Asthma Symptoms and Treatment
Asthma is a temporary narrowing of the tubes through which air flows into and out of the lungs. This narrowing is caused by a spasm in the tiny muscles which surround the air tubes. The problem is further aggravated by the excess production of phlegm in the lungs and swelling of the lung tissue through inflammation.
The narrowing of the airways causes shortness of breath and wheezing. Asthmatics usually find they cannot breathe out easily because, as they try to exhale the lung collapses further, and the small amount of space left in the airways is obliterated. Asthmatic symptoms also include coughing, particularly in children, or a mild tightness and discomfort in the chest.
If asthma is suspected, the first step is to perform tests on the lungs to assess their function. This involves blowing into a number of different machines which either draw a graph a doctor can interpret, or give a reading on a gage. The tests are performed on several occasions at different times of the day before a definite diagnosis of asthma is made. The patient's response to medication is also checked on these machines.
Many people who have asthma never see a doctor, even though they may be aware of the diagnosis. Although they may feel well, they often do not have their asthma under adequate control. Their quality of life and exercise tolerance could be improved dramatically if a doctor saw them regularly to keep their asthma under review. Attacks may build up slowly over many weeks, and the individual may be unaware of the deterioration in his lung function until it is measured.
The absolute cause of asthma is unknown, but certain triggers can start an attack in susceptible individuals. The triggers include colds and other viral infections, temperature changes, allergies, exercise, smoke, dust and other irritants. Once the diagnosis has been established, it is important to identify any trigger substances which might start an attack. This can often be done by the patient on a trial and error basis, but an allergist is usually called upon in severe cases to help in the identification of potential risk factors.
A tendency to develop asthma runs in families, along with hay fever and some forms of eczema. If you have a parent with asthma, you have a 15 times greater chance of developing it than the average person.
The treatment of asthma is divided into two broad categories - prevention of attacks, and treatment of the acute attacks when they occur. It is true that asthma cannot be cured, but doctors can control the disease very effectively in the vast majority of patients. Asthma treatment is a team effort involving the doctor, physiotherapists and other health professionals, and the cooperation of the patient and his/ her parents and family is vital.
Prevention is always better than cure, and all but the mildest of asthmatics should be using one or more of several different types of sprays or tablets to prevent attacks. These include steroid sprays such as Aldecin, and anti-allergy sprays. If one form of prevention does not work, other types should be tried, or combinations used, under doctor recommendations. Severe asthmatics may need to use prednisone tablets (a type of steroid) to both prevent and treat their attacks. These may have significant side effects if used over long periods of time, and their dosage must be kept to a minimum under the strict guidance of a doctor. Some asthmatics who react to specific substances may benefit from allergen desensitization.
The best way to treat an asthma attack is by aerosol sprays which take the drug directly into the lungs where it is needed. These can be in the form of pressure pack sprays, motor or gas driven nebulisers, or capsules which can be broken and their powder inhaled. They act to dilate the airways and liquefy the thick mucus. These are a class of drugs called sympathomimetics and include Ventolin, Respolin, Bricanyl and Berotec. A spray called Atrovent is often used in conjunction with these. Many of these sprays can have their effectiveness and ease of use improved, particularly in children, if a spacing device such as a Misthaler or Nebuhaler is used with the spray.
Mixtures and tablets are also available for the treatment of asthma attacks, but they work more slowly and have greater side effects. Most of these are in a class called xanthinates. Very severe attacks may require oxygen by mask and injections of theophylline or steroids.
People can die rapidly from a sudden, severe asthma attack. If an attack of asthma does not respond rapidly to the normally used treatments, seek further medical assistance immediately.
Research into asthma and its control continues though research organizations, and new treatments and control methods are being marketed every year. Asthma is no longer the torture of years past, and the future is looking brighter all the time.
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