Asthma

Introduction
Asthma is a medical condition wherein the airways become narrow, swell and produce extra mucus. This can make breathing difficult, trigger coughing, wheezing and shortness of breath.

While asthma is slightly developed in some people, it can become a major problem that interferes with daily activities causing fatal asthma attack.

While Asthma affects people of all ages, it usually develops during childhood. Around 25 million people in US alone are known to be afflicted with asthma. Of these, about 7 million are children.

Though asthma is difficult to cure, its symptoms are controllable. Asthma changes its route with time. Hence, it is important to consult doctor for advice depending on symptoms and follow suitable treatment.

Asthma symptoms range from minor to severe and differ from person to person. One could get afflicted with asthma attacks only during specific times or undergo repetitive attacks.

Symptoms

  • Shortness of breath
  • Chest tightness or pain
  • Trouble sleeping caused by shortness of breath, coughing or wheezing
  • A whistling or wheezing sound while exhaling
  • Coughing or wheezing attacks, which worsens with respiratory virus, such as cold or flu

Causes
Asthma could be exercise-induced, allergy-induced or occupational in nature.

Diagnosis
In order to rule out other respiratory ailments, a physical exam is mandatory.

A pulmonary function test is carried out to determine the amount of air flow while inhaling and exhaling. These tests include:

  • Spirometry determines the rate of breathing and also the amount of air exhaled after every deep breath.
  • Peak flow measures the extent a patient can exhale. Lower peak flow readings signify under functioning of one’s lungs and indicate that asthma could be worsening.
  • Lung function tests are done with the help of a bronchodilator such as albuterol, to unclog the airways. When the lung function improves with use of a bronchodilator, there is a likelihood of asthma.
  • Allergy test confirms allergy to pets, dust, mold and pollen. This can be conducted by skin test or blood test.
  • Methacholine test is used to determine lung function. Any reaction to methacholine confirms the presence of asthma.
  • Nitric oxide test measures the gas present in a person’s breath. Inflammation in the airways confirms the presence of asthma.
  • Imaging tests including X-ray and high-resolution computerized tomography (CT) scan of lungs and nose cavities recognize structural abnormalities and diseases related to breathing.
  • Sputum eosinophils help to identify white blood cells in the mixture of saliva and mucus expelled while coughing. Eosinophils take up rose colored stain of eosin.

Prevention and long-term control are responsible in stopping asthma attacks. Treatment involves learning to recognize triggers and taking steps to avoid them. Daily intake of asthma medications controls the symptoms. Use of quick-relief inhaler, such as albuterol helps to deal with asthma on a faster rate.

Treatment
Preventive, long-term medications reduce the inflammation in airways. Quick-relief inhalers (bronchodilators) open swollen airways. Medications for long term control of asthma are administered for routine use. Types of long-term control medications include:

  • Inhaled corticosteroids comprise of anti-inflammatory drugs such as fluticasone, budesonide, flunisolide, ciclesonide, beclomethasone and mometasone are largely beneficial.
  • Leukotriene modifiers such as montelukast, zafirlukast and zileuton relieve asthma symptoms for up to 24 hours. Sometimes, it can cause psychological reactions.
  • Oral and intravenous corticosteroids such as prednisone and methylprednisolone help to heal inflammation in airway caused by rigorous asthma. Allergy medications  help in reducing symptoms of asthma worsened by allergies. These include oral and nasal spray antihistamines and decongestants.
  • Allergy shots reduce the intensity of immune system to specific allergens. They are taken once a week for few months with reduced intensity over time.
  • Omalizumab (Xolair) is used as an injection every two to four weeks for people with allergies and severe asthma.

Nutrition
Consumption of Omega-3 oils helps in balancing allergic pathways in the body.  Vitamins C, B6, and B12 along with selenium and molybdenum are helpful nutrients in treating Asthma.

Ayurvedic Medicines
Kapha kartari, Kanakaasava, Chyavana praasa, Bhaarangee guda Sitopalaadi choorna and Agastya rasaayana.

Homeopathic Remedies
Ipecac, Arsenicum, Nux vomica, Kali bichromicum, Antimonium tartaricum and Moschus are homeopathic remedies of choice for treating this ailment.

 

References:
1. Martinez FD. Genes, environments, development and asthma: a reappraisal. Eur Respir J. 2007 Jan;29(1):179-84. Review. PubMed PMID: 17197483.

2. Lemanske RF, Busse WW. Asthma: Clinical Expression and Molecular Mechanisms. The Journal of allergy and clinical immunology. 2010;125(2 Suppl 2):S95-102. doi:10.1016/j.jaci.2009.10.047.

3. Kumar, Vinay; Abbas, Abul K; Fausto, Nelson; Aster, Jon, eds. (2010). Robbins and Cotran pathologic basis of disease (8th ed.). Saunders. p. 688.

4. Boulet LP. Influence of comorbid conditions on asthma. Eur Respir J. 2009 Apr;33(4):897-906. doi: 10.1183/09031936.00121308. Review. PubMed PMID: 19336592.

5. Boulet LP, Boulay MÈ. Asthma-related comorbidities. Expert Rev Respir Med. 2011 Jun;5(3):377-93. doi: 10.1586/ers.11.34. Review. PubMed PMID: 21702660.

6. Miller RL, Ho S. Environmental Epigenetics and Asthma: Current Concepts and Call for Studies. American Journal of Respiratory and Critical Care Medicine. 2008;177(6):567-573. doi:10.1164/rccm.200710-1511PP.

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