Asthma is one of the more popular conditions that affect people and has been increasing in prevalence over the years. To date, one in four urban children are affected with asthma, and an approximate 20.5 million Americans have asthma.
The condition was identified by Greeks with the term, aazein, which meant “sharp breathâ€. While the word aazein first appeared in Homer’s Iliad, it was only used to describe the said medical condition around 450 BC by Hippocrates. Hippocrates noted, during this time, that the spasms relating to asthma were common among tailors and metalworkers. Galen, six centuries later, studied asthma in great detail and observed that the symptoms of asthma included bronchial obstruction. It was later on studied by the influential medieval philosopher, rabbi, and physician Moses Maimonides in 1190 AD, who wrote a treatise on the prevention, diagnosis, and treatment of asthma. The connection between asthma and organic dust was made in the 17th century by Bernardino Ramazzini. It was only in the year 1901 that bronchodilators became widely used, and not until the 1960s that physicians recognized the need for anti-inflammatory medication in order to deal with a previously unrecognized inflammatory aspect of asthma symptoms.
What is Asthma?
Asthma is a chronic respiratory condition that is characterized by the inflammation of the airways. When a person has asthma, his or her airways get inflamed as a result of exposure to any range of asthma triggers. The airways, tubes proximate to your lungs that carry air to and from the lungs, constrict, limiting the amount of air that travels through the airway, swells, and becomes lined with excessive amounts of mucus. Some of the common symptoms that accompany asthma include a feeling of tightness in the chest cavity, wheezing, coughing, and shortness of breath.
When the symptoms of asthma are extreme, the situation is usually referred to as an asthma attack or an episode of asthma. Usually, these symptoms are managed with a combination of drugs (usually bronchodilators which are drugs that help open the airway) and a change in environment.
How can you know that you have asthma?
Usually, it is easy for a physician to diagnose a person as having asthma on the basis of the patient’s medical history .A history, for example, of eczema or other allergic conditions that point to an atopic constitution, makes the patient a likely candidate for asthma. A family history of asthma is also taken into consideration during diagnosis. The primacy of family history and medical history in diagnosing asthma is usually for when children are being diagnosed, as a lot of other more scientific means of diagnosis cannot be performed on children.
Some of these more scientific means of diagnosis for adults include a study of the reaction to bronchodilator medication, peak flow meter, and a formal lung function test.
In studying the reaction to bronchodilator medication, a person is asked to take a bronchodilator drug. The subsequent improvement following the introduction of an inhaled bronchodilator drug shows whether or not the person has asthma.
The peak flow meter, on the other hand, tests airway restriction by looking at both reversibility following the inhaled bronchodilator, and the diurnal variation. A variation of the peak flow meter test may be done on young asthmatics who experience asthma induced by exercise: the peak flow at rest (or baseline peak flow) and the peak flow after exercise is measured for comparison.
The lung function test, also known as spirometry, is one of the pulmonary function tests (PFTs) that may be done in order to test for asthma. Usually, the spirometer used displays volume-time curve, or the volume of air, and flow-volume loop, or the rate of the airflow through the lungs.
Other doctors may also examine chest x-rays, perform a variety of blood tests, and even measure arterial blood gas.
What triggers asthma?
There are a huge variety of environmental, usually external stimuli that can trigger asthma. There are ten recognizable categories of asthma triggers. These include the allergenic air pollutants that come in the form of dust mites, pet epithelial cells, grass pollen and mold spores. Allergens that come from the indoor pollution of newsprint, junk mail, leaflets, and magazine particulates may also trigger asthma. Other external stimuli include exposure to fossil fuels that contribute to allergenic air pollution, which is the reason why there is a greater proclivity to asthma in urban areas, and a variety of other chemical compounds.
Food allergies, like allergies to peanuts, milk, and eggs may trigger asthma. However, these allergies that trigger asthma also calls on a host of other symptoms that are characteristic of their food allergy reactions. Medication such as aspirin, beta-blockers, and other non-steroidal anti-inflammatory treatments may trigger asthma. These beta-blockers and anti-inflammatory treatments are also called bronchoconstrictors, and narrow the air passage way of some patients.
Emotional stress, while unpopular among the other asthma triggers, is in fact one of the more common asthma stimulants. Hormonal changes in adolescent and adult females during their menstrual cycle and even during pregnancy have been known to increase the likelihood of an asthma attack, and may aggravate the episodes of asthma they experience. Early childhood infections, especially viral respiratory infections are also known to trigger the onset of an asthma attack. This is the reason why the onset of the common cold can make a person suffering from asthma prone to the possibility of an asthma attack. One asthma trigger has a potentially different trigger, and this is exercise. As mentioned earlier, even the tests administered in order to determine having asthma is different from those whose asthma attacks are triggered by exercise.
How extreme can asthma attacks get?
Based on the symptoms displayed by those suffering from asthma, there are four basic levels of asthma severity. The first level is called mild intermittent, which means that the person suffering from asthma has asthma attacks twice a week or less, has regular lung function, is bothered by symptoms at night at least twice a month, and experience no other symptoms. This is a sort of asthma that more or less “comes and goes†and causes no particular discomfort to a person affected by it.
The second level is called a mild persistent asthma. Mild persistent asthma causes asthma attacks more than twice a week but no more than once per day. A person with mild persistent asthma is bothered by asthma at night at least twice per month, and do experience the other symptoms of asthma sufficiently to affect his or her activities.
Moderate persistent asthma means that asthma symptoms manifest themselves everyday, causing discomfort from nighttime symptoms more than once a week. Asthma attacks themselves pose effects to most activities.
Severe persistent asthma, the highest of these four levels, means that asthma symptoms manifest themselves throughout the day on most days, with nighttime symptoms causing inconvenience often. With severe persistent asthma, limits to physical activities exist.
When does an asthma attack turn into an emergency?
The symptoms of asthma are wide-ranging as the various triggers that can cause it. However, there are telling emergency symptoms that would require more attention than other asthma attacks. The symptoms of an emergency attack include extreme difficult breathing. This difficulty in breathing may cause the lips and the face to turn blue, and cause the pulse to accelerate. There may also be severe anxiety from this shortness of breath, sweating, and a decrease in the level of alertness that may cause severe confusion or drowsiness.
How does the future look for people with asthma?
Unfortunately, asthma does not have one single cure. However, a variety of medications as well as self-monitoring can help a person with asthma enjoy the life of a normal person.
Some of these medications include anti-inflammatory drugs, bronchodilators, among others. Self-monitoring and management, which will entail consciously avoiding known allergens, may also help manage the occurrence of asthma.
Though there has been evidence that asthmatic symptoms do decrease over time yet an attack can be precipitated even after years of remission. So one has to be prepared to deal with one with the help of nebulizers or inhalers which help the delivery of drugs at the exact site of action in a short time and abort an attack instantly. Another modality of treatment is sensitization to the allergens which involves slow and controlled exposure to the allergens in order to sensitize the receptors which lead to release of asthmatic mediators leading to narrowing of airways and the cascade of events which ultimately lead to an asthma attack. Thus the basic cause of the disease is modified and the occurrence of asthma attacks is greatly reduced. This therapy is however quite time consuming and if a person is sensitive to many allergens then quite cumbersome and not very effective.
So you can see that life of an asthma patient can be quite distressing which in turn increases the frequency of attacks due to emotional stress of the disability. Hence it is very important to take utmost care of such people and give them emotional support whenever needed. This helps them to lead a more successful and purposeful life.
Related Links:
http://en.wikipedia.org/wiki/Asthma
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