Asthma: Symptoms, Causes, Diagnosis, Prevention & Treatments

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The word “asthma” originates from the Greek word, ásthma that means, “panting.” Asthma is a medical condition in which the airways swells and produces extra mucus that can make breathing difficult. Because of the inflammation and the extra mucus, it can trigger shortness of breath and wheezing or coughing.

Documented as early as Ancient Egypt, Asthma can be either a minor nuisance or life threatening. In asthma, the inside walls of the airways gets inflamed so that lesser air can pass through them from and to the lungs making breathing a difficult exercise. This swelling can also make the airways really sensitive and increase a person’s susceptibility to allergic reactions.

Asthma has been on the rise significantly since the 1960s and now according to WHO estimate, around 300 million people suffer from asthma worldwide. In fact Asthma is one of the most common chronic childhood illness.

What is Asthma?

Asthma is an inflammatory disease of the airways of the lungs. In this condition, the patients feel difficulty in breathing and make some physical activities impossible.

Normally when a person breathes it goes through the nose and down in the throat into airways, eventually making it to the lungs. There are various small air passages in the lungs that help in delivering oxygen from the air into the bloodstream. Asthma occurs due to swelling in the lining and muscles of the airways which reduces the passage of the amount of the air through it.

Symptoms of Asthma:

The symptoms of asthma vary. But what most people with asthma have in common is the extreme airway sensitivity because of triggered airway inflammation. Some people have frequent asthma attacks, some people experience asthma only during certain times, some people have it all the time and some people only experience it infrequently.

Common asthma signs and symptoms include:

  • Wheezing or coughing
  • Shallow breathing
  • Breathlessness
  • Chest pain
  • Throat infection
  • Faster heart rate
  • Trouble in sleeping
  • Difficulty in speaking

What Are Causes of Asthma?

Although the causes are not particularly clear and anyone can get asthma at any age, it is more common childhood ailment. The studies are still underway to prove a clear asthma cause but according to the researches this disease is believed to be caused by a blend of genetic and environmental factors. Genomics, which is the study of how a person’s genes interrelate with environmental factors, may be the key to understanding why certain people are more prone to asthma than others.

Asthma Triggers:

Asthma triggers can differ from person to person and the key is to know what irritants trigger your asthma to ensure minimized exposure to it. Some generic asthma signs and symptoms can include:

  • Cold air
  • Exercise and other physical activities
  • Common cold and other respiratory infections
  • Stress
  • Airborne substances like pollen, mold spores, pet dander, cockroach waste, dust mites, etc.
  • Airborne substances, such as pollen, dust mites, mold spores, pet dander
  • Certain chemicals and air pollutants (smoke)
  • Certain preservatives (added to food and beverages)
  • Gastroesophageal reflux disease (GERD)
  • Certain medicines like aspirin , ibuprofen , etc.

Risk factors of Asthma:

Asthma affects people of all ages and it starts during childhood. The cause of asthma is unknown. The main symptom that people may experience during asthma is a wheezing and respiratory infection.

Asthma often develops as a result of a complex interaction between genes that may be inherited or due to certain environmental factors such as pollution, ozone, nitrogen oxide, Sulphur dioxide, cold temperatures, and high humidity.

High pollution tends to be the major cause of the recurrence of asthma. Smoggy condition releases one of the most destructive element ozone which causes coughing, chest pain and shortness of breath.

A sudden change in weather may also stimulate an asthma attack.

Humidity may lead to difficulty in breathing for people in some areas.

Diagnosis of Asthma:

Even though it is a common childhood disease, it doesn’t mean, as an adult one cannot develop it. If a person is feeling any of the symptoms whether a child or an adult, it is always a good idea to get checked to know for sure if you have asthma. Asthma symptoms can come and go since it is a ‘variable’ disease.

It is also important to not do self-diagnosis, as some symptoms, which may look like asthma triggers, may not be actually asthma like persistent cough caused by other diseases like certain heart diseases and chronic obstructive pulmonary disease (COPD).

Effective diagnosis of Asthma depends upon its classification. There are four different classifications of Asthma:

Classification of Asthma

  • Mild intermittent – It is a mild case of asthma if the symptoms last only for up to two days a week, symptoms flaring up mainly at night and the asthma lasting not more than two nights in a month.
  • Mild persistent – Mild persistent asthma is when the symptoms can occur twice in a week but not more than one episode per day.
  • Moderate persistent – This happens when a person experiences symptoms once a day and in excess of one night a week.
  • Severe persistent – Symptoms can last throughout the day and frequently at night on most days.

Testing and Diagnosis of Asthma:

Physical test

The doctor would want to rule out other possible condition through a physical exam to get to know the signs and symptoms.

Some lung function tests, can help in determining how the lung in functioning in a person.

Spirometry

One of the most common pulmonary function tests, spirometry measures lung function by checking the amount of air a person can inhale and exhale after deep breaths.

Peak flow

The peak expiratory flow is a pulmonary device that can measure the maximum speed one can breathe out. If the readings are low, it may be a sign that the person’s lungs are not working properly and could be a potential sign of asthma.

These tests can be done with a medicine called as bronchodilator (albuterol) to check if the lung functions better with the medication. If the test gets better after the use of bronchodilator, then it is highly likely for a person to suffer from asthma

Types of Asthma:

Normally people suffering from an asthma attack tend to have a whistling or wheezing sound when exhaling. There are different types of asthma. Some of the most common types of asthma are:

Exercise-induced asthma

Also called as exercise-induced bronchoconstriction, this type of asthma is induced by strenuous exercises and can cause symptoms like coughing, wheezing, shortness or breath and other symptoms. These symptoms may worsen when the air is dry and cold and usually get triggered during or after an exercise.

Occupational asthma

As the name suggests, occupational asthma is triggered by breathing in certain chemical fumes, dust, gases, or other kinds of exposure to allergens at the workplace.

Allergy-induced asthma

Allergy-induced asthma is the most common type of asthma, which is triggered by common airborne allergens like pollen, mold spores, dust mites, or particles of skin.

Additional tests and Diagnosis For Asthma:

Other tests that may be required to diagnose asthma include:

Methacholine challenge

Methacholine is considered an asthma trigger and so when it is inhaled it can cause mild constriction of the airways. Most people who have asthma are likely to react to methacholine. Doctor could use this test to determine whether you have asthma.

Imaging tests

Certain imaging tests like x-rays and CT scan can help in identifying certain abnormalities that might be causing breathing issues.

Allergy testing

Most allergy tests can help in identifying allergy to triggers like pollen, dust, etc.

Sputum eosinophils

This test can help in identifying the while blood cells in the mucus to see if asthma is present or not.

Nitric oxide test

For people whose airways are inflamed, they may have higher nitric oxide level than normal which may be able to help in identifying whether the person is suffering from asthma or not.

Provocative testing for exercise and cold-induced asthma

As the name suggests, in this a person is made to perform vigorous physical activities in a controlled environment to check for the triggers.

Prevention of Asthma:

Listed below are various preventive measures for asthma:

  1. Know your asthma triggers and avoid being in contact with them
  2. Identify the asthma attacks timely and treat them at early stage
  3. Take the prescribed medicines on time
  4. Do exercise and participate in sports frequently
  5. Be active and follow your asthma action plan properly
  6. Constantly monitor breathing
  7. Get vaccinated for pneumonia and influenza
  8. Avoid smoking

Treatment of Asthma:

Although there is no known cure available for asthma and it is generally a life-long condition, treatment can control asthma symptoms so a person can lead a normal life. Also when it comes to asthma, there is no one-size fit all treatment methodology. The idea is to understand the triggers that worsen your symptoms, taking steps to avoid them and taking the medication on time to keep the asthma in check.

Inhalers

Inhalers are medical devices, which are used for supplying medication into the body through the lungs. There are three types of inhalers. These are:

  • Reliever Inhalers: These inhalers are used for the purpose of relieving symptoms at the time of asthma attack. Normally reliever inhalers don’t have many side effects, in some people they may increase heart beat and induce shaking.
  • Preventive Inhalers: True to their name, this types of inhalers are used to stop the symptoms from developing.
  • Combination Inhalers: If either of these kinds of inhalers don’t work for a person, they would need an inhaler that would both relieve the attack and prevent it from happening again.

Tablets –

If inhalers don’t work to control the symptoms, one may also use tablets.

Leukotriene receptor antagonists (LTRAs)

LTRAs are the oral tablets prescribed for asthma and are also available in syrup and powder forms. It can be taken everyday without many side effects. However, some people may experience some side effects including headaches and stomach pain.

Theophylline

If LTRAs tablets cannot be prescribed for some reasons or is not working, doctors may also prescribe Theophylline. It should be taken every day.

Steroid tablets

Steroid tablets are given to give relief from an asthma attack. Long-term usage of steroid tablets for is not recommended unless a person is suffering from severe asthma and if inhalers aren’t handy controlling the symptoms. Some possible side effects of using steroid tablets for long term are, mood swings, fragile bones, high blood pressure , etc.

Other treatments for Asthma:

Other treatments like surgery or injections may be required in case other treatments don’t work for a person.

Injections

For certain people with severe asthma, some injections like omalizumab, mepolizumab, or reslizumab may be able control the symptoms. For some severe asthma patients, injections are prescribed every few weeks in order to control the symptoms. However, these injections should be taken only under the prescription from an asthma specialist, as these injections may are not advisable for every asthma patient.

Surgery

For some people for whom treatments like inhalers, tablets, and injections don’t work or in certain cases cannot be administered, a surgical procedure called as bronchial thermoplasty can be used. In this treatment, a flexible thin tube is passed down the throat into the lungs and heat is used to warm up muscles surrounding the air controlling nerves to stop causing asthma like symptoms.

However, this process is fairly new and so much research has not been done on its long-term relief.

Complementary therapies

There are many complementary therapies that can help ease the symptoms, prevent asthma from happening, and help strengthen the lungs and the airway muscles. However, before incorporating any of these therapies in your lifestyle, it is always best to check with your asthma specialist first. These therapies include

Certain breathing exercises including yoga

  • Alternative medicines like homeopathy, chiropractic, and Ayurveda
  • Dietary supplements
  • Acupuncture
  • Certain traditional Chinese medicine
  • Ionisers

Complications

If asthma is not managed carefully then the patient may face various complications such as:

  1. Respiratory failure
  2. Severe chest pain
  3. Increased mucus production
  4. Constant fatigue
  5. Pneumonia
  6. Constant asthma flare-ups
  7. Thickening and narrowing of bronchial tubes

Myths:

Myth #1: Asthma is a psychological disease

One of the biggest beliefs that many people have is that asthma is psychological and thus they don’t believe in getting medical help. Since asthma affects the airways it is to be noted that is not psychological as it causes the immune system and the lungs to behave erratically when it comes to certain triggers.

Myth #2: Asthma medications lose their effectiveness over time

Asthma meds don’t lose their effectiveness over time and can be used for long term if the right doses are taken as directed.

Myth #3: People with Asthma should avoid physical activity

Although strenuous exercises can sometimes induce asthma, simple exercises can keep a person fit and healthy and help them lead a normal life.

Myth #4: You can outgrow Asthma

Some asthma symptoms may improve over time. People also learn how to deal with asthma better as they age since they know what triggers it and what doesn’t. However, there is no outgrowing asthma because it is a lifelong condition.

Myth #5: Asthma Is Easy to Control

Asthma can be easy or difficult to control depends on the kind of asthma a person is suffering from and the triggers. Although even in mild form of asthma, the treatment is required to give the necessary relief to a person to reduce flares and maintain proper lung functions.

Frequently Asked Questions (FAQs):

1) Can a person die from Asthma?

Ans: Although asthma is rarely ever dangerous, for some people it could be fatal if the inhalers or medicines are not administered on time.

2) What factors can trigger Asthma?

Ans: Asthma could be triggered by a lot of factors like dust mites, pollen, strenuous exercise, certain chemical fumes, some infections, animal dander etc.

3) Can Asthma lead to lung cancer?

Ans: Certain studies may suggest the inflammation caused by asthma may be an influencer in causing lung cancer ; there are no definitive studies that state that asthma lead to lung cancer.

4) Can you cure Asthma permanently?

Ans: Asthma is a life-long disease for which the symptoms can be managed but not cured.

5) What are the various causes of Asthma?

Ans: Asthma is a chronic disease and the major symptom is wheezing and regular infections in the respiratory tract.

The various causes of asthma are:

  1. Allergies: There is a strong link between asthma and allergies.
  2. History of viral infections: Patients with history of viral infection are more prone to develop asthma.
  3. Hygiene hypothesis: This is the condition in which the babies are not exposed to bacteria in their initial years. Hence their immune system are not enough strong to fight various asthma symptoms and other conditions.

6) What are the different home remedies for Asthma?

Ans: Asthma can be life-threatening if not treated properly. Listed below are some of the home remedies for asthma that may escalate the symptoms and are effective only in an emergency:

  1. Essential Oils: Inhaling eucalyptus oil, basil, and lavender oils help in easing breath difficulties occurred due to asthma. Although for some individuals inhaling these essentials may worsen the conditions of asthma as strong smell may trigger asthma or worsen the symptom.
  2. Mustard Oil: Massage mustard oil to the skin which may help in opening the airways. It is medicinal oil which is different than essential oil and can’t be applied directly to the skin.
  3. Caffeinated Tea or Coffee: A specific chemical in caffeine acts similarly as asthma drug known as theophylline. It helps in opening airways and eases the symptoms of asthma for up to four hours.

7) What are the symptoms that children may experience during asthma?

Ans: Following are the various symptoms that children may experience during asthma:

  1. Panting
  2. A nagging cough
  3. Difficulty in eating or suckling
  4. Laborated breathing
  5. Rapid breathing that pulls the skin around their neck and ribs tight
  6. Frequent cold that settle into the chest

Older children face these symptoms

  1. Chest Tightness
  2. Wheezing especially while exhaling
  3. Cough
  4. Feeling winded after physical activities

8) What are the various measures to be taken care for the management of Asthma?

Ans: Listed below are different measures used to manage Asthma:

  1. Maintain a healthy weight
  2. Eat Healthier
  3. Exercise Regularly
  4. Managing Stress
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