What is Asthma?
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Pollutants and other factors in the environment, called triggers, can bring about an asthma attack. Triggers of asthma attack vary from person to person, but common ones include cold air; exercise; allergens such as dust mites, mold, pollen, animal dander, cockroach debris; and some types of viral infections.
When you breathe in, air travels through your nose and/or mouth through a tube called the trachea (commonly called “windpipe”). The trachea divides into bronchi, and these in turn subdivide 16-21 times into a series of smaller tubes (called bronchioles) that lead to the alveoli (air sacs). During an asthma attack, the bronchi and bronchioles become narrowed. Here is how an asthma attack occurs. When the airways come into contact with an asthma trigger, the walls of the bronchi and bronchioles become inflamed. Fluid and cellular debris accumulate in and around the walls making them thicker. At the same time, the muscles around the airways contract (bronchoconstriction), causing the lumen of the airways to become narrower. Narrowing of the airways makes breathing more difficult. Bronchoconstriction can be reversed rapidly with quick acting broncholilators but inflammation takes longer to reverse with slow acting drugs such as corticosteroids.
Asthma strikes across all ages, sexes and racial groups. People who suffer from asthma are exceptionally sensitive to pollutants in the environment. The airways of these people are in a chronic state of inflammation, and any minor exposure to one of the triggers can further stimulate the airways and cause then to constrict making breathing more difficult. The condition is more serious in people with allergies to environmental pollution because an allergic reaction can exacerbate asthma and can trigger asthma symptoms. Having colds and flu makes a person more susceptible to their asthma triggers. It is important to know that asthma episodes do not always occur immediately after a person is exposed to a trigger. Depending on the type of trigger and how sensitive a person is to it, asthma episodes may be delayed.
Asthma Facts and Figures
More people than ever say they are suffering from asthma. It is this country’s most common and costly illness.
The prevalence of asthma has been increasing since the early 1980s across all age, sex and racial groups. Asthma is more prevalent among children than adults, and among blacks than whites.
An estimated 26 million Americans suffer from asthma, nearly 8 million are under age 18. It is the most common chronic childhood disease.
Each day 14 Americans die from asthma.
Between 1979 and 1992, asthma related death rates increased 58 percent overall. The death rate for children less than 19 years old increased by 78 percent.
More females die of asthma than males and more blacks die of asthma than whites.
Many asthma-related deaths and hospitalizations are preventable when asthma is properly managed. People with asthma need to recognize early warning signs, avoid asthma triggers, take appropriate medications as prescribed, and seek prompt medical help when problems occur.
Treatment of asthma in 1998 was estimated to cost $11.3 ion. Hospitalizations accounted for the largest portion of the cost.
Asthma among children ages 5 to 17, accounts for most school absences.
For adults, asthma is the fourth leading cause of work loss, resulting in nine million lost workdays each year.
Asthma accounts for about 1.8 million emergency room visits and 10 million-doctor offices visits each year.
Who is likely to get asthma?
There are a number of factors that determine if one is likely to have asthma. The events that happen following exposure to an irritant in the air are a normal immune and defensive response. However, in people with asthma, the response may become exaggerated and out of control. Asthmatics may have predisposing conditions such as slightly inflamed airways that makes them more twitchy leading to an exaggerated bronchoconstriction and inflammatory response. Everyone’s airways constrict somewhat in response to irritating substances like dust and mold. In a person with asthma, the airways are hyper reactive. This means that the airways overreact to things that would just be minor irritants in people without asthma.
Doctors do not know for certain why some people get asthma and others do not. However, researchers have found that certain traits make it more likely that a person will develop asthma. To some extent, asthma seems to run in families. People whose brothers, sisters or parents have asthma are more likely to develop the asthma. In such cases, it is prudent to take precautions to avoid allergy and asthma triggers in children who have more likelihood of developing asthma.
How Is Asthma Treated?
There are many things that one can do to control asthma and minimize its impact on one’s life. Because each case of asthma is different, treatment needs to be tailored for each person. One general rule that applies, though, is before starting on medication it is important to protect yourself from asthma triggers. Avoidance of asthma triggers can be accomplished by cleaning up the air that you breathe starting at home. People can start by removing or avoiding the things in the environment that you know are irritants to your health and are factors that make your asthma worse. When these measures are not enough, it may be time to try one of the many medications that are available to control symptoms.
What Are Asthma Triggers?
If you have asthma, it is important to know what irritants and environmental factors can trigger asthma symptoms. These factors vary from person to person. Some of the more common factors or triggers are described here.
Allergens. In many people with asthma, allergy triggers can also trigger an asthma episode. These allergens are suspended in the air and can be inhaled, such as pollen, pet dander, mold, or dust mites. In addition, allergy to food may also precipitate an asthma attach. A severe allergy response is called anaphylactic shock. It is best to avoid exposure to known allergens in order to prevent asthma symptoms.
Tobacco smoke. People are aware that smoking can lead to cancer and heart disease. However, smoking is an important risk factor for people with asthma especially in children. Tobacco smoke is also a common trigger of asthma symptoms for all ages. People with children or other family members who have asthma should not smoke at home. Secondhand smoke (passive smoking) can trigger asthma symptoms in people with the asthma. Studies have shown a clear link between secondhand smoke and asthma, especially in young people.
Exercise. Asthma symptoms can be triggered by physical activities especially in cold air. This is called exercise-induced asthma. Symptoms during exercise may not appear until after several minutes of sustained exercise. The kind of physical activities that can bring on asthma symptoms also include such activities as laughing, crying, holding one’s breath, and hyperventilating (rapid, shallow breathing). The symptoms of exercise-induced asthma usually go away within a few hours. With proper treatment and management, a child with exercise-induced asthma can undertake a normal level of physical activity.
Other factors: Cold air, wind, rain, and sudden changes in the weather can sometimes bring on an asthma episode. Medications like aspirin can also be related to asthma episodes in adults who are sensitive to aspirin. Chemical irritants in the environment can also bring on an asthma episode. These irritants may include paint fumes, smog, aerosol sprays and even perfume. Each case of asthma is unique. If you have asthma, it is important to identify factors or triggers that would provoke asthma episodes. Because the symptoms do not always occur right after exposure, this may take a bit of detective work.
Asthma Management Plan:
Among the tools that a doctor uses to diagnose asthma is a test called spirometry in which pulmonary function is evaluated. Other additional respiratory tests may be needed, spirometry provides a complete set of information about the lungs condition, severity of asthma, and whether it is reversible with a bronchodilator. It is mandatory to diagnose and characterize asthma severity.
Spirometry is recommended:
At the initial visit
After treatment is initiated, and symptoms have stabilized, to document attainment of near normal lung function and to establish an appropriate dose of medication.
At least once every year to confirm conditions of airways.
Following a change in therapy.
There is no cure for asthma, however, there are several things that your doctor can provide to help you manage asthma and live a long and normal life. The doctor can help you establish a management plan, the goal of which is to help you recognize signs of asthma, avoid triggers, and prevent the symptoms. A good management plan according to the NIH guidelines should accomplish the following:
A patient should maintain normal activity.
Pulmonary function should be near normal.
Chronic and acute symptoms should not be present.
Recurring visits to the hospital should be minimal.
Optimal medication regime should be established.
Patient and family should be satisfied.
Monitoring your asthma:
Spirometry test is a comprehensive procedure done at the doctor’s office to test for lung function. Monitoring of lung conditions, however, can also be done at home using a simple device called a peak flow meter. A peak flow meter provides expiratory peak flow value, which is one of the most important parameters for pulmonary function. A peak flow meter for asthma is like a thermometer for a fever. It’s a tool that is integral to a management plan and helps the patient monitor what’s going in the lungs. Decisions about when to take medicine, when to see a doctor, when not to go to school, or when to participate in physical activity or a social event can be made with confidence.
Asthma should not prevent adults or children from doing anything. Some people are hesitant to do things because they are afraid asthma attack may occur. A quick test with a peak flow meter can give the patient the confidence to proceed with normal activity. Sometimes a person is feeling fine, but a quick test with the peak flow meter may reveal that lung function may be slightly decreased and special caution or more medication may be needed. A peak flow meter can help you determine airway changes and thus, better manage your asthma.