Bronchial asthma is a condition caused by chronically hyperactive and inflamed airways, punctuated by acute episodes of reversible narrowing of the airways. For reasons not fully understood, those suffering from asthma may be particularly sensitive to irritants such as dust, cold air, and viral infections.

Such irritants may periodically cause bronchospasm—contraction of the muscles within the bronchi (the airways between the trachea and the air sacs of the lungs)—and provoke increased mucus production. These two reactions further narrow the already inflamed airways and make it very difficult for the asthma sufferer to breathe. Attacks may be mild or severe and may last anywhere from a few minutes to days.

Asthma may develop at any age. Fifty percent of children with asthma outgrow the condition as they get older and the bronchial passages widen.

Symptoms of Asthma

• Typical symptoms include: sudden breathing difficulty, wheezing, rapid, shallow breathing eased by sitting up, and a sense of suffocation; painless tightness in the chest; coughing, possibly with production of a thick, clear, or yellow sputum (symptoms in young children may in fact mimic those of a viral infection).

• More severe symptoms include: inability to speak more than a few words without gasping for breath; clenched or constricted neck muscles; rapid pulse; sweating; severe anxiety.

• Emergency symptoms: bluish tinge in the face or lips; extremely labored breathing; mental confusion; profound feeling of exhaustion.

What Causes Asthma?

• While asthma is generally caused by allergy to some foreign substance (allergen) or irritant, no extrinsic trigger can be found in some types of asthma. Allergens include (but are not limited to) pollen, dust mites, feathers, animal dander, molds, some drugs such as aspirin, and, rarely, foods. Asthma may also occur in association with other allergic conditions, such as eczema or hay fever. Other precipitants of asthma attacks include cold or dry air, smoke, air pollution, bronchitis and other lung infections, vigorous exercise, emotional excitement, or stress.

• A predisposition to asthma may be hereditary.

Prevention of Asthma

• Try to identify allergens in home and work environments, and eliminate them if possible.

• Don’t smoke; try to avoid secondary smoke.

• Reduce the amount of dust in your home: vacuum regularly, encase mattresses with plastic to discourage dust-mite infestation, and eliminate carpets that are difficult to clean.

• Avoid foods (such as milk, nuts, chocolate, fish) and medicines (such as aspirin or ibuprofen) that have triggered asthma attacks in the past.

• Drink at least eight glasses of liquid a day to keep mucus secretions loose.

• Each morning, practice deep breathing by inhaling fully, bending over with arms crossed over abdomen, and coughing to loosen accumulated lung secretions.

• Take preventive medications as prescribed.

• There is no need to avoid exercise; however, your doctor may advise you to take preventive medicines before exercising.

Diagnosis of Asthma

• Your doctor will conduct a physical examination.

• Allergy skin tests will be performed. A small amount of a suspected allergen will be injected just under the skin. If the area turns red or itchy, or a lump appears, you may be allergic to that substance.

• Chest x-rays are frequently required.

• Blood samples may be taken.

• Pulmonary-function tests that measure the strength and efficiency of your lungs will be performed.

• Keep a diary of the occurrence and severity of asthma attacks.

How To Treat Asthma

• A bronchodilator inhaler should be kept on hand in the event it is needed to relieve a severe attack. However, it is not recommended for regular use as overreliance on it may be harmful.

• Regular use of inhaled corticosteroids (anti-inflammatory drugs) helps control the underlying inflammation. These agents are the principal therapy for many patients with asthma.

• If attacks are frequent, oral bronchodilator drugs (such as long-acting theophylline) or an antileukotriene agent (such as zafirlukast) may be used to help reduce frequency. Inhaled long-acting bronchodilators are sometimes used as well.

• When possible, inhalers should be used with a spacer to help ensure that the medicine reaches the lungs, rather than just being sprayed into in the back of the throat.

• Your doctor may advise you to use a peak flow meter (a small, handheld device that measures airflow) to monitor your lung function. Your peak airflow will go down hours, and sometimes even a day or two, before an attack, so the meter can serve as an early warning system.

• Corticosteroid pills may be prescribed briefly during severe asthma attacks, which at times may require an emergency room visit or hospitalization.

• If specific allergens have been identified, your doctor may give you desensitizing injections.

When To Call A Doctor

• Call a doctor if you notice that the frequency of asthma attacks has increased significantly or if you need to use a bronchodilator more than six times a day.

• Emergency: Call an ambulance if an asthma attack becomes severe (markedly worsened shortness of breath, difficulty speaking, extreme fatigue) or does not respond to two doses of prescribed inhalant.

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