Asthma

Asthma is a chronic lung disease in which the airways become narrow and swollen. Severe asthma can cause difficulty in breathing or talking. It is a very common disease that affects millions of people in the country.

Types

Asthma can be classified depending on the cause and severity of the symptoms. Here’s what you need to know:

Allergy-induced Asthma. This is triggered by substances like house dust mite, pollen, dog dander (hair), fungal spores, cockroach and  many more.

Adult-Onset Asthma. This occurs after the age of 18 years.

Exercise-induced Bronchoconstriction (EIB). This type of asthma occurs after a few minutes of exercise or physical activity.

Aspirin-induced Asthma. This occurs when someone takes aspirin or another NSAID medicine.

Occupational Asthma. This occurs in a workplace where there is a exposure to chemical fumes, gases, dust or printing ink.

Symptoms

Some of the common symptoms associated with asthma include:

  • •Shortness of breath (during nightime)
  • • Chest pain or tightness
  • • Wheezing sound (muscial sound in the chest during sleeping)
  • • Trouble sleeping
  • • Coughing

 

Causes

Researchers are still trying to figure out why some people have asthma while others don’t. However, it is considered an interaction between environmental and genetic factors. Moving on, there are specific triggers that can worsen the condition of the people who have asthma. These may include:

  • • Change in season (cold temperature)
  • • Infections like flu(viral), bacterial infections & sinusitis
  • • Irritants like strong perfume or cleaning solutions
  • • Allergens like pollens, mould, pet dander
  • • Air pollution
  • • Medicines like aspirin
  • Gastroesophageal reflux disease (GERD)

 

Diagnosis

The diagnosis of asthma starts with a physical examination to rule out other possible conditions or respiratory disorders. The doctor may also perform a series of tests to determine the severity of asthma. These may include:

Spirometry. This test is done to get an estimation of the narrowing of the airways (severity of asthma)

Peak flow. This lung function test uses a peak flow meter to measure how hard a patient can breathe out.

Blood tests. These are done to determine the any blood infection causing asthma.

Allergy testing.These are done by blood (IgE test) or through skin testing

Chest X-ray. This helps to identify any obvious infection or pneumonia in lungs which may trigger asthma attack.

Methacholine challenge. In this test, the doctor gives you an asthma trigger known as Methacholine. If you react to the stimulus, you may have asthma.  

Treatment

The treatment of asthma depends on the severity of the condition. Asthma is classified into four categories based on its severity. These include mild intermittent, mild persistent, moderate persistent, and severe persistent. Depending upon the diagnosis, the doctor may suggest the following treatment:

Medications: The doctor may prescribe inhaled bronchodilators, corticosteroids or combination inhalers for long-term asthma control and leukotriene modifiers ( Oral tablets ). The doctor will also provide quick-relief medications to help you in case of an acute asthma attack. These may include short-acting bronchodilators, oral corticosteroids, nebulized medications and more.

Biologicals. (Omalizumab, Mepolizumab,Benralizumab) These medications are approved for severe & uncontrolled asthma and are available in India, They are the latest drugs in asthma management and have shown very good results in reducing asthma attacks.

Bronchial Thermoplasty: This is a endoscopic, minimally invasive procedure, that helps to treat  moderate - severe asthma (only 5 – 10%) when other treatment options fail. During the procedure, the doctor heats (thermal energy) to shrink the muscles inside the airways with an electrode. The heat limits the ability of the airway to tighten and makes breathing easier in asthma patients.

Risk Factor

Some common risk factors for asthma include:

  • • Family history of asthma
  • • Allergic conditions like atopic dermatitis, eczema, allergic rhinitis
  • • Childhood respiratory tract infections
  • • Exposure to certain chemicals , fumes in workplace

 

Prevention

Sadly, there is no way to prevent asthma. However, there are specific ways through which one can keep his/her asthma in control. These include: 

  • • Know your asthma triggers and try to avoid them
  • • Take your inhalers regularly
  • • Vaccination (FLU& PNEUMONIA)
  • • Quit Smoking
  • • Maintain healthy lifestyle
  • • Follow up with your doctor

 

Complications

If left untreated, asthma can cause certain complications, including

  • • Pneumonia
  • • Respiratory failure
  • • Allergic bronchopulmonary aspergillosis (fungal infection)
  • • Bronchiectasis (Holes in lungs)
  • • Lung collapse

 

Outcome for Patients

Asthma is a chronic condition and has very good outcome.  All patient improve and become symptom free but require regular inhaler use. Some children even outgrow from their asthma and do not require inhalers. However, there are newer medications available in the form of biologicals for the treatment of asthma that helps to control the symptoms of asthma. Moreover, it is noted that one should know & avoid his asthma triggers and lifestyle changes for better asthma management.