods.