The Breath-Taker: Understanding Bronchial Asthma
A disease of airways produced by hypersensitivity inflammatory response of tracheobronchial tree to a wide variety of stimuli resulting in reversible narrowing of the air passages. It is an episodic disease with acute exacerbations being interspersed with symptom-free periods. The attacks of it are typically short-lived and are characterised by cough, wheeze and dyspnea.
The Prevalence of Bronchial Asthma Worldwide
It is a common disorder and 10 – 20 % of the population suffers from it. It may be mild and may go unrecognised. The prevalence of it is increasing without any known reasons. In spite of better understanding of the pathophysiology of the disease combined with improved methods of treatment, the mortality has not changed; rather, it has increased in the developing countries.
- Allergens for atopic ( early onset ) or nonatopic ( intrinsic or late onset asthma )
- Cold, air, tobacco smoke, respiratory infections, occupational pollutants, drugs and strenuous exercise.
Faces of Asthma: Recognizing Different Asthma Phenotypes
Depending on the presence or absence of allergens, it is broadly classified into two types :
Atopic Asthma – These are hypersensitive asthmatic children who commonly develop IgE antibodies to allergens, hence called atopic asthma. This type of asthma is commonly associated with families/persons with a history of allergic diseases, such as rhinitis, urticaria etc. Most common allergens for atopic are pollen, house dust, feathers, animal dander, insects etc.
Non-Atopic Asthma – This is common in adults. Atopy does not play any role, hence, also called an intrinsic asthma. Primary causes of non-atopic asthma are certain medicines, household chemicals, infections such as cold or flu etc. While the secondary causes include respiratory infection, hormonal deficiencies, stress etc.
Spotting Asthma: Recognizing Clinical Clues
Its symptoms vary from person to person. Common symptoms include :
- Chest pain
- Shortness of breath
- Trouble sleeping caused by shortness of breath
- Common cold
The Diagnostic Odyssey: Navigating Asthma Testing
It is difficult to establish the diagnosis of it in the laboratory as no test is convulsive, hence, diagnosis rests mostly on clinical grounds. Common tests include :
- Sputum and blood examination may show eosinophilia.
- Serum IgE levels are raised in atopic asthma.
- Chest X-ray should be performed in each and every patient with severe acute asthma.
- Pulmonary function tests
- Provocative tests – Measurement of bronchial reactivity can be of value in diagnosis and response to treatment.
- Exercise tests – These are useful in children who are asked to run for 6 minutes on a treadmill at a workload sufficient to increase heart rate more than 160/min.
- Arterial blood gas analysis – PaO2 and PaCO2 are performed invariably in severe acute asthma.
- Skin hypersensitivity tests
Medications and Inhalers: The Arsenal Against Asthma
In the vast majority of cases, however, asthmatic patients are sensitive to a wide variety of allergens, and attempts to avoid them become impracticable. The allergens play a major role in provoking attacks of it. Its medicines can be taken in several different ways. Patients can breathe in the medicines using a metered-dose inhaler, nebuliser or another type of inhaler. Other treatment options include :
- Bronchodilators – These medicines relax the muscles around your airways.
- Anti-inflammatory medicines, which helps to reduce swelling and mucus production in your airways.
- Biologic therapies for asthma – These are used for severe asthma when symptoms persist despite proper inhaler therapy.
Asthma In Children
In case of childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers. Common symptoms include shortness of breath, chest congestion, trouble sleeping etc and can cause irritating daily symptoms that interfere with play, school and sleep. Factors that might increase childhood asthma are exposure to tobacco, including before birth, a family history of it, living in a high pollution and respiratory conditions such as pneumonia, chronic runny nose etc.
Conclusion: Breathing Easy, Living Fully
As we conclude our exploration of bronchial asthma, envision a future where individuals with it can breathe easy and live life to the fullest. With knowledge, support, and proactive management, It doesn’t define but becomes a part of a thriving life.