A lung disorder characterized by narrowing of the airways, the tubes which carry air into the lungs, that are inflamed and constricted, causing shortness of breath, wheezing and cough.
Causes: The exact cause of asthma is not known; it is suspected to be due to genetic and/or environmental factors. Know More
Symptoms: Symptoms could be mild in some people while it might interfere with daily activities in many others. Most commonly observed symptoms include shortness of breath, wheezing, coughing and chest tightness and in severe cases, it might lead to life-threatening asthma attacks. Know More
Diagnosis: A careful and detailed history as well as a clinical examination helps in diagnosis of asthma. The doctor may conduct some tests to confirm the diagnosis and to exclude other lung conditions. Know More
Facts
Treatable by a medical professional
Diagnosed by medical professional
Requires lab test or imaging
Can last several years or be lifelong
Family history may increase likelihood
Urgent medical attention recommended in severe cases
Know More
There are various types of asthma and they can be broadly classified into 2 types:
Allergic
Most common, especially in children
Usually, there is a history of atopy (such as eczema, hay fever, and rhinitis)
Triggered by allergens such as pet dander, dust mites, pollen, seafood, or peanuts
Non-allergic
May be linked to:
Respiratory viral infection (e.g. cold, bronchitis and sinusitis)
Exercise
Stress
Medications
Irritants in the air (e.g. cigarette smoke, air pollution)
Irritants at the workplace (e.g. chemicals, metals, wood dust and plant products)
Pregnancy and obesity can affect the severity of symptoms
Symptoms
CHARACTERISTIC
COMMON
RARE
Symptoms of asthma vary from person to person. There could be sudden outbursts of symptoms. Most common symptoms of asthma are:
Dyspnea or difficult breathing
Wheezing
Chest tightness
Persistent coughing, more commonly at night. Most commonly cough with mucus or phlegm
During Asthma attack, the patient presents below symptoms:
Very low blood pressure
Abnormally rapid breathing
Wheezing sounds may accompany both inspiration and expiration or expiration alone
If the person is suffering from asthma for a prolonged period, Respiratory failure, a syndrome when the blood vessels around the air sacs fail to exchange gases of carbon dioxide and oxygen efficiently, may occur. The symptoms of Respiratory failure include:
Hyperinflation: Patients with long standing uncontrolled asthma may have a barrel-shaped chest caused by hyperinflation of lungs
Loss of consciousness
Skin and mucous membrane turning to blue in color
Low blood pressure, which could lead to heart attack
Oxygen saturation dropping less than 90%
Causes
COMMON
RARE
The causes of asthma are unknown, but it is most probably due to either genetic or environmental factors. Certain factors are known to trigger asthmatic symptoms they are:
Allergens like dust mites, animal dander, pollen, molds, cigarette smoke, chemical pollutants, and cold air
Sinusitis
Extreme emotional responses and physical exercise
Medications like aspirin, beta-blockers or NSAIDs
Gastro esophageal reflux disease
Other factors like dietary insufficiencies in vitamins C and E, and omega-3 fatty acids
Foods with sulfites and preservatives may also trigger symptoms
Diagnosis
COMMON
IN SOME CASES
A careful and detailed history as well as a clinical examination helps in diagnosis of asthma. The doctor may conduct some tests to confirm the diagnosis and to exclude other lung conditions.
Peak flow rate
Peak flow assesses airway obstruction by measuring the air out of lungs while breathing. The air flow will be lower in asthmatic patients.
Spirometry
This test is done to confirm the presence of airway obstruction. This estimates the functioning of the lungs by measuring the air inhaled and the air exhaled and how fast the air is exhaled.
Allergy blood test
This is done to identify triggers. The allergens, allergy causing substances could be pets, pollen, dust or chemical fumes. If allergy triggers are identified, allergy shots may be recommended.
Methacholine challenge test
Methacholine is known to trigger asthma. This test is conducted when spirometry results are normal.
Sputum eosinophils
The count of eosinophils, a type of white blood cells, found in the sputum (mixture of mucus and saliva), helps in the diagnosis.
vTreatments
COMMONLY RECOMMENDED
IN SEVERE CASES
Asthma can be managed with medications. Medications vary depending on the severity of symptoms. The medications are administered through inhalers or nebulizers. The medication through tablets helps manage the condition.
MEDICATION
Inhaled short-acting beta-2-agonists
Quick relief inhalers reduces the symptoms like shortness of breath. Usually prescribed for quick relief of symptoms.
Common drugs : Albuterol, Terbutaline
Inhaled steroids
Help in reducing the airway inflammation. Usually given for severe symptoms.
Common drugs : Fluticasone, Budesonide
Inhaled long-acting beta-2-agonists
Help in dilation of airways. Usually prescribed for chronic conditions.
Common drugs : Formoterol, Salmeterol
Leukotriene-modifying agents
Help in both dilation of airways and reducing inflammation. For managing symptoms.
Common drugs : Zafirlukast, Zileuton
Xanthines
Help in dilation of airways. Usually prescribed if sudden shortness of breath occurs.
Common drugs : Theophylline
Beta-2-agonist tablets
Help in dilation of airways.
Common drugs : Levalbuterol, Metaproterenol
IL-4 antagonist
Reduces inflammation of airways. Usually given in moderate to severe cases.
Common drugs : Reslizumab
Steroid tablets
Help in reducing the airway inflammation. Usually given in severe uncontrolled cases.
Common drugs : Prednisone, Beclomethasone dipropionate
IL-5 antagonist
Reduces inflammation of airways. Usually given in severe uncontrolled cases.
Common drugs : Mepolizumab
IL-5 receptor antagonist
Reduces inflammation of airways. Usually given in severe uncontrolled cases.
Common drugs : Benralizumab
SURGERY
Bronchial thermoplasty
Reduces the bulk of smooth muscles and thereby dilates the airways. Performed in people with severe asthma. Usually done when the long term medications and inhalations don't help reduce the symptoms.
Complications
Uncontrolled long term asthma may lead to:
Deterioration of lung function
Increase in airway inflammation
Interference in daily activities
Weakness
Hospitalization during severe attacks
Prevention
While there is no prevention for asthma, the symptoms and asthma attacks can be managed through regular monitoring and treatment.
Identify and avoid the triggers - triggers could be exercise, certain foods, pollen
Follow medication as prescribed
Learn proper use of inhalers - including cleaning the inhalers
Carry the inhalers and medicines to workplace/while travelling, to get an immediate relief during the attack
Monitor your breathing often. If you suspect breathing difficulty, wheezing or cough, it is recommended to see the doctor
Questions To Ask Your Doctor
What would be the recovery time?
Will I be completely cured?
Is there any specific diet to follow?
What are the symptoms to look for, if in case of any other complications?
When should I come for the follow-up check?
Nutrition
FOODS TO EAT FOOD TO AVOID
Foods to eat:
Foods rich in Vitamin C such as kiwis, broccoli, berries, oranges and tomatoes
Foods rich in Vitamin E such as almonds, spinach and sweet potato
Foods rich in omega-3 fatty acids such as canola oil, cod liver oil, flaxseed oil and mustard oil
Food to avoid:
Dried fruits like dried apricot
Alcoholic drinks like wine or beer
Frozen or prepared shrimp
Food with high amount of sulphites and preservatives like pickles
Food that is allergic to your body
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