Asthma is a chronic disease that affects humans as a result of inflammation of the airways in the lungs (bronchi) and its narrowing, which reduces or prevents the flow of air to these bronchi, causing repeated attacks of shortness of breath accompanied by wheezing in the chest and some other symptoms.
Where the muscle that surrounds the bronchi contracts and a large amount of phlegm accumulates in the airways, which leads to blockage, accordingly, symptoms of asthma range from crackling and slight wheezing when breathing and between asthma attacks that may endanger life, knowing that children are more affected by the disease.
There is no cure for asthma, but it is possible to control its symptoms by following different methods.
Ways to control asthma:
- Avoid triggers and monitor symptoms.
- Taking medications for the long-term, and consistently, to prevent asthma attacks.
- Short-term medications for the treatment of asthma in emergency cases, as soon as they arise.
If asthma is not monitored, it may cause frequent and prolonged absenteeism from school or work, which may reduce productivity.
The severity of asthma changes over time for most people, so it is necessary to undergo constant health monitoring and follow-up, monitor signs and symptoms, and adapt asthma treatment as needed.
Asthma symptoms range from mild to severe and vary from person to person.
Mild symptoms, such as wheezing and crackles, may appear during breathing, and asthma attacks may occur from time to time, and asthma symptoms may appear mainly at night hours or only when physical effort is exerted.
In between episodes, the patient may be in good condition and face no breathing difficulties.
How to Treat an Asthma Attack
Asthma symptoms and signs include:
- Shortness of breath.
- Contractions or chest pain.
- Sleep problems due to shortness of breath.
- Coughing, wheezing, or crackling when breathing.
- A whistling or crackling sound that can be heard on exhalation.
- Spells of coughing or cracking during breathing, which increase in intensity as a result of infection of the airways with a virus, in cases of cold and influenza, for example.
Signs of worsening asthma:
- Exacerbation of symptoms: an increase in the severity and frequency of symptoms of the disease.
- Fall in the maximum airflow rates: measured by the maximum expiratory velocity meter, which is a simple device designed to measure the level of lung performance.
- An increased need for the use of bronchodilators, which are drugs that open the airways, by relaxing the surrounding muscles.
It is necessary for the asthma patient to be under permanent medical observation, to check whether there is a need to increase the drug dose and when to increase it, or to take other measures to treat symptoms or the severity of the disease until it is controlled again.
But if asthma continues to worsen, there may be a need sometimes to go to the hospital. The doctor can help diagnose the signs and symptoms that require going to the hospital’s emergency room so that the patient is aware of when to go for help.
Causes and risk factors of asthma
It is unclear why some people develop asthma while others do not. It is likely that asthma is the result of a combination of several environmental and genetic factors (hereditary).
The factors that trigger asthma vary from person to person. Exposure to a large number of allergens (allergens – a substance that causes hypersensitivity) can trigger asthma signs and symptoms, including:
Airborne allergens, such as pollen (flower pollen), animal scales, mold, dust mites, and cockroaches.
Infection in the airways, such as in the common cold.
Physical activity (exercise-induced asthma).
- Air pollutants and allergens, such as smoke.
- Certain medicines, including beta-blockers, aspirin, and other anti-inflammatory drugs that do not contain steroids.
- Excessive emotion and tension.
- Sulfates (sulfuric acid salts), preservatives added to some food products.
- Gastroesophageal reflux disease (GERD), which is a condition in which acid from the stomach returns and reaches the throat.
- The menstrual cycle for some women.
- An allergic reaction to various foods, such as pistachios or mollusks.
Asthma is a widespread disease that affects millions of adults and children. It is also being diagnosed annually in an increasing number of people, but the reason for this is still unknown.
Asthma risk factors
There are a number of factors that are known to increase the risk of developing asthma, including:
- Previous cases of asthma in the family.
- Frequent infections in the airway during childhood.
- Passive smoking.
- Life in an urban area, especially if the air pollution there is great.
- Exposure to factors that may provoke disease in the workplace, such as chemicals in factories, used in agriculture, or in hairdressing.
- Small birth weight or obesity.
Asthma can cause many complications, including:
- Go to the emergency room and hospitalization (hospitalization) for the treatment of acute asthma. Permanent narrowing of the airways (re-structuring of the airways again). Side effects due to prolonged use of certain medicines to treat severe asthma.
It is difficult to diagnose asthma at times, and it may also be difficult at times to distinguish between asthma and bronchitis accompanied by wheezing, pneumonia, or another disease in the airways in response to certain stimuli.
In order to rule out other possible diseases, the doctor conducts a physical examination and asks questions about signs and symptoms and other health problems.
Sometimes a test of lung function is performed to determine the amount of air entering and leaving during the breathing process, with the aim of diagnosing asthma.
Lung function tests include:
1- Sperometer: This examination tests the extent of bronchial constriction, during which the amount of air that can be expelled after a deep inhalation is measured and at what speed is the exhalation.
2- Peak flow meter: The peak flow meter is a simple device that can be used at home and its detection of small changes that may occur, even before the symptoms are felt. If the result is lower than normal, that is an indication that asthma will soon appear. The doctor provides instructions on how to monitor and deal with low results.
Lung function tests are often performed before and after the use of a bronchodilator to open the airways.
If the person’s lungs have improved function as a result of their extended use, then it is likely that they have asthma.
Additional tests to diagnose asthma
- Methacholine Challenge: Inhaling a substance known to stimulate asthma by an asthmatic person, called methacholine, creates slight pressure in the airways. A positive result on the methacholine test confirms the diagnosis of asthma. Such an examination is performed if lung function tests show normal results.
- Nitric oxide test: It is a test sometimes used to diagnose and monitor asthma. It measures the amount of gas called nitric oxide in the breath. If there is inflammation in the airways – and this is a sign of asthma – the level of nitric oxide is higher than normal. This test is not common.
How is asthma classified?
In order to determine the severity and severity of asthma, the doctor – in addition to the physical examination and laboratory tests – evaluates the subject’s responses to symptoms related to symptoms (such as: How often do asthma attacks appear and how severe are they?).
Determining the degree of severity of asthma helps the doctor to choose the most effective asthma treatment, noting that the degree of severity of asthma often changes over time, which requires, therefore, the suitability of asthma treatment.
Asthma is divided into 4 general categories
1- Light alternating: mild symptoms for up to two days a week and up to two nights a month.
2- Fixed (permanent) hidden: symptoms more than twice a week, but not more than once a day.
3- Fixed (permanent) normal: symptoms once a day and more than one night per week.
4- Constant (persistent) severe: symptoms throughout the day, on most days, often at night.
Asthma treatment often includes avoiding the factors that trigger attacks and taking one or more medications, as asthma treatment differs from one person to another.
Most people with persistent asthma use a combination of long-term medication to control their asthma and a quick-relief medication that is given by an inhaler.
Since asthma changes with time, there is a need for medical follow-up, to monitor the symptoms, and to know which modifications and changes should be made in the treatment regimen to remain appropriate for the disease, always.
Treatment of asthma with drugs includes long-term medications aimed at controlling asthma, drugs for rapid relief (rescue), and medications to treat allergies, hypersensitivity to the antigen. The choice of medication depends on age and symptoms.
Chronic asthma medications
They are usually daily use medicines, and their types include:
- Corticosteroids inhaled: The aim of using this drug is to reduce the long-term severity and frequency of attacks and damage to asthma, but it should be noted that this medicine does not reduce the symptoms of the disease at the time of the acute attack.
- Long-acting beta-2 agonists (LABAs), such as salmeterol (Serevent Diskus): This type of medication is used to widen narrowed airways and reduce the possibility of severe asthma attacks.
- Leukotriene controls, such as Montelukast (Singulair): This is a drug that blocks certain substances that cause inflammation in the airways called leukotriene.
- Cromolyn and Nedocromil (Tilade): used to reduce the risk of developing an asthma attack when exercising or exposure to asthma triggers.
- Theophylline: This medication helps widen the airways to treat and relieve asthma symptoms.
- Medicines for quick relief: Also called rescue drugs – these drugs are used for rapid relief as needed, for immediate relief of symptoms, in the event of an asthma attack or before sports, or if the doctor recommended it.
Fast treatment for asthma
- Short-term beta-2 agonists, such as salbutamol.
- Corticosteroids to be swallowed or injected into a vein.
- Medicines for allergies that cause asthma. Medicines of this type reduce the sensitivity of the body to a specific allergen (the substance that causes hypersensitivity) or prevent the immune system from reacting to any of these allergens.
Allergy Asthma Treatment
- Treating asthma with the vaccine.
- The monoclonal antibody of the IgE type.
Through cooperation and joint work with the doctor, it is possible to set up a step-by-step program of action that facilitates facing asthma and preventing asthma attacks:
- Writing a program of action for the treatment of asthma.
- Identify and avoid the factors that provoke asthma.
- Monitor breathing.
- Identify seizures and treat them at an early stage.