Asthma

asthma

What is Asthma?

Asthma is a chronic condition that affects the airways. It causes wheezing and can make it hard to breathe. Inflammation of airways causes asthma. In asthma the muscles of the airways become stiff and swollen, so less amount of air can enter through them.

Asthma: Causes and Risk Factors

Some of the common triggers of asthma are:

  • Dust
  • Animal (dander or pet hair)
  • Mould
  • Pollen
  • Respiratory infections, such as the common cold
  • Strong emotions (stress)
  • Tobacco smoke
  • Changes in weather (most often cold weather)
  • Chemicals in the air or in food
  • Exercise
  • Some non steroidal anti-inflammatory drugs (NSAIDs)drugs and aspirin can also cause asthma
  • Allergen 0r allergy causing substances like pollens, etc may also cause asthma.

Asthma: Types

There are mainly two types of asthma- intrinsic and extrinsic asthma. Allergy- causing substances, family history and some underlying respiratory pathology may be responsible for causing asthma.

Extrinsic or Allergic Asthma

It develops in early childhood. About 90% of cases of asthma heave extrinsic type. Usually there is family history of asthma and conditions like allergic rhinitis or other allergies are also present. Allergic asthma usually disappears as the age advances but in 75% cases it may reappear.

Intrinsic Asthma


About 10% all cases of asthma have intrinsic asthma. It is not related to allergic conditions and develops usually after the age of 30 years. Respiratory infections are believed to be responsible for the condition. Women are more affected by this type of asthma. The symptoms are severe and difficult to treat.

Asthma: Facts and Diagnosis

Asthma can be diagnosed by allergy testing and by finding out respiratory irritants. Allergy testing helps in the identification of the allergens which may exaggerate the asthmatic attack.

Asthma can be diagnosed by allergy testing. Some of the common allergens are as under:

  • Dust mites
  • Molds
  • Pet dander
  • Pollens
  • Cockroach allergens

A list of common respiratory irritants is:

  • Pollution
  • Tobacco smoke
  • Fumes from burning wood or gas

Other important diagnostic tests include:

  • Chest x-ray
  • Lung function tests
  • Peak flow measurements
  • Arterial blood gas
  • Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of immune system protein called an immunoglobulin).

Asthma: Signs and Symptoms

Some of the common symptoms of asthma are wheezing, coughing, chest tightness and difficulty in breathing particularly in early morning and during night. Shortness of breath may also be an important symptom.

The duration of an asthmatic attack may vary from few minutes to 2-3 days, depending of the degree of airway swelling.

Some of the common symptoms include:

  • Cough either productive or non-productive.
  • Coughing may be chronic, is usually worse at night and early morning, and may occur after exercise or when exposed to cold, dry air.
  • Intercostal retraction or the pulling of skin in the ribs while breathing.
  • Shortness of breath, especially with exertion or at night.
  • Chest tightness may occur with or without the above symptoms
  • Chest pain
  • Wheezing is a whistling or hissing sound when breathing out.

Characteristic wheezing which may:

  • Be episodic with symptom-free intervals in between
  • Be worse during night and in morning
  • Disappear on its own
  • Be worsened by breathing in cold damp air
  • Be worsened with reflux
  • Begin suddenly without any definite cause

Emergency Symptoms:

Few important emergency symptoms are:

  • Bluish coloration of the lips and face.
  • Decreased level of alertness, such as severe drowsiness or confusion.
  • Extreme difficulty  in breathing.
  • Rapid pulse.
  • Severe anxiety due to shortness of breath
  • Sweating
  • Abnormal breathing pattern –breathing out takes more than twice as long as breathing in
  • Breathing temporarily stops
  • Tightness in the chest
  • Chest pain
  • Nasal flaring

Asthma: Signs and Symptoms

Some of the common symptoms of asthma are wheezing, coughing, chest tightness and difficulty in breathing particularly in early morning and during night. Shortness of breath may also be an important symptom.

The duration of an asthmatic attack may vary from few minutes to 2-3 days, depending of the degree of airway swelling.

Some of the common symptoms include:

  • Cough either productive or non-productive.
  • Coughing may be chronic, is usually worse at night and early morning, and may occur after exercise or when exposed to cold, dry air.
  • Intercostal retraction or the pulling of skin in the ribs while breathing.
  • Shortness of breath, especially with exertion or at night.
  • Chest tightness may occur with or without the above symptoms
  • Chest pain
  • Wheezing is a whistling or hissing sound when breathing out.

Characteristic wheezing which may:

  • Be episodic with symptom-free intervals in between
  • Be worse during night and in morning
  • Disappear on its own
  • Be worsened by breathing in cold damp air
  • Be worsened with reflux
  • Begin suddenly without any definite cause

Asthma: Emergency Symptoms

Few important emergency symptoms are:

  • Bluish coloration of the lips and face.
  • Decreased level of alertness, such as severe drowsiness or confusion.
  • Extreme difficulty  in breathing.
  • Rapid pulse.
  • Severe anxiety due to shortness of breath
  • Sweating
  • Abnormal breathing pattern –breathing out takes more than twice as long as breathing in
  • Breathing temporarily stops
  • Tightness in the chest
  • Chest pain
  • Nasal flaring

Asthma: Prognosis and Complications

The prognosis of asthma is quite good and requires proper self-management by avoiding the allergy-inducing substances. The complications of asthma are severe.

Asthma prognosis is quite good. There is no absolute cure for asthma. Symptoms improve with passage of time. By following adequate medical treatment and proper self management, asthma can be controlled. Lifestyle alterations also prove effective in controlling the ailment.

  • Death
  • Decreased ability to exercise and take part in other activities
  • Lack of sleep due to nighttime symptoms
  • Permanent changes in the function of the lungs
  • Persistent cough

Asthma: Treatment

The treatment of asthma involves identification of allergens and their avoidance. The medication used are of two types=-quick relief causing and long term medicines for controlling the symptoms.

Since 90% of cases of asthma are due to allergy causing substances so the goal of asthma treatment is to avoid the asthma triggers.

Well, there are two types of medicines available for treating asthma:

  • Quick-relief drugs for use during attacks
  • Control drugs to prevent attacks

Some of the common control drugs are as follows;

  • Inhaled corticosteroids (such as Azmacort, Vanceril,etc) to prevent airways swelling.
  • Long-acting beta-agonist inhalers also help in controlling symptoms of asthma.

These drugs are used along with the inhaled steroids.
Other control drugs:

  • Omalizumab (Xolair), which blocks a pathway that the immune system uses to activate asthma symptoms
  • Cromolyn sodium (Intal) or nedocromil sodium (Tilade)
  • Aminophylline or theophylline (rarely used anymore)
  • Leukotriene inhibitors (such as Singulair and Accolate)

The important quick-relief drugs are:

  • Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, and Xopenex
  • Oral steroids (corticosteroids).

Asthma: Glossary

Here are mentioned explanation for some important words related to Asthma.

  • Asthma– Asthma is a chronic inflammatory disease of the respiratory airways.
  • Wheezing– Wheezing is a whistling or hissing sound when breathing out.
  • Intercostal Retractions- or the pulling of skin in the ribs while breathing
  • Allergen: A substance (such as a food or pollen) that your body perceives as dangerous and that can cause an allergic reaction.
  • Allergy: An exaggerated response to a substance or condition produced by the release of histamine or histamine-like substances in affected cells.
  • Anti-inflammatory: Medicine that reduces inflammation (swelling in the airway and mucus production)
  • Dander, animal: Tiny scales shed from animal skin or hair. Dander floats in the air, settles on surfaces, and is a major part of household dust. Cat dander is a classic cause of allergic reactions.
  • Inflammation: A response in the body that includes swelling and redness
  • Inhaler: See “metered dose inhaler (MDI)” or “dry powder inhaler (DPI)”
  • Inhalation: Breathing air into the lungs
  • Irritants: Things that bother the nose, throat, or airways when they are inhaled; irritants do not include allergens
  • Long term control medicine: A medicine that must be taken every day to control asthma symptoms; not used for quick relief.
  • Triggers: Things that cause asthma symptoms to start or become worse.