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Asthma ClearlyExplained.Com

Asthma

ClearlyExplained.Com

14th April 2007

by Dr. Pradeep Bhandari M.B.B.S., M.MED

A straightforward and fast information
guide to Asthma from ClearlyExplained.Com

The lungs are most affected by asmtha
image: www.3dscience.com

What is asthma?

Asthma is a very common long-term medical condition in which one experiences difficulty in breathing and other associated symptoms whilst coming in contact with certain triggering factors. Some people may only have a few symptoms, where as others may have many. Some people may experience it periodically where as others may do so all the time. Asthma can cause a lifetime of suffering and interference with normal lifestyle.

It can also be life-threatening if the symptoms are not well controlled with medications. It is wise to see the doctor if a person thinks that he or she has developed asthma. Doctors diagnose the condition by examining the patient and conducting certain tests. They then prescribe medications which can keep the condition under control.

What
Why
News
How
History
Future

Why is asthma Important?

Asthma consumes a large share of limited health resources and is a major public health problem in developed countries. Frequent visits to the doctor and the emergency departments, as well as the hospitalisation, the cost of treatment and other associated costs, make asthma one of the most cost-incurring medical conditions for the governments.

Cost of asthma

In 2000/2001 alone the health expenditure on asthma in Australia was estimated to be $693 million. This was 1.4% of total health expenditure in that year. The proportion of this expenditure attributed to asthma care was highest among children; particularly boys aged 5–14 years. Over half (54%) of the above mentioned expenditure allocated to asthma was attributed to pharmaceuticals.

Millions of work days are lost to asthma annually, a factor which makes the disease of significant interest to employers. The Australian Burden of Disease Study estimated that asthma accounted for 64,523 disability adjusted life years (DALYs) in 1996.

News about asthma

Asthma is often reported in the press, particularly in relation to new treatments.

• Google News Search - Asthma
• Yahoo! News Search - Asthma

1 May 2007 is World Asthma Day

Some reliable and user-friendly resources on Asthma and its recognition and management are:

• Asthma UK
• Wikipedia - Asthma
• NHS Direct - Asthma
• Patient UK
• Asthma & Allergy Information & Research
• BUPA
  

How does asthma occur?

Asthma occurs when the muscles around the small airways(bronchi) that allow air to get in an out of the lungs tighten due to irritation. The airways in a person with asthma is very sensitive and can easily swell and produce sticky mucous and phlegm. The net effect on the sufferer is the great difficulty in breathing, together with wheezing, coughing and tightness in the chest. Symptoms vary day to day, but are often worse at night and with exercise. Symptoms worsening quickly, difficulty in breathing and talking, flaring of nostrils, extreme tightness in the chest, lips and finger nails turning blue and racing pulse are indications of a severe attack when one should immediately seek medical help.

It is difficult to say what causes asthma. Asthma is partly allergic and partly genetic. A person is more likely to develop asthma if there is a history of asthma or other allergic conditions in the family. Household irritants, environment and work place pollution, and sometimes even particular foods can cause or worsen asthma. Smoking by a pregnant mother can lead to her child developing asthma, and children of parents who smoke have chances of developing it too. Asthma sometimes follows a viral infection.

How is asthma Treated?

Proper treatment of Asthma is essential to remain free of symptoms and lead a normal healthy life with minimal attacks that can be quickly controlled with medicines. This also means using quick-relief medicines less often. An evaluation of the condition by the doctor, setting up of treatment goals, and learning to meet those goals by recognising the worsening of symptoms and responding to prevent an attack, are the essence of treatment.

Medicines used for the control of asthma fall into two types:

1. Quick-relief medicines that are taken as soon as the symptoms occur. They are used as inhalers to provide instant relief from the symptoms and can be either short or long acting. Some of the medicines in this category are beta-agonists such as Salbutamol and Terbutaline, which act as bronchodilators.

2. Long-term control medicines are used for prevention of the asthma attacks and thus need to be taken every day for longer periods of time. The medicines take days to weeks to have their full effect. People with persistent asthma generally require this type of medicines. Medicines in this group are corticosteroid and long-acting beta-agonist inhaler, leukotriene modifiers, Cromolyn and nedocromil, and theophylline.

If these medicines are stopped abruptly, asthma is likely to worsen. Necessary changes in the treatment regimen needs to be made with the changes in the clinical condition of the patient. A self-management plan is also required that includes monitoring the lung function with a ‘Peak Flow Meter’. In addition, it is also necessary to recognise and avoid things that make asthma worse, and to know when to see the doctor and when to seek emergency medical treatment.
During a severe and acute attack of asthma, the steroids and other drugs are used in tablet or other forms, as well as with nebuliser that can help deliver more amounts of the drugs to the most effective areas of the lungs.

History of asthma

The word 'asthma' comes from the Greek word ‘aazein’ which means a sharp breath. Hippocrates used this term in 450 BC for the medical condition that caused spasms similar to asthma, which he had noted more frequently in metalworkers, tailors and others who worked in polluted environment. Scholars have explained the condition more explicitly only after centuries since Hippocrates first referred to it. The connection between asthma and organic dust was noted around the 17th century. The use of bronchodilators started in 1901, but the inflammatory component of asthma was recognised only in the 1960s, with a consequent use of anti-inflammatory medications for the treatment of asthma. Several studies have been conducted on the cause, effect and treatment of asthma. One of the recent studies in the control of this condition includes the protection of children from respiratory allergies and asthma by eating a Mediterranean type diet rich in fruits and vegetables.

Asthma is a complex human disease that is not accurately depicted in other species. However, rhesus monkeys have been increasingly used for studying the immunological aspect of asthma and the effect of drugs on the allergies. The ability to measure lung function in these monkeys in a similar way to human has remained an advantage for such research. Some of the studies have shown that occasional exposure to the air pollutant ozone can change how the lungs of young rhesus monkeys develop and lead to a disease similar to childhood asthma in humans.

Future of asthma

Although there is no cure for asthma yet, new understanding of the immunology of the disease and gradual discovery of genes having strong links to asthma has given hope for the development of new drugs that can provide timely and better control of the condition. There are many ongoing researches that are striving to find improved treatment for asthma. There are also possibilities of controlling the condition, or even avoiding it altogether, through gene treatment in the future.