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| Asthma |
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According to the American Lung Association,
more than 20 million Americans have asthma, four million under
the age of 18. The disease often starts in younger people
but can occur at any time in life from childhood to adulthood.
While many sufferers are able to manage the disease, every
year nearly a half million hospitalizations occur and 5,000
people lose their lives to asthma.
Asthma is a condition in which the airways in the lungs (bronchial
tubes) narrow in response to various stimuli, such as allergens
or stress. With appropriate treatment, obstruction can be
reversed; that is, airways can be re-widened to allow for
adequate airflow.
Cells in the bronchial tubes have three different types of
receptors that alter airflow. One type is sensitive to certain
chemicals that make airway muscles relax and widen to increase
the flow of air. A second and third type reacts to different
chemicals to force muscles to contract and decrease the rate
of airflow.
During an asthma attack, airway muscle bands tighten, linings
become inflamed, mucus is overproduced and air is obstructed
from passing through the bronchial tubes easily.
Asthma is more common among individuals with a family history
of the disease.
Cause: Certain “triggers” – responses
to allergic and non-allergic stimuli which differ from patient
to patient and from time to time -- can cause an asthma episode.
These include:
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Pollen, dust mites, cockroaches,
feathers, pets, foods, mold and other common allergens |
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Infections, such as colds, flu and viruses |
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Sinusitis |
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Tobacco smoke |
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Cold air and changes in temperature |
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Air pollutants and irritants |
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GERD (gastroesophageal reflux disease),
when stomach acids back up into the esophagus |
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Physical exercise |
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Certain food preservatives |
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Some medications |
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Emotions, such as laughing or crying
hard |
Symptoms: Shortness of breath, a tight feeling or pain
in the chest, frequent coughing and wheezing are the most
common signals. These symptoms can be mild to so severe that
the individual gasps for breath and experiences extreme anxiety.
Sweating, pounding chest, a rapid pulse, confusion, and lethargy
may also occur in severe attacks. A person’s skin may
take on a blue cast because the oxygen supply is decreased.
He or she may even lose consciousness.
Diagnosis: Because symptoms of asthma are similar to
other lung diseases, diagnosis can prove difficult. After
determining the person’s medical and family history
and conducting a physical exam, the physician may perform:
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Pulmonary function tests,
to find out how much air is moving in and out of the
lungs |
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Peak flow meter test, to measure the
speed air is expelled |
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Methacholine bronchial challenge. When
the chemical methacholine is inhaled, the asthmatic
person’s airways constrict mildly. |
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Allergy and skin testing |
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Blood test |
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Spirometry test before and after exercise
to assess the degree of airway blockage |
Treatment: While asthma can’t be cured, it can
be controlled with medication to ease symptoms and avoid hospital
emergency visits. Anti-inflammatory drugs that reduce swelling
and production of mucus and help stave off reactions to triggers
are the most help in managing the condition. They include
corticosteroids and leukotriene modifers. Leukotrienes cause
airway linings to become inflamed.
Bronchodilator medications may be used to open airways by
relaxing the muscle bands around them. Some types are long-acting
to help control symptoms; some are short-acting to provide
quick relief during flare-ups.
Immunotherapy can help some individuals avoid asthma triggers
through injections of small doses of allergens. Over time,
this may reduce sensitivity to the allergens.
Physicians often suggest an asthma action plan for patients.
This plan clearly outlines medication use, describes what
to do when the condition gets worse, and lists signs that
indicate the need for emergency treatment.
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