Asthma is a chronic (long-term) lung illness that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing.
Asthma affects people of all ages. As an example in the United States, more than 22 million people have asthma. Nearly 6 million of these people are children. Ginasthma and WHO has estimated that in 2011 about 300 million people got asthma world wide. In Norway approximately 1,5 millioner people got asthma and allergies. Facts from WHO: Chronic respiratory diseases worldwide caused over 4 million deaths in 2005, including over 3 million deaths from COPD and 255,000 deaths from asthma.
The airways in the lungs are tubes that carry air into and out of your lungs. Those airways in the lungs are called the bronchioles. People who have asthma have inflamed airways. This makes the airways swollen and very sensitive. This is not an inflammation as we normally know it like a sore throat, this one is chronic and will not go away. Only treatment is using asthma medicine that keep the asthma down. They who have asthma tend to react strongly to certain substances that are breathed in.
When the airways react, the muscles around them tighten. This causes the airways to narrow, and less air flows into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways may make more mucus than normal. Mucus is a sticky, thick liquid that can further narrow your airways.
This chain reaction can result in asthma symptoms. Symptoms are likely to happen each time the airways are irritated.
Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms. (Click image for bigger picture.)
Sometimes symptoms are mild and go away on their own or after minimal treatment with an asthma medicine. At other times symptoms continue to get worse. When symptoms get more intense and/or additional symptoms appear, this is an asthma attack. Asthma attacks also are called flare-up or exacerbation.
What happens in the airways?
There are three factors in particular which individually trigger attacks;
- Spasm of the musculature surrounding the airways. Airways tighten and you get a problem breathing.
- Inflammation of the mucosa in the airways – not due to infection. The inflammation leads to swelling of the mucosa and hence the bronchi become narrower and tighter. The work of breathing is increased and the sufferer feels short of breath.
- Collection of mucous in the airways.
It’s important to treat symptoms when you first notice them. This will help prevent the symptoms from worsening and causing a severe asthma attack. Severe asthma attacks may require emergency care, and they can cause death.
Asthma can’t be cured. Even when you feel fine, you still have the illness and it can flare up at any time.
But with today’s knowledge, medicines and treatments, most people who have asthma are able to manage the disease. They may have few, if any, symptoms, or have more but can treat it themselves. Treatment with asthma medicines increase the chance to live normal active lives, and sleep through the night without interruption from asthma.
For successful, comprehensive, and ongoing treatment, take an active role in managing the illness.
What Causes Asthma?
The exact cause of asthma isn’t known. Researchers think a combination of factors (family genes and/or certain environmental exposures) can interact to cause asthma to develop, most often early in life. No more than one factor is needed, but more than one factor together can be the cause. These factors include:
- An inherited tendency to develop allergies, called atopy (AT-o-pe)
- Parents who have asthma
- Certain respiratory infections
- Contact with some airborne allergens or exposure to some viral infections.
- Non-inhereted asthma is developed by for example tobacco smoke, chemicals, dust, compounds in home decor products, sprays, damage caused by damp in houses, mould, cold and more.
- Some people develop asthma because of exposure to certain chemical irritants, fumes or industrial dusts in the workplace. This is called occupational asthma.
If you got asthma exposure to airborne allergens (for example, house dust mites, cockroaches, and possibly cat or dog dander, chemicals) and irritants (for example, tobacco smoke, parfume a.s) make your airways more reactive to substances in the air you breathe.
Different factors may be more likely to cause asthma in some people than in others. Researchers continue to explore what causes asthma.
Most, but not all, people who have asthma have allergies.
What Are the Signs and Symptoms of Asthma?
Common asthma symptoms include:
- Coughing. (Coughing from asthma is often worse at night or early in the morning, making it hard to sleep. But it also occur in daytime or when you are exposed to things you are sensitive to.)
- Wheezing. Wheezing is a whistling or squeaky sound that occurs when you breathe.
- Chest tightness. This may feel like something is squeezing or sitting on your chest.
- Shortness of breath. Some people who have asthma say they can’t catch their breath or they feel out of breath. You may feel like you can’t get air out of or in your lungs.
A lung function test, done along with a medical history (including type and frequency of your symptoms) and physical exam, is the best way to diagnose asthma for certain. Your doctor will use a test called spirometry (PEF) to check how your lungs are working.
This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. When your asthma get worse the result from the test gives a lower rate, and the more sick you are in asthma at the time of the test the lower result you get. Your doctor also may give you medicines and then test you again to see whether the results have improved. If the starting results are lower than normal and improve with the medicine, and if your medical history shows a pattern of asthma symptoms, your diagnosis will likely be asthma.
If your suspect your asthma is work related it is smart to make separate tests at home and at work at the same time over time to see if there is any difference in your lung capasity between the places. This helps determine if your lungs works best at home or at work. Other tests that may be taken by your doctor is allergy testing.
One measure the lung capacity and also forces an attack to break out the check if there really are asthma. A test to measure how sensitive your airways are. This is called a bronchoprovocation test. Using spirometry, this test repeatedly measures your lung function during physical activity, after you receive increasing doses of cold air or a special chemical to breathe in. (This one is a real nightmare. I got so tight airways that I could not breathe. Like putting a sock down your throat. Had to inhale a lot of medicine after to be ok again. I never want to do that again if I can help it. It took all afternoon the get my strength back. Annelie’s comment)
The types of asthma symptoms you have, how often they occur, and how severe they are may vary over time. Sometimes your symptoms may just annoy you. Other times they may be troublesome enough to limit your daily routine.
Severe symptoms can threaten your life. It’s vital to treat symptoms when you first notice them so they don’t become severe.
With proper treatment, most people but not all who have asthma can expect to have few, if any, symptoms either during the day or at night. But it is important to avoid what makes your asthma break out if possible. Subjecting yourself to what makes your asthma break out will make the illness worsen over time. It is also very important that the people round you is considerate and caring to help you avoid that when necessary.
(September 2008 I have had my asthma for one year. In November 2008 I have had an astma attack that made me have to go the hospital and get connected to a machine that gave me asthma medicine to inhale for 15 min. I coughed very hard and had a tight chest. I got very weak and had trouble breathing and got sick leave. Annelie’s comment)
What Causes Asthma Symptoms To Occur?
A number of things can bring about or worsen asthma symptoms. Your doctor will help you find out which things (sometimes called triggers) may cause your asthma to flare up if you come in contact with them. Triggers may include:
- Allergens found in dust, animal fur, cockroaches, mold, and pollens from trees, grasses, flowers a.s
- Irritants such as cigarette smoke, smoke, fumes, air pollution, chemicals or dust at home, public places, transportation or in the workplace, compounds in home decor products, and sprays.
- Certain medicines such as aspirin or other non-steroidal anti-inflammatory drugs and non-selective beta-blockers
- Sulfites in foods and drinks
- Viral upper respiratory infections such as colds and airway infections
- Exercise (physical activity)
- People with food allergies (f.eks nuts) can in addition to normal allergy reactions get an asthma attack.
- Psychological and emotional stress, including stress, grief, depression a.s
- Laughter, big positive emotions a.s.
- Fright, being afraid is a kind of stress and can trigger asthma.
- Excitement do a reaction to the body, that can trigger asthma.
- Sex, involves all of the emotional levels mentioned and can trigger asthma.
Other health conditions—such as runny nose, sinus infections, reflux disease, psychological stress, and sleep apnea—can make asthma more difficult to manage. These conditions need treatment as part of an overall asthma care plan.
In dayly contact with an asthmatic person you should always consider these facts. Employ it in your dayly rutines to help the asthma sick person to remain well.
Causing unnecessary psychological stress on an asthma sick person can cause serious effects on that person’s health. Asthma is located in the same groups of illness as psoriasis and eczema that worsens from stress, grief and psychological stress. Try to solve problems to help the asthma sick person remain well. Great stress are damaging for the health of an asthmatic.
Asthma is different for each person. Some of the factors listed above may not affect you, other factors that do affect you may not be on the list. It is very personal what triggers asthma and how much you react to them.
Source: nhlbi.nih.gov, Norges Astma- og Allergiforbund NAAF, and own experiences.
On Wikipedia you can read even more: http://en.wikipedia.org/wiki/Asthma
First posted 30. november 2008 19:39
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