Understanding Asthma

May 06, 2018 Dr Zulfikar Bux, Features / Columnists

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By Dr Zulfikar Bux
Assistant Professor of Emergency Medicine

Asthma is a chronic (long-term) disease of the lungs. It inflames and narrows the airways. These are tubes that carry air into and out of your lungs. It most often starts in childhood, but can affect people of all ages. The airways of people who have asthma are extra sensitive to the things they’re allergic to (allergens). They are also sensitive to certain substances that can be inhaled through the air.
Asthma symptoms start when irritants cause the lining of the airways to become inflamed (swollen) and narrow. The muscles around the airways can then spasm (contract rapidly). This causes the airways to narrow even more.
When the lining of the airways is inflamed, it produces more mucus (cold). The mucus clogs the airways and further blocks the flow of air. When these symptoms are severe and not easily controlled, persons start to cough, have shortness of breath and wheeze. This is called an “asthma attack.”

WHAT ARE THE SYMPTOMS OF ASTHMA?

An asthma “flare up,” or attack, happens when excess mucus causes your air tubes to swell and tighten. Asthma attacks can be mild, moderate, or severe. Symptoms of an asthma attack include the following:
 Coughing – coughing from asthma is usually worse early in the morning and at night. This can lead to problems sleeping.
 Tightness in the chest – you may feel breathless and like something is squeezing your chest.
 Wheezing – a hoarse, squeaky, musical, or whistling sound when you breathe.
 Coughing with mucus – or coughing up “cold” as is better known locally.
 Shortness of breath

WHAT CAUSES ASTHMA?

An exact cause of asthma has not been determined. There is a general thought that genetic and environmental causes lead to asthma. These may include:
 One or both parents have asthma.
 A genetic history of allergies in the family.
 Having certain respiratory infections during childhood.
 Contact with allergens or infections during infancy and early childhood, when the immune system is still developing.

Many things can cause your asthma to flare up, including:
 allergies
 viral infections (such as a cold) and sinus infections
 tobacco
 air pollutants (such as wood smoke)
 cold air
 exercise
 perfume or chemical fumes
 heartburn.

For some people, strong emotions or stress can trigger an asthma attack. Pay attention to the way these things affect your asthma. Work with your doctor to figure out which things bother your asthma.

HOW IS ASTHMA DIAGNOSED?

Your doctor will ask you for your medical history, especially any family history of allergies and asthma. Keep a record of your asthma symptoms and when and how often they occur. Your doctor will want to know what seems to trigger and worsen your symptoms. They will listen to your breathing and look for signs of allergies and asthma. These can include wheezing, swollen nasal passages, and allergic skin conditions (such as eczema).
They will conduct a spirometry test. You will breathe into a machine called a spirometer to see how well your lungs work. It records the amount of air and how quickly you breathe in and out. Your doctor may need to perform other tests, such as:
 Allergy testing.
 Tests to rule out other conditions with symptoms similar to asthma.
 Chest X-ray or ECG (electrocardiogram) to make sure there is nothing else in your lungs (a disease or foreign object) that is causing the symptoms.

CAN ASTHMA BE PREVENTED OR AVOIDED?

Asthma cannot be prevented, and there is no cure. You can help avoid asthma attacks by avoiding the triggers that can start an asthma attack. Examples of common allergens and irritants include:
 air pollution
 dust
 mold
 pollen
 tobacco smoke
 pet dander
 exercise
 changes in temperature
 certain foods
 sulfite (food preservative in red wine, beer, salad bars, dehydrated soups, and other foods)
 heartburn
 strong emotions (such as crying or laughing)
 perfume
 colds and viruses.

WHAT ARE THE TREATMENT OPTIONS?

Your doctor will work with you to create an action plan to control your asthma. The plan will include recognizing your symptoms and avoiding your asthma triggers. It will give guidance on taking medicines properly. Your plan will help you track your level and control and know when to seek emergency care when needed.
Asthma medicines are divided into two groups: controller medicines (to prevent attacks) and rescue medicines (to treat attacks). Your doctor will talk to you about these medicines and what to do if you have an asthma attack.
Ensure you understand how to use these medicines as it can be the difference between you having mostly asthma-ridden days or normal days.

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