Asthma Part 1: An Overview

Asthma is a chronic lung disease that causes inflammation and narrowing of the airways in the lungs. Recurring periods of wheezing, chest tightness, shortness of breath, and coughing are all hallmarks of asthma.

Asthma affects people of all ages, but most often starts during childhood.


Overview

Asthmatics have inflamed airways in their lungs. Inflamed airways are narrowed and very sensitive, thereby reacting very stronging to inhaled allergens.

When the airways react, the muscles around them tighten, narrowing the airways causing reduced airflow into the lungs. The swelling can and will progress, farther narrowing the airways. Associated with this process is the increased production of mucus, a thick, sticky fluid that farther narrows the already narrowed airways.

These reactions result in the symptoms of asthma - Wheezing, chest tightness, shortness of breath, and coughing.

Asthmatic symptoms are often mild and spontaneously resolve or are easily treated with minimal treatment. However, in some cases, it can progress and become worse, resulting in what is commonly known as an asthmatic attack.

Hence, treating symptoms of asthma early is paramount. By the time an asthmatic attack ensues, emergency care is required and if left untreated, asthma can be fatal.

There is no cure for asthma. However, with proper and thorough ongoing treatment, asthma can be managed and sufferers of asthma can and will continue to lead normal and active lives.


Populations At Risk

Most often, asthma starts during childhood but it can affect all ages.

Young children who frequently suffer from respiratory infections are at highest risk of developing asthma. Other risk factors influencing the development of asthma include being atopic (having multiple allergies), eczema, or, as mentioned above, having parents who are also asthmatic.

Boys have a higher risk of developing asthma compared to girls. However, once adulthood is reached, there are more female asthmatics compared to their male counterparts. As a sum total, most people with asthma have allergies.

Another significant population with asthma are industrial workers who come into contact with chemical irritants or industrial pollutants in their workplace. This population develops occupational asthma, a contentious disease label.


Causes of Asthma

A multitude of causes for asthma have been documented so far. These include :

• Genetic causes, especially atopic individuals or asthmatic parents
• Childhood Respiratory Infections
• A multitude of airborne allergens have been implicated

Signs and Symptoms of Asthma

Common signs and symptoms of asthma include:

• Coughing 
• Wheezing.
• Chest tightness  
• Shortness of breath.

Coughing caused by Asthma is often worse at night, disrupting sleep. Wheezing is a squeaky, whooshy sound that is audible with each breath. Chest tightness and shortness of breath can and is often confused with cardiac causes and can result in undue stress to the patient.

Having one or more of the above symptoms do not automatically diagnose asthma. Proper lung function tests, history taking and a physical examination by a health profession is the only way of confirming asthma.

The type and severity of symptoms of asthma suffered by the patients though determines the management of the disease. Because symptoms vary over time, asthmatics need to be aware of their own symptoms and fluctuations thereof, and seek treatment early because while mild symptoms can be simply annoying, severe symptoms can seriously limit daily routines and exercise, and very severe symptoms can potentially cause death if untreated.

Treatment is now available to prevent the onset of asthma in known asthmatics.


Triggers Of Asthma

These include:

• Allergens - dust, animal fur, cockroaches, mold, and pollens from trees, grasses, and flowers etc.
• Chemical Irritants - cigarette smoke, air pollution, chemicals, workplace dust, sprays etc.
• Medicines - NSAIDs (eg aspirin) and B-Blockers (eg Atenolol).
• Upper respiratory infections
• Physical activity - exercise can trigger asthma.

This list is not exhaustive. Each asthmatic is unique and it is best if you seek advice from your health professional.


Prevention Of Asthma

Asthma can’t be cured. But you can prevent it. Following these simple steps will go a long way in managing asthma.

• Educate yourself about asthma. Empower yourself. 
• Have an Asthma Action Plan and follow through with it. 
• Follow your physician’s medicine regime
• Identify the triggers that cause your asthma and avoid them
• Document progression of your asthma
• Regular visits to your treating physician

About The Author

Dr Lau Tzun Hon is a resident housecall doctor at CMY Medical. He received his MBBS (Hons) from Sydney University in 2001 and has served in the both private and government restructured hospitals prior to commencing his practice in Home Care.

While in the Government Restructured Hospitals, Dr Lau served primarily in the Department of Accident & Emergency Medicine and Anaesthesia. Upon entering the Private sector, Dr Lau worked in both public and private A&E departments before venturing into Home Care.

Over the years, he has developed a strong passion to maintain and  enhance the quality of life for patients under his care.  A strong believer that healthcare does not need to be financially straining, Dr Lau often delivers more value beyond expectations.