Asthma – Symptoms and Causes

Asthma is the condition caused by the narrowing and swelling of airways along with increased production of mucus.  This can trigger coughing, make breathing difficult and a whistling sound (wheezing) when you breathe out. Asthma can cause minor disruptions to daily activities in some , but can also sometimes cause a threat to life too. Hence it is always safer to be aware and take all steps to keep asthma under control.

What is asthma?

Asthma is a chronic, inflammatory condition affecting your airways and lungs. It  affects your normal breathing pattern due to inflammation or narrowing of the airways, which ultimately leads to a disturbed airflow.

Your doctor will focus on controlling the symptoms to prevent the condition from worsening. The signs and symptoms of asthma keep changing over time and vary from one person to another. Your doctor will help you track symptoms and advise an appropriate treatment plan. Asthma does not have a cure but is manageable .

What are the different types of asthma?

Asthma is characterized into four different categories:

1. Mild intermittent asthma
2. Mild persistent asthma
3. Moderate persistent asthma
4. Severe persistent asthma

What are the symptoms of asthma?

Signs and symptoms of asthma vary from person to person. Commonly noticed symptoms of asthma are as follows:

• Severe shortness of breath
• Chest tightness and pain
• Coughing
• Exhaling accompanied by wheezing
• Agitation
• Decreased lung function
• Difficulty in sleeping due to the above-mentioned symptoms

Some might face a flare-up of the signs and symptoms in specific conditions like:

• When asthma is induced due to exercising, also known as exercise-induced asthma
• Asthma induced by  occupational conditions involving the usage of irritants like gases, chemical fumes, and dust
• Allergy-induced asthma due to airborne particles like pollens, spores, etc.

When to see a doctor for asthma?

You should seek medical care if you are experiencing severe asthma attacks, also known as asthma exacerbation. This is  an emergency and must be handled with caution as it can be life-threatening. You can identify the condition by the following circumstances:

• If you are facing shortness of breath that is rapidly worsening
• If you do not feel relieved even after the usage of an inhaler
• If you are experiencing severe shortness of breath while performing day-to-day activities

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Other situations where it is important to see a doctor are:

• If you are an asthmatic patient
• To get your asthmatic condition monitored after diagnosis
• If you see your asthma getting more severe
• To get your treatment reviewed

What causes asthma?

The fact remains unclear why some people develop asthma, and some do not. The cause is probably the combination of genetic and environmental factors that affects how your body reacts to  asthma triggers.

The asthma triggers mentioned below vary from person to person:

• Pollen, pets, spores, cockroach waste particles, and dust mites come under the category of airborne allergens
• Outdoor air pollution, like smoke
• Upper respiratory infections like the common cold
• Inhaling cold, dry air
• Gastroesophageal reflux disease (GERD) in which acid of the stomach backs up in your throat
• Stressful emotions
• Physical activities
• Some medications like beta-blockers, non-steroidal anti-inflammatory drugs, aspirin, and naproxen sodium

What are the risk factors of asthma?

Several factors can increase your risk of developing asthmatic conditions. The risk factors are:

• Hereditary – Your family member had asthma, and the genes  have been inherited 
• Allergic conditions, such as atopic dermatitis. This causes redness, itchiness, hay fever, runny nose, and congestion.
• Obesity
• Smoking
• Conditions that involve exposure to chemical fumes

What are the complications of asthma?

Asthma can turn into a lifestyle disorder, which can cause various complications like:

• Trouble sleeping due to wheezing and coughing.
• Missing school, college, or work due to asthma flare-ups.
• Side-effects due to long-term usage of inhalers and medications

What treatment is advised for patients with asthma?

Medications

Medication depends on several factors, such as age, asthma triggers, symptoms, and medications that you can tolerate . They are divided into long-term medications, quick-relief medications, and allergy medications.

• Long-term medications

The long-term medications to control asthma are taken every day and are the foundational basis for treating asthma. These medicines are used to keep the symptoms under control and prevent an asthma attack from happening. The types of long-term asthma control medicines are:

• Inhaled corticosteroid inhalers for asthma include medications like fluticasone furoate, budesonide, fluticasone propionate, and beclomethasone. They are different from oral corticosteroids and have relatively lesser side effects.
• Leukotriene modifiers are oral medications to ease the symptoms of asthma. They consist of montelukast, zileuton, and zafirlukast. Few side effects of montelukast linked with aggression, suicidal thinking, and depression are recorded. Make sure to seek medical care urgently if you witness or experience such reactions.
• Combination inhalers like fluticasone-salmeterol, budesonide-formoterol, fluticasone furoate-vilanterol, etc. have combinations of a long-acting beta-agonist with a corticosteroid.
• Theophylline pills are taken daily to help clear out the airways by opening and relaxing the muscles around them.

• Quick-relief medications

Quick-relief medicines are used to relieve symptoms on a short-term basis. They act rapidly during an asthma attack. Your doctor is likely to recommend these before exercising or doing any strenuous activity. They are as follows:

• Short-acting β agonists (SABA), when inhaled, provide relief within minutes. They are quick-relief bronchodilators to ease the signs and symptoms in the middle of an asthma attack. They consist of albuterol and levalbuterol.

• Ipratropium and tiotropium are anticholinergic agents to relax the airways. This helps you to breathe without any interference. They are primarily used for chronic bronchitis and emphysema.

• Oral and intravenous corticosteroids like prednisone and methylprednisolone provide relief from inflammation. They can lead to severe side effects if used in the long-term.

• Quick-relief inhalers can be used to ease asthma flare-ups. But, these inhalers should not be used excessively and frequently if your long-term asthma control medications are showing positive results.

• Allergy medications

If your asthma is worsened or triggered by allergies, allergy medications come into play. They are:

• Immunotherapy: Usage of allergy shots eventually reduces your immune system’s reaction to particular allergens. Your doctor is likely to give you the shots once a week for a few months. Gradually your doctor will advise you to take it once a month for 3-5 years.
  • Biologics include mepolizumab, reslizumab, omalizumab, etc. are used for treating severe asthma.

Bronchial thermoplasty

Bronchial thermoplasty is not used for every asthmatic patient. The treatment is advisable for the ones not benefiting by either inhaled corticosteroids or prescribed long-term medications. The procedure involves heating of the airways in the lungs with the help of an electrode.

Asthma action plan

The asthma plan developed with your doctor can help you manage the symptoms and acute attacks. It focuses primarily on:

• How to use oral corticosteroids (OCS)?
• When and how to access medical care?
• Self-monitoring of symptoms and/ or lung function.
• Asthma triggers you must avoid.

Your doctor is likely to recommend you to track and keep a note of your symptoms. You will be recommended to use a peak flow meter to monitor the efficiency of the treatment.

How to prevent asthma from worsening?

While there are no methods to prevent asthma from occurring, there are ways to manage the condition and prevent it from taking a toll. Your concerned doctor will provide you with an asthma plan and advise you to take the following preventive measures religiously:

• Make sure to follow your asthma action plan to prevent acute attacks and the worsening of symptoms.
• Monitor your breathing regularly to see if the treatment is benefiting you.
• Get yourself vaccinations for pneumonia and influenza to prevent flu from setting off asthma flare-ups.
• Be alert and avoid the agents that trigger your asthma.
• Take timely medications as prescribed by your doctor and do not change any dosage by yourself. Consult your doctor before attempting anything different from the advised dosage and asthma action plan.
• If you see yourself using the quick-relief inhaler more than normal (too often), see your doctor. This increased usage emphasizes the fact that treatment is not working properly.

Conclusion

Asthma is an extremely common chronic condition. It is an illness where the airways swell, and bronchial tubes narrow due to extra mucus production, and the muscles contract making normal breathing  difficult. To some, it can be a minor difficulty, whereas to others, it can result in a life-threatening asthmatic attack.

Asthma requires a medical diagnosis and is entirely treatable by medical professionals. It usually causes difficulty in breathing, pain in the chest, coughing, and wheezing. Flaring up of symptoms is common among asthmatic patients. With proper asthma action plans and timely medications, asthma can be controlled effectively.

Frequently Asked Questions (FAQs)

1.         How can I avoid asthma triggers?

Asthma triggers can be avoided:

• By using an air conditioner to lessen the number of airborne allergens
• By decontaminating décor
• By maintaining optimum humidity with the help of a dehumidifier
• By preventing any mold spores by cleaning your bathrooms regularly

2.         How to measure peak flow rate?

You can easily measure your peak expiratory flow rate (PEFR) by handheld devices such as a peak flow meter. This device will measure the ability of your lungs to push the air out of them. Your healthcare provider will advise you regarding the type of peak flow meter to use.

3.         What are some major side-effects of bronchodilators?

Nervousness, rapid heartbeat, tremors, and frequent headaches are some major side effects of bronchodilators  and quick-relief asthma medications. These side effects worsen with oral forms than with inhaled ones.

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