Asthma









About this Condition



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The definition of asthma has been evolving over time, as more is learned about this distressing illness that plagues so many people. Currently this disease in described as an inflammatory process that occurs when a susceptible individual is exposed to a pro-asthma environment. Several key things are considered features of the condition, including reversible airway obstruction, hyper-irritability and inflammation, particularly in the bronchial tubes.

There are both genetic and environmental components that together create a reaction in some individuals. The immune system, including the production of antibodies like IgE, contributes to the asthma response. Symptoms of this illness include wheezing, coughing, shortness of breath, sinus pain, eczema or the presence nasal polyps.

According to the National Institutes of Health, this disease may be classified as “mild intermittent”, “moderate persistent”, or “severe persistent.” In the mild intermittent category, attacks generally occur less than twice per week and never during sleep. With mild persistent, symptoms are felt more than twice per week but not daily. Moderate persistent is characterized by daily symptoms and one night-time attack each week or more.



The Dreaded Attack



Asthma attacks are episodes characterized by constriction of the bronchial wall muscle, inflammation and swelling of the bronchial lining, secretion of mucus and plugging of small air tubes. The frequency and severity of these attacks vary from person to person; an extreme attack can result in hospitalization. Generally all attacks include shortness of breath and wheezing. Some patients will cough excessively and some many cough very little or not at all. Breathlessness may occur to the point where a patient cannot speak since they are so consumed with just trying to breathe. If not treated quickly enough or appropriately it is possible for attacks to be fatal.



Diagnosis



The diagnosis of asthma begins with a thorough physical examination and medical history. Due to the genetic component of the condition, it will be particularly helpful for the physician to be informed of any relatives who suffer as a result of the disease. Information about the patient’s work environment will be as important as his home environment, as so many environmental factors can trigger this illness: from the presence of second-hand smoke to dust mites to a particular type of chemical in the workplace. The patient’s ability to take full deep breaths without difficulty will be assessed.

A further step in diagnosis is to eliminate other possible causes for the symptoms suffered by the patient. Some conditions that can cause similar symptoms include emphysema, chronic bronchitis, cystic fibrosis, heart failure, or vocal cord dysfunction syndrome.

Laboratory testing is used, both to rule out other conditions and to test for asthma. The presence of immunoglobulin E in the blood is an indicator that an allergy is likely present. Chest x-rays and sputum examinations may also be conducted, and then pulmonary function testing will almost certainly be conducted as it is one of the most important diagnostic tests for this condition in the physician’s arsenal.



Common Types of this Disorder



This disease can occur at different life stages and with different triggers that set off symptoms. Childhood asthma is one of the most frequent long-term children’s diseases. Viral infections and coughs can easily set off attacks. Exposure to allergens such as dust, mold or pet dander are common triggers as well.

Exercise is actually a very common trigger for this disease, and in fact over 70% of patients will experience exercise-induced attacks. Such attacks will be particularly problematic if the exercise takes place in a cold or dry environment. Taking preventative measures, such as using an inhaler or daily inhaled corticosteroids may allow the individual to continue with a healthy and active lifestyle.

Occupational asthma is an illness that results due to exposure to particular materials within the workplace. There are a number of triggers that can lead to the occupational form, and examples include a baker who develops flour-induced attacks, a welder who is sensitive to steel fumes, or a hospital worker whose attacks are triggered by latex or disinfectants. A significant concern with the occupational form of the disease is that with prolonged exposure to the irritant an individual’s condition may become chronic. The best treatment for the occupational variety of this illness is to stop exposing oneself to the offensive material, which may unfortunately require a change of profession. Immunotherapy is another option that some individuals can consider.






Treatment



There are several factors to be considered when creating an asthma treatment plan, including the type of the disease suffered, the severity of attacks, and lifestyle. Medications are a big part of treatment, but it is important to also implement avoidance techniques to whatever extent possible.

Avoidance may mean learning and then avoiding contact with allergens that are particular triggers for the individual. For some people this may mean avoiding yard work and for others it could mean ripping out all carpeting in their home and changing the types of cleaning solutions they use. Still others may need to find ways to either alter their work environment or consider giving up a beloved hobby.

As for asthma medications, there are two main categories. The first is bronchodilator drugs, which act to reverse the constriction of bronchial tubes. Bronchodilators are often derivatives of epinephrine, which is an important hormone produced by the adrenal gland. B2adrenergic agonists are medications that have been developed to stimulate the lung structures, so that when they are used the bronchial wall muscles will relax and produce bronchodilatation. Bronchodilators have the best effect if inhaled, thus they are administered via metered dose inhalers or dry powder inhalers. Nebulizers can also be used to administer bronchodilator medications, but this is more commonly done in a hospital setting as it allows for a larger amount of medication to be administered. Overuse of B2-agonist drugs can be problematic for asthma sufferers and in fact there has been shown to be relationships between overuse of certain B2-agonists and fatal asthma attacks.

Another type of bronchodilator preparation that may be used is an anticholinergic agent. An anticholinergic agent will affect the bronchial wall muscle and help it to relax and therefore increase bronchodilatation. Examples of such agents are ipatropium bromide and tiotropium bromide.

Thanks to increasing awareness of the inflammatory nature of this disease, anti-inflammatory drugs are often utilized in the treatment of asthma. Corticosteroids are anti-inflammatory medications that, while typically used in oral or injectable form, are increasingly becoming available in inhalable form (better absorption). This form reduces the consequences that occur when oral or injectable types are used. For example, corticosteroids have side effects that include increased appetite and thirst, muscle weakness, bone loss, stomach irritation or higher risk of glaucoma.



Alternative Treatment



While medication may be a true necessity for asthma sufferers, that does not mean that some supplementary alternative treatments won’t provide benefits. Breathing exercises such as tai-chi or yoga can help reduce stress and anxiety and therefore lessen the number of stress-related attacks. Specific dietary changes may not improve this disease, but any healthy weight loss regime could improve the overall health of patients and reduce the incidence of attacks.



Conclusion



Asthma is a very serious condition that can affect people of all ages and all walks of life. If appropriate treatment is sought, This condition can generally be treated and individuals can live wonderful, productive lives, although significant changes may be required in lifestyle and work to allow for optimum health after the initial diagnosis is made.


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