Asthma – Diagnosis & Treament

Main Features of Asthma:

1. Airway obstruction.

During normal breathing, the bands of muscle that surround the airways are relaxed, and air moves freely. But in people with asthma, allergy-causing substances and environmental triggers make the bands of muscle surrounding the airways tighten, and air cannot move freely.

Less air causes a person to feel short of breath, and the air moving through the tightened airways causes a whistling sound known as wheezing. Fortunately, this airway narrowing is reversible, a feature that distinguishes asthma from other lung diseases such as bronchitis or emphysema.

2. Inflammation. 

People with asthma have red and swollen bronchial tubes. This inflammation is thought to contribute greatly to the long-term damage that it can cause to the lungs. And, therefore, treating this inflammation is key to managing asthma in the long run.

3. Airway irritability.

The airways of people with asthma are extremely sensitive. The airways tend to overreact and narrow due to even the slightest triggers such as pollen, animal dander, dust or fumes. People who have a family history of asthma have an increased risk of developing the disease.

However, anyone can develop asthma at any time, and adult-onset asthma happens frequently. If you have symptoms , talk to your doctor. If you have adult-onset asthma, your doctor will instruct you in using the inhalers and other medications to prevent further breathing problems

Major Symptoms

People with this disease experience symptoms when the airways tighten, inflame, or fill with mucus. Common symptoms include:

• Coughing, especially at night
• Wheezing
• Shortness of breath
• Chest tightness, pain, or pressure

Still, not every person with this condition has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your symptoms may also vary from one attack to the next, being mild during one attack and severe during another.

Some people with may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms called asthma attacks. Others might have symptoms every day. In addition, some people only have asthma during exercise or with viral infections like colds.

Mild attacks are generally more common. Usually, the airways open up within a few minutes to a few hours. Severe attacks are less common but last longer and require immediate medical help. It is important to recognize and treat even mild symptoms to help you prevent severe episodes and keep it under better control.

Know the Early Symptoms

Early warning signs are changes that happen just before or at the very beginning of an attack. These attack symptoms may start before the well-known symptoms of asthma and are the earliest signs that your asthma is worsening.

In general, these signs are not severe enough to stop you from going about your daily activities. But by recognizing these signs, you can stop an attack or prevent one from getting worse. Early warning signs include:

• Frequent cough, especially at night
• Losing your breath easily or shortness of breath
• Feeling very tired or weak when exercising
• Wheezing or coughing after exercise
• Feeling tired, easily upset, grouchy, or moody
• Decreases or changes in lung function as measured on a peak flow meter
• Signs of a cold, or allergies (sneezing, runny nose, cough, nasal congestion, sore throat, and headache)
• Trouble sleeping

The condition is characterized by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes. Not all adults with asthma wheeze. Chronic coughing  may be the only obvious sign, and adult asthma may go unrecognized if the cough is attributed to recurrent bronchitis. If you have early warning signs or symptoms, you should take more medication as described in your asthma action plan.

Know the Symptoms of an Asthma Attack

An asthma attack is the episode in which bands of muscle surrounding the airways are triggered to tighten. This tightening is called bronchospasm. During the attack, the lining of the airways becomes swollen or inflamed and the cells lining the airways produce more and thicker mucus than normal.

All of these factors — bronchospasm, inflammation, and mucus production — cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack include:

• Severe wheezing when breathing both in and out
• Coughing that won’t stop
• Very rapid breathing
• Chest pain or pressure
• Tightened neck and chest muscles, called retractions
• Difficulty talking
• Feelings of anxiety or panic
• Pale, sweaty face
• Blue lips or fingernails

The severity of an attack can escalate rapidly, so it’s important to treat these symptoms immediately once you recognize them. Without immediate treatment, such as your inhaler or bronchodilator, your breathing will become more labored. If you use a peak flow meter at this time, the reading will probably be 50%.

Treatment

If you or a loved one has asthma, it’s important that you know about the most effective treatments for short-term relief and long-term control. Understanding treatments will enable you to work with your doctor to confidently manage your symptoms daily. When you do have an attack or symptoms, it’s important to know when to call your doctor or asthma specialist to prevent an asthma emergency.

Medications

Medications can save your life — and let you live an active life in spite of your asthma. There are two basic types of medications used in treatment:

Steroids and Other Anti-Inflammatory Drugs

Anti-inflammatory medications, particularly inhaled steroids, are the most important treatment for most people with this disease. These life saving medications prevent the disease attacks and work by reducing swelling and mucus production in the airways. As a result, the airways are less sensitive and less likely to react to its triggers and cause asthma symptoms.

Bronchodilators

Bronchodilators relieve the symptoms by relaxing the muscle bands that tighten around the airways.

Short-acting bronchodilator inhalers are used to quickly relieve the cough, wheeze, chest tightness, and shortness of breath caused by asthma (they dilate or widen the bronchial tubes). The most commonly prescribed short-acting bronchodilator is Albuterol. However, Albuterol only lasts for a few hours. If you need to use a reliever more than twice a week, then your asthma is not optimally controlled.  Ask your doctor about improving your asthma controller medication.

Long-acting bronchodilators are often combined with inhaled steroids when someone has asthma symptoms more than once a week despite treatment with an inhaled steroid alone.

For in-depth information, see WebMD’s article on Bronchodilators: Airway Openers.

Inhalers

Inhalers are the most common and effective way to deliver medication to the lungs. There are some combination inhalers, which contain two different medications: an inhaled steroid and a long-acting bronchodilator. These combination inhalers are popular due to their convenience, and the medications last for at least 12 hours.