Asthma

Published: 6 Nov 2023, 09:32 AM

Medically Reviewed by

Dr Manav Manchanda

What is Asthma?

Causes of Asthma

Asthma is caused by swelling or inflammation of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow. While there’s no exact cause of asthma, these factors may play an important role in its development:

• Hereditary: Hereditary factors play a crucial role in asthma. Individuals with a family history of the condition are more susceptible, suggesting a genetic component. Certain genes related to immune responses and airway sensitivity can increase one’s likelihood of developing asthma.
• Allergy: Allergies are closely linked to asthma. Allergic reactions to substances such as pollen, dust mites, pet dander, and mold can trigger asthma symptoms in sensitive individuals. The immune system’s response to allergens can lead to airway inflammation and constriction.
• Air pollution: Air pollution is a well-documented environmental factor that can exacerbate or trigger asthma. Pollutants like fine particulate matter and ozone can irritate the airways, worsening asthma symptoms and potentially leading to the development of the condition in those with genetic predispositions.
• Infections: Respiratory infections, particularly during early childhood, can increase the risk of asthma. Viral infections like the common cold or respiratory syncytial virus (RSV) may contribute to airway inflammation and heightened sensitivity in susceptible individuals.
• Irritants: Irritants in the environment, such as strong odors, fumes, and airborne chemicals, can provoke asthma symptoms. These irritants can vary widely, from perfumes and cleaning products to industrial pollutants.
• Obesity: Obesity is associated with a higher risk of asthma, as excess body weight can lead to inflammation and increased respiratory effort.
• Exercise: Exercise-induced asthma is a specific subtype triggered by physical activity, particularly in cold, dry air. While exercise is generally beneficial, some individuals may experience asthma symptoms during or after physical exertion.
• Tobacco smoke: Tobacco smoke, whether from active smoking or exposure to secondhand smoke, is a known asthma trigger. Smoking damages the airways and can lead to chronic inflammation.
• Gastroesophageal reflux disease (GERD): Gastroesophageal reflux disease (GERD) can also play a role in asthma. Stomach acid reflux into the esophagus may enter the airways, leading to irritation and asthma symptoms.
• Strong emotions: Strong emotions and stress can exacerbate asthma symptoms, although their exact mechanisms are not fully understood.
• Cold weather: Cold weather can trigger asthma in some individuals, likely due to the constriction of airways in response to the cold, dry air.
• Medications: Certain medications, such as non-steroidal anti-inflammatory drugs (NSAIDs) and beta-blockers, can worsen asthma symptoms in susceptible individuals.

Key Facts About Asthma

Major Symptoms	Wheezing (whistling sound when breathing) Shortness of breath Persistent cough, especially at night or early in the morning Chest tightness Increased mucus production Difficulty in exhaling Rapid breathing Chest pain Fatigue Trouble sleeping Allergic triggers such as dust, pollen, and smoke
Necessary Health Tests	Medical history Physical examination Breathing tests Peak flow measurements Bronchoprovocation tests Allergy tests
Treatment	Lifestyle changes Identifying triggers Stop smoking Regular exercise Healthy diet Medications Relievers (Bronchodilators) Controllers (Anti-inflammatories) Biologics Combination inhalers Oral steroids

Symptoms of Asthma

Asthma is a chronic respiratory condition that can vary in severity, and these symptoms may differ in individuals. Common symptoms of asthma include:

• Wheezing (whistling sound when breathing)
• Shortness of breath
• Persistent cough, especially at night or early in the morning
• Chest tightness
• Increased mucus production
• Difficulty in exhaling
• Rapid breathing
• Chest pain
• Fatigue
• Trouble sleeping
• Allergic triggers such as dust, pollen, and smoke

An asthma attack is also one of its dangerous symptoms, which occurs only when asthma symptoms become severe. During an asthma attack, a person may experience:

• Severe shortness of breath
• Intense chest tightness or pain
• Inability to speak due to breathlessness
• Anxiety and panic
• Bluish lips or fingernails

These symptoms can improve with inhaler use.

Diagnosis of Asthma

For proper diagnosis, your doctor may review your medical history and various tests, including physical examination, imaging tests, and lung function tests.

• Medical history: The doctor will ask about your symptoms, including coughing, wheezing, shortness of breath, and chest tightness. They will inquire about the frequency and triggers of these symptoms.
• Physical examination: The doctor will listen to your lungs with a stethoscope, looking for wheezing or other abnormal sounds. They will also assess your overall health and breathing patterns.
• Breathing tests: Spirometry is a key test for asthma diagnosis. It measures how much air you can exhale and how quickly.
• Peak flow measurements: This test involves blowing into a peak flow meter to measure how fast you can breathe out. Variations in peak flow readings can help diagnose and monitor asthma.
• Bronchoprovocation tests: These tests are done in specialized cases and involve inhaling substances that trigger asthma symptoms to confirm the diagnosis.
• Imaging test: In some cases, a chest X-ray or CT scan may be performed to rule out other respiratory conditions.
• Allergy tests: Identifying allergens that trigger asthma can be important. Allergy skin tests or blood tests may be conducted.

Treatment of Asthma

Asthma is a chronic respiratory condition that can be effectively managed with a combination of lifestyle changes and medications. Here’s an overview of both aspects of treatment:

Lifestyle changes

• Identify triggers: The first step in managing asthma is recognizing and avoiding triggers. Common triggers include allergens, smoke, pollution, and respiratory infections.
• Stop smoking: If you’re a smoker, quitting is crucial. Smoking irritates the airways and worsens asthma symptoms. Also save yourself from second-hand smoke.
• Regular exercise: Physical activity is beneficial, but it should be done with caution. Consult your healthcare provider to develop an exercise plan that suits your condition.
• Healthy diet: A well-balanced diet can support overall health. Some individuals with asthma may benefit from anti-inflammatory foods like fruits and vegetables.
• Stress management: Stress can trigger asthma symptoms. Relaxation techniques, such as deep breathing exercises, can help.

Medications

• Relievers (Bronchodilators): These are quick-acting medications, such as albuterol, that provide immediate relief by relaxing the airway muscles during an asthma attack or when symptoms worsen.
• Controllers (Anti-inflammatories): Inhaled corticosteroids, long-acting beta-agonists, leukotriene modifiers, and other anti-inflammatory medications are used to prevent asthma symptoms by reducing airway inflammation and bronchoconstriction.
• Biologics: These medications target specific immune system components involved in asthma. They are used for severe, uncontrolled asthma.
• Combination inhalers: Some medications combine a corticosteroid and a long-acting beta-agonist for both short- and long-term control.
• Oral steroids: In severe cases or during exacerbations, oral corticosteroids like prednisone may be prescribed.

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