Asthma

Definition

Asthma is the chronic condition that causes inflammation, swell, produce extra mucus and narrowing in the airway of the lungs. People who have this chronic condition for a long time or recurrent is said to be asthmatic. This causes wheezing, chest tightness, coughing and shortness of breath. A cough often occurs early morning or at night time. Asthma cannot be cured but some treatments can reduce the symptoms and can be controlled. It affects people with all age groups and often occurs in children’s.

History

The term asthma comes from the Greek word aazein which means to exhale through an open mouth, to pant and sharp breath.

460 BC- Hippocrates (460 BC) was the first to use the term Asthma as a panting and respiratory distress. Many physicians considered him that who was identified the relation between respiratory disease & the environment.

327 BC- smoking the herb stramonium (which is an anticholinergic agent related to ipratropium and tiotropium which are currently used in inhalers today) was used to help relax the lungs.

100 AD – Aretaeus of Cappadocia, a Greek physician, is credited with the first accurate description of asthma, as we know it today. He wrote symptoms include chest heaviness, difficulty in breathing and tiredness.

A Jewish physician & scholar by the name of Maimonides (1135-1204 AD) prescribed sleep, fluids, and chicken soup. He noted that his patient’s symptoms became worse during the wet months which proceeded to the person gasping for air and coughing until phlegm was expelled.

Epidemiology

The prevalence of asthma varies widely in different regions of the world due to distinct genetic, environmental and occupational risk factors. However, this disparity appears to be closing as the prevalence in high-income countries is reaching a plateau whereas the prevalence in low and middle-income countries continues to rise.

Worldwide, it is estimated that approximately 334 million people currently suffer from asthma, and 250,000 deaths are attributed to the disease each year. The prevalence of the disease is continuing to grow, and the overall prevalence is estimated to increase by 100 million by 2025.

Types

Child onset asthma: For some children’s the onset of asthma may begin during childhood. Due to genetic reason, the child may become sensitized to common allergens in the environment. The child is a topic- generally in the state of hypersensitivity due to environmental allergens. Allergens are the substances that act as a foreign body that triggers the immune to respond.

Adult-Onset Asthma: This term is used when a person develops asthma after reaching 20 years of age. Adult-onset asthma affects women more than men, and it is also much less common than child-onset asthma. It is also triggered by some allergic materials or an allergy. The cause of adult-onset asthma seems to be triggered by the exposure to the allergens called nonallergic adult-onset asthma. This type of non-allergic asthma is also called as intrinsic asthma. Exposure to chemicals, plastics, metals, certain medicines or wood dust can cause adult-onset asthma.

Exercise-Induced Asthma: After exercise, if you feel difficulty in breathing or wheezing, then you could be suffering from exercise-induced asthma. Obviously, your level of fitness is also a factor – a person who is unfit and runs fast for ten minutes is going to be out of breath. However, if your coughing, wheezing or panting does not make sense, this could be an indication of exercise-induced asthma. Some exercise may cause the inflammation of airway tubes or bronchial and thus it results in asthma.

Cough-Induced Asthma: Cough-induced asthma is one of the most difficult asthmas to diagnose. The doctor has to eliminate other possibilities, such as chronic bronchitis, post nasal drip due to hay fever, or sinus disease. In this case, the coughing can occur alone, without other asthma-type symptoms being present. The coughing can happen at any time of day or night. If it happens at night it can disrupt sleep.

Nocturnal Asthma: It occurs only during night time from night to 8 am. It is due to the dust and pet dander or may be due to a sinus condition. The patient may have wheezing or short breath when lying down and may not notice these symptoms until awoken by them in the middle of the night – usually between 2 and 4 AM. Nighttime symptoms may also be a common problem in those with daytime asthma as well.

Steroid-Resistant Asthma (Severe Asthma): Some steroid therapy, the patient responds to regularly inhaled glucocorticoid (steroid) therapy, due to steroid resistance. By reducing airway inflammation and immune activation, glucocorticoids are used to treat asthma. However, patients with steroid-resistant asthma have higher levels of immune activation in their airways than do patients with steroid-sensitive (SS) asthma.

Risk factors

Some of the risk factors that may cause the risk of having asthma are as follows:

Being a smoker

Exposure to occupational triggers, such as chemicals used in farming, hairdressing, and manufacturing

Having a blood relative (such as a parent or sibling) with asthma

Having another allergic condition, such as atopic dermatitis or allergic rhinitis (hay fever)

Being overweight

Second-hand smoking

Exposure to exhaust fumes or other types of pollution

Obesity is the greater risk of getting asthma

Causes

It’s not clear why people get asthma, but probably due to some allergic, genetic and environmental factors. Asthma triggers are different from person to person. Some of the causes of asthma are as follows:

Air pollution and smoke

Cold air

Emotions and stress

Tobacco smoke

Atopy

Gene

Allergies such as dust, mites, fungi, and cockroaches

Certain medication such as including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)

Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

Early warning signs of asthma

Itchy, scratchy, or sore throat

Waking up at night

Dark circles under eyes

Runny, stuffy or congested nose

Increased tiredness

Chest tightness, pain, or pressure

Shortness of breath

Coughing, especially at night

Wheezing

Thirst

Itchy, glassy or watery eyes

Rubbing nose a lot

Sneezing

Stomach ache

Headache

Fever

Feeling restless

Change in face color – pale or flushed

Throat clearing

Symptoms of asthma in Children

Nagging cough that lingers for days or weeks to sudden and scary breathing emergencies

Trouble breathing or fast breathing that causes the skin around the ribs or neck to pull in tightly

Frequent colds that settle in the chest

Effects of asthma

Stress, anxiety and depression.

pneumonia (infection of the lungs)

Lung collapse

Respiratory failure, where the levels of oxygen in the blood become dangerously low, or the levels of carbon dioxide become dangerously high

Status asthmaticus which do not respond to treatment).

Diagnosis of asthma

Physical exam and medical history:

Your doctor will investigate your symptoms and their cases. They will question you about the family history of asthma, medicines you consume, and your lifestyle. Also, ask about previous medical conditions like allergy and eczema that might increase your asthma. During such investigations by your doctor, you should inform about your work and home environment that may worsen your asthma.

Diagnostic tests

Lung function tests: The function of the lungs is tested for how much air that you breathe in and out. It also measures the rate at which you breathe out by using equipment called spirometer. Hence this test is also called a spirometry test.