Asthma — Know It All!

Editorial

All you need to know about Asthma.

Know your ailment well, so you can manage it better!!

Here we come with Asthma today!

What is Asthma?

Asthma is a disease that narrows and swells the airways and can create excess mucus. This can find it hard to breathe and cause coughing, a whistling sound (wheezing) and shortness of breath as you breathe out.

Asthma, for certain individuals, is a mild annoyance. For some, it may be a big concern that interferes with everyday lives and can lead to an asthma attack that is life-threatening.

It is difficult to cure asthma, but its effects can be managed. Since asthma frequently varies over time, it is crucial to consult with your doctor to control your signs and symptoms and, if appropriate, to alter your medication.

What causes Asthma?

Your risk of developing asthma can be improved by a variety of factors. They include:

These are classified as atopic disorders for an asthma-related disease such as eczema, a food allergy or hay fever.

  • Having a family history of atopic disorders or asthma
  • Bronchiolitis is a common lung infection in infants.
  • Tobacco smoke sensitivity as an infant
  • Smoking through your mother’s birth
  • Premature pregnancy (before 37 weeks) or reduced birth weight
  • Any individuals can also, from their profession, be at risk of contracting asthma.

Triggers with Asthma

  • In reaction to a cause, asthma symptoms frequently emerge. Usual causes include:
  • Infections such as colds and measles
  • Allergies such as pollen, dust mites, hair or feathers in animals
  • Pollution, smoke and fumes
  • Medicines such as ibuprofen and aspirin, especially anti-inflammatory painkillers,

Feelings, like fear, or laughter

Climate, such as rapid temperature swings, cold air, wind, hurricanes, heat and humidity

Mold or Humidity

Practice

Trying to stop them will better regulate the symptoms of asthma until you know the causes.

Work-related asthma

  • Asthma is associated with chemicals you might be exposed to at work in certain situations. This is listed as workplace asthma.
  • Many of the most prominent causes of asthma at work include:
  • Isocyanates (chemicals often found in spray paint)
  • Flour and Ashes of Grain
  • Colophonies (a substance often found in solder fumes)
  • Latex
  • livestock
  • Dust from wood

Examples of people who may have a greater chance of being exposed to these chemicals include paint sprayers, bakers, pastry makers, nurses, chemical workers, animal handlers, wood workers, welders and food service workers.

What are the types of Asthma?

There are several forms of asthma that are distinct. Bronchial asthma, which affects the bronchi in the lungs, is the most common form.

Childhood asthma and adult-onset asthma have additional types of asthma. Symptoms do not manifest in adult-onset asthma until at least the age of 20.

Below is a description of other particular types of asthma.

Allergic asthma (extrinsic asthma)

Allergens trigger this common type of asthma. These might include:

  • pet dander from animals like cats and dogs
  • food
  • mold
  • pollen
  • dust

Allergic asthma is often seasonal because it often goes hand-in-hand with seasonal allergies.

Nonallergic asthma (intrinsic asthma)

Irritants in the air not related to allergies trigger this type of asthma. These irritants might include:

  • burning wood
  • cigarette smoke
  • cold air
  • air pollution
  • viral illnesses
  • air fresheners
  • household cleaning products
  • perfumes

Occupational asthma

Occupational asthma is a type of asthma induced by triggers in the workplace. These include:

  • dust
  • dyes
  • gases and fumes
  • industrial chemicals
  • animal proteins
  • rubber latex

These irritants can exist in a wide range of industries, including:

  • farming
  • textiles
  • woodworking
  • manufacturing

Exercise-induced bronchoconstriction (EIB)

Exercise-induced bronchoconstriction (EIB) usually affects people within a few minutes of starting exercise and up to 10–15 minutes after physical activity.

This condition was previously known as exercise-induced asthma (EIA).

Up to 90 percent of people with asthma also experience EIB, but not everyone with EIB will have other types of asthma.

Aspirin-induced asthm

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Aspirin-induced asthma (AIA), also called aspirin-exacerbated respiratory disease (AERD), is usually severe.

It’s triggered by taking aspirin or another NSAID (nonsteroidal anti-inflammatory drug), such as naproxen (Aleve) or ibuprofen (Advil).

The symptoms may begin within minutes or hours. These patients also typically have nasal polyps.

About 9 percent of people with asthma have AIA. It usually develops suddenly in adults between the ages of 20 and 50.

Nocturnal asthma

In this type of asthma, symptoms worsen at night.

Triggers that are thought to bring on symptoms at night include:

  • heartburn
  • pet dander
  • dust mites

The body’s natural sleep cycle may also trigger nocturnal asthma.

Cough-variant asthma (CVA)

Cough-variant asthma (CVA) doesn’t have classic asthma symptoms of wheezing and shortness of breath. It’s characterized by a persistent, dry cough.

If it’s not treated, CVA can lead to full-blown asthma flares that include the other more common symptoms.

What are the symptoms of Asthma?

According to the leading experts in asthma, the symptoms of asthma and best treatment for you or your child may be quite different than for someone else with asthma.

The most common symptom is wheezing. This is a scratchy or whistling sound when you breathe.

Other symptoms include:

• Shortness of breath

• Chest tightness or pain

• Chronic coughing

• Trouble sleeping due to coughing or wheezing

Asthma symptoms, also called asthma flare-ups or asthma attacks, are often caused by allergies and exposure to allergens such as pet dander, dust mites, pollen or mold.

Non-allergic triggers include smoke, pollution or cold air or changes in weather.

Asthma symptoms may be worse during exercise, when you have a cold or during times of high stress.

Children with asthma may show the same symptoms as adults with asthma: coughing, wheezing and shortness of breath. In some children chronic cough may be the only symptom.

If your child has one or more of these common symptoms, make an appointment with an allergist / immunologist:

• Coughing that is constant or that is made worse by viral infections, happens while your child is asleep, or is triggered by exercise and cold air

• Wheezing or whistling sound when your child exhales

• Shortness of breath or rapid breathing, which may be associated with exercise

• Chest tightness (a young child may say that his chest “hurts” or “feels funny”)

• Fatigue (your child may slow down or stop playing)

• Problems feeding or grunting during feeding (infants)

• Avoiding sports or social activities

• Problems sleeping due to coughing or difficulty breathing

Patterns in asthma symptoms are important and can help your doctor make a diagnosis. Pay attention to when symptoms occur:

• At night or early morning

• During or after exercise

• During certain seasons

• After laughing or crying

• When exposed to common asthma triggers

What are the risk factors of Asthma?

A number of factors are thought to increase your chances of developing asthma. They include:

  • Having a blood relative with asthma, such as a parent or sibling
  • Having another allergic condition, such as atopic dermatitis — which causes red, itchy skin — or hay fever — which causes a runny nose, congestion and itchy eyes
  • Being overweight
  • Being a smoker
  • Exposure to secondhand smoke
  • Exposure to exhaust fumes or other types of pollution
  • Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing

What are the complications of Asthma?

Complications of asthma include:

  • Signs and signs of fatigue, work and other behaviours that conflict with
  • During asthma flare-ups, sick days from work or school
  • A permanent narrowing of the tubes (bronchial tubes) that bring oxygen to and from the lungs, which affects how much you can breathe.
  • Visits to an emergency department and hospitalizations for extreme asthma attacks
  • Side effects of certain drugs used to stabilise serious asthma related to long-term use
  • In the avoidance of both short-term and long-term risks caused by asthma, proper care makes a major difference.

How is Asthma diagnosed?

A doctor will ask the person about their symptoms, their family medical history, and their personal medical history. They will also carry out a physical examination, and they may conduct some other tests.

When the doctor makes their diagnosis, they will also note whether the asthma is mild, intermittent, moderate, or severe. They will also try to identify the type.

People can keep a log of their symptoms and possible triggers to help the doctor make an accurate diagnosis. This should include information about potential irritants in the workplace.

The sections below discuss some other tests a doctor may conduct to help diagnose asthma.

Physical exam

The doctor will focus on the upper respiratory tract, the chest, and the skin. They will listen for signs of wheezing, which can indicate an obstructed airway and asthma.

They will also check for:

  • a runny nose
  • swollen nasal passages
  • any growths on the inside of the nose

They will also check the skin for signs of eczema or hives.

Asthma tests:

  • The doctor may also carry out a lung function test to assess how well the lungs are working.
  • A spirometry test is one example of a lung function test. The person will need to breathe in deeply and then breathe out forcefully into a tube. The tube links up to a machine called a spirometer, which shows how much air a person inhales and exhales and the speed at which they expel the air from the lungs.
  • The doctor will then compare these results with those of a person who is similarly aged but who does not have asthma.
  • To confirm the diagnosis, the doctor may then give the person a bronchodilator drug — to open the air passages — and repeat the test. If these second results are better, the person may have asthma.
  • This test may not be suitable for young children, however. Instead, the doctor may prescribe asthma medicines for 4–6 weeks and monitor any changes in their symptoms.

Other tests:

Other tests for diagnosis include:

A challenge test. This test allows a doctor to assess how cold air or exercise affect a person’s breathing.

A skin prick. A doctor can use this test to identify a specific allergy.

Tests to rule out other conditions. Sputum tests, X-rays, and other tests can help rule out sinusitis, bronchitis, and other conditions that can affect a person’s breathing.

What is the classification of Asthma?

Your doctor will assess how much you have signs and symptoms and how severe they are, to classify your asthma severity. The findings of a physical evaluation and laboratory testing will also be considered by your doctor.

Determining the seriousness of your asthma allows the doctor to select the right medication. With time, asthma incidence frequently varies, causing improvements to medication.

Asthma is classified into four general categories:

Asthma classification

Signs and symptoms

Mild intermittent

Mild symptoms up to two days a week and up to two nights a month

Mild persistent

Symptoms more than twice a week, but no more than once in a single day

Moderate persistent

Symptoms once a day and more than one night a week

Severe persistent

Symptoms throughout the day on most days and frequently at night

What is the treatment for Asthma?

The key to preventing asthma attacks before they occur is avoidance and long-term management. Treatment typically includes learning to know the triggers, taking measures to eliminate triggers, and controlling your breathing to ensure that symptoms are held under control by the drugs. You will need to use a quick-relief inhaler in the event of an asthma flare-up.

Medications

A lot of factors depend on the right medicines for you: the age, signs, causes of asthma and what works best to keep your asthma under control.

Preventive, long-term control drugs minimise the swelling (inflammation) that contributes to symptoms of the airways. Quick-relief (bronchodilator) inhalers easily loosen up swelling airways that restrict respiration. Allergy medicines are required in some situations.

Long-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you’ll have an asthma attack. Types of long-term control medications include:

  • Inhaled corticosteroids. These medications include fluticasone propionate, budesonide, ciclesonide, beclomethasone, mometasone and fluticasone furoate.
    You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, inhaled corticosteroids have a relatively low risk of serious side effects.
  • Leukotriene modifiers. These oral medications — including montelukast), zafirlukast — help relieve asthma symptoms.
    Montelukast has been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away if you experience any of these reactions.
  • Combination inhalers. These medications — such as fluticasone-salmeterol, budesonide-formoterol, formoterol-mometasone and fluticasone furoate-vilanterol — contain a long-acting beta agonist along with a corticosteroid.
  • Theophylline. Theophylline is a daily pill that helps keep the airways open by relaxing the muscles around the airways. It’s not used as often as other asthma medications and requires regular blood tests.

Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an asthma attack. They may also be used before exercise if your doctor recommends it. Types of quick-relief medications include:

  • Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to rapidly ease symptoms during an asthma attack. They include albuterol and levalbuterol.
    Short-acting beta agonists can be taken using a portable, hand-held inhaler or a nebulizer, a machine that converts asthma medications to a fine mist. They’re inhaled through a face mask or mouthpiece.
  • Anticholinergic agents. Like other bronchodilators, ipratropium and tiotropium act quickly to immediately relax your airways, making it easier to breathe. They’re mostly used for emphysema and chronic bronchitis, but can be used to treat asthma.
  • Oral and intravenous corticosteroids. These medications — which include prednisone and methylprednisolone — relieve airway inflammation caused by severe asthma. They can cause serious side effects when used long term, so these drugs are used only on a short-term basis to treat severe asthma symptoms.

If you have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But you shouldn’t need to use your quick-relief inhaler very often if your long-term control medications are working properly.

Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication.

Allergy medications may help if your asthma is triggered or worsened by allergies. These include:

  • Allergy shots (immunotherapy). Over time, allergy shots gradually reduce your immune system reaction to specific allergens. You generally receive shots once a week for a few months, then once a month for a period of three to five years.
  • Biologics. These medications — which include omalizumab, dupilumab, reslizumab and benralizumab — are specifically for people who have severe asthma.

Bronchial thermoplasty

For extreme asthma that may not progress with inhaled corticosteroids or other long-term asthma drugs, this procedure is used. It’s not generally open to anyone, nor is it right.

Your doctor heats the insides of the airways in the lungs with an electrode during bronchial thermoplasty. The smooth muscle within the airways is diminished by the heat. This inhibits the airways’ ability to tighten, making it difficult to breathe and likely reducing asthma attacks. In total, the treatment is performed over three outpatient visits.

Treat by severity for better control: A stepwise approach

Your care should be versatile and should be focused on symptom improvements. Upon each appointment, the doctor may inquire about your symptoms. Your doctor will change your medication accordingly on the basis of your signs and symptoms.

For starters, your doctor can recommend less medicine if your asthma is well managed. Your doctor can raise your prescription and prescribe more regular visits if your asthma isn’t well managed or is getting worse.

Asthma action plan

Work with your doctor to create an asthma action plan that outlines in writing when to take certain medications or when to increase or decrease the dose of your medications based on your symptoms. Also include a list of your triggers and the steps you need to take to avoid them.

Your doctor may also recommend tracking your asthma symptoms or using a peak flow meter on a regular basis to monitor how well your treatment is controlling your asthma.

Check with the doctor to build an action plan for asthma that explains in writing when to administer those drugs or when to raise or reduce the drug dosage depending on your symptoms. A list of the causes and the action you need to take to stop them is also included.

Your doctor can also consider monitoring your asthma symptoms or regularly using a peak flow metre to check how well your asthma is managed by your medication.

How to prevent Asthma?

Although there is no way to avoid asthma, a step-by-step strategy for dealing with your disease and avoiding asthma attacks can be planned by you and your doctor.

Follow your action plan for asthma. Write a comprehensive schedule for taking drugs and treating an asthma episode with the doctor and health care staff. Make sure to execute the schedule, then.

Asthma is an ongoing disease that requires monitoring and medication on a daily basis. It can help you feel more in control of your life to take control of your treatment.

Get vaccinated for influenza and pneumonia.

Staying current with vaccines will prevent asthma flare-ups from being caused by influenza and pneumonia.

Identify and avoid asthma triggers.

A variety of outdoor allergens and irritants can cause asthma attacks, ranging from pollen and mould to cold air and air pollution. Find out what your asthma induces or worsens, and take measures to prevent those reasons.

Track the respiration.

You can learn to recognise warning signs, such as mild coughing, wheezing or shortness of breath, of an imminent attack.

But because your lung capacity can decline until you experience any signs or symptoms, a home peak flow metre routinely monitors and tracks your peak airflow. A peak flow metre tests how difficult it is to breathe out. You will be shown by your doctor how to track your optimum flow at home.

Identify and treat attacks early.

You’re less likely to get a serious assault if you respond quickly. In order to manage your effects, you would therefore not require too much medicine.

Take your medicine as advised as your peak flow measurements decrease and alert you of an oncoming threat. Also, avoid any action immediately that could have caused the attack. Get medical attention as directed in your action plan if your symptoms don’t change.

Take your medication as prescribed.

It’s a smart idea to have your prescription with you on any visit to your doctor. Your doctor will be there to make sure that you use the prescription properly and that you are taking the right dosage.

Pay attention to the growing use of fast-relief inhalers. Your asthma is not under control if you find yourself relying on your rapid-relief inhaler, such as albuterol. Consult the physicians on how to change your condition.

References:

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https://www.mayoclinic.org/diseases-conditions/asthma/diagnosis-treatment/drc-20369660

https://www.who.int/news-room/fact-sheets/detail/asthma

https://www.healthline.com/health/asthma#classifications

https://www.medicalnewstoday.com/articles/323523#takeaway

https://www.webmd.com/asthma/ss/slideshow-asthma-overview

https://www.aaaai.org/conditions-and-treatments/asthma

https://www.medicinenet.com/asthma_overview/article.htm