Asthma

Asthma is a respiratory disorder. Before you know about its causes, symptoms and other facts, it is good to know the structure of the human respiratory system.

Lungs are the human respiratory organs, located in the chest region on either side of the heart. The lungs help the human body to take in oxygen and release carbon dioxide. The air inhaled through the nostrils passes through the trachea and enters into the main airway called bronchi.that leads to the lungs, where it splits into smaller airways called bronchioles. Bronchioles lead to alveolar ducts which lead to air-sacs called alveoli. It is here in the alveoli, the exchange of gases take place.

Now let us go on to understand what causes asthma. An asthma attack occurs when the muscles surrounding the airways contract tightly and make the air passages narrow. In addition, the membranes lining the inner walls of the airways become swollen and inflamed, and the glands in this region produce a protective fluid called mucus in excess. Inflammation of the airways is the main aspect of the disease.

Common Asthma Triggers

• It can be a hereditary disease. If there is a family history of asthma, or other allergic conditions like atopic dermatitis or hay fever, anyone in the family may be affected
• Allergens such as pollen, mould spores, dust mite, animal dander, food, feathers
• Air pollutants such as cigarette smoke, gases, dirt and paint fumes
• Odours in the house-hold such as house-hold cleaners, perfumes, paints, varnishes, detergents and cooking fumes
• Respiratory viral infections such as the common cold, specifically in children under five years
• Exercises in some children
• Inhaling cold air
• Emotional stress such as fear or excitement
• Certain medications
• Sinus infections
• Disorder of the immune system, where enough antibodies are not produced to protect the body

Symptoms

Frequent coughing, that worsens at night, with exercise, or after contact with an irritant or an allergen

Wheezing sound while inhaling or exhaling

Rapid breathing, that may be accompanied sometimes by vomiting

Shortness of breath, loss of breath

Weakness and tiredness

Chest tightness, finger nails and lips turning blue in severe cases

Diagnosis of Asthma

Diagnosis is difficult in infants, but in older children, on the basis of physical examination, medical history and symptoms the disease can be diagnosed.

• Physical examination - Doctor will listen to the child’s breathing and look for signs of asthma or allergies. Wheezing, runny nose or swollen air passages or allergic skin condition like atopic dermatitis.are the signs the doctor will look for.
• Medical history - History of breathing trouble the child may have had, and family history of asthma, allergies and atopic dermatitis will be taken note of by the doctor in the process of diagnosis.

Whether symptoms like coughing, wheezing, shortness of breath and so on occur, if they occur, when and how often they occur must be described by you in detail. Based on this the doctor can diagnose the condition.

Tests

• Lung function test, using devices like spirometer and peak flow meter, can be performed only in children above 5 years. This test measures how much air the child can breathe in and out, and how fast she can blow the air out.
• Allergy tests to find out which allergens affect you.
• Broncho Provocation tests to know how sensitive the airways are.
• A Chest x-ray and ECG to know whether the symptoms are due to another disease with similar symptoms, or due to presence of a foreign body or an infection.

Treatment

In the vast majority of children with wheezing, the symptoms lessen considerably as the child becomes older and most children become symptom-free by their early teens. The risk of asthma symptoms extending into adolescence and adulthood is higher in children with a positive family history of the disease.
Asthma is not curable, but can be controlled with medications and by avoiding contact with environmental triggers for asthma.

If the symptoms are mild and occur infrequently, the doctor might prescribe a bronchodilator drug given orally or by inhalation, for the purpose of opening the airways. This drug may be used at the time when the symptoms appear.

If the symptoms are recurrent or chronic, medicines will have to be taken on regular basis. The drugs prescribed may include bronchodilators, steroids in a nebulizer or inhaler and cromolyn sodium as inhaler. The inhalers reduce the airway inflammation, while the bronchodilators directly increase the opening of the bronchioles. In severe cases, oral corticosteroids may be prescribed additionally.

If it is clear that the symptoms are due to exposure to allergens, allergy immunotherapy may be recommended.

Preventing Asthma Attack

• Keep the child away from allergens such as dust, pollen, mold spores etc and irritants such as cigarette smoke, gases, dirt, paint fumes, etc.
• Continue medical treatment and keep a watch over the child’s condition to assess if the therapy is adequate.
• Keep a diary of when the attacks occur and what preceded them. This will help you to identify the triggering substances.
• If asthma follows every time after viral infections, you may start giving medications from the start of the viral infection, without waiting for asthma symptoms of cough and wheezing.
• It is good to know how to use a peak flow meter, which measures how well the lungs are working. This measures how much air the lungs push out. If the child is not able to push out as much air as usual, she may get an asthma attack soon.