Asthma is an inflammatory disease that causes your airways to narrow and swell, making it hard to breathe.
Asthma is a chronic condition that affects both children and adults. The air passages in the lungs become narrowed by inflammation and there is tightening of muscles around the airways. This makes it difficult for air to move in and out of the lungs smoothly. Symptoms can be controlled but severe asthma attacks can be life-threatening. There may be genetic, environmental or occupational factors that trigger asthma.
Who gets asthma?
Asthma may have a hereditary component, meaning if someone in your immediate family has it, you may have a higher likelihood of developing the condition.
Most people with asthma have atopic asthma, where they tend to develop allergies to certain substances such as pollen, pet dander, skin particles and dust mites, causing inflammation of the airways. On the other hand, there are a handful of patients with non atopic asthma, where there is no trigger for their symptoms.
Other people may have seasonal asthma, where symptoms are triggered by different periods of the year, for example due to rainy or cold seasons, or hay fever seasons.
In certain circumstances, some people have occupational asthma. This is when there is a certain substance in the work environment that causes symptoms. Workplace irritants could include chemical fumes or dust. Usually these patients would develop asthma only as an adult, and their symptoms improve on days they are not at work.
Exercise-induced asthma is when people who do not usually have asthma get chest tightness, breathlessness or coughing triggered only by exercise. This may be worsened when the air is cold and dry.
The doctor will take a detailed history to see if there are any triggers/exposures that might be causing asthma symptoms in a patient. They will screen for any family history of asthma as well. A clinical examination of the lungs will be done to listen for any wheezing.
A spirometry (otherwise known as lung function test) is done to see how well or poorly the lungs work. It involves blowing air into a mouthpiece connected to a tubing and machine and measuring how much air you blow out and how fast. Supporting tests to assess airway inflammation include the exhaled nitric oxide breath test, which measures the amount of nitric oxide in your breath. A methacholine challenge test can also be performed to look for airway hypersensitivity. A negative test would usually exclude a diagnosis of asthma.
Other tests include a chest X-ray and a CT scan, as well as allergy tests.
Asthma can be controlled by recognising the warning signs of an asthma attack, avoiding certain triggers that usually result in the attack, and following a written action plan of what to do if certain symptoms come on. Patients who smoke should also try to stop.
Medications There are different types of inhalers available to help administer medicine into the airways to decrease inflammation and widen the air passages. Not everyone takes the same medicine.
Quick relief inhalers are taken to instantaneously relieve symptoms of asthma. If a patient finds a need to use a quick relief inhaler more and more frequently for symptom control, this would indicate that they should seek medical attention earlier to better manage the overall asthma condition.
Long-term control inhalers are taken daily, regardless whether symptoms of asthma are present at that point in time. It helps to prevent severe asthma attacks and keep your asthma under control by preventing inflammation in the airways.
If it is difficult to coordinate breathing while using an inhaler, a
‘spacer’ device is used together with the inhaler to improve administration.Steroids in the form of tablets or injections are sometimes given for a few days during an asthma attack to help decrease overall inflammation within the airways.