Asthma, a disease of lungs and airway.
Asthma is a long-standing lung disease that causes inflammation and constriction of the airways passage. Asthma includes frequent phases of wheezing (a whistling sound on breathing), chest stiffness, shortness of breath, difficulty in breathing and coughing.
In some cases, asthmatic attacks are seen only on physical exercise. While asthma symptoms in a healthy individual are common while doing exercise that can also be called as exercise-induced asthma. So, stay active, stay healthy don’t let asthma conquer you. Take help of your physician to develop a management plan to keep your symptoms under control.
Asthma not only affects adults but children too. In the US about 25 million people are affected by asthma of these 7 million are children. Surprised, yeah that’s true. Basically, asthma is a type of allergic reaction and thus it has been divided into some types according to the type of allergen that causes it.
People with a family history of allergies are more prone to asthma. sometimes people with asthma also have allergies. This is called allergic asthma.
Occupational asthma is mainly caused by inhaling fumes, gasses, dust or other potentially harmful substances at your workplace.
Millions of children and their families are affected by this. In fact, you will be surprised to know that the children affected are 5 years of age.
Till date, our science has not found the exact asthma treatment, but yes if diagnosed and properly treated asthma patients can live a wholesome life.
An allergist\immunologist is the best one who can help you with this, that can easily diagnose your condition and guide you regarding your daily needs and thus help you lead a normal life.
Causes of Asthma
Many factors are responsible for worsening of the asthmatic condition. Your doctor is the best one who can guide you to dis triggering factors.
These may include:
- Allergens can be any like dust, animal fur, cockroach, mold, and even pollens from tress, grass or either flower.
- Irritants may be some nearby things such as cigarette smoke, pollution, dust from the work place or either routine home décor products like hairspray, perfume etc.
- Medicines are also a cause like aspirin or other Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) or Non-selective beta blockers.
- Foods and drinks containing sulfites.
- Viral infections of upper respiratory tract such as cold.
- Physical activity like exercise or running.
Some other conditions can also make asthma worse like a runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea. You need to consult your doctor regarding this and discuss your problem and get a required treatment plan.
Symptoms of Asthma
The most common symptom of asthma is wheezing. It is scratchy and you can hear a whistling sound on breathing. Other symptoms include:
- Trouble sleeping due to coughing or wheezing
- chronic coughing
- pain in chest or tightening of the chest
- shortness of breath
Children with asthma may show the same symptoms as adults with asthma. In some children, chronic cough is seen as the main symptom.
If your child is having any of such symptoms then do consult your immunologist soon. The symptoms are:
- constant coughing that can be worsened by viral infections or the child happens to have to cough while asleep or early morning or while performing an exercise.
- a whistling sound on exhalation.
- either rapid breathing or shortness of breath while doing exercise.
- your child starts to avoid sports or other activities.
- problems feeding or grunting during feeding (infants)
- your child may happen to slow down in his routine activities and experiences fatigue soon.
- chest tightness (a young child may say that his chest “hurts” or “feels funny”)
- incomplete sleep due to coughing or breathing difficulties.
Asthmatic symptoms have a pattern in their symptoms like they may occur at night or early morning, or might be during certain seasons, during laughing or crying harder, during or after exercise, or when exposed to asthma triggers. You need to know them with the help of your consulting allergist/immunologist.
Diagnosis of Asthma
The diagnosis of asthma is based on the medical history, family history, physical examination of the patients and the results of various tests conducted on the patient.
- When and why would you need an immunologist for asthma?
- In a case when you have life threating asthmatic attack?
- When do you start getting more medicines for your asthma attacks?
- In the case of family history of asthma or either medical history?
You may have questions by your doctor regarding your family history of asthma or might be about your frequency and time of the asthmatic attack.
You need to tell your doctor whether your symptoms occur at day or night.
You have to let him know regarding the trigger factors that cause the attack, what factors worsen your condition and even any other psychological stress, runny nose, depression, exercise whatever might be the reason for your attack your doctor needs to know.
The doctor might diagnose your condition like wheezing, runny nose, or your breathing pattern.
Lung function tests: Spirometry is a test used to check the condition of the lungs. It helps measure the breathing capacity of your lungs. And the speed with what you can blow out air. Your doctor also may give you medicine and then test you again to see whether the results have improved.
Some other tests might be required to confirm the diagnosis:
To find the allergen that affects you
To find out how sensitive your airways are. Using spirometry, that measures the amount of cold air on a chemical you breathe in. Bronchoprovocation is a test to confirm whether you are having another condition with symptoms like acid reflux disease, vocal cord dysfunction, or sleep apnea that are similar to asthma symptoms.
A chest x-ray or an ECG (electrocardiogram)
To find out any foreign body present inside your lungs. Chest x-ray or an ECG (electrocardiogram) is also used to rule out any other condition rather than Asthma.
Diagnosing Asthma in Young Children
As we said earlier the frequency of asthma is seen is children below 5 years of age. At such age group, it becomes difficult for us to diagnose the condition because such symptoms can be seen in other diseases too. Might be some children wheeze in cold or during some respiratory infections but that does not prove they are asthmatic if they are above 6 years of age, might be because of smaller airway passage it would be wheezing, but this condition corrects with increasing age.
The chances of a young child having asthma are:
- The child has allergic reactions to pollens or other airborne allergens
- The child wheezes even when he or she doesn’t have a cold or other infection
- The child has signs of allergies, including the allergic skin condition eczema
- One or both parents have asthma
The most certain way to diagnose asthma is a lung function test, a medical history, and a physical exam. However, it’s difficult to do lung function tests in children younger than 5 years. Hence, doctors must depend on children’s medical histories, signs and symptoms, and physical exams for proper diagnosis. Doctors similarly may give asthma medicines to see how well a child responds.
Treatment of Asthma
There is no cure for asthma but yes with proper guidance and following instructions and treatment protocols of the doctor asthmatic patients can lead a normal life. You just need to take care of the triggering factors that affect you the most.
Your initial treatment plan depends on the severity and the follow-up asthma treatment will depend on how well your asthma action plan is controlling your symptoms and preventing asthma attacks.
Two types of drugs are available to treat asthma. First is long-term control and the second one is quick-relief drugs. Long-term control drugs may help decrease airway inflammation whereas Quick-relief, drugs decrease sudden onset asthma symptoms.
A list of some controller medications is given below:
- Inhaled corticosteroids such as fluticasone, budesonide, mometasone, ciclesonide, flunisolide, beclomethasone.
- Asthma inhalers contain an inhaled corticosteroid along with a long-acting beta-agonist that are helpful in opening your airways such as fluticasone + salmeterol, budesonide + formoterol, and mometasone + formoterol. Long-acting beta-agonist should never be prescribed without asthma inhalers to treat asthma.
- A combination of Montelukast, Zafirlukast, and Zileuton.
Some quick-relief drugs are used to rapidly relax and open the airways to eliminate symptoms during the sudden onset of asthma.
Oral and intravenous (I.V.) corticosteroids such as Prednisone and Methylprednisolone may be mandatory for sudden onset of asthma or for severe asthma symptoms. But on the extensive use, they may cause serious adverse effects.
Along with medications you also need to take proper measures to prevent chronic symptoms like coughing and shortness of breath, reduce need for quick-relief medicines, maintain good lung function and try to prevent asthma attacks that can result in an emergency room visit or hospitalization.
In a case of children aged 10 or older—and younger children who are able—should take an active role in their asthma care and their parents need to be attentive towards their medications and triggering factors.
Visit the AAAAI Drug Guide for a complete list of medications commonly used to treat asthma.
In a case of pregnancy, you don’t have to worry about your medication, you can take your medicines because if not taken it can be harmful to you and your baby also. Consult your doctor and discuss with him regarding your pregnancy and related medications.
Asthma patients are at a risk of developing influenza and pneumonia, so they need to get vaccinated annually.
Asthma treatment for definite groups of children, pregnant women, or those having asthma symptoms on workout requires distinctive needs.
In a case of uncontrolled asthmatic attacks, the doctor needs to increase the dose of medicines. On great control for several months, your doctor may reduce your medicines. These alterations to your medicine will help you conserve the best control potential with the minimum amount of medicine required.
Proper treatment and appropriate management plan these patients and lead a normal and better life.