Asthma

Asthma is the condition in which a person experiences difficulty breathing due to their airways swelling up and narrowing. They may produce excess mucus, as well as develop a heavy cough. Exposure to triggers can make an asthmatic person develop symptoms such as shortness of breath, tightness in the chest, and heavy mucus, which can lead to fatigue and respiratory dysfunction. In severe cases, asthma can be life threatening. As of yet, asthma is incurable, although symptoms can be controlled. 

Causes of Asthma
The main causes of asthma include environmental factors and genetics:

  • Environmental factors, in which symptoms can be triggered by a person’s surroundings. These may include:
                  ◦ Allergens; when coming into contact with an allergen (environmental trigger), it can lead to a negative respiratory system reaction. Different people react to different triggers. Common allergens include pollen, grass pollen, dust, animal hair, and pollutants
                  ◦ Respiratory infection, such as influenza or sinusitis
                  ◦ Cold weather
                  ◦ Overexertion during exercise
                  ◦ GERD, gastroesophageal reflux disease
                  ◦ Medications; certain medications such as aspirin or other NSAIDs such as ibuprofen
                  ◦ Food preservatives
                  ◦ Stress
 
  • Genetics, a family history of asthma will increase one’s risk of developing asthma
People with asthma may develop symptoms including coughing, excessive phlegm, tightness in the chest, shortness of breath, wheezing, and gasping for air, all of which come and go throughout the day. Generally, the symptoms will occur at night and in the early morning or when coming into contact with an allergen. Symptoms can be mild or severe.
 
Aside from reviewing the patient’s medical history, a physical examination includes monitoring of the lungs as air is breathed in and out.

Tests to diagnose asthma may also be performed; these include:

  • Spirometry – This is a method to measure lung capacity as air is breathed in and out. This is the most common of the asthma diagnostic tests. A spirometry test involves taking a deep breath and breathing out into a spirometer, and measuring how much oxygen is released in one second. Based on the results, the doctor is able to assess the presence of asthma.
  • Peak Expiratory Flow (PEF) – This is a test to measure a person’s speed of exhalation, measured through a peak flow meter. A lower than normal reading may indicate asthma.    

If a person experiences symptoms that indicate asthma, but has gone through all the initial diagnostic tests with normal results, the following additional tests may be performed:

  • Methacholine challenge test to measure how responsive or reactive the lungs are to substances found in the environment
  • Exercise induced asthma testing which determines if asthma occurs as a result of exercise
  • CT Scan or X-ray of the chest in order to rule out other diseases that produce the same symptoms
  • Checking for allergies which may be the cause of asthma
  • Examination for airway passage inflammation
Inflammation of the airways in asthmatic patients, if chronic, may produce both physical and functional changes in the lungs, including bronchospasm, the sudden constriction of the muscles in the walls of the bronchioles. As a result, the lungs become impaired as well as permanently sensitive to stimuli.

The guidelines for treating asthma involve treating the inflammatory conditions in order to control symptoms, as well as preventing relapse by avoiding triggers and stimuli.

Asthma medications include both inhalants and oral medications, which come in two distinct categories:

  1. Medications to suppress or control bronchial inflammation and medications such as inhaled corticosteroids
  2. Medications to relieve symptoms, known as beta agonists, which work by opening the airways. They reduce symptoms of coughing, gasping for air, and difficulty breathing.  These are taken as symptoms flare up but do not help reduce airway inflammation
As asthma symptoms constantly fluctuate, the doctor may keep adjusting the prescriptions to treat symptoms as they arise. This approach is used to get the best results in managing asthma attacks and help avoid the onset of chronic obstructive pulmonary disease (COPD)
Currently, there is no definite way to prevent the onset of asthma, but controlling symptoms is possible. Doctors search for the cause of a patient’s asthma, which may include allergens, irritable substances, and pollutants, and will advise on how to stay clear of these triggers.

Properly monitoring one’s surroundings for pollutants and keeping in good health can help with staying clear of asthma. Maintaining a healthy weight, treating gastroesophageal reflux disease (GERD) if it arises, getting vaccinated for influenza, keeping stress minimal, and getting sufficient sleep can all help in fighting asthma as well.

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