Asthma

By Talsk Research's Physician Group

Overview

Asthma is a medical condition that affects the respiratory system and causes difficulty in breathing. Certain factors cause inflammation or swelling of the mucosal lining of the tubes resulting in excessive and thicker mucus secretions narrowing the airways. When people with the hyper responsive airways are exposed to triggering factors, the muscles around the breathing tubes tighten further narrowing the air passages. This results in less air flowing in and out of the lungs, causing wheezing, shortness of breath, chest tightness and coughing which is usually referred to as an asthma attack. It may be mild and go away on its own or after self treatment with an asthma medicine. Other times, symptoms continue to get worse and may need immediate medical attention.

Asthma most often starts in childhood but can affect persons of all age groups. Frequent asthma attacks can be debilitating and frightening and at times life threatening when a severe attack is not promptly treated. When not properly controlled, it can interfere with work and activities of daily living. The condition can be kept under check by avoiding the triggering factors, whenever possible, and taking medicines best suited for your problem, as prescribed by a physician.

Causes

Though the exact cause of asthma is not known, asthma can be triggered by many factors. Studies have shown combinations of genetic and environmental factors early in life interact to cause asthma. These factors include:

• An inherited tendency to develop allergies called ‘atopy’

• Parents who have asthma

• Exposure to airborne allergens such as house dust mites, cockroaches, cat, or dog dander

• Some respiratory infections that affect children can make them prone to asthma later in life

• Viral infections that might affect the immune system can lead to asthma-like conditions

• Irritants like tobacco and smoke

About half the adults with asthma have another allergy-related condition and there are various factors that can trigger asthma and these include:

• Airborne substances such as tree, grass, and weed pollen, all of which are extremely common

• Mold or damp conditions, house dust mites, chemicals in flooring material, dust trapped in carpets are also common culprits

• Cockroach droppings or their body parts

• Allergies due to foods like eggs, cow’s milk, peanuts, soy, wheat, fish, shrimp, and shellfish and some food preservatives

• Exercise

• Indigestion or Acid Reflux disease

• Active or passive smoking,

• Viral or bacterial infection of lungs

• Cold air, changes in temperature, and humidity can also trigger an attack

• Wood dust, pesticides, asbestos etc can cause occupation related asthma

• Odors from perfumes, talc powders, incense, spray deodorant, and hairsprays

• Some common medications such as aspirin

Risk Factors

There are various risk factors that predispose one to asthma and they include:

• Hereditary or genetic predisposition

• Personal history of allergies such as hay fever

• Gender - Men are affected more than women

• Ethnicity - African-Americans are affected more than Caucasians

• Tobacco smoking - Both active and passive

• Obesity

• Low birth weight

• Hormonal fluctuations or changes in hormone levels may play a role in the severity of asthma in women.

Symptoms

Common symptoms include:

• Shortness of breath or difficulty in breathing

• Frequent cough, especially at night

• Wheezing or coughing after exercise

• Chest tightness

• Anxiety

• Fast heartbeat

• Excessive sweating

• Cold or allergies (sneezing, runny nose, nasal congestion, and sore throat)

• Trouble sleeping

Some symptoms such as bluish color to the lips and face, severe anxiety, fast heartbeat, excessive sweating, and decreased level of consciousness such as drowsiness or confusion need immediate medical attention.

Diagnosis

A detailed history and physical examination by the clinician should be the starting point for diagnosis of asthma. The clinician may include one or more of the following tests to aid in the diagnosis.

• Allergy skin tests

• Blood tests - to measure eosinophil count and Immunoglobulin E levels

• Lung function tests - a device called spirometer is used to check how quickly you can breathe out, to evaluate lung function and capacity.

• Chest X-ray

• Electrocardiogram

• Computerized tomography of the chest

• Magnetic resonance imaging

Treatment

• Quick-relief or rescue medicines such as short acting bronchodilators (e.g. proventil) are used to reduce symptoms of coughing, shortness of breath, wheezing or a tight feeling in the chest. They are also used a few minutes before exercise for preventing exercise induced asthma.

• Long acting bronchodilators are used to provide relief for at least 12 hrs and are usually used on a regular basis along with steroid inhalers (e.g. advair) to control moderate to severe asthma

• Oral corticosteroids such as predinisone are generally reserved for severe acute attacks not responding well to the inhaler treatments.

• Peak flow meters are usually provided to the patients with asthma which can help them manage the disease well.

Prevention

• Following the clinician’s instructions carefully, using the inhalers properly and keeping an asthma diary to note the peak flow, symptoms, triggering factors, medicines used will help manage this condition very effectively.

• Identifying and avoiding allergens that trigger the symptoms at home and work environments

• Keeping the house free of mold and dust by using home air filtration systems and dehumidifiers reduces the concentration of allergens. Keeping doors and windows closed during high pollen counts will also help

• Avoiding exposure to tobacco smoke is of paramount importance

• Regular exercise and active lifestyle helps curb asthma attacks.

• Food related allergic asthma can be prevented by paying attention to food labels and knowing the ingredients when eating out

• A flu shot is highly recommended for people with asthma

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References

• Centers for Disease Control and Prevention

http://www.cdc.gov/asthma/

• National Heart Lung and Blood Institute

http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/

• National Institutes of Health

http://www.nlm.nih.gov/medlineplus/asthma.html

• American Lung Association

http://www.lungusa.org/lung-disease/asthma/

• American College of Allergy, Asthma, & Immunology

http://www.acaai.org/

• University of Maryland Medical Center

http://www.umm.edu/altmed/articles/asthma-000015.htm

• Centers for Disease Control and Prevention

http://www.cdc.gov/asthma/

• United States Environmental Protection Agency

http://www.epa.gov/asthma/

• Mayo Foundation for Medical Education and Research

http://www.mayoclinic.com/print/asthma/DS00021/METHOD=print&DSECTION=all

• Johns Hopkins Health Alerts

http://www.johnshopkinshealthalerts.com/symptoms_remedies/asthma/73-1.html#4

• MD Consult

http://www.mdconsult.com/das/patient/body/280851038-3/1202850940/10041/9385.html

All information provided above is for basic awareness and education purposes only and should not be used for diagnosis or treatment of any medical condition under any circumstance. Please consult a licensed medical professional for these purposes. In case of medical emergency please call 911.

Copyright 2011 Talsk Research Inc. All rights reserved.