ASTHMA AWARENESS MONTH - MAY

Reference and Info source - www.medicinenet.com


What is the medical definition of Asthma?

Asthma is a complex clinical syndrome of chronic airway inflammation characterized by recurrent, reversible, airway obstruction. Airway inflammation also leads to airway hyperreactivity, which causes airways to narrow in response to various stimuli.

8-10% of the worldwide population is effected by Asthma

Asthma Symptoms and Signs

Symptoms of asthma develop as a result of the narrowing and inflammation of the airways. Wheezing is a characteristic symptom of asthma, along with shortness of breath. Chest pain or tightness can accompany an asthma attack.

Asthma Related Symptoms and Signs

  • Wheezing
  • Shortness Of Breath
  • Cough

What are risk factors and causes of asthma?

Asthma results from complex interactions between an individual's inherited genetic makeup and their interactions with the environment.  The following are risk factors for asthma:

  • Family history of allergic conditions
  • Personal history of hay fever (allergic rhinitis)
  • Viral respiratory illness, such as respiratory syncytial virus (RSV), during childhood
  • Exposure to cigarette smoke
  • Obesity
  • Lower socioeconomic status

 

What are the different types of asthma?

The many potential triggers of asthma largely explain the different ways in which asthma can present. In most cases, the disease starts in early childhood from 2-6 years of age. In this age group, the cause of asthma is often linked to exposure to allergens, such as dust mites, tobacco smoke, and viral respiratory infections. In very young children, less than 2 years of age, asthma can be difficult to diagnose with certainty. Wheezing at this age often follows a viral infection and might disappear later, without ever leading to asthma. Asthma, however, can develop again in adulthood. Adult-onset asthma occurs more often in women, mostly middle-aged, and frequently follows a respiratory tract infection. The triggers in this group are usually nonallergic in nature.

Types: allergic (extrinsic) and nonallergic (intrinsic) asthma

Your doctor may refer to asthma as being "extrinsic" or "intrinsic." A better understanding of the nature of asthma can help explain the differences between them. Extrinsic, or allergic asthma, is more common and typically develops in childhood. Approximately 70%-80% of children with asthma also have documented allergies. Typically, there is a family history of allergies. Additionally, other allergic conditions, such as nasal allergies or eczema, are often also present. Allergic asthma often goes into remission in early adulthood. However, in many cases, the asthma reappears later.

Intrinsic asthma represents a small amount of all cases. It usually develops after the age of 30 and is not typically associated with allergies. Women are more frequently affected and many cases seem to follow a respiratory tract infection. Obesity also appears to be a risk factor for this type of asthma. Intrinsic asthma can be difficult to treat and symptoms are often chronic and year-round.

What are asthma treatment options?

As per widely used guidelines, the treatment goals for asthma are to:

  • adequately control symptoms,
  • minimize the risk of future exacerbations,
  • maintain normal lung function,
  • maintain normal activity levels, and
  • use the least amount of medication possible with the least amount of potential side effects.

Inhaled corticosteroids (ICS) are the most effective anti-inflammatory agents available for the chronic treatment of asthma and are first-line therapy per most asthma guidelines. It is well recognized that ICS are very effective in decreasing the risk of asthma exacerbations. Furthermore, the combination of a long-acting bronchodilator (LABA) and an ICS has a significant additional beneficial effect on improving asthma control.

What should someone do when experiencing an asthma attack?

Patients experiencing acute asthma symptoms should first use their rescue inhaler (albuterol). If asthma symptoms are worsening and use of albuterol is increasing, then asthma patients should have a medical evaluation. A course of oral steroids may be indicated and an adjustment in asthma maintenance therapy may be needed. If symptoms are rapidly progressive, asthma patients should seek emergency medical care.

What is the prognosis for asthma?

The prognosis for asthma is generally favorable. Children experience complete remission more often than adults. Although adults with asthma experience a greater rate of loss in their lung function as compared to age-controlled counterparts, this decline is usually not as severe as seen in other conditions, such as chronic obstructive pulmonary disease (COPD) or emphysema. Asthma in the absence of other comorbidities does not appear to shorten life expectancy. Risk factors for poor prognosis from asthma include

  • a history of hospitalizations, especially ICU admissions or intubation,
  • frequent reliance on systemic steroids,
  • significant medical comorbidities.

The airway narrowing in asthma may become fixed over time and can resemble COPD or emphysema. The other main complication of asthma is due to side effects from oral steroid use, which can include bone loss (osteoporosis), weight gain, and glucose intolerance.

Is it possible to prevent asthma?

With the increasing prevalence of asthma, numerous studies have looked for risk factors and ways to potentially prevent asthma. It has been shown that individuals living on farms are protected against wheezing, asthma, and even environmental allergies. The role of air pollution has been questioned in both the increased incidence of asthma and in regards to asthma exacerbations.

Climate change is also being studied as a factor in the increased incidence of asthma. Maternal smoking during pregnancy is a risk factor for asthma and poor outcomes. Tobacco smoke is also a significant risk factor for the development and progression of asthma. Treatment of environmental allergies with allergen immunotherapy, or allergy shots, has been shown to decrease a child's risk of developing asthma. The development of asthma is ultimately a complex process influenced by many environmental and genetic factors, and currently there is no proven way to decrease an individual's risk of developing asthma.

 

Reference and Source – www.medicinenet.com