Asthma: Symptoms, Causes, Types, Diagnosis And Treatment, Prevention. What You Should Know

This article focuses on enlightening on what asthma really is and its related health issues...

What is Asthma

Asthma is a chronic inflammatory disorder of the airways resulting in variable airflow bronchial Obstruction, which is potentially reversible with appropriate therapy or spontaneously. It is typically characterized by episodic attacks of breathlessness, cough, and wheezing (asthma triad). Although asthma is a chronic obstructive condition, it is not considered a part of chronic obstructive pulmonary disease, as this term refers specifically to combinations of diseases that are irreversible, such as bronchiectasis and emphysema.

Asthma attacks also are called flare-ups or exacerbations. In order to fully understand what asthma is all about, it is necessary to understand what happens when you breathe. When a human person breathes, air goes through your nose or mouth, down into your throat, and into your airways, eventually making its way into your lungs. There are lots of small air passages in your lungs that help deliver oxygen from the air into your bloodstream. Asthma symptoms occur when the lining of your airways swells, and the muscles around them tighten. Mucus then fills the airways, further reducing the amount of air that can pass through.

These conditions can then bring on asthma “attack,” which is the coughing and tightness in the chest that is typical of asthma. Symptoms of asthma which includes episodes of wheezing, coughing, chest tightness, and shortness of breath, may occur a few times a day or a few times per week. Depending on the person, asthma symptoms may become worse at night or with exercise. Asthma is a long-term inflammatory disease of the airways of the lungs. It is characterized by variable and recurring symptoms, reversible airflow obstruction, and easily triggered bronchospasm.

Although asthma can develop at any age, including during adulthood, it begins mostly during childhood and is the most chronic condition in children. Some common triggers of childhood asthma can include respiratory infections and colds, cigarette smoke, including secondhand tobacco smoke, allergens, air pollutants such as ozone and particle pollution both indoors and outside, and exposure to cold air. In adulthood, some of the factors which may occasion the occurrence of asthma include respiratory illness, allergies and exposure to allergens, hormonal factors, and stress, amongst others. In 2019, an estimated 455,000 deaths were recorded as a result of asthma (WHO, 2022). Records have it that before the COVID-19 outbreak in 2019, the prevalence of asthma in Nigeria was approximately 13 million cases which ranked the highest in Africa. Asthma is a chronic inflammatory lung disease that can cause repeated episodes of cough, wheezing, and breathing Difficulty.

What are the Characterizations and Symptoms of Asthma 

Typically, asthma is characterized by

(1) Airway inflammation: the airway lining becomes red, swollen, and narrow.

(2) Airway obstruction: the muscles around the airway tighten, causing the airway to become narrow, thereby making it difficult for air to get in and out of the lungs.

(3) Airway hyper-responsiveness: the muscles around the airway respond more quickly and vigorously to small amounts of allergens and irritants.

Some symptoms of asthma are:

(1) Wheezing

(2) Coughing

(3) Shortness of breath

(4) Chest tightness

(5) Experience fatigue due to breathing

(6) Chest or abdominal pain

(7) Difficulty when talking

(8) Anxiousness or panic

(9) Paradoxical pulse

(10) A blue color of the skin and nails may occur as a result of a lack of oxygen

It is important to note that these symptoms differ among individuals, and not every individual experiences the same symptoms. Asthma attacks are most likely to occur at night or early in the morning, after an exercise, or due to cold air. However, some people experience these symptoms consistently during the day. It is true that an asthma attack occurs when the symptoms become severe. Attacks can begin suddenly and range from mild to life-threatening; it is always medically and professionally advised that people who experience mild or severe asthma attacks need and should seek urgent medical attention and care. These symptoms can, however, be prevented by avoiding asthma attack triggers such as allergens and respiratory irritants.

What are the Causes of Asthma

Research has it that asthma is caused by a number of genetic and environmental factors. Genetically, it is believed that a person who has one or both parents living with asthma is more likely than others to develop the condition. The environment in which one lives also plays a vital role in the development of asthma.

(1) Environmental factors

Some of the environmental factors which trigger asthma in people include allergens, air pollution, metal or wood dust, animal hair and dander, molds, latex, fumes from household cleaners and paints, low air quality due to traffic pollution, crowds, or high ozone levels. Smoking or inhaling smoke during pregnancy and even after delivery, exposure to indoor volatile organic compounds, cockroaches, pesticides, strong chemicals or smells, perfumes, and other occupational exposures. All of these could trigger asthma attacks in people.

(2) Genetic factors

A child who has either of the parent or siblings with asthma is more likely to have it too. However, asthma is more likely in people who have other allergic conditions, such as eczema and rhinitis. It has also been proven that there exists a correlation between obesity and the risk of asthma, with both having increased in recent years. In spite of the genetic factors involved, Some genetic variants may only cause asthma when they are combined with specific environmental exposures. According to studies, asthma that starts before the age of 12 years old is more likely due to genetic causes.

Other causes of asthma include:

(1) Stress

(2)Health conditions, such as respiratory infections

(3)Smoking of Tobacco during or after pregnancy

(4) Hormonal factors

(5) extreme weather conditions

(6) intense emotions such as joy, anger, crying, and laughter.

(7) Children and adults who are overweight or obese are at a greater risk of asthma.

(8) Events in early life affect the developing lungs and can increase the risk of asthma. These include low birth weight, prematurity, exposure to tobacco smoke and other sources of air pollution, as well as viral respiratory infections.

(9) Urbanization is associated with increased asthma prevalence, probably due to multiple lifestyle factors.

(10) People with a history of severe viral infections during childhood, such as respiratory syncytial virus infection (RSV), may be more likely to develop the condition.

What Are The Types of Asthma

Asthma is the result of chronic inflammation of the conducting zone of the airways (most especially the bronchi and bronchioles), which subsequently results in increased contractability of the surrounding smooth muscles. This, among other factors, leads to bouts of narrowing of the airway and the classic symptoms of wheezing. Asthma is usually broken down into types based on the cause and the severity of the symptoms. The types of asthma are:

(1) Allergic Asthma

This type of asthma is triggered by an allergic reaction to allergens such as pollen or pet dander from animals such as cats and dogs, molds, food, pollen, and dust. This is the most common type of asthma, representing up to 60 percent of all cases of asthma, and is mostly seasonal based on the fact that it goes hand in hand with seasonal allergies. If one has allergic asthma, he or she is likely to have a family history of allergies, such as allergic rhinitis or hay fever. Triggers for allergic asthma include respiratory infections such as the common cold, the flu, or a sinus infection, as well as exercise, cold air, sudden changes in air temperature, and even gastroesophageal reflux (heartburn)

(2) Non-Atopic Asthma

This is also known as non-allergic asthma or intrinsic asthma and is triggered by Irritants in the air not related to allergies. Studies have shown that this type of asthma makes up between 10 and 33% of asthma cases. People with non-allergic asthma may have the same symptoms as those with allergic asthma, but they are not bothered by allergens from the natural world, like pollen or mold. Non-allergic asthma triggers include substances (irritants) in the air, such as tobacco smoke, room deodorizers, pine odors, fresh paint, household cleaning products, cooking odors, perfumes, and outdoor air pollution, burning wood, viral illnesses, and cold air.

(3) Occupational Asthma

This type of asthma is a result of exposure to an allergen or irritant present in one’s workplace. It is estimated that 5–25% of asthma cases in adults are work-related. People whose work activities have to do with activities such as spraying paints, bakers, nurses, chemical workers, timber workers, hairdressers, and animal workers, bear the highest risk of having asthma attacks. It is important to note that occupational asthma does not refer to people who are already diagnosed with asthma and who are most susceptible to flare-ups when exposed to allergens or irritant dust or fumes in their workplace. It is also important to note that both indoor and outdoor working environments can expose an individual to asthma triggers. Some of these asthma triggers evident in the workplace include dust, dyes, gases and fumes, industry chemicals, animal proteins, rubber latex,

(4) Nocturnal Asthma

This type of asthma attack mostly happens at night. Factors that trigger asthma attacks at night include sinus infections or postnasal drip caused by allergens such as dust mites or pet dander. Although the body makes adrenaline and corticosteroids, which protect against asthma attacks, the rate at which the body produces these two substances is at its lowest level at night, usually between midnight to 4 am, thereby giving rise to asthma attacks during this period. Symptoms of nocturnal asthma include: coughing fits, tightness in the chest, wheezing, and shortness of breath just before and during sleep. Nocturnal asthma occurs in both children and adults.

(5) Aspirin-Induced Asthma

This consists of asthma, nasal polyps, sinus disease, and respiratory reactions to aspirin and other NSAID medications (such as ibuprofen and naproxen) and is usually severe. Aspirin-induced asthma (AIA) refers to the development of bronchoconstriction in asthmatic individuals following the ingestion of aspirin. Research has it that about 9 percent of asthma patients are affected by aspirin-induced asthma, and it usually develops in adults between the ages of 20 and 50. Symptoms of aspirin-induced asthma include Difficulty breathing, wheezing, coughing, sneezing, or stuffy and running nose.

Other types of asthma are:

(6) Alcohol-induced Asthma (AIA)

Some people may experience asthma attacks after the intake of alcohol. Alcohol contains varying amounts of chemicals, such as histamines and sulfites, that can cause people with asthma to have an attack. Histamine is found naturally in many foods and drinks and is what your body releases whenever you have an allergic reaction. Sulfites are a natural byproduct of the manufacture of beer, cider, and wine or may be added as a preservative to wine to stop it from fermenting. Some people experience asthma symptoms when they drink any kind of alcohol, while others may only have symptoms that are triggered by a particular type of drink, such as wine or beer. Research suggests this may be because of the various additives found in alcoholic drinks rather than the alcohol itself.

(7) Exercise-induced Bronchoconstriction (EIB) Research has it that this type of asthma can occur in people with or without asthma. It usually occurs within a few minutes of exercise and endures up to ten or fifteen minutes after physical exercise. It occurs mostly in people with asthma and up to 20 percent of people without asthma, and it is more common when the weather is dry and cold. A good percentage of people living with asthma also experience Exercise-induced bronchoconstriction, otherwise known as Exercise-induced Asthma, due to physical exercise or fatigue.

Diagnosis and Treatment of Asthma

The fact that one experiences symptoms similar to that of asthma are in no way a guarantee that the person has the disease. Medical advice and consultation are highly required when symptoms are evident. During the diagnosis, the medical personnel takes into the record the symptoms experienced by the person. The medical personnel also asks questions about the person’s medical history and family and also goes through the test results to determine the type of asthma. The medical personnel may also decide to take a chest x-ray, allergy test, challenge test, blood test, or skin test. Asthma may be suspected if there is a history of recurrent wheezing, coughing, or Difficulty breathing, and these symptoms occur or worsen due to exercise, viral infections, allergens, or air pollution. Spirometry which is often recommended to aid in diagnosis and is the single best test for asthma may also be carried out by the medical personnel. The medical personnel may also decide to carry out other physical examinations, such as signs of wheezing, which can indicate an obstructed airway and asthma.

Although there exists no known cure for asthma, it can be treated and regulated. Its symptoms can be controlled or totally prevented by avoiding triggers, such as allergens and respiratory irritants, and suppressed with the use of inhaled corticosteroids. Treatments for asthma are usually based on the type of asthma, the person’s age, and the symptoms or triggers. Treatments for asthma are categorized into two main classes, which are

(1) The Quick-relief medications

(2) The long-term control medications

(1) The Quick-relief medications

As the name implies, quick-relief medications are used to provide quick relief to the asthmatic to enable him or her breathe again. These quick-relief medications include drugs such as bronchodilators which work within minutes to relax the tightened muscles around your airwaves and decrease symptoms quickly. Bronchodilators are medications that relax muscle bands that tighten around your airways. This opens the airway and lets more air move in and out of your lungs. Bronchodilators may be used as either a quick relief (rescue inhalers) from sudden, unexpected attacks of asthma or as long-term, used regularly to help control breathlessness in asthma and chronic obstructive pulmonary disease (COPD) and increase the effectiveness of corticosteroids in asthma. Inhaled corticosteroids are the main treatment to reduce inflammation and prevent flare-ups in asthma. Although they can be administered orally or injected, bronchodilators are most commonly taken with an inhaler (rescue) or nebulizer.

(2) The long-term control medications

These refer to those medications taken regularly or daily to help ease the number or severity of asthma attacks. Long-term medications achieve and maintain control of persistent asthma. The most effective long-term-control medications are those that attenuate the chronic inflammatory aspect of asthma. Examples of long-term asthma medications include Inhaled corticosteroids, long-acting bronchodilators (LABAs), Cromolyn and theophylline, leukotriene modifiers, Immunomodulators, Anti-inflammatories, Anticholinergics.

Ways to Prevent Asthma Attacks 

Some of the ways in which asthma attacks can be prevented are:

(1) Avoiding triggers or risk factors such as chemicals, smells, tobacco smoke, air pollution, chemical irritants including perfume, and the number of lower respiratory infections

(2) Avoid exposure to allergens

(3) Taking preventive medications

(4) Eating a healthy and balanced diet

(5) Managing stress

(6) Immunization

(7) Prevent colds

(8) Consider Immunotherapy Allergy Shots

(9) Use a Home Peak Flow Meter

(10) Follow your asthma action plan.

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