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Dr Pengovile Ltu
Chest Physician, Department of Medicine, CIHSR
Ever hear the term “bronchial asthma “and wonder what it means? When people talk about bronchial asthma, they are really talking about Asthma.
So What really is Asthma?
Asthma is a long term problem in the bronchial tubes (windpipes) that carry air into your lungs that can make it hard for you to breathe. It is characterized by inflammation of the bronchial tubes with increased production of sticky secretions insidethe tubes. This airwaygets so narrow that air can’t move freely. People with asthma experience symptoms when the airways tightened, inflamed and/ or filled with mucus.
What are the common symptoms of asthma?
. Coughing
. Wheezing (whistling sound)
. Shortness of breath
. Chest tightness
Not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your asthma symptoms may also vary from one asthma attack to the next, being mild during one and severe during another. In children,all asthma may not wheeze. Chronic coughing with asthma may be the only obvious sign, and a child’s asthma may go unnoticed if the cough is attributed to recurrent bronchitis.
Some people with asthma may be symptoms free for a long time (periods of remission), interrupted by periodic worsening of their symptoms called asthma attacks. Others might have asthma symptoms everyday (chronic). Although most people can control their asthma symptoms, but as such there is no cure.
Early warning signs of asthma.
It is important to recognize the early warning signsso that you can stop an asthma attack or prevent it from getting worse. These signs include frequent cough especially at night, losing your breath easily, feeling very tired,wheezing or coughing after exercise, signs of a cold or allergies like sneezing, running nose, nasal congestions,decrease or changes in lung function as measured in the Peak flow meter.
What are the triggering factors of asthma?
. Smoking, secondhand smoke
. Infections such as colds, flu
. Allergens such as dust mites, pet dander’s, molds, pollens, cockroaches, food such as peanuts , eggs, fish
. Exercise
. Air pollution and toxins
. Weather, especially extreme changes in temperature
. Drugs (NSAIDS, aspirin,beta blockers)
. Food additives such as MSG
. Emotionalstress,anxiety,singing, laughter or crying
. Perfumes and fragrances
. Acid reflux
Allergies are strongly linked to asthma. It may co-exist with conditions like Allergic rhinitis, Atopic dermatitis. Those who had both allergies and asthma are much more likely to have nighttimeawakening due to asthma, miss work because of asthma and require more medications to control their symptoms. Some occupations can raise your chance of having asthma as an adult, such as working in a factory or another place where you are regularly around and breathing in chemicals or dusts. Although exercise is good for you, physical activity can trigger symptoms for many people. This is called exercise- induced asthma. Fortunately, you can control the asthma so that you don’t have to give up your work out, sports, or other activities you enjoy.
Who gets asthma?
Typically, it develops during childhood but it can affect you at any age, most children have their first asthma symptoms by age 5. People who have allergies or parent or close family member with asthma are more likely to have asthma. More boys have asthma than girls, but its more common in women than in men.
What are the important tests for asthma?
1. Spirometry: A lung function test to measure breathing capacity and how well you breathe. You will breathe into a device called a spirometer.
2. Peak expiratory flow (PEF): By using a simple device called Peak Flowmeter, (youjust have to blow hard into this device) to measure how well air is moving out of your lungs. This can be done at home by yourself. A change in your Peak flow score can warn you that an asthma attack might happen soon or your asthma is getting worse. Your doctor will teach you how to use it.
3. Chest X- Ray: This is done to rule out any other lung diseases that may be causing similar symptoms.
These tests are available at CIHSR.
Treatment
Avoid asthmatriggers:It is the first step to manage asthma. You may need to stay indoors when the smog index is high or get special bedding to combat dust mites. The most effective way to fight the allergens in your home is to remove their sources and places they gather.That can include pets, carpets, upholstered furniture, dust regularly and use a vacuum cleaner.
Your doctor can help you plan a written Asthma Action Plan for you.
Asthma treatment can vary in the form of Inhalers with or without Oral medications.
Long term or Controller medications:It is virtually impossible for someone with asthma to avoid all their triggers all the time. Many people need to take medicines every day to prevent asthma attack. These are used for regular maintenance treatment. They reduce airway inflammation, control symptoms, and reduce future risks such as exacerbations(attacks) and decline in lung function. Drugs called corticosteroids are the most effective medications. They work by bringing down inflammation in your airways, which makes them less sensitive to allergens and irritants in the air.
Quick relief or Reliever medications for asthma attack: Even when you use long term medication, asthma symptoms sometime flare up. Rescue inhalers likeshort-acting beta agonists can quickly relax the tightened muscles around your airways, so air can flow in and out of your lungs. One can carry the Inhaler with them for emergency use.
There are add-on therapies for people with severe asthma, it may be considered when symptoms are persistent and there are attacks despite the treatment with the combination of high dose of corticosteroids with bronchodilators.
Even though a lot of people have apprehensions to use Inhaler, all asthma drugs ideally should be taken through the Inhaled route as much lower dose is required through this route and targeted therapy to the airway is attained with much lesser side effect.
In conclusion, Asthma can be well controlled with regular treatment, one can expect to have normal activities including exercise.
