Asthma

Asthma is a respiratory ailment characterized by difficulty in breathing due to tightening of the airway of the lungs. There are two types of asthma – allergy asthma, which is induced by allergies to certain substances; and non-allergy asthma, which is triggered by infection, cold air, exercise or gastroesophageal reflux disease (GERD).

Allergy asthma is the most common type of asthma. People who have a family history of allergies are at the greatest risk of developing the ailment because the same substances that trigger allergies can also cause inflammation of the airways, resulting in breathing difficulty, chest pain, coughing and wheezing.

What causes allergy asthma?

Allergy asthma is caused by triggers known as allergens, the most common of which are dust, plant pollen, molds, animal dander, cockroach particles, cigarette and other smoke, dust mites and chemicals. These allergens trigger the inflammation of the lining of the nose and the airways. For people with asthma, such triggers eventually lead to an asthma attack.

What are the symptoms of asthma?

The symptoms of asthma are very similar to regular allergies – nasal congestion, difficulty in breathing, chest pains, scratchy eyes, sneezing or wheezing and even skin reactions – except that in an asthma attack, the symptoms become severe over a short period of time. The muscles surrounding the airways tighten up and breathing becomes very difficult. In some cases, the attack, when left unattended, can be fatal. This is why people having an asthma attack should be given medical attention as soon as possible.

How is asthma diagnosed?

A doctor evaluating a patient for asthma will take the patient’s complete medical history and symptoms and recommend a physical examination and laboratory tests to determine pulmonary function. During the physical examination, the doctor will look for signs of a reversible airway obstruction, which would indicate that the asthma can be addressed with appropriate treatment.

Airway obstruction can be determined through several tests:

  • Spirometry. This test uses a device called a spirometer that is connected to a disposable mouthpiece through which a patient inhales and exhales. The test measures the amount of air entering and leaving a patient’s lungs.
  • Peak flow meter. When spirometry fails to indicate any airway obstruction, the doctor may recommend a peak flow meter test, which measures the maximum force with which a patient can blow air through the device twice daily (once in the morning upon waking and again in the afternoon or early evening) over a period of two weeks. A variability of more than 20 percent between the morning and evening peaks would indicate a reversible airway obstruction.
  • Bronchial provocation. When both spirometry and peak flow monitoring do not confirm an airway obstruction, the doctor may have a patient undergo a bronchial provocation test. The patient inhales an aerosolized chemical (usually histamine or methocholine) that results in a hyperresponsive reaction. A positive response to the chemical indicates asthma.

There are other tests that may be prescribed to rule out the presence of other diseases or to confirm what factors trigger or worsen an asthmatic condition. These tests include chest X-rays; skin or blood allergy tests to confirm if the asthma is allergy-induced and what allergens cause it; and sinus X-rays and tests for gastroesophageal reflux disease.

How is asthma treated?

Asthma treatment methods vary according to the type of asthma attack and from person to person. The best treatment is usually removing the cause of the attack – so in the case of allergy-induced asthma, a patient must stay away from what triggers the asthma in the first place. This would include keeping away from moldy, dusty or smoke-filled areas and pets, or avoiding chemical irritants or extreme changes in temperature.

There are also a variety of medications for asthma, the most common of which involve the use of inhalers/bronchodilators or pills, corticosteroids (for inflamed bronchial tubes), beta-2 agonists (when mucus is present) and leukotriene modifiers (for both inflamed bronchial tubes and presence of mucus).

Allergy shots are also an alternative. These shots boost a patient’s immune system, making him/her less sensitive to allergens. In addition, natural remedies that use vitamins, herbs, natural extracts and even magnets are also available.

As with any other medical ailment, asthma medication or treatments must be approved by a doctor.

Can asthma be prevented?

Yes, asthma can be prevented by learning what triggers an attack and identifying and eliminating such triggers from the home or workplace. An asthma patient should work with his/her doctor in creating an action plan that would help prevent future attacks or address an attack properly in the event that it happens.

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