Asthma - Don’t be panic! It can’t be cured but can be managed!
Asthma is a very common chronic disease involving the respiratory system in which the airways constrict, become inflamed, and are lined with excessive amounts of mucus, often in response to one or more triggers.

These episodes may be triggered by such things as exposure to an environmental stimulant such as an allergen, environmental tobacco smoke, cold or warm air, perfume, pet dander, moist air, exercise or exertion, or emotional stress.

This airway narrowing causes symptoms such as wheezing, shortness of breath, chest tightness, and coughing. The airway constriction responds to bronchodilators.

Public attention in the developed world has recently focused on asthma because of its rapidly increasing prevalence, affecting up to one in four urban children.

In some individuals asthma is characterized by chronic respiratory impairment. In others it is an intermittent illness marked by episodic symptoms that may result from a number of triggering events, including upper respiratory infection, stress, airborne allergens, air pollutants (such as smoke or traffic fumes), or exercise.

An acute exacerbation of asthma is commonly referred to as an asthma attack.

Signs of an asthmatic episode include wheezing, prolonged expiration, a rapid heart rate (tachycardia), rhonchus lung sounds (audible through a stethoscope), the presence of a paradoxical pulse (a pulse that is weaker during inhalation and stronger during exhalation), and over-inflation of the chest.

During very severe attacks, an asthma sufferer can turn blue from lack of oxygen (so-called blue bloaters), and can experience chest pain or even loss of consciousness. Just before loss of consciousness, there is a chance that the patient will feel numbness in the limbs and palms may start to sweat.

Asthma is caused by a complex interaction of environmental and genetic factors that researchers do not yet fully understand. These factors can also influence how severe a person’s asthma is and how well they respond to medication. As with other complex diseases, many environmental and genetic factors have been suggested as causes of asthma, but not all studies posing such claims have been verified by further studies.

Many environmental risk factors have been associated with asthma development and morbidity in children, but a few stands out as well-replicated or those have a meta-analysis of several studies to support their direct association.

Environmental tobacco smoke, especially maternal cigarette smoking, is associated with high risk of asthma prevalence and asthma morbidity, wheeze, and respiratory infections.

Poor air quality, from traffic pollution or high ozone levels, has been repeatedly associated with increased asthma morbidity and has a suggested association with asthma development that needs further research.

Caesarean sections have been associated with asthma when compared with vaginal birth; a meta-analysis found a 20% increase in asthma prevalence in children delivered by Cesarean section compared to those who were not.

Psychological stress has long been suspected of being an asthma trigger, but only in recent decades has convincing scientific evidence substantiated this hypothesis.

Viral respiratory infections at an early age, along with siblings and day care exposure, may be protective against asthma, although there have been controversial results, and this protection may depend on genetic context.

Antibiotic use early in life has been linked to development of asthma in several examples; it is thought that antibiotics make one susceptible to development of asthma because they modify gut flora, and thus the immune system (as described by the hygiene hypothesis).

The hygiene hypothesis is a hypothesis about the cause of asthma and other allergic disease, and is supported by epidemiologic data for asthma.

All of these things may negatively affect exposure to beneficial bacteria and other immune system modulators that are important during development, and thus may cause increased risk for asthma and allergy.

Asthma treatment is tailored for each person and can change over time. Everyone who has the condition can benefit from asthma treatment to relieve tight, inflamed airways. You’ll need to work closely with your doctor to develop a written asthma treatment plan that’s right for you.

Asthma medication plays a key role in gaining good control of your asthma.

There are two general types of asthma medication which can give you long-term control or quick relief of symptoms.

This is the most important type of therapy for most people with asthma because these asthma medications prevent asthma attacks on an ongoing basis. Steroids, also called “corticosteroids,” are an important type of anti-inflammatory medication for people suffering from asthma.

These asthma medications relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways. This action rapidly opens the airways, letting more air come in and out of the lungs.

These asthma medications can be administered in different ways.

NOTE: A newer asthma medication, called Xolair, works by inhibiting the allergic reaction that often causes constriction of the airways.

Doctors and asthma specialists recognize that asthma has two main components: airway inflammation and acute bronchoconstriction (constriction of the airways).

Long-term control asthma medications are taken daily over an extended period of time to achieve and maintain control of persistent asthma (asthma that causes symptoms more than twice a week and frequent attacks that affect activity).

The most effective long-term control asthma medications are those that stop airway inflammation (anti-inflammatory drugs), but there are others that are often used along with anti-inflammatory drugs to enhance their effect.

However, many people with asthma are interested in trying treatments and therapies that do not use prescribed medicines. These treatments and therapies such as yoga, acupuncture, homeopathy, hypnosis and Buteyko and other breathing techniques, are usually referred to as complementary therapies. There is little scientific evidence that complementary therapies are effective especially used on their own. Complementary therapies and treatments should only ever be used alongside your prescribed medicines

Side effects of asthma medicines
Relievers are a safe and effective medicine and have very few side effects. You cannot overdose on reliever medicine.

The possibility of side effects from taking your inhaled preventer medicine is very low.

If you use preventer medicine there is a small risk of having a sore tongue, sore throat, hoarseness of the voice and a mouth infection called thrush.

Children should be monitored closely if they are taking preventer medicines - especially for growth.

It is possible that long-term and high-dose use of preventer medicines (inhaled steroids) may cause some other side effects (See ‘Side effects of long-term use of steroid tablets’, below).

Several studies have suggested the possibility of a very slight increased risk of the development of cataracts in elderly people who have used inhaled steroids.

For a small number of people, a short-term course of steroid tablets, can lower the body’s resistance to chickenpox, so you should contact your doctor if you or your child are taking steroid tablets and you/they come into contact with chickenpox.

Other possible side effects from taking a short course of steroid tablets are mood swings (especially in children) and increased hunger.

There are very few other side effects from taking occasional (three to four) short courses of steroids per year.

A small minority of people with severe asthma need to take steroid tablets for a longer period.

For these reasons your doctor and asthma nurse will always try to prescribe the smallest possible dose of daily steroid tablets.

If you have severe asthma and you have been prescribed long-term steroid tablets your doctor and asthma nurse should discuss and consult with you about the risk of side effects against the benefits of controlling your asthma symptoms (if untreated, severe asthma can lead to permanent lung damage).

Steroid tablets do not have any side effects that damage the heart.

What can I do about side effects of steroid tablets? Most importantly, don’t smoke. If you smoke, bone thinning side effects are worse. There are some suggestions about avoiding side effects of steroid tablets such as taking the tablets first thing in the morning, using daily calcium supplements, doing exercises such as walking daily. Those activities will help to protect against the bone thinning effect of long-term steroids.