Asthma Diagnosis, Causes, Management & Prevention.
Asthma is a chronic condition of the airways which usually manifests in childhood but can also manifest in adulthood.
This condition is characterized by constriction of the air ways also known as bronchoconstriction. When bronchoconstriction happens, the air way vessels become smaller, causing obstruction in air flow.
Because of this, not enough air gets into the lungs which can cause difficulty in breathing.
The exact cause of asthma is still unknown but studies show that genetics can play a role in its development.
Persons with family members with asthma and/or atopic dermatitis are more likely to develop asthma than those who don’t. Asthma is also characterized by attacks or exacerbations which present with more severe symptoms than usual symptoms.
These exacerbations can be triggered by smoke, stress and allergies but sometimes can be idiopathic which means they just happen without an identifiable trigger.
Who Can Get It?
Persons with a family history of asthma, allergies and atopic dermatitis may be more likely to develop asthma. Asthma usually manifests in childhood but is usually resolved before adulthood.
However for some patients, asthma persists into adolescence and even adulthood. It can also appear for the first time in adulthood but is less common.
What Are The Symptoms?
Asthma is usually characterized by wheezing. A wheeze is a high pitched sound heard upon expiration during asthma attacks. It is also usually accompanied by difficulty breathing and chest tightness.
These symptoms are usually worse at night and are aggravated by physical activity and cool air.
In severe exacerbations, fingernails and lips can turn blue due to the lack of oxygen that flows into the lungs.
How Is It Diagnosed?
Asthma is usually diagnosed by a physician based on clinical symptoms and a spirometry test. Spirometry measures air flow into the lungs and can detect a decrease in air flow.
The parameter that is usually measured is the peak expiratory flow or PEF. A significant decrease in PEF signifies asthma or other obstructive lung diseases.
The diagnosis of asthma is further classified into categories based on the severity of exacerbations and the frequency of symptoms.
How Is It Treated?
Mild to moderate asthma is usually treated using bronchodilators such as beta agonists. Salbutamol, levalbuterol and terbutaline are examples of beta agonists. Severe asthma will usually require treatment with steroids to decrease inflammation.
Steroids are also used for long-term control. These medications are usually delivered to the lungs via inhalers or nebulizers.
Inhalers are handy devices that hold powdered medications. The medicine goes in to the lungs during inhalation which will require the patient to simultaneously inhale while administering the medications.
Use of inhalers requires good coordination skills which is why it is hard to prescribe inhalers to children below 5 years of age.
Children under 5 years usually need a nebulizer to deliver the medications. Nebulizers are also used for acute exacerbations in adults but these devices pose a disadvantage because they are bulky and not handy.
How Can It Be Prevented?
There is no definite strategy to prevent development of asthma. However, asthma symptoms can be prevented by taking medications on a regular basis.
Triggers like pollen, stress, pet fur and other allergens should also be avoided. Smoking and inhaling of second-hand smoke is also a major factor that aggravates asthma which is why diagnosed asthmatics should avoid exposure at all times.