Do you also get asthma? Shall we learn more about asthma?

Do you sometimes feel like you have trouble breathing? Your chest feels tight, or you often cough at night? These could be symptoms of asthma . Today, let's talk about asthma in simple terms, what exactly it is, how it develops, and what to do about it.

What is asthma?

Simply put, asthma is a condition that affects your lungs. Some people also call it 'bronchial asthma'. It is a chronic disease . That means it does not get better all of a sudden, it is a condition that is ongoing and requires medical treatment. There are quite a few people with asthma in Sri Lanka, including young children. If not treated properly, asthma can sometimes be life-threatening , so it is very important to be aware of this.

What is an asthma attack?

When you breathe normally, the muscles around your airways are relaxed. This allows air to flow in and out easily. But when you have an asthma attack, three main things can happen:

• Bronchospasm: This is when the muscles around your airways tighten. When they tighten, the airways narrow, making it difficult for air to flow in and out.
• Inflammation : The lining of the airways swells. This swelling reduces the amount of air that can enter and leave the lungs.
• Mucus Production: During an attack, your body produces more mucus. This thick mucus gets stuck in your airways, blocking them.

When the airways are this tight, you make a 'whistling' sound when you breathe out, some say a 'ree ree' sound. This is what we call ' wheezing ' . Sometimes an asthma attack is also called an 'exacerbation' or 'flare-up'. This means that your asthma is getting worse and worse.

Are there types of asthma?

Yes, asthma can be divided into several types. These classifications are based on the cause and how severe the symptoms are. Doctors diagnose asthma as follows:

• Intermittent asthma : This type of asthma comes and goes. This means you can be normal between periods of severe asthma.
• Persistent asthma: In this case, you have symptoms that are constant. These symptoms may be mild, moderate, or severe. Doctors determine the severity of your asthma by looking at how often you have symptoms and how well you can function normally after an attack.

There are several reasons why asthma develops:

• Allergic Asthma: Some people can have an asthma attack due to allergies . For example, things like molds, pollens , pet dander, and dust mites can trigger this.
• Non-allergic asthma: Asthma can also be aggravated by external factors. Things like exercise, stress , certain illnesses, and weather changes can all exacerbate asthma.

Furthermore, asthma can also be classified as:

• Adult-onset asthma: This type of asthma begins after the age of 18.
• Pediatric Asthma: This is also called 'Childhood Asthma '. It often starts before the age of 5. It can sometimes affect babies and young children. Keep in mind that some children outgrow their asthma as they grow older. However, if your child has asthma, you should talk to your doctor about things like whether they need to keep an inhaler with them and what to do if they have an attack. Your doctor can explain the risks to you.

In addition, there are also types of asthma such as:

• Exercise-induced asthma: This is aggravated by exercise. It is also called ``Exercise-induced Bronchospasm''.
• Occupational Asthma: This mainly occurs in people who are exposed to irritating substances in the work environment. For example, people who work in some factories or agricultural workplaces may be at risk.
• Asthma-COPD Overlap Syndrome (ACOS): This happens when you have both asthma and chronic obstructive pulmonary disease (COPD). Both of these conditions cause breathing difficulties.

Who can develop asthma?

In fact, anyone can develop asthma at any age. However, people with allergies and those exposed to tobacco smoke are at higher risk of developing asthma. This includes 'secondhand smoke' (`(Secondhand smoke)`), which is breathing in smoke when someone else is smoking, and '(Thirdhand smoke)`), which is exposure to smoke on clothes and furniture in a place where smoking has occurred. Smoking is especially bad in places where young children are present. Asthma is more common among women. Also, there are differences in its prevalence among some ethnic groups.

What are the causes of asthma?

Researchers still don't know exactly why some people develop asthma and others don't, but they have found that certain factors increase the risk:

• Allergies: If you have allergies, you are at higher risk of developing asthma.
• Environmental factors: Some people develop asthma after exposure to things that are harmful to the respiratory tract. These include allergens, toxins, smoke, and, as mentioned earlier, second-hand or third-hand smoke. These are especially harmful to babies and young children whose immune systems are not yet fully developed.
• Genetics: If someone in your family has asthma or allergies, you are at a higher risk of developing asthma. This means that it can be inherited.
• Respiratory infections: Some respiratory infections, such as respiratory syncytial virus (RSV), can damage the developing lungs of young children, which can lead to asthma later in life.

What are the common triggers for an asthma attack?

You can have an asthma attack if you come into contact with substances that are harmful to you, that is, things that irritate you. Doctors call these 'triggers'. When you know what things make your asthma worse, it's easier to avoid having an asthma attack.

For some people, the attack may occur immediately after exposure to this 'trigger'. For others, the attack may begin at a different time, hours or days later.

These 'triggers' can vary from person to person, but some of the most common 'triggers' are:

• Air pollution: Many things outdoors can make asthma worse. This includes smoke from factories, vehicle exhaust, and smoke from forest fires.
• Dust mites: Although we can't see these creatures, they are in our homes. If you are allergic to dust mites, they can trigger an asthma attack. They are especially common in old mattresses, pillows, and carpets.
• Exercise: Some people can experience an attack from exercising.
• Mold: Mold grows in damp places. If you have asthma, this mold can cause problems. You don't have to be allergic to mold to have an attack.
• Pests: Pests in the home, such as cockroaches and rats, can also cause asthma attacks.
• Pets: Your pets can also trigger asthma attacks. If you are allergic to the tiny particles (`(Pet dander)`) that your pets shed, inhaling them can irritate your airways.
• Tobacco smoke: If you or someone in your home smokes, you are at higher risk of developing asthma. Never smoke in enclosed spaces, such as inside your car or home. The best thing to do is to quit smoking. Your doctor can help you with this.
• Strong chemicals or smells: Some things like perfumes and cleaning products can aggravate asthma in some people.
• Certain occupational exposures: You may be exposed to various things at work. Examples include cleaning products, dust, wood dust, or other chemicals. These can all be triggers if you have asthma.

What are the symptoms of asthma?

People with asthma usually have clear symptoms. These symptoms are very similar to those of respiratory infections:

• Feeling of tightness, pain, or pressure in the chest.
• Cough (especially at night).
• Shortness of breath.
• Wheezing (making a 'ree ree' sound when breathing).

When you have asthma, you may not have all of these symptoms during every attack. A person with chronic asthma may have different symptoms at different times. Also, symptoms may change during an asthma attack.

How do doctors diagnose asthma?

Your doctor will review your medical history. This will include information about your parents and siblings. He or she will also ask about your symptoms. The doctor will also want to know about any allergies, eczema (a skin condition with blisters caused by allergies), and other lung diseases.

Your doctor may order a spirometry test. This test measures how quickly air moves through your lungs. It is used to diagnose asthma and monitor your progress with treatment. In addition, you may be asked to have a chest X-ray , a blood test, or a skin test.

What are the treatments for asthma?

You have different options for managing your asthma. Your doctor will prescribe medication to control your symptoms. These include:

• Bronchodilators: These medications work by relaxing the muscles around your airways . When the muscles relax, air can move through your airways more easily. It also makes it easier for mucus to move through your airways . These medications help relieve symptoms when they occur. They are used for both intermittent and chronic asthma.
• Anti-inflammatory medicines: These medicines reduce swelling and mucus production in your airways . They make it easier for air to enter and leave your lungs. Your doctor may prescribe these to you every day to control or prevent symptoms of chronic asthma.
• Biologic therapies for asthma: These are used for severe asthma, such as when symptoms persist despite treatment with an inhaler.

There are different ways to take your asthma medication. You can breathe in your medication using a metered-dose inhaler, a nebulizer, or another type of asthma inhaler. Your doctor may also prescribe oral medications.

What is Asthma Control?

The main goal of asthma treatment is to control symptoms. Asthma control means that the following things happen:

• Being able to do the things you want to do at home and at work.
• Absence (or very few) of asthma symptoms.
• You rarely need to use your rescue inhaler.
• Being able to sleep without being disturbed by asthma.

If you can get to this point, it means your asthma is well controlled. Then you can live a normal life.

How to monitor asthma symptoms?

It is important to keep a record of your asthma symptoms. It is an important part of managing your condition. Your doctor may ask you to use a 'Peak Flow' (PF) meter . This device measures how fast you can blow air out of your lungs. It can help your doctor make changes to your medication. It can also help you see if your symptoms are getting worse.

What is the outlook for someone with asthma?

Even if you have asthma, you can still lead a very productive life and engage in sports and other activities. Don't worry. Your doctor can help you manage your symptoms, find out what your triggers are, and help you prevent or manage attacks.

How to prevent an asthma attack?

If your doctor tells you that you have asthma, you need to find out what your 'triggers' are that can cause an attack. Avoiding those 'triggers' can help prevent an attack. But we can't prevent asthma from developing.

What is an Asthma Action Plan?

Your doctor will work with you to create an asthma action plan. This plan tells you how and when to take your medications. It also tells you what to do if your asthma symptoms occur, and when to seek emergency care. Ask your doctor to explain anything you don't understand.

What to do if you have a severe asthma attack?

If you have a severe asthma attack, you need immediate medical attention . Just think, some people can turn blue and have trouble breathing. It can be that severe.

The first thing you should do is use your 'rescue inhaler' . This 'rescue inhaler' contains fast-acting medicine that opens up your airways. This is different from the 'maintenance inhaler' that you use every day. You should use your 'rescue inhaler' when your symptoms are bothering you. If the attack is severe, you can use it more often.

If your rescue inhaler doesn't help, or you don't have it with you, go to a hospital emergency department immediately if you have any of these symptoms:

• Anxiety or panic.
• Blue nails, blue lips (for people with fair skin), or gray or white lips or gums (for people with dark skin).
• Chest pain or pressure.
• A persistent cough or a loud wheezing sound when breathing.
• Difficulty speaking.
• A pale, sweaty face.
• Very rapid breathing.

How do you know if you have asthma or not?

To find out if you have asthma or another condition, you should definitely see a doctor. There are other respiratory diseases that cause shortness of breath, coughing, and wheezing. Therefore, it is wise to seek medical advice rather than self-diagnosing.

Can asthma be cured?

No. Asthma cannot be cured completely. However, it can be managed well. Some children outgrow their asthma as they grow older.

Why does my asthma get worse at night?

Asthma that worsens at night is sometimes called 'nighttime asthma' or 'nocturnal asthma'. It is not possible to say for sure what causes this, but there are a few things that can be speculated:

• The way you sleep: Sleeping on your back can cause mucus to go up into your throat, or acid from your stomach (`(Acid reflux)`) can come back up. Also, sleeping on your back can put pressure on your chest and lungs, making it difficult to breathe. However, sleeping on your face or side can also put pressure on your lungs.
• Bedroom triggers and evening triggers: Your sheets, pillowcases, and pillows may contain dust mites, mold, or pet dander. If you've been outside in the evening, you may have brought pollen inside.
• Side effects of medications: Some asthma medications, such as steroids and montelukast, can affect your sleep.
• Air that is too hot or too cold: Breathing in hot air can narrow the airways. Cold air is an asthma trigger for some people.
• Changes in lung function: As a natural process, lung function decreases slightly at night.
• Asthma that is not well controlled during the day: Symptoms that are not controlled during the day will not improve at night. It is very important to talk to your doctor about how to control your asthma symptoms both during the day and at night. It is very important to treat your nighttime symptoms. Severe asthma attacks, sometimes even fatal, can occur at night.

What do I need to know about COVID-19 and asthma?

If you have moderate to severe asthma, or if your asthma symptoms are not well controlled, you are at higher risk of being hospitalized if you get COVID-19. So, wear a mask when you go to indoor places with other people, get vaccinated, and stay away from people who have the virus.

Many people with asthma live fulfilling lives. Some professional athletes with asthma have even set records in their sports. Your doctor can help you find the best way to manage your asthma. Talk to your doctor about how to control your symptoms.

Final Take-Home Message

Okay, so we've talked a lot about asthma, haven't we? Remember, asthma is a disease that, if managed properly, doesn't interfere with your ability to live a normal life.

• Identify your asthma triggers and stay away from them as much as possible.
• Use the medication your doctor prescribes exactly and at the right time. In particular, always keep your rescue inhaler with you.
• Be familiar with your Asthma Action Plan. Know what to do in an emergency.
• If your asthma worsens at night, talk to your doctor about that too.
• Stay away from places where people smoke. If anyone in your home smokes, tell them about it too.
• Whenever you have any doubts, don't hesitate to seek advice from a doctor.

Living with asthma can be challenging, but you are not alone. With proper medical advice and your commitment, you too can live a comfortable life.