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The word "asthma" originates from the Greek word, ásthma that means, "panting.” Asthma is a medical condition in which the airways swells and produces extra mucus that can make breathing difficult. Because of the inflammation and the extra mucus, it can trigger shortness of breath and wheeze or coughing.
Documented as early as Ancient Egypt, Asthma can be either a minor nuisance or life-threatening. In asthma, the inside walls of the airways get inflamed so that lesser air can pass through them from and to the lungs making breathing a difficult exercise. This swelling can also make the airways really sensitive and increase a person’s susceptibility to allergic reactions.
Asthma has been on the rise significantly since the 1960s and now according to WHO estimate, around 300 million people suffer from asthma worldwide. In fact Asthma is one of the most common chronic childhood illness.
Symptoms of Asthma-
The symptoms of asthma vary. But what most people with asthma have in common is the extreme airway sensitivity because of triggered airway inflammation. Some people have frequent asthma attacks, some people experience asthma only during certain times, some people have it all the time and some people only experience it infrequently.
Common asthma signs and symptoms include:
- Wheezing or coughing
- Shallow breathing
- Throat infection
- Faster heart rate
- Trouble in sleeping
- Difficulty in speaking
Types of Asthma-
Normally people suffering from an asthma attack tend to have a whistling or wheezing sound when exhaling. There are different types of asthma. Some of the most common types of asthma are:
1. Exercise-induced asthma
Also called exercise-induced bronchoconstriction, this type of asthma is induced by strenuous exercises and can cause symptoms like coughing, wheezing, shortness or breath and other symptoms. These symptoms may worsen when the air is dry and cold and usually get triggered during or after an exercise.
2. Occupational asthma
As the name suggests, occupational asthma is triggered by breathing in certain chemical fumes, dust, gases, or other kinds of exposure to allergens at the workplace.
3. Allergy-induced asthma
Allergy-induced asthma is the most common type of asthma, which is triggered by common airborne allergens like pollen, mold spores, dust mites, or particles of skin.
What Are Causes of Asthma?
Although the causes are not particularly clear and anyone can get asthma at any age, it is more common childhood ailment. The studies are still underway to prove a clear asthma cause but according to the researches this disease is believed to be caused by a blend of genetic and environmental factors. Genomics, which is the study of how a person’s genes interrelate with environmental factors, may be the key to understanding why certain people are more prone to asthma than others.
Asthma triggers can differ from person to person and the key is to know what irritants trigger your asthma to ensure minimized exposure to it. Some generic asthma signs and symptoms can include:
- Cold air
- Exercise and other physical activities
- Common cold and other respiratory infections
- Airborne substances like pollen, mold spores, pet dander, cockroach waste, dust mites, etc.
- Airborne substances, such as pollen, dust mites, mold spores, pet dander
- Certain chemicals and air pollutants (smoke)
- Certain preservatives (added to food and beverages)
- Gastroesophageal reflux disease (GERD)
- Certain medicines like aspirin, ibuprofen, etc.
There are several risk factors that can increase your chances of developing asthma including:
- Genetics. Having a family especially a blood relative suffering from asthma
- Having other allergic condition (hay fever)
- Exposure to secondary smoking
- Obesity (people who are overweight are at a greater risk of developing asthma)
- Exposure to increasing amount of smoke or other pollutants
- Occupational triggers
- Stress and anxiety
Diagnosis of Asthma-
Even though it is a common childhood disease, it doesn’t mean, as an adult one cannot develop it. If a person is feeling any of the symptoms whether a child or an adult, it is always a good idea to get checked to know for sure if you have asthma. Asthma symptoms can come and go since it is a ‘variable’ disease.
It is also important to not do self-diagnosis, as some symptoms, which may look like asthma triggers, may not be actually asthma-like persistent cough caused by other diseases like certain heart diseases and chronic obstructive pulmonary disease (COPD).
Effective diagnosis of Asthma depends upon its classification. There are four different classifications of Asthma:
Classification of Asthma
- Mild intermittent – It is a mild case of asthma if the symptoms last only for up to two days a week, symptoms flaring up mainly at night and asthma lasting not more than two nights in a month.
- Mild persistent – Mild persistent asthma is when the symptoms can occur twice in a week but not more than one episode per day.
- Moderate persistent – This happens when a person experiences symptoms once a day and in excess of one night a week.
- Severe persistent - Symptoms can last throughout the day and frequently at night on most days.
Diagnosis of Asthma
1. Physical test
The doctor would want to rule out other possible condition through a physical exam to get to know the signs and symptoms.
Some lung function tests can help in determining how the lung in functioning in a person.
One of the most common pulmonary function tests, spirometry measures lung function by checking the amount of air a person can inhale and exhale after deep breaths.
3. Peak flow
The peak expiratory flow is a pulmonary device that can measure the maximum speed one can breathe out. If the readings are low, it may be a sign that the person’s lungs are not working properly and could be a potential sign of asthma.
These tests can be done with a medicine called as bronchodilator (albuterol) to check if the lung functions better with the medication. If the test gets better after the use of bronchodilator, then it is highly likely for a person to suffer from asthma
Additional tests and Diagnosis For Asthma
Other tests that may be required to diagnose asthma include:
1. Methacholine challenge-
Methacholine is considered an asthma trigger and so when it is inhaled it can cause mild constriction of the airways. Most people who have asthma are likely to react to methacholine. Doctor could use this test to determine whether you have asthma.
2. Imaging tests-
Certain imaging tests like x-rays and CT scan can help in identifying certain abnormalities that might be causing breathing issues.
3. Allergy testing-
Most allergy tests can help in identifying allergy to triggers like pollen, dust, etc.
4. Sputum eosinophils-
This test can help in identifying the while blood cells in the mucus to see if asthma is present or not.
5. Nitric oxide test-
For people whose airways are inflamed, they may have higher nitric oxide level than normal which may be able to help in identifying whether the person is suffering from asthma or not.
7. Provocative testing for exercise and cold-induced asthma-
As the name suggests, in this a person is made to perform vigorous physical activities in a controlled environment to check for the triggers.
Treatment of Asthma-
Although there is no known cure available for asthma and it is generally a life-long condition, treatment can control asthma symptoms so a person can lead a normal life. Also when it comes to asthma, there is no one-size fit all treatment methodology. The idea is to understand the triggers that worsen your symptoms, taking steps to avoid them and taking the medication on time to keep asthma in check.
Inhalers are medical devices, which are used for supplying medication into the body through the lungs. There are three types of inhalers. These are:
- Reliever Inhalers: These inhalers are used for the purpose of relieving symptoms at the time of asthma attack. Normally reliever inhalers don’t have many side effects, in some people they may increase heart beat and induce shaking.
- Preventive Inhalers: True to their name, this types of inhalers are used to stop the symptoms from developing.
- Combination Inhalers: If either of these kinds of inhalers doesn’t work for a person, they would need an inhaler that would both relieve the attack and prevent it from happening again.
2. Tablets -
If inhalers don’t work to control the symptoms, one may also use tablets.
Leukotriene receptor antagonists (LTRAs)
LTRAs are the oral tablets prescribed for asthma and are also available in syrup and powder forms. It can be taken every day without many side effects. However, some people may experience some side effects including headaches and stomach pain.
If LTRAs tablets cannot be prescribed for some reasons or is not working, doctors may also prescribe Theophylline. It should be taken every day.
- Steroid tablets-
Steroid tablets are given to give relief from an asthma attack. Long-term usage of steroid tablets for is not recommended unless a person is suffering from severe asthma and if inhalers aren’t handy controlling the symptoms. Some possible side effects of using steroid tablets for long-term are mood swings, fragile bones, high blood pressure, etc.
Other treatments for Asthma
Other treatments like surgery or injections may be required in case other treatments don’t work for a person.
For certain people with severe asthma, some injections like omalizumab, mepolizumab, or reslizumab may be able control the symptoms. For some severe asthma patients, injections are prescribed every few weeks in order to control the symptoms. However, these injections should be taken only under the prescription from an asthma specialist, as these injections may are not advisable for every asthma patient.
For some people for whom treatments like inhalers, tablets, and injections don’t work or in certain cases cannot be administered, a surgical procedure called bronchial thermoplasty can be used. In this treatment, a flexible thin tube is passed down the throat into the lungs and heat is used to warm up muscles surrounding the air controlling nerves to stop causing asthma-like symptoms.
However, this process is fairly new and so much research has not been done on its long-term relief.
There are many complementary therapies that can help ease the symptoms, prevent asthma from happening, and help strengthen the lungs and the airway muscles. However, before incorporating any of these therapies in your lifestyle, it is always best to check with your asthma specialist first. These therapies include
Certain breathing exercises including yoga
- Alternative medicines like homeopathy, chiropractic, and Ayurveda
- Dietary supplements
- Certain traditional Chinese medicine
Common Myths About Asthma
Myth #1: Asthma is a psychological disease
One of the biggest beliefs that many people have is that asthma is psychological and thus they don’t believe in getting medical help. Since asthma affects the airways it is to be noted that is not psychological as it causes the immune system and the lungs to behave erratically when it comes to certain triggers.
Myth #2: Asthma medications lose their effectiveness over time
Asthma meds don’t lose their effectiveness over time and can be used for long-term if the right doses are taken as directed.
Myth #3: People with asthma should avoid physical activity
Although strenuous exercises can sometimes induce asthma, simple exercises can keep a person fit and healthy and help them lead a normal life.
Myth #4: You can outgrow asthma
Some asthma symptoms may improve over time. People also learn how to deal with asthma better as they age since they know what triggers it and what doesn’t. However, there is no outgrowing asthma because it is a lifelong condition.
Myth #5: Asthma Is Easy to Control
Asthma can be easy or difficult to control depends on the kind of asthma a person is suffering from and the triggers. Although even in mild form of asthma, the treatment is required to give the necessary relief to a person to reduce flares and maintain proper lung functions.
Allergic bronchopulmonary aspergillosis (ABPA) is a allergic manifestation to the fungus Aspergillus sp. Patient with underlying Bronchial Asthma or Cystic Fibrosis are more susceptible to this. The patient may be having severe symptoms of asthma which respond poorly to inhaled medications.
This fungus is very commonly found in the surroundings and is referred to as mold. It is found at various places like soil, water, air and even on decaying matter. This fungus has the characteristic feature of spore formation and these spores are inhaled commonly from the air, without causing any disease or discomfort.
The fungus enters the body and produces colonies by inhabiting the airways. But the presence of Aspergillosis in the lungs does not always indicate an infection. In people with weakened immunity, this fungus enters the lungs and produces an acute infection that spreads along the respiratory tract. An allergic response given by the immune system to the Aspergillus fungi causes the allergic bronchopulmonary aspergillosis.
Symptoms of this disease are as follows:
1. Frequent cough
2. Brown colored mucus while coughing
3. Hemoptysis (blood in cough)
4. Difficulty in breathing
5. Wheezing sounds from the chest
6. Lethargy and weakness
7. Tightness of the chest In case of an asthmatic patient, if asthma is in a poorly controlled state, this condition is most likely to develop.
People suffering from asthma can contract ABPA when the medications are unable to control asthma. ABPA can also occur with cystic fibrosis which is a condition that has a genetic basis.
Diagnosis of this condition is difficult. It is usually diagnosed on the basis of the symptoms experienced by the patient. Certain specific tests like lung function tests (spirometry) can be carried out to evaluate the breathing capacity of the lungs.
An evaluation of the levels of the immunoglobulin IgE is also required. In conditions that are related to allergic responses from the immune system, it is observed that the levels of IgE are raised than above normal.
However, in ABPA the levels of the immunoglobulin IgE rise to a very high count. Monitoring of the IgE levels is done regularly during the management of ABPA. Chest x- rays do not help in the diagnosis of this disease. While treating ABPA, the evaluation of the immunoglobulin levels is done regularly. To relieve inflammation corticosteroids can be given.
Treatment of ABPA is Oral corticosteroids and in case of steroid dependence or persistent symptoms consider adding antifungal. Also, to treat the fungal infection, anti-fungal medications are prescribed. Repeated episodes of ABPA require more targeted treatment. Itraconazole is the anti-fungal drug which is effective in treating the fungal infection.
Asthma is a condition marked by the swelling and narrowing of the airways thus, producing excess mucus. This triggers coughing, breathing difficulties and wheezing. Asthma can be a minor inconvenience for some, while for others, it can often result in a deadly asthma attack.
It isn’t definite as to what causes asthma in some and not in others, but a combination of genetic and environmental factors is a probable reason. Factors that trigger asthma is varied, and is subjective. Some common causes of asthma include:
- Airborne matters, such as cockroach waste particles, pet dander, mould spores, dust mites or pollen
- Respiratory infections
- Physical activity
- Cold air
- Irritants (such as smoking) and air pollutants
- Some medications, such as naproxen, ibuprofen, beta blockers and aspirin
- Stress and strong emotions
- Preservatives and sulphites added to some beverages and food, such as wine, beer, processed potatoes, dried fruit and shrimp
- Gastroesophageal reflux disease (Stomach acids retreat into the throat)
- Breathing difficulties
- Chest pain or tightness
- Trouble sleeping due to breathing problems, wheezing or coughing
- A wheezing or whistling sound at exhaling
- Wheezing or coughing attacks that are aggravated by respiratory virus, such as flu or cold
Complications associated with asthma include:
- Symptoms and signs that interfere with recreational activities or school work
- Sick days from work or school when asthma flares up
- Persistent contractions of the bronchial tube that can lead to problems in breathing
- Hospitalisation and visits to the emergency room during critical asthma attacks
- Long-term consumption of certain medications to fix severe asthma can cause side effects
Long-term control and prevention are the main goals of asthma treatment. Treatment generally applies learning about the things that trigger your asthma, taking necessary steps to dodge them and checking your breathing to ascertain that your regular medications are effectively controlling your asthma. Inhaled corticosteroids, long-acting beta agonists, theophylline are some common long-term treatments to control asthma.
Medicines are prescribed based on your symptoms, age, triggers and what best keeps your asthma regulated. Also, you and your doctor need to work together to come up with a plan to counter your asthma. For example, if you think your symptoms are getting better, consult with your doctor to reduce your medication doses.
Sir, I am suffering from allergic problem in my breath last long time and my age 27 years. I am really trouble so what can I do basically I am using montair LC but I want a permanent solution it is possible. Sir I belongs to a poor family we do not have enough money, tablet also costly.
Hello Doctor, I am having cough & cold problem due this I am facing breathing problems as well. I am allergic to most of the things like dust, perfume, smoke, some food smells like desi ghee pineapple etc. I have gone many treatment but there is no result. My nose get blocked or start running due to temperature change, I usually start sneezing. To cure this I start taking hot drinks & food but that causes heartburn & white discharge even I am having problems with digestion. I had tried allopathic, homeopath & home therapy as well but after one or two doses there is no effect of medicine on my body. It causes weakness as well. What are the treatment that I can go through to get a proper results.
I am using aerocort Inhaler once or twice a day since 10 years. Now My department free medical facility clinic has given FORACORT 200. PLEASE ADVICE CAN I USE FORACORT 2OO?
Hi, Which specialist to show for dust mite allergy. I've asthma too. I'm having issues such as itching in eyes, watery eyes, swollen eyes, noise while sleeping, shortness of breath, running nose.
My age 24 years old I am female. I am an asthmatic patient. Fomtide and tiova inhaler are used now. Tablets are not used then ok.
Asthma is a condition characterized by wheezing and difficulty in breathing. Asthma is a common disease that affects children, teenagers and adults alike. Depending on what triggers an asthmatic attack, asthma can be categorized as four types. These are:
- Allergic asthma: This sort of asthma usually begins in childhood and is caused by the overproduction of immunoglobulins as a reaction to the allergen. This type of asthma can also be passed on from one generation to another through genes.
- Infective asthma: This is caused by viral bronchial or upper respiratory tract infections. It is not hereditary.
- Emotional asthma: Some cases of asthma can be triggered by psychological factors such as stress, grief or anxiety. However, it is not clear if this is the sole trigger for asthma.
- Occupational asthma: Exposure to metallic dusts, biological detergents, polyurethane, etc. can also trigger asthmatic attacks. This type of asthma is called occupational asthma.
A homeopath will not only determine the type of asthma, but will also delve into a detailed medical history of the patient before prescribing medication. Some forms of homeopathic medication that can be used to treat asthma are:
- Lpecac: This is used to treat asthma in cases where the difficulty breathing is accompanied by a feeling of heaviness over the chest, dyspnoea, constant coughing with no expectoration and cold perspiration. It is often aggravated by motion.
- Arsenicum: Asthmatic attacks that begin in the middle of the night and are accompanied by restlessness and anguish can be treated with arsenicum. This is especially beneficial in cases of chronic asthma in elderly people and habitual dyspnoea.
- Nux vomica: This is used mainly to treat asthmatic attacks triggered by gastric troubles or be excessive intake of coffee and alcohol. A constricted feeling around the lower part of the chest is another symptom of this type of asthma.
- Kali bichromicum: Asthmatic attacks that wake a patient up in the wee hours of the morning compelling him to sit up, in order to be able to breathe can be treated with Kali bichromicum. A stringy yellow mucus expectoration is another symptom of this type of asthma. It can also be used as an effective form of treatment for asthmatic attacks caused by nervousness.
- Natrum sulphuricum: This is used to treat asthmatic attacks caused by a change in weather. In such cases, the asthmatic attack is accompanied by diarrhea and greenish expectoration. It is usually worst in the early mornings.