Here’s what you need to know about Asthma

Asthma is a condition characterised by the airways narrowing, swelling and even producing extra mucous. This can lead to breathing difficulty, coughing and there may be a whistling sound (wheezing) when you breathe out.

It may be mild in some people but for others it can be severe and interfere with daily activities. It is a chronic condition that cannot be cured, but its symptoms can be controlled.

If you think you have Asthma, maybe have frequent coughing or wheezing that lasts more than a few minutes you need to see your doctor urgently. Treating Asthma early may prevent long-term lung damage. Don’t take more medication than prescribed. Overusing can cause side-effects and may make your Asthma worse.

Symptoms

Asthma symptoms vary from person to person and include:

• Shortness of breath
• Chest tightness or pain
• Wheezing when exhaling
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu. Your Asthma may be worsening if signs and symptoms are more frequent or you have increasing difficulty breathing or you need to use a quick-relief inhaler more often.
  For some people, Asthma symptoms may be triggered by exercise, workplace fumes, allergic reactions, respiratory infections like a common cold, smoking, certain medications and even strong emotions and stress.

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Risk factors

A number of factors are thought to increase your chances of developing Asthma. They include:

• Having a blood relative with Asthma.
• Having another allergic condition, such as atopic dermatitis or hay fever.
• Being overweight.
• Being a smoker.
• Exposure to smoke.
• Exposure to exhaust fumes or other types of pollution.
• Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing.

Prevention

There is no way to prevent Asthma but the following will prevent triggers from leading to an attack:

• Follow your Asthma action plan as guided by your doctor.
• Get vaccinated for influenza and pneumonia.
• Identify and avoid Asthma triggers such as allergens and irritants. Also, immediately stop any activity that may have triggered the attack. If your symptoms don’t improve, get medical help as directed in your action plan.
• Monitor your breathing. You may learn to recognise warning signs of an impending attack, such as slight coughing, wheezing or being short of breath.
• Identify and treat attacks early. If you act quickly, you’re less likely to have a severe attack.
• Take your medication as prescribed. Don’t change your medications without first talking to your doctor, even if your Asthma seems to be improving.
• Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your Asthma isn’t under control. See your doctor about adjusting your treatment.

Diagnosis

Your doctor will perform a physical exam to rule out other possible conditions, such as a respiratory infection or chronic obstructive pulmonary disease. Your doctor will also ask you questions about your signs and symptoms.

Tests to measure lung function

You may be given lung function tests to determine how much air moves in and out as you breathe. These tests may include:

• Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
• Peak flow. A peak flow meter measures how hard you can breathe out. Lower than usual peak flow readings are a sign that your lungs may not be working well and the Asthma may be getting worse.

Treatment

Prevention and long-term control are key to stopping Asthma attacks. Treatment involves recognising triggers, avoiding triggers and tracking your breathing to make sure your medications are keeping symptoms under control.

In case of an Asthma flare-up, you may need to use a quick-relief inhaler. The right medications for you depend on a number of things – your age, symptoms and Asthma triggers.

Preventive, long-term control medications reduce the swelling (inflammation) in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. Long-term Asthma control medications are the cornerstone of treatment.

Types of long-term control medications include:

• Inhaled corticosteroids. You may need to use these medications for several days to weeks before they reach their maximum benefit. Inhaled corticosteroids have a relatively low risk of serious side effects.
• Leukotriene modifiers. These oral medications relieve Asthma symptoms. Montelukast has been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking.
• Combination inhalers. These medications contain a long-acting beta agonist along with a corticosteroid.
• Theophylline. This helps keep the airways open by relaxing the muscles. Quick-relief (rescue) medications are used as needed for rapid, short-term symptom relief during an Asthma attack.
• Short-acting beta agonists. These inhaled, quick-relief bronchodilators act within minutes to ease symptoms.
• Anticholinergic agents. They immediately relax your airways, making it easier to breathe.
• Oral and intravenous corticosteroids. These relieve airway inflammation.

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