Asthma is non-communicable chronic disease of respiratory tract that can affect children as well as adults. It is a common disease affecting about 25 million American individuals. [i]

Asthma also sometimes referred to as ‘bronchial asthma’ is characterized by an inflammation of bronchial tubes and increased secretion of sticky mucus in the tubes. The major signs of asthma in most people include inflamed airways, tightening of airways or accumulation of mucus in the tubes. It is a long-term chronic respiratory disorder in which it becomes difficult and hard to breathe.

Asthma attacks can either be mild or severe but in general mild asthma attacks are more common. In a normal situation the airways open up in a few minutes or in some hours. But in some less common situations these attacks can be severe. Severe asthma attacks can last longer and medical help should be seeked in these cases right away.

The recognition and treatment of both mild and severe asthma is important to further prevent the patient from asthma attacks and frequent episodes.

Major Signs of Asthma

Three major signs of this disease include:

  • Blockage of airways
  • Inflamed bronchial tubes
  • Irritable or sensitive airways

Causes of Asthma

Although it can be difficult to point out a single cause of this disease, some factors have been found to be associated with asthma. It can be caused by various factors including different triggers that can stimulate an asthma attacks. These triggers include pollens from flowers or trees, dust, grass, feathers, fur of animals, environment changes, fumes from cars or industries, smoke, dust, perfumes, soaps, and viral infections.

All of these three things – increased mucus secretion and production, bronchospasm, and inflammation of airways can cause signs and symptoms of asthma such as trouble in breathing, coughing and wheezing, and difficulty in performing normal daily activities.

In a normal person the muscles around the airways are usually relaxed and the air is free to move from these airways but in persons having asthma muscle tightening occurs and there is difficulty in passage of air through them.

In case of asthma, the bronchial tubes located in the lungs become red and swollen. This swelling can cause damage to the lungs. In the long run, treating this inflammation can help in management of asthma.

The airways of asthma patients become sensitive and tend to narrow leading to irritation even on slight triggers.

Risk Factors of asthma

  • Genetic factors: Asthma can be transferred from a parent to child. It may occur in family members like siblings, parents or close relatives.
  • Allergic conditions: Conditions like rhinitis, hay fever, cold or eczema may stimulate asthma in most people.
  • Urbanisation: Increased prevalence of asthma may be linked to urbanisation, probably because of various lifestyle factors.

Other factors that may lead to the risk of developing asthma and damaged lungs include tobacco smoke, air pollution, viral respiratory tract infections, premature birth and low birth weight. Exposure to house mites, occupational chemicals, molds, fungus, dusty air, dust from air vents, and various irritants are also triggers for asthma. People who are obese or overweight are more at risk of developing asthma.

Symptoms of Asthma

The symptoms of asthma differ from person to person. It does not affect every person in a same way. Also, the symptoms vary from time to time in a same individual or according to the severity of the asthma attack. Various symptoms of asthma include:

  • Shortness of breath
  • Coughing
  • Trouble walking or talking
  • Pale face
  • Wheezing
  • Chest tightness
  • Fast breathing
  • Blue lips or fingernails
  • Inward pulling of skin around the ribs on breathing in
  • Difficulty in breathing [ii]

The symptoms are often sporadic and become worse during the night, during exercise or exertion. The symptoms might not appear for a long period of time in some asthma patients. Furthurmore, in some people the attacks only occur when they exercise or due to colds or viral infections.

Under-treated asthma in people can lead to sleep disturbances, poor focus, low concentration, tiredness and irritability. Disturbances may be occur in the routine activities of asthma sufferers and even their families. A child may miss their school; an adult might require a leave from work leading to a financial impact on both family and community.

In case of severe symptoms, people may need an emergency health care and may require a hospital admission for treatment and monitoring. Asthma can also lead to death in most severe cases.

Treatments for asthma

The treatment of asthma is very important to prevent the patient from worse attacks or episodes. It is often under-treated or under-diagnosed especially in the countries with low or middle income. Asthma can be treated by either an inhaler (a device used to breathe the medicines in) or oral medicines like bronchodilators. Although it cannot be completely cured but a good management can help in controlling this disease and help the people to enjoy and lead an active and normal life. Some of the quick-relief medications include Metaproterenol, Albuterol, Levalbuterol, and Terbutaline.

Two main types of inhalers are there for the treatment of asthma:

  • Bronchodilators such as salmeterol, formeterol, salbutamol, and vilanterol. These medications act by widening the air passages, relax the bronchial muscles and relieving the symptoms of asthma.
  • Corticosteroids such as beclomethasone, budesonide, fluticasone, and mometasone. These inhaled corticosteroids help in reduction of inflammation in the airways, thus improving the asthma symptoms and risk of severity in asthma attacks or death.

The frequency of usage of inhalers and the dose can vary from patient to patient depending upon the severity of disease and the type of inhaler being used.

For people who find it difficult to use the inhaler such as children or old age patients, a device called ‘spacer’ is available. This is a plastic container having a mouthpiece at one side and a hole on the other side. A spacer helps in conveying the medicine from an inhaler to the lungs of a patient more effectively.