Asthma: Symptoms, Causes, Risks, Complications, Diagnosis, Treatment, Prevention and Prognosis

0
144
A little boy with an asthma inhaler

1Overview

Have you ever felt a sudden difficulty of breathing that affects your daily activities?
You might have bronchial asthma. Asthma is chronic and long-lasting respiratory disease. It is a condition wherein the airways narrow and become inflamed, making breathing difficult.

These attacks are called “flare-ups.” During flare-ups, the lungs respond to triggers,
and as a result, the muscles around the airway become tight, making the airways swell and become narrow. The lining of the airways produce mucus, and as a result, it will be hard to breathe. The air can’t effectively enter the airways.

For some people, asthma can be a small annoying disease to experience.
However, for other people, this lung disease could interfere with daily activities and even lead to potentially-fatal complications, like an acute asthma attack.

According to the American Academy of Allergy Asthma and Immunology, the number of people with asthma in the United States continues to grow. In fact, an estimated one in 12 people, or 25 million had asthma in 2009. That’s in comparison to 2001’s one in 14, or 20 million people.

Moreover, about 300 million people worldwide have asthma, with 250,000 deaths occur every year. The number of people with asthma will increase to more than 100 million by 2015. Asthma can’t be cured but the symptoms can be managed and the triggers can be avoided.

To understand asthma, it is a great help to know how the airways work. The airways are tubes that carry air into and out of the lungs. However, in people with asthma,
their airways become inflamed, causing less air to enter. The mucus produced tend to worsen the problem because it’s sticky, further narrowing the airways.

2Symptoms

The signs and symptoms of asthma results from the narrowed airways. These include:

  • Difficulty of breathing
  • Shortness of breath
  • Chest tightness
  • Chest pain
  • Trouble sleeping due to coughing or wheezing
  • Wheezing
  • Cough

The symptoms usually happen at night, during or after an activity and early in the morning. If asthma is controlled, expect just occasional flare-ups. Not all people experience these symptoms. Also, having these symptoms won’t automatically say that you have asthma. The doctor will decide if the patient has asthma based on the lung function tests, physical examination, and medical history.

When are the symptoms severe and require medical attention?

  • Asthma signs and symptoms are frequent
  • The symptoms interfere with daily activities
  • There is a need for a quick-relief inhaler more often
  • There is increasing difficulty of breathing

3Causes

The exact cause of asthma is still unclear, but many people with asthma often have relatives and family members who also have asthma. Other people have a family history of eczema and hayfever.

Also, the emergence of asthma may be probably due to a combination of inherited and environmental factors. These are called asthma triggers, which include:

  • Allergens such as pollens from trees, weeds, and grass
  • Allergens in the house like pet dander, dust mites, and mold
  • Respiratory infections like colds, the flu, and cough
  • Weather conditions like cold air or dry or wet weather
  • Stress
  • Irritants in the air like smoke and strong odors
  • Physical activity
  • Certain medications like beta blockers, ibuprofen, naproxen and aspirin
  • Strong emotions
  • Preservatives added to some foods
  • Gastroesophageal reflux disease (GERD) 

4Risk Factors

Asthma can happen to anyone even without any risk factors. However, it is less likely if there are no risk factors present. The following are the factors that may increase the risk of asthma:

Gender

Asthma, especially in kids occurs more frequently in boys than girls. The reason behind this is still unclear, but studies have suggested that the smaller size of young male’s airway compared to females is linked to asthma attacks.

The family history of asthma

Asthma can run in families. A person’s genetic makeup predisposes him or her to have asthma. In fact, about three-fifths of all asthma cases are inherited.

Other risk factors:

  • Having other allergic conditions like eczema or allergic rhinitis
  • Obesity or being overweight
  • Being a smoker
  • Exposure to secondhand smoke
  • Exposure to occupational triggers like chemicals
  • Exposure to air pollution

5Complications

Badly controlled asthma can affect the quality of life of those who have the condition. The illness may result in:

  • Problems with sleep, work or recreational activities
  • Permanent narrowing of the bronchial tubes
  • Emergency room visits or hospitalizations after severe asthma attacks
  • Fatigue
  • Sick days from school and work
  • Side effects of long-term use of some medications for asthma
  • Underperformance in work or school
  • Psychological problems like anxiety, stress or depression

Uncontrolled asthma may lead to the following complications:

  • Pneumonia or infection of the lungs
  • Status asthmaticus (severe asthma attacks that do not respond to treatment)
  • Lung atelectasis or collapse
  • Respiratory failure (low levels of oxygen and high levels of carbon dioxide)
  • Underperformance in work or school

6Diagnosis

To diagnose bronchial asthma, the doctor will conduct a complete and comprehensive interview for both medical and family history of the patient. After that, the doctor can perform a physical examination, noting if there is a current acute attack, which may manifest as wheezing upon auscultation of the lungs.

Personal, family and medical history

The doctor will ask questions about the symptoms and history of the illness. A history of allergies or eczema will also be asked because these can increase the risk of asthma.

Physical examination

The doctor will inspect the lungs through auscultation. If there is a present attack,
he or she may hear wheezing.

Lung function tests

Usually, doctors use these tests to determine one’s lung function. They are often done before and after inhaling a medicine called a bronchodilator, which helps open the airways. The most common tests include spirometry, trigger tests, and peak airflow test.

Other tests:

There are other tests to diagnose asthma, which include:

  • Methacholine challenge
  • Nitric oxide test
  • Sputum eosinophils
  • Provocative testing for exercise and cold-induced asthma
  • Imaging tests like x-ray and CT scan
  • Allergy testing

7Treatment

Since asthma can’t be cured, prevention and long-term control are important in stemming asthma attacks even before they start. The treatment of asthma involves learning to recognize what triggers these bouts and taking steps in avoiding them.

Understanding the treatment options of asthma will enable you to work with your doctor. This will help manage the disease and its symptoms each day. Furthermore, when you experience a flare-up, it’s important to know when to call your doctor to prevent its progression into an asthma emergency, which can be fatal.

Asthma Medications

Asthma has many medications. The right type of drugs for patients depends on the age, triggers, and symptoms. Most importantly, the drugs depending on what works best for the patient.

  • Long-term asthma medications

These are drugs that are taken to manage and control asthma.
The patient needs to take these medicines daily, to prevent asthma attacks.

Inhaled Steroids – Inhaled corticosteroids are anti-inflammatory medicines.
These medicines reduce the swelling in the airways. Some examples include budesonide, fluticasone, ciclesonide, beclomethasone, mometasone, and fluticasone.

Leukotriene modifiers – These medicines are taken orally to relieve asthma symptoms for up to 24 hours. The most popular drug under this group is montelukast.

Theophylline – Theophylline is taken daily, and it helps keep the airways open.

Long-acting beta-agonists – These are also in the form of inhalers.
The most common examples include formoterol and salmeterol.

  • Quick-acting medicines

These are also called rescue medications. These are used when you need to perform an activity or exercise. Some examples include short-acting beta-agonists, ipratropium, and oral or intravenous corticosteroids.

  • Bronchodilators

Bronchodilators relieve the symptoms of asthma by relaxing the muscles that become tight around the airways. They are used to open the airways.

8Prevention

One of the best ways to manage asthma is to prevent and avoid its triggers. Many common asthma triggers can set off or even worsen the asthma symptoms. If you have identified which triggers can cause asthma bouts, you can effectively reduce the chances of experiencing attacks.

  • Follow the asthma action plan you devised with your doctor. This plan will contain the schedule of your medications and manage the symptoms.
  • Get vaccinated for both pneumonia and influenza.
  • Avoid asthma triggers – cockroaches, dust, pollen, molds, and smoke.
  • Monitor your breathing. Identify symptoms of an impending asthma attack to be able to take the needed medicine accordingly.
  • Take your medications as prescribed.
  • Avoid strenuous activities and those involving high-intensity exercises (though exercise in moderation can help manage asthma).

9Prognosis

The success of treatment in people with asthma depends on how well he or she manages the disease. Most people with asthma can control the condition if they have an asthma action plan created with a healthcare professional.

The patients should follow the treatment regimen properly and carefully. The prognosis is good for controlled asthma. People who do not seek medical care are more likely to have frequent asthma attacks.

In children, there is a greater chance of overcoming asthma if treatments are properly done to manage the symptoms of the disease. If the treatments are followed properly, there is a lesser risk of the disease affecting daily activities.