What is asthma?
Asthma is a chronic disease with frequent episodes of breathlessness, chest tightness, and coughing. Asthmatic episodes usually occur during early morning or at night.
Worldwide 235 million people suffer from asthma.Around 15-20 million people are estimated to suffer from asthma in India. Asthma primarily starts in childhood but affects people of all age groups. In India prevalence of asthma in children is believed to range from 10-15% in children of 5-11 years age group. It is the most common cause of school absenteeism in children.
Causes and risk factors
Asthma is a lung disease of chronic nature characterised by inflammation and narrowing of airways. It is believed to arise due to a mix of environmental and genetic factors. Numerous irritants can trigger asthma.
The triggers of asthma can include:
- Allergens like pollen and smoke
- Infections of the respiratory system
- Mites in carpets, bedding, stuffed toys, cats and cockroaches
- Certain medications (non-steroidal drugs, beta blockers, aspirin, etc.)
- Strong emotions and stress
- Certain preservatives like sulphites in few beverages and foods
In asthma, there is swelling of the bronchial tubes, leading to narrowing of airways. Recurrent asthma attacks cause sleepiness, fatigue, school and work absenteeism.
Symptoms and signs
The symptoms of asthma can vary from individual to individual. The symptoms and signs of asthma can include:
- Wheezing: It is the most common symptom of asthma, characterised by a whistling sound when one breathes.
- Chronic coughing
- Shortness of breath
- Chest tightness or pain
- Troubled sleep due to coughing, wheezing or shortness of breath
Severe attacks of asthma may be fatal in nature. Seek medical attention when the symptoms and signs of asthma worsen.Emergency care must be sought if the wheezing or shortness of breath worsens.
Your doctor or an allergist might conduct a detailed analysis of the medical history and recommend breathing tests to evaluate the lung functioning.
Tests to diagnose asthma may include:
- Spirometry: Here one takes a deep breath followed by blowing into a sensor to evaluate the lung capacity to hold air and know the speed of inhalation or exhalation.
- Peak flow test: It evaluates how hard one can breathe out.
- Imaging tests: X-rays of the chest or CT scan may be performed to check for any structural anomalies.
- Allergy-testing: Potential allergens can be identified that trigger asthma.
Treatment and prevention
Asthma can’t be cured but with effective medication, the symptoms of asthma can be managed.
Owing to the chronic nature of asthma, continuous medical care is needed for its management.
Triggers for asthma must be avoided. The flares of asthma can be managed by use of quick-relief inhalers.
Long-term medication is required for individuals with moderate to severe asthma for preventing attacks of asthma and controlling the underlying inflammation. Such medication can include:
- Anti-inflammatory drugs like inhaled corticosteroids
- Leukotriene modifiers can help in management of symptoms up to 24 hrs
Quick relief medication includes quick-relief bronchodilators, oral and intravenous corticosteroids.
Allergy medication might be prescribed if asthma worsens or is triggered by allergens.
There are no proven ways of preventing asthma. With a proper asthma management plan in place and treatment, the symptoms of asthma can be minimised.
- Avoid asthma triggers: Make a note of potential irritants that trigger asthma and avoid them.
- Identify early warning sign and act: Quickly responding to such signs can prevent the likelihood of severe attacks.
- Breath monitoring: A cough, shortness of breath and other warning signs must be monitored. Peak airflow measurements can be carried out.
- Following the asthma management plan: Regular monitoring and treatment can aid in effective management of asthma.
Complications of asthma may include:
- Pneumonia(infections of lungs)
- Collapse of lung
- Respiratory failure
Visit your doctor if you or the child is having difficulty in walking a few steps because of shortness of breath, wheezing or a persistent cough.
Emergency medical attention must be sought :
- When there is worsening symptoms of asthma like rapid aggravation of wheezing or shortness of breath despite use of a quick-relief inhaler
- When there is work and sleep interferences
- When there is permanent bronchial tube narrowing leading to frequent hospitalisation with cyanosis (bluish discoloration of skin due to inadequate oxygenation)
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- Asthma Information. American College of Allergy, Asthma & Immunology. Accessed 29 Feb. 16. http://acaai.org/asthma
- Asthma. American Academy of Allergy, Asthma & Immunology. All Rights Reserved. Accessed 29 Feb. 16. http://www.aaaai.org/conditions-and-treatments/asthma
- Bronchial asthma. World Health Organization. Accessed 29 Feb. 16. http://www.who.int/mediacentre/factsheets/fs206/en/
- What Is Asthma? NIH- National Heart, Lung and Blood Institute. Accessed 29 Feb. 16. http://www.nhlbi.nih.gov/health/health-topics/topics/asthma