Asthma

Asthma is a chronic condition of the cardiopulmonary system that causes inflammation and constriction of bronchial airways, making it difficult to breathe.

Onset of asthma can range from being slow and mild to sudden and severe. A moderate to severe onset of symptoms is known as an asthma attack. The presence of asthma symptoms alternates with periods of relief.

Asthma is considered a serious, and sometimes life-threatening, disease. Over 22 million people in the U.S. have been diagnosed with asthma and it results in an average of 2 million trips to the emergency room in a single year. Although asthma is more common in children and young adults, symptoms can occur for the first time in people of any age.

Asthma is chronic, obstructive, and affects the cardiopulmonary system, but several factors keep it in a separate category from chronic obstructive pulmonary disease (COPD), emphysema, and chronic bronchitis.

Asthma has three defining characteristics

Inflammation

During an attack, the bronchial tubes become swollen, red, and sometimes painful. Inflammation can cause long-term lung damage, so treatment of the inflammation is of great concern to overall life expectation and quality of health.

Obstruction

Bronchial tubes are surrounded by bands of muscle. During regular breathing, these muscles stay relaxed. For asthmatic people, as an attack is triggered, the muscular bands tighten, restricting breathing. As the person tries to force air through the bronchial tubes to their lungs, it often makes a sound called wheezing.

Sensitivity

The airways of asthmatics are very sensitive to the environment and situations causing excessive activity. It is normal for the airways to tighten slightly when exposed to large amounts of allergens, but even slight amounts can trigger airways to tighten to a point near closure.

Symptoms of Asthma

The severity of symptoms varies greatly from person to person and from incident to incident. Symptoms are often characterized in four categories: mild, moderate, severe, and pending arrest.

These are the most common symptoms of asthma

• Difficulty breathing/shortness of breath
• Tight chest
• Painful chest
• Wheezing
• Coughing
• Increased heart rate
• Anxiety
• Loss of color
• Excessive perspiration
• Rapid breathing
• Increased mucus production

Symptoms occur at different intervals with different people, and the intervals can be unpredictable. Some people can go for weeks or even months without any symptoms, while others experience symptoms daily. In addition, symptoms can also be brought on by specific triggers. In any case, it can be important to recognize the early warning signs of an impending asthma attack.

By recognizing these early signs, short-term treatment can be administered that may prevent the more severe symptoms of the attack

• Coughing
• Shortness of breath
• Fatigue or weakness
• Wheezing after exercise
• Altered mood/easily annoyed
• Allergy symptoms – runny nose, sneezing, congestion, headache
• Difficulty sleeping

If an asthma attack goes untreated, it may worsen in severity very quickly. The lungs and airways may continue to tighten until airflow is so restricted that even wheezing is impossible. This condition is dangerous and is known as silent chest. These situations usually require professional treatment because not enough air is getting to the body. The person’s lips may turn blue, and if still left untreated, they may lose consciousness or die.

Causes of Asthma

The exact cause of asthma is unknown. As scientists continue to study the cause, it is thought to be a combination of genetic and environmental factors. Those with a family history of asthma are more likely to have it themselves.

Asthma symptoms can begin for no apparent reason but often begin with what is called a trigger. A trigger is an environmental factor or physical situation that sets in motion physiology changes causing an onset of symptoms.

Asthma triggers are different for every person. It is important for those who suffer from asthma and those close to someone who suffers from asthma to recognize the specific triggers that cause their symptoms to begin.

Most triggers are discovered simply through experience. Doctors can also identify some triggers through blood or skin testing. Some people who suffer from asthma use a peak flow meter. This device measures the quantity and frequency of air being exhaled. It can help to identify triggers. Once the triggers are recognized, it is possible to eliminate or reduce them from the person’s life. Although triggers differ, some are more common than others.

Here are some of the most common asthma triggers

Allergies

Most people with asthma (80%) also have allergies to airborne particles such as pollen, mold, animal hairs or dander, or dust mites. Cockroach droppings have also been found to cause allergic reactions related to asthma attacks.

Emotions

Strong emotions, stress, and anxiety have been known to trigger asthma attacks. These emotions can include sadness (crying), joy (laughing), and anger (yelling).

Exercise

Exercise or excessive physical activity is a very common asthma trigger. Symptoms usually begin in the first minutes of exercise and then subside about 30 minutes later. However, another attack may be induced hours later while at rest.

Food

Some foods can trigger allergic reactions that can lead to asthma attacks. Common food allergies related to asthma are eggs, milk, peanuts, wheat, fish, and fruit. Some food preservatives may also act as asthma triggers. Many different food preservatives exist, and some are safe for some people. It is important to watch for the specific additive.

Heartburn

Many people who suffer from asthma also suffer from heartburn or gastroesophageal reflux disease (GERD). In people who suffer from GERD, stomach acid can rise up into the throat and cause irritation of the airways, leading to an asthma attack.

Illness

Colds and flu can cause asthma symptoms to be triggered because airways are much more sensitive under these afflictions.

Irritants

Foreign particles in the air can often cause asthma symptoms to be triggered. Irritants can include perfume, smoke, cleaners, paint, and anything else with a strong smell.

Medication

Some people are sensitive to certain medications. No one drug causes more asthma attacks than another. It varies between individuals.

Sinusitis

Sinusitis causes inflammation in the sinus cavities. Because the sinus cavities are connected to the airways, it causes them to become inflamed, also, leading to an asthma attack. Sinus infections must be treated quickly to reduce the onset of asthma symptoms.

Smoking

Believe it or not, many people who have asthma continue to smoke. Smoking makes asthma symptoms worse and triggers their onset often. People who have asthma and do not attempt to quit are only asking for trouble.

Weather

Asthma attacks often occur because of inclement weather. Those who suffer from asthma are usually susceptible to cold, but any temperature changes or changes in humidity or barometric pressure can trigger symptoms.

Risk Factors

The number of people diagnosed with asthma continues to grow each year, but scientists and doctors have yet to discover the exact reason. While the exact cause is unknown,

several risk factors have been linked to people who suffer from asthma

• Family history/genetics
• Severe childhood respiratory infections
• Smoking or exposure to secondhand smoke
• Living in dense populations that suffer from air pollution
• Frequent exposure to irritable chemicals
• Obesity
• Low birth weight

Diagnosis

Many tests are available to determine if what a patient is suffering from is asthma. One newer method is the methacholine bronchial challenge test.

Methacholine is a substance that a patient inhales. If the patient’s bronchial passages begin to narrow or spasm, it is a positive indication of asthma.

In most cases, however, a doctor can diagnose asthma through other means. Every doctor also has his or her favorite tests for detecting asthma, which may change from person to person, depending on the situation.

As with any diagnosis, if a patient feels something is wrong with it, they can ask for an explanation or receive a second opinion from another doctor.

One popular test for asthma is a simple question and answer test. This test is effective because many times when a patient visits the doctor for a diagnosis, they are not currently experiencing any symptoms.

When an asthmatic is not experiencing symptoms, they appear to be breathing normally. Patients should be sure to provide the doctor with as detailed answers as can be provided.

Here are some other tests used to determine asthma

Chest x-rays – These are usually only used for those currently experiencing symptoms.
Nitric oxide test –This test measures the amount of nitric oxide gas a patient exhales. People with inflamed airways tend to have higher levels than those with normal airways.
Peak flow test – This can be done either at home or in the doctor’s office. A doctor can explain the best way to use and read the peak flow meter.

Spirometry – This is a test that determines the volume of air a patient is able to exhale. It can prove or disprove bronchial obstruction. Spirometry is also used to ascertain the effectiveness of specific treatments.

Once diagnosed, a doctor will classify the condition on one of four severity levels

Mild intermittent – The patient experiences mild symptoms for two days or less and no more than two nights in a single month.
Mild persistent – The patient experiences mild symptoms at least twice per week, but never on the same day.
Moderate persistent – The patient experiences symptoms once per day at more night per week.
Severe persistent – The patient experiences symptoms multiple times most every day and several nights of the week.

Prevention

Asthma prevention is accomplished by designing a specific plan with a doctor that includes several facets

Put the plan in writing. This makes sure it is easy to follow and maintain.

Avoid asthma triggers. Avoiding the triggers that cause asthma reduces attacks.

Recognize early warning signs of an attack. If a person who suffers from asthma can recognize the signs leading to an attack, steps can be taken to prevent it.

Take medication as instructed. Some medication works long-term to help prevent attacks while other medication only relieves symptoms.

Treatment of Asthma

Numerous medical treatments exist for people who suffer from asthma, but all of them rely on medications. There is no cure for asthma nor is there any surgery that can relieve asthma except in life-threatening, emergency situations.

Asthma medication is divided into three groups

Long-term medication

These medications include anti-inflammatory drugs such as steroids. They are critical in reducing asthma attacks. They work by minimizing inflammation of and mucus production in the airways. This makes the body more resistant to triggers.

Corticosteroids – This group of drugs includes beclomethasone, budesonide, fluticasone, mometasone, and triamcinolone. They are usually inhaled and it may take several day up to several weeks before any noticeable effects are reached.

Leukotriene modifiers – These drugs include montelukast, zafirlukast, and zileuton. They are taken orally and can prevent attacks for up to 24 hours. These drugs, however, have been linked to psychological side effects, such as aggression, depression, hallucinations, becoming easily aggravated, and suicidal thoughts.

Long-acting beta agonists (LABA) – LABAs include formoterol and salmeterol. They open the airways upon inhalation, but some patients may experience severe attacks after their use.

Combination – These inhalers combine an LABA with a cortosteroid for maximum effectiveness and a reduction in side effects.

Quick-relief medications

These medications are bronchodilators that are inhaled and open the airways almost immediately in the case of asthma attacks. They provide fast relief from wheezing, coughing, tightness of the chest, and shortness of breath. Quick-relief medications are almost always used in conjunction with long-term medications.

Short-term beta agonists – This group of bronchodilators includes the most popular asthma medication – albuterol inhalers. Others include levalbuterol and pirbuterol. They act within one minute and last for several hours.

Ipratropium – This inhaled medication is another type of bronchodilator.

Corticosteroids – When injected, these long-term drugs can also provide fast relief from asthma attacks. Since injected corticosteroids have several side effects, they are only used in emergency situations.

Ephedrine – Ephedrine is an over-the-counter medication that opens the airways and eases breathing 30 – 60 minutes after taken orally. Ephedrine is a stimulant and therefore has side effects of increased heart rate, nervousness, and wakefulness.

Allergy-control Medications

These medications benefit those whose asthma is triggered by allergic reactions.

Antihistamines – Antihistamines and decongestants provide relief from allergy symptoms.

Immunotherapy – These injections are usually given weekly for several months and then reduced to monthly for several years. They help to provide long-term relief of allergy symptoms.

Omalizumab – Created for people who are susceptible to allergic triggers. It reduces the body’s reaction to airborne allergens.

Home Remedies for Asthma

Because asthma is such a widespread disease that has been known throughout history, home remedies and treatments abound. Many are ineffective and some provide short-acting relief, long-lasting relief, or even both for certain individuals. Most home remedies do not harm the patient, but if they do not work, it is recommended to use doctor-prescribed medications.

Here are some of the most popular and effective home remedies for asthma

Steam – Steam treatments are especially popular for the relief of asthma. Some say sweating is necessary in conjunction with the steam, but others say it provides no added benefits.

The steam should be breathed deeply to open the airways and relieve excess mucus. The steam in ideally inhaled from a bowl. Sometimes a towel is used to cover the head and the bowl together. Many people advocate the use of other ingredients in the water creating the steam. Such ingredients include garlic, ginger, garlic and ginger, juniper oil, and caraway seeds.

Honey – Honey has long been considered an effective treatment for asthma. During an attack, the patient should inhale the scent of a jar of honey for several minutes. It is also recommended to drink one teaspoon of honey in warm water three times per day.

Garlic – Boil one clove of garlic in one-half cup milk. Eat the garlic and drink the milk.

Turmeric – Drink one teaspoon of turmeric powder mixed with milk three times daily.

Mustard oil and Camphor – These two ingredients can be combined into an ointment that is rubbed into the back and chest.

Licorice root tea – Steep licorice root in hot water for 10 minutes and drink.

Cloves – Boil 5 cloves in one cup of water. Add honey and drink three times per day.

Ginger and Black Pepper – Mix ingredients in one tablespoon of molasses or honey and eat.

Fennel – Chewing on fennel is said to reduce mucus. It is not necessary to eat it.

Fresh air, sun, and water – Taking a break from the inside of buildings can help some people achieve relief from asthma. If heat is not a trigger, spending time at the beach, especially an ocean beach, can work wonders.

Resources

nlm.nih.gov

Mayoclinic.Com

EmedicineHealth.Com

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