ASTHMA: SYMPTOMS, TYPES, CAUSES, TREATMENT & DIAGNOSIS

What's asthma?

Millions of air tubes or airways called bronchi and bronchioles allow air to enter and exit the body through the lungs. The airways' walls include a smooth muscle layer that permits them to constrict or dilate. Asthma affects the airways, which are the narrow tubes that move air into and out of the lungs, and causes episodes of breathing difficulty.

Asthma develops when the airways become more sensitive to particular triggers, causing them to constrict, inflame, swell, and produce more sticky mucus.

Asthma affects around 5% of the global population and is getting increasingly prevalent globally. It usually starts in childhood, although it can also affect adulthood. We do not know the exact cause of asthma, but it appears that both genetics and the environment have a role.

What’s an asthma attack?

In patients with asthma, the changes in the flow of air lead to some or all of the following asthma symptoms, such as difficulty in breathing and more. The airways become inflamed, constricted, and more sensitive to specific chemicals. When the airways react to these chemicals, an asthma attack, or exacerbation, occurs. 

During an attack, the smooth muscle contracts, compressing the airways and narrowing them further, and mucus secretion increases, furthermore blocking the airways. Depending on the severity, symptoms may occur every day or only on occasion. If asthma attacks are not treated immediately, they can be fatal.

Types of Asthma

Doctors classify asthma as either intermittent (comes and goes) or persistent (lasts). Persistent asthma can be mild, moderate, or severe.

The severity of your asthma is determined by how frequently you experience attacks. They also take into account how well you can do tasks during an attack.

Asthma appearance can be as follows:

•Allergic: Asthma attacks can be triggered by allergies in certain persons. Moulds, pollens, and other allergens can trigger an allergic reaction.

•Non-allergic: Asthma flare-ups can be triggered by external events. Exercise, stress, sickness, and the weather can trigger a flare, leading to an asthma attack.

Asthma symptoms

The symptoms you encounter may be determined by the type of asthma you have. However, the most common asthma symptoms are as follows: 

•Coughing

•Breathlessness

•Tightness across the chest

•Wheezing (whistling noise when breathing).

•Anxiousness or panic

•Fatigue

•Chest pain

•Rapid breathing

•Trouble sleeping 
 

Some individuals have symptoms that last all day. Others may discover that particular activities worsen their symptoms.

These symptoms are not experienced by everyone who has asthma. Make an appointment with your doctor if you suspect your symptoms are related to asthma. 

Also, bear in mind that even if your asthma is well-controlled, you may still suffer a flare-up of symptoms occasionally. Flare-ups generally improve with the use of quick-acting medications, such as an inhaler, but in extreme situations, medical help may be required.

Causes of asthma

A family history of asthma is a well-known risk factor. There are at least twenty genes related to asthma, several of which are involved in the immune system.

There is no one cause of asthma. Instead, researchers believe it is the result of a combination of factors. These factors are as follows:

•Genetics: You are more likely to get asthma if a parent or sibling has it.

•History of viral infections: People who have had a history of severe viral infections as a kid, such as respiratory syncytial virus infection (RSV), may be susceptible to the illness.

•Hygiene hypothesis: According to this notion, when newborns are not exposed to enough microorganisms in their early months and years, their immune systems do not develop sufficiently to fight off asthma and other allergy conditions.

Asthma can also be triggered by a variety of events, causing symptoms to intensify. Asthma triggers can vary, and some people are more sensitive to particular triggers than others. Common triggers include the following:

•Allergens such as pollen, animal hair, pet dander, and sulfites present in preserved food.

•Irritating substances such as cigarette smoke, industrial chemicals, dust, home chemicals, and so on.

•Medicines such as aspirin, beta-blockers, and others.

•Exercise and physical activities.

•Intense emotions.

•Medications, including aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs)

When to see a doctor?

An ‘asthma attack’ can even be fatal if not promptly treated. This is why it is important to see a doctor if you think you might have asthma. 

Some other conditions may also cause similar breathing problems, but a doctor will be able to diagnose asthma based on your history of symptoms and through breathing tests, which are used to support diagnosis, determine severity, and monitor treatment response over time. 

Consult a doctor when you feel the need. 

Risk factors of asthma

The most common risk factors for asthma are as follows:

•Smoking: Cigarette smoke affects the respiratory tract. Asthma is more common in smokers. Those who were exposed to secondhand smoke or whose mothers smoked during pregnancy are likewise more likely to have asthma.

•Air pollution: The major component of smog (ozone) increases the risk of asthma. Asthma is more common in those who grew up or reside in cities.

•Obesity: Although the causes of asthma are unknown, some doctors believe that excess weight causes low-grade inflammation in the body. Obese people frequently require more medications, have more symptoms, and are less able to control their asthma than healthy individuals.

•Occupational exposures: Exposure to certain components in the workplace might trigger asthma symptoms if you have asthma. In addition, exposure to certain dust (industrial or wood dust), chemical fumes and vapours, and moulds might develop asthma for the first time in certain people.

Prevention of asthma

Most people with asthma will be able to manage their condition and lead normal and healthy lives. Asthma has no known cure. Treatment is usually very effective for controlling the symptoms. The most efficient strategy to control symptoms is to identify and prevent the causes of asthma attacks.

While there is currently no cure for asthma, these symptoms may lessen over time or even disappear for long periods, particularly in people with mild asthma, whereas in others, symptoms will be more severe and long-lasting. 

However, in all cases, simple steps can make a big difference: 

•Quitting smoking.

•Identifying and avoiding possible triggers. 

•Keeping fit and healthy.

•Taking medication correctly and as prescribed.

•Keeping a reliever inhaler with you at all times.

•Getting a flu vaccine every year.

•Keeping track of symptoms.

•Having regular asthma check-ups with a nurse or doctor.

What is an asthma action plan? 

An asthma action plan is a written, personalised worksheet that outlines the measures to follow to prevent your asthma from getting worse. It also advises when to contact your healthcare professional or go to the emergency room.

It is a valuable resource to share with caregivers of children who have asthma, such as daycare providers, schools, and aftercare programs.

Your asthma action plan should contain the following items:

•Factors that worsen your asthma, often known as "asthma triggers"

•Medicines you use to treat your asthma, with particular names for each

•Symptoms or peak flow measurements (if utilised) indicating worsening of asthma

•Medications to take depending on your symptoms, indicators, or peak flow measurements

•Symptoms or peak flow measurements that suggest the need for immediate medical care

•Numbers for an emergency contact, your healthcare practitioner, and the nearest hospital

What should one do when encountering a severe asthma attack? 

Inhalers are the main treatment for asthma as they deliver medication directly to your airways, helping them to expand. There are two main types of inhalers: 

•Preventer inhalers, which you take every day to help prevent symptoms from occurring over the long term.

•Reliever inhalers, which you use to immediately relieve symptoms as and when needed. Combination inhalers combine both types. 

A nurse or doctor can show you the right inhaler technique, which is important to make sure the medicine actually reaches the airways. They can also help you decide which type of inhaler device will work best for you. 

Apart from inhalers, another key step is to avoid the things that trigger your symptoms. These will vary from person to person:

•Cold weather

•Cigarette smoke

•Pollution

•Pollen

•Dust and mould

•Animal fur

•Chemicals and fumes

•Stress and anxiety

•Strenuous exercise

•Infections like common colds or flu

Some of these triggers are unavoidable, which is why you should always carry a reliever inhaler with you. It’s also important to monitor your symptoms over time. 

If you notice that symptoms are happening more frequently, see your doctor at the earliest opportunity as you may need to be stepped up onto higher doses or other medications, including oral tablets. 

Also, remember that if an asthma attack gets worse and your inhaler does not seem to be helping, you must seek immediate medical attention as stronger medications may need to be given in the hospital.