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Asthma

Asthma is a common chronic inflammatory condition where the airways of the lungs become narrow, swollen, and inflamed, thereby making it difficult for the affected individual to breathe easily. It is characterized by an increased responsiveness of the tracheobronchial tree to a variety of stimuli. It is manifested as paroxysms of dyspnea, cough, and wheezing resulting from narrowing of the airways by a combination of muscle spasm, mucosal edema, and viscid bronchial secretion.

 

Currently, asthma is one of the long-term and most common ailments which affects about 300 million individuals around the globe. In the last 30 years, the prevalence of asthma has increased in affluent nations. However, it has now stabilized with about 15% kids and 10% to 12% of adults affected by this discomforting condition.

 

The triad of atopic eczemaallergic rhinitis and asthma together is called atopy. There is a correlation between obesity and the risk of developing asthma, as both these conditions have increased in the recent years.

 

Classification:

Asthma can be classified into the following groups:

 

  1. Early Onset Asthma (atopic, allergic, extrinsic):

The onset of asthma affecting Atopic individuals occurs at an early age. Generally, asthma is diagnosed before the age of 12. External allergens have a strong role to play. Allergens which trigger this type of asthma include mold spores, pollen, dust, food, and pet dander. Allergic asthma is more likely to be seasonal because it often goes hand-in-hand with the seasonal allergies. There is a positive personal or family history of allergic diseases, such as rhinitis, urticaria, and eczema. There is an increase in the level of IgE in the serum and the Skin Hypersensitivity tests tend to be positive. The affected individual gives a positive response to provocation tests.

 

  1. Late Onset Asthma (Non- topic, idiosyncratic, intrinsic):

The onset of asthma affecting non-atopic individuals occurs late. Generally, asthma in such conditions is diagnosed after the age of 12. External allergens have no role to play. There is a negative personal or family history of allergic diseases. IgE levels are normal. Skin Hypersensitivity tests are negative, and the concerned individual’s response to provocation tests is negative.

 

  1. Nocturnal Asthma:

Asthma symptoms tend to turn worse at night. Asthma triggers include heartburns, pet dander, dust mites, and occurrence of coughing, wheezing, feeling breathless at night while sleep.

 

Ask your questions to Dr. Shah's team directly & get an expert opinion on your ailment!

 

  1. Occupational Asthma:

Occupational asthma is a type of asthma that is induced by triggers in the workplace. Triggers of occupational asthma include dust, dyes, gases, fumes, chemicals, animal proteins, and rubber latex.

 

  1. Exercise-Induced Asthma:

Exercises can trigger bronchoconstriction both in people with or without asthma, and bronchoconstriction and symptoms of asthma may turn worse when the air is cold and dry. Exercise-induced asthma is common in professional athletes, cyclists, swimmers, and cross-country skiers.

 

  1. Aspirin-induced Asthma:

Aspirin-exacerbated respiratory disease (AERD), also known as aspirin-induced asthma, consists of asthma, nasal polyps, sinus disease, and respiratory reactions to aspirin and other NSAID medications (such as ibuprofen and naproxen).

 

  1. Alcohol-induced Asthma:

Alcohol may worsen the symptoms of asthma in asthma patients.

 

What causes Asthma?

Asthma occurs due to environmental and genetic factors. Individuals suffering from asthma may possess certain genetic risk factors which can make them more susceptible to the ailment. Also, certain environmental factors, such as certain viral infections affecting an infant for child and exposure to certain allergens, may increase the risk of developing asthma.

 

There are several factors which may trigger asthma. Some of them are mentioned below.

Triggering factors of Asthma

  • Exercise
  • Hyperventilation
  • Cold air
  • Air pollutants and irritants
  • Tobacco smoke
  • Dust & acrid fumes
  • Respiratory viral infections
  • Emotional stress
  • Climatic change or a sudden change in the temperature
  • Occupational hazards
  • GERD (Gastro-Esophageal Reflux Disorder or acid reflux)
  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer, and wine.
  • Aspirin, Beta-Blockers

Also Read: 7 Safety Measures For Asthma Patients For Protection From Cold Climate

Risk factors:

There are various risk factors which increase the chances of developing asthma. Some of the common risk factors for asthma are mentioned below.

  • Positive family history of Asthma
  • Having atopic dermatitis, allergic rhinitis.
  • Obesity
  • Exposure to exhaust fumes or several other types of pollution
  • Being a chronic smoker
  • Exposure to certain occupational triggers, such as certain chemicals which are utilized in farming, manufacturing, and hairdressing.

 

Symptoms of Asthma:

Some of the common symptoms of asthma are mentioned below.

  • Cough
  • Shortness of breath
  • Tightness of chest
  • Wheezing
  • Difficulty in sleeping

 

Based on the clinical features and the intensity, the asthma is classified into three headings

  1. Episodic Asthma:

Episodic asthma occurs in episodes with asymptomatic intervening periods. It is characterized by paroxysms of wheeze and dyspnoea with relatively sudden onset. Episodes may be spontaneous in onset or get triggered by allergens, exercises, or viral infections. Episodic asthma attacks may be mild or severe and may last for hours, days, or even weeks

  1. Severe Acute Asthma (Status Asthmaticus):

Severe acute asthma is a condition, in which severe airway obstruction and asthmatic symptoms persist despite the initial administration of standard acute asthma therapy. The affected individual may suffer from severe dyspnea and unproductive cough. The patient adopts an upright position fixing the shoulder girdle to assist the accessory muscles of respiration. Physical signs of severe acute asthma include sweating, central cyanosis, Tachycardia, and Pulsus paradoxus.

  1. Chronic Asthma:

The symptoms of chronic asthma are usually chronic unless controlled by appropriate therapy. The symptoms include chest tightness, wheezing, and the occurrence of breathlessness on exertion. Episodes of a spontaneous cough and wheezing occur during the night. A chronic cough may have mucoid sputum, and it’s punctuated by recurrent attacks of purulent expectoration from frank infection.

 

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Clinical Evaluation of The Patient History:

Wheezing, dyspnea, and cough are the common respiratory symptoms which a patient of asthma usually suffers. As a matter of fact, these discomforting symptoms vary widely with respect to a specific patient. Also, these symptoms may vary spontaneously or with the season of the year, age, and the treatment. Asthma symptoms may turn worse at night, and the affected individual may experience a nocturnal awakening, which serves as an indication of insufficient asthma control. The severity of a patient’s asthmatic symptoms as well as the patient’s need for systemic steroid treatment, hospitalization, and intensive care treatment, are important to ascertain. Cigarette smoking leads to a greater need for hospital admissions and a more rapid decline in the lung function in asthmatics. So, smoking cessation is essential.

Physical Examination:

It is essential to identify and evaluate the signs of respiratory distress that include cyanosis, tachypnea, and the use of accessory respiratory muscles. On lung examination, there may be wheezing and rhonchi throughout the chest, typically more prominent during expiration than inhalation. Localized wheezing may indicate an endobronchial lesion. Evidence of allergic nasal, sinus, or skin disease should be assessed. When asthma is adequately controlled, the physical examination may be normal.

 

Diagnosis:

The diagnosis of asthma is predominantly clinical and is based on the combination of the history, lung function, and other tests, which help diagnose the presence of high, intermediate or low probability of asthma. The approach may vary from patient to patient and may need to be re-evaluated following the introduction of the treatment.

 

Investigations done to diagnose Asthma:

Here are some crucial investigations which are necessary for the right and proper diagnosis of asthma.

 

  1. Chest X-Ray:

Chest radiography is the initial imaging evaluation recommended to the most individuals with symptoms of asthma.

 

  1. CT Scan:

CT scans in asthma are typically indicated either to identify the associated conditions, for instance, bronchopulmonary aspergillosis, or detect conditions that mimic asthma, such as hypersensitivity pneumonitis.

 

  1. Nitric Oxide Test:

Nitric oxide test measures the amount of nitric oxide gas in the air you breathe out. High levels of nitric oxide may signify asthma.

 

  1. Pulmonary Function Tests Including Spirometry & Peak Flow Meter:

Spirometry is a simple breathing test which measures how much and how fast one can blow the air out of the lungs. It is often used to determine the amount of airway obstruction.

 

A peak flow meter is a simple device which measures how hard one can breathe out. You get the peak expiratory flow rate (PEFR) which offers you the maximum speed of your expiration. It offers a reliable measure of your airway function.

 

  1. Methacholine Challenge:

The methacholine challenge test may be performed if symptoms and screening spirometry do not diagnose asthma clearly.

 

  1. Arterial Blood Gas Analysis:

An arterial blood gas (ABG) test measures oxygen and carbon dioxide levels in your blood.

 

  1. Skin Hypersensitivity Tests:

Skin allergy testing or Skin prick test is a method for medical diagnosis of allergies that attempts to provoke a small, controlled, allergic response.

Also Read: Precautions you must take if your child is suffering from asthma

 

  1. Sputum And Blood Eosinophilia:

Eosinophils are present when symptoms develop, and they become visible when stained with a rose-colored dye.

 

  1. Serum IgE Levels:

Allergic asthma is associated with high levels of immunoglobulin E (IgE).

 

 

Treatment for Asthma

  1. Conventional Treatment:

There is no cure for asthma. Asthma symptoms can be prevented by avoiding triggers, such as allergens and irritants, and by the use of inhaled corticosteroids. It includes bronchodilators, anti-allergic medications, corticosteroids, and other conventional medications.

 

Oral and intravenous corticosteroids may be required for acute asthma flare-ups or for severe symptoms. Examples include prednisone and methylprednisolone.

 

Long-term asthma control medicines are taken every day to prevent the symptoms and attacks, thereby reducing airway inflammation and help improve asthma control.

 

  • Antileukotrienes or leukotriene modifiers
  • Inhaled corticosteroids
  • Long-acting inhaled beta2-agonists
  • Methylxanthines
  • Oral corticosteroids
  • Immunomodulators

They can cause serious side-effects if used on a long-term basis.

 

Nowadays, many asthma patients are becoming dependent on them which is a cause for concern.  

  1. Homeopathy for Asthma:

Homeopathy can alter the hypersensitivity of the immune system, as homeopathy recognizes the disease as a holistic disturbance. Homeopathic system of medicine believes in totality and an individualistic approach, and it takes considers that the physical asthma symptoms manifested in the affected individual’s body are co-related to his emotional and mental state.

The efficacy of homeopathic treatment for asthma focuses on reducing the intensity, frequency, and duration of the attacks thereby works on a boosting the immunity of the individual.

 

Homeopathy treatment helps in reducing the intensity and frequency of asthma symptoms, such as difficulties in breathing, cough, fever, and other symptoms, quite effectively as well as aids in controlling the allergies. Besides this, homeopathy is safe and effective for individuals of all age groups, from babies to the elderly people. Homeopathic medicines also improve your breathing capacity, which can be measured by the peak flow meter.

 

The noteworthy benefit of homeopathy is that it not only provides you good symptomatic or palliative relief from asthma but also aims to cure the condition permanently by eliminating the ailment from your body. Homeopathy not only suppresses or treats the symptoms of asthma but also achieves equilibrium within the individual.

 

Ask your questions to Dr. Shah's team directly & get an expert opinion on your ailment!

 

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*Please note that results and duration of treatment may vary depending on the constitution of your body.