Asthma
What you need to know about bronchial asthma
And how to treat it
In my day-to-day practice, I come across many patients with cough as their primary ailment or symptom. In some cases, a thorough examination of chest reveals they have spasm of their air tubes-the bronchi. This patient has difficulty breathing unlike others, accompanied by hoarse sounds that we may hear normally without a stethoscope. This is called wheezing, which is the prime symptom of Asthma.
What is bronchial asthma?
Bronchial asthma is an inflammatory disease of the airways that affects more than 300 million people worldwide.
It is triggered by exposure to pet hair, pollen, mould, cigarette smoke, and other indoor and outdoor allergens, as well as scratchy or itchy throats [any throat infection], persistent coughs, and wheezing after overexertion.
If you feel breathless because of the above-mentioned triggers and aren’t sure if your condition is bronchial asthma, keep reading. This article will give you extensive information about the ailment so you can get the care you need.
What is Asthma
Asthma is an autoimmune disorder that can affect people of any age. Your airways narrow and inflame, limiting your ability to breathe and causing chest discomfort.
If you have asthma, it means that your immune system is overactive. There is a higher chance of developing this condition during allergy seasons because the air contains more allergens [like pollen, dust] than normal.
It is also common in people who were born prematurely or weighed a low birth weight as a result of family history of the condition or smoking. Other risk factors include family history of the condition or smoking.
Different Types of Asthma
The most common forms of bronchial asthma include-
- allergic asthma,
- exercise-induced asthma,
- intrinsic asthma,
- and eosinophilic asthma.
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Risk Factors for Asthma
Family history, low birth weight, and smoking are all risk factors for developing a milder form of asthma.
Asthma can also be accompanied by hay fever, in addition to being more severe. If you have allergies or atopy, you are more likely to have asthma.
In addition to having atopy, being overweight, having a family history of allergies, and being exposed to secondhand smoke [as in cigarette smoking], there is a higher chance of developing a more severe form of this condition [asthma].
Signs and Symptoms of Asthma
As mentioned earlier, if you have asthma, you may also experience an itchy or scratchy throat, a persistent cough, or wheezing after overexertion.
Other diseases, such as rhinitis, gastroesophageal reflux disease, and COPD [Chronic Obstructive Pulmonary Disease], may also cause these symptoms.
If you have constricted airway symptoms, like wheezing, you may have bronchial asthma. A doctor can assist you in getting an accurate diagnosis if you experience any of these symptoms.
COPD has symptoms that are also common in this disease, so you must see your doctor to rule out any other conditions. As a result, you may be advised to see an allergist, who may diagnose the cause and advise you on medication to manage your asthma.
If you think you may have bronchial asthma, you should make an appointment with a physician.
What are the investigations for diagnosing Asthma?
Your medical history, symptoms, and breathing test results will be evaluated. If suspected, your doctor may advise you to take a few tests.
These procedures are —
- Peak flowmetry- this test allows you to know if your lungs are working fine. In a normal person, the peak flow meter reading ranges from 350 to 400 units. In asthma, it is much below this [around 150 to 200 units]
- Spirometry- This test is carried out to find out the breathing capacity of your lungs. There are various parameters like forced vital capacity [FVC], forced expiratory volume in one second [FEV1], forced expiratory volume in six seconds [FEV6], FEV1/FVC ratio, etc. To know more about these parameters, click this link.
- Chest X-ray- to rule out pneumonia, bronchitis, etc.
- Bronchoscopy- if symptoms do not improve with treatment, an instrument with a miniature telescope is inserted down the windpipe into your bronchus, [the tube which connects the lungs to the nose, that which carries oxygen and throws out carbon-di-oxide] to find out the cause of breathlessness.
- Sputum analysis- to rule out eosinophils [a blood component of white blood cells] that come into the sputum because of exposure to some allergens like pollen, animal dander, etc.
If COPD is not the cause, it is possible that allergies or some other condition may be responsible.
Mucus collected from your lungs (sputum analysis) is evaluated for eosinophil levels in a process called pulmonary eosinophilia.
What actually happens in Asthma?
During an asthma attack, your breathing becomes labored because of constricted airways and spasms of bronchi in your lungs. See the picture below-
How to manage an asthmatic attack-
There is no cure available to treat asthma, although some people practicing alternate medicine like ayurveda and homeopathy advocate that they can cure asthma. But there is no harm in trying these methods.
Asthma can be controlled with lifestyle adjustments and medication. Triggers such as allergens can also be avoided in your environment to avoid asthma. You should see your physician if you feel that your asthma is not under control.
If you’re taking bronchodilators to control and alleviate the symptoms of asthma, and if it helps, well and good. Otherwise, your doctor might prescribe several medicines available to help control and relieve the symptoms of bronchial asthma.
These drugs, known as bronchodilators, include Phyllins [theophylline, etofylline] terbutaline and salbutamol. These drugs are available as tablets, syrups or inhalers.
Other drugs in the list includes [ these are available in India]-
- Ambroxol-e.g. Ambrolite-s syrup, and Pulmoclear syrup, among others. They help in liquifying the mucus in the bronchi that aggravates breathlessness.
- Deriphyllin- helps in bronchodilation and ease breathlessness.
- Bromhexine- a drug used to liquify sticky mucus] is frequently used in combination with other medications to treat asthma- e.g., Bromex syrup, Mucospel syrup, and Bromhexine 8 tablets.
- Steroids like dexamethasone, prednisone, and beclomethasone are used as well. They help in reducing the inflammation around bronchi in the lungs as well as reverse allergy.
- Montelukast with either fexofenadine or levocetirizine- Montek LC, Air-M. These medicines counter the allergic effects of the allergens that cause asthma.
These medicines reduce symptoms like coughing, wheezing, and shortness of breath.
To overcome eosinophilia, Hetrazan (diethylcarbamazine) is used in some situations. In severe cases, nebulization is also advised by the attending doctor.
The drugs used in nebulizers are the same as those used in inhalers. Your own doctor will advise you as to which you have to use.
Complication of Asthma
A drop in SpO2 [blood oxygen level] of over 50% triggered by uncontrolled bronchial asthma can result in severe breathlessness. This is known as Status Asthmaticus. Status Asthmaticus is a condition characterized by severe breathlessness and a low SpO2 level. Normal SpO2 range is 93 to 100 percent.
Conclusion
People with uncontrolled acute bronchial asthma may be at risk for developing COPD over time. Patients should carry their inhalers with them at all times, because a slight change in the atmosphere may trigger an acute asthma attack.
Disclosure-
This article contains links that may pay a small commission to the author if a purchase is made by clicking the link without any extra charge to the purchaser of the item.
