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Asthma Disease

   What is Asthma
  Sign and Symptoms
  Risk factors and causes of Asthma
  Types of Asthma
  Diagnosis
  Treatment Options
  Prevention methods
  Possible complications
  Prognosis
  History
  New study on Asthma
  World Asthma Day

  What is Asthma

 Asthma is an inflammatory disorder of the airways, which causes attacks of wheezing, shortness of breath, chest tightness, and coughing. The airways are the tubes that carry air in and out of your lungs. In case of asthma, the inside walls of airways are inflamed (swollen). The inflammation makes the airways very sensitive, and they tend to react strongly to things that you are allergic to or find irritating. When the airways react, they get narrower, and less air flows through to your lung tissue.

Muscles around the  bronchiole have normal  tone

    Muscles around the bronchiole have normal tone

         muscles around the  airways tighten

  During an asthma attack, muscles around the airways tighten up, making the airways narrower so less air flows through.



 During an asthma attack, muscles around the airways tighten up, making the airways narrower so less air flows through. Inflammation increases, and the airways become more swollen and even narrower. Cells in the airways may also make more mucus than usual. This extra mucus also narrows the airways. These changes make it harder to breathe.

  Asthma education is essential for asthma management. The patient should understand their disease process, understand their medication and how to use it, and be able to react to changes in their disease by symptoms and/or actual measured peak flow.

  Sign and Symptoms

 Asthma is Greek word meaning “panting or short drawn breath’’. Patients suffering from this disease appear gasping for breath. Actually they have more difficulty in breathing out than breathing in and this is because of spasm of air passage in the lungs. The effect is to blow the lung up because the patient can not drive the air properly out of the lungs before he has to take another breath.

  Asthma onset is either abrupt or gradual. Sudden spells of coughing can be the first sign. When the onset is gradual, the attack is usually brought on by respiratory infections. A severe attack causes an increase in heartbeat and respiratory rates and the patient feels restless and fatigued. There may be coughing, tightness in the chest, profuse sweating and vomiting. There may also be abdominal pain, especially if the coughing is  severe. The wheezing sound identified with asthma is produced by the air being pushed through the narrowed bronchi. All asthmatics have more difficulty at night, especially late nights/ very early mornings.

  In the elderly, the recurring periods of distressing and often nocturnal cough, may occur after an upper  respiratory infection, suggesting the late onset of asthma. Wheezing if not the original complaint, would have been noticed often by the patient or people around him. The lungs may appear normal when examined during the day, but serial measurements of peak expiratory flow rate several times a day and night if woken by cough will normally show the wide fluctuations characteristic of asthma.

  During very severe attacks, an asthma sufferer can turn blue from lack of oxygen, and can experience chest pain or even loss of consciousness. Just before loss of consciousness, there is a chance that the patient will feel numbness in the limbs and palms may start to sweat. The person's feet may become icy cold. Severe asthma attacks,  are life-threatening and may lead to respiratory arrest and death. Despite the severity of symptoms during an asthmatic episode, between attacks an asthmatic may show few or even no signs of the disease. 

  Risk factors and causes of Asthma

  There are different theories about the low prevalence of asthma. The genetic background of the patients, increasing  pollution, including that from allergens, smoke and toxins, weak immune system  and changes in lifestyle are the main reason for the increase in the prevalence of asthma.  Asthma is caused by a complex interaction of genetic and environmental factors.

 Environmental factors:  Many environmental risk factors have been associated with asthma, some that support their direct association:

 Environment Pollution , Poor air quality, from traffic pollution or high ozone levels, has been associated asthma development.

  Environmental tobacco smoke, especially maternal cigarette smoking, is associated with high risk of asthma prevalence and asthma morbidity, wheeze, and respiratory infections. 
  Viral respiratory infections at an early age.

  Antibiotic use early in life has been linked to development of asthma as they modify gut flora, immune system.

  Psychological stress on the part of a child's caregiver has been associated with asthma, because stress may influence the immune system.
  Genetic factors:  Over 100 genes have been associated with asthma in at least one genetic association study. Through the end of 2005 study, 25 genes had been associated with asthma in six or more separate populations. Many of these genes are related to the immune system or to modulating inflammation.

 Gene-environment Interactions:  Research suggests that some genetic variants may only cause asthma when they are combined with specific environmental exposures.

Use of inhalers

For people suffering from mild asthma (infrequent attacks), the use of inhalers can be need-based


  The first World Asthma Day
  The first World Asthma Day, in 1998, was celebrated in more than 35 countries in conjunction with the first World Asthma Meeting held in Barcelona, Spain. Participation has increased with each World Asthma Day
held since then, and the day has become one of the world's most important asthma awareness and education events.

  The risk factors
 The strongest risk factors for developing asthma are  exposure to indoor allergens such as house dust mites in bedding, carpets and stuffed furniture; pollution and pet dander; outdoor allergens such as pollens and moulds; tobacco smoke and chemical irritants in the workplace. Asthma triggers can include cold air, extreme emotional arousal such as anger or fear, and physical exercise.
                          
  'Late' asthma research unearths potential new treatment
  Scientists have stumbled on a potential new treatment for delayed asthma attacks which can occur several hours after exposure to allergens, a study shows.
A team from Imperial College London found that blocking sensory nerve functions stopped a "late asthmatic response" in mice and rats. Around half of people with asthma experience delayed symptoms.

 Allergens: Asthma cause due to allergens from nature, typically inhaled, which include waste from common household pests, such as the house dust mite and cockroach, grass pollen, mould spores, and pet epithelial cells. Indoor air pollution from volatile organic compounds, including perfumes and perfumed products. Food allergies such as milk, peanuts, and eggs. However, asthma is rarely the only symptom, and not all people with food or other allergies have asthma. 
  Use of fossil fuel related allergenic air pollution, such as ozone, smog, summer smog, nitrogen dioxide, and sulfur dioxide, which is thought to be one of the major reasons for the high prevalence of asthma in urban areas.  Various industrial compounds and other chemicals, notably sulfites; chlorinated swimming pools generate chloramines —monochloramine (NH2Cl), dichloramine (NHCl2) and trichloramine (NCl3) - in the air around them, which are known to induce asthma

 Early childhood infections: However, persons of any age can have asthma triggered by colds and other respiratory infections.Eighty percent of asthma attacks in adults and 60% in children are caused by respiratory viruses.

   Types of Asthma

 Inflamed airways asthma:  Airways narrowed as a result of the inflammatory response cause wheezing. 

  Bronchoconstriction: During an asthma episode, inflamed airways react to environmental triggers such as smoke, dust, or pollen. The airways narrow and produce excess mucus, making it difficult to breathe. In essence, asthma is the result of an immune response in the bronchial airways

  Stimuli: The airways of asthmatics are "hypersensitive" to certain triggers known as stimuli     In response to exposure to these triggers, the bronchi (large airways) contract into spasm (an "asthma attack"). Inflammation soon follows, leading to a further narrowing of the airways and excessive mucus production, which leads to coughing and other breathing difficulties.

 Occupational asthma:  That's asthma caused by exposure to allergens present in the average office - and a new study says it's on the rise. Exposure to wood dust, paint fumes, solvents, latex and baking flour - all workplace allergens - cause thousands of cases of asthma every year, according to a report released on Moay 12, 2008  by 
the Australian Institute of Health and Welfare (AIHW). The study shows that anywhere from 9 to 15 per cent of adult-onset asthma cases can be attributed to exposure to agents at the workplace, Science Alert reported. Occupations with the greatest risk for occupational asthma include farming, painting, cleaning, baking, animal handling and chemical work. Other at-risk occupations include nursing, welding, food processing, dentistry, timber and forestry industries, and industries that produce metals, plastics, electronics, rubber and textiles. 

  Diagnosis

 Asthma is defined simply as reversible airway obstruction. Reversibility occurs either spontaneously or with treatment. The basic measurement is peak flow rates. In many cases, a physician can diagnose asthma on the basis of typical findings in a patient's clinical history and examination. Diagnosis in children is based on a careful compilation and analysis of the patient's medical history. Monitoring asthma with a peak flow meter on an ongoing basis assists with self monitoring of asthma. Peak flow readings can be charted on graph paper charts together with a record of symptoms or use peak flow charting software. A peak flow meter, a simple device to measure lung volume, can be used at home to help you "see an attack coming" and take the appropriate action, sometimes even before any symptoms appear.

  Asthma Diagnosed by a device called a spirometer to check how your lungs are working. This test is called spirometry. The test measures how much air you can blow out of your lungs after taking a deep breath, and how fast you can do it . The results will be lower than normal if your airways are inflamed and narrowed, or if the muscles around your airways have tightened up. 
  In  capnography which measures the amount of exhaled carbon dioxide, along with pulse oximetry which shows the amount of oxygen dissolved in the blood, to determine the severity of an asthma attack as well as the response to treatment.  Direct aspiration (dysphagia) can be diagnosed by performing a Modified Barium Swallow test and treated with feeding therapy.   

   Treatment Options

 For people suffering from mild asthma (infrequent attacks), the use of inhalers can be need-based, while those having significant asthma (symptoms occurring every week) must be treated with anti-inflammatory medication, preferably inhaled corticosteroids and bronchodilators. Acute or severe asthma attacks may require hospitalization, administration of oxygen and intravenous medication.

 Drugs and inhalers have only a limited value in alleviating symptoms. Most of these drugs are habit forming and the dose has to be increased from time to time, thus making patient more dependent on them. The root cause, i.e., allergy has to be taken care of. The natural way to treat asthma consists of stimulating the functioning of slack excretory organs, adopting appropriate diet patterns to eliminate morbid matter and reconstruct the body, and practicing yoga-pranayam for assimilation of food and strengthen lungs, digestive system and circulatory system.

 The patient should be given enema to clean the colon and prevent auto-intoxication. Mud packs applied to abdomen will relive fermentation caused by undigested food and will promote intestinal peristalsis. Wet packs should be applied to the chest to relive congestion of lungs and to strengthen them. The patient should be made to perspire through steam bath, hot foot bath, hot hipbath and sun bath. This will remove accumulated toxins and will also help in removing congestion of lungs.
  The patient should fast for 3-4 days on lemon juice with honey. After fasting, he/she should start a fruit diet, but care has to be taken that acid forming foods are kept limited. More liberal use of alkaline food should be made, like green vegetables and germinated gram. Fried foods,  rice, sugar, lentils and curds should be avoided as it forms phlegm.

  Asthmatics should avoid taking water with meals and should always eat less then their capacity to make stomach fire stronger and thereby hardly leaving any chance to form phlegm. In acute cases, do no force the patient to eat. Warm water sips at frequent intervals will be helpful. 2 spoons of dry ginger powder are added in one liter of water, which is boiled for 10 minutes, and this water on cooling is supposed to be sipped every hour. This produces sufficient heat in the body to break down the mucus, dilate air passages and decrease congestion by reducing inflammation.

  Regular intake of onion juice helps in reliving acute symptoms as it is a strong anti-inflammatory. This quality is because of the compound named diphenylthiosulphinate, thiosulphinates which has stronger anti-inflammatory 
property than prednisolone.

  The patient’s diet should contain regular use of black pepper powder and garlic. Both of them have mucus moving capacity thereby making breathing easier. Honey contains higher alcohols and ethereal oils and the vapors given off by them are soothing and beneficial to asthma patients. Honey usually brings relief when the air flowing over it is inhaled or is consumed with warm water/ milk. It tones up the pulmonary parenchyma and thereby prevents the production of mucus in future. 

  The patient should do breathing exercises twice a day at an empty stomach. After taking a deep breath (in a way that even the clavicular part of shoulder is raised up while inhalation), the patient should practice keeping the air inside the lungs, forcefully as long as possible, followed by very slow exhalation. 

  Prevention methods

 Inhaled glucocorticoids are the most widely used of the prevention medications and normally come as inhaler devices. Long-term use of corticosteroids can have many side effects including a redistribution of fat, increased appetite, blood glucose problems and weight gain. To control bronchitis and asthma some suggestions:

 Quit smoking:  If you smoke, quit. Bronchitis will ease dramatically and may even be cured within a few years when you quit smoking. Walk away from people who smoke.  
Gargle:  Gargle with warm water twice a day. It cleanses the grease off your throat. When the throat gets an oily film, it gets irritated and makes you hack. Avoid salt in the gargling water as it’s not asthma-friendly.

  Drink hot fluids:  Have hot clear soups, hot milk laced with honey and haldi, hot water through the day. Keep a thermos handy for soothing sips whenever possible

  Use expectorants sparingly:  Some expectorants are addictive - avoid them. Have a safe expectorant only if you have dry cough. If you’re coughing up phlegm, avoid expectorants, stick to hot water.

  Walk, don’t run:  If jogging makes you cough, walk daily for 30-45 minutes at a speed you can manage. Carry your thermos of hot water with you. You could also swim as swimming is ideal for asthma. Keep active — play 
tennis, cricket, golf.

  Fresh and nourished meal:  Avoid oily or fatty food and be selective for fresh and nutritious  vegetable food. For example, have only plain steamed rice, salad, yoghurt, bread, cheese, fruits, cornflakes, digestive biscuits, roast channa, jam, baked beans, pickles etc. You can also have them with warm milk, or try a banana sandwich.

  Eat light:   Overeating presses on your insides and causes wheezing. Stop when you’re on top - that is when you are comfortable, not ‘full’ or ‘heavy’.  Asthmatics should avoid taking water with meals and should always eat less then their capacity to make stomach fire stronger and thereby hardly leaving any chance to form phlegm.

  Sleep elevated:  Sleep with two pillows. Keeping your head slightly elevated prevents stomach reflux. Sometimes, if the stomach acid drips into your throat, it causes coughing and asthma.

  Learn deep breathing:  Correct deep breathing regularly. Learn the correct technique from an experienced Yoga teacher. Practicing yoga-pranayam to permit proper assimilation of food and strengthen lungs, digestive system and circulatory system.

  Asthma medication:   If you are on asthma medication, you can have it 15 minutes before you exercise.

 Lose weight:  Lose your excess weight and it  will dramatically improve your health and level of confidence. You will lose weight when you follow the lifestyle of an athlete.

 No depression:  Never allow yourself to be depressed. Be always cheerful and do all the positive things gladly, joyfully.

  Herbal medicines:  Regular intake of onion juice helps in reliving acute symptoms as it is a strong anti- inflammatory. The patient’s diet should contain regular use of black pepper powder and garlic. Both of them have mucus moving capacity thereby making breathing easier. Honey is soothing and beneficial to asthma patients. Use of turmeric powder - half a spoon thrice a day with one full glass of water acts as anti-infective and anti - inflammatory.

  During an attack, mustard oil mixed with little camphor should be massaged over the back of the chest. This loosens phlegm immediately and eases breathing. Inhaling vapors of caraway seeds (ajwain seeds) after adding it to boiling water dilates the bronchial passage.

Indians eat live fish to cure asthma
  Thousands of asthma patients were queuing in soaring summer temperatures on June 8, 2011 to eat live fish smeared in a masala spice mix to cure their condition. The treatment which is administered by 200 members of the Goud family in Hyderabad, Andhra Pradesh, southern India, has been criticised as unscientific while the festival itself is currently under investigation by human rights campaigners. They say the practice is an abuse of children forced to eat the fish. 
 The so-called fish medicine festival takes place in the city every June on an auspicious date selected by astrologers at the onset of the monsoon season.
  Several hundred thousand sufferers of asthma and other respiratory conditions line out to be served a live two inch long sardine smeared in a secret spice mix by 200 members of the Goud family. The family claim the recipe was received 170 years ago from a Hindu saint who had warned them it would not work if they tried to profit from it.

  Possible complications

 Respiratory fatigue, side effects of asthma medications, Pneumothorax and Death.

   Prognosis

 Current research suggests that the prevalence of childhood asthma has been increasing. Asthma prevalence, morbidity, mortality, and drug response vary greatly across populations. There is an almost 30-fold difference in asthma prevalence between some of the countries included in the International Study of Asthma and Allergy in Childhood , with a trend toward more developed and westernized countries having higher asthma prevalence.

   History

  Asthma was long considered a psychosomatic disease, and during the 1930s–50s, was even known as one of the 'holy seven'  psychosomatic illnesses. At that time, psychoanalytic theories described the aetiology of asthma as psychological, with treatment often primarily involving psychoanalysis and other 'talking cures'.

   New study on Asthma

 Tree-lined streets lower asthma risk :  Columbia University scientists on May 10, 2008 have suggested that tree-lined streets can reduce the risk of developing asthma in young children.  While it is commonly believed that the pollen released by trees can contribute to asthma attacks, the present study shows trees cut asthma risk by cleaning the air and encouraging kids to play outdoors. According to the study published in the Journal of Epidemiology and Community Health, an increase of 343 trees per square kilometer lowers the prevalence of asthma by 29%.

  World Asthma Day

 World Asthma Day is an annual event organized by the Global Initiative for Asthma (GINA). This year Asthma Day 2014 was observed on Tuesday, May 6, 2014 The event raises awareness about asthma and works to improve asthma care around the world.

 The world Asthma Day in 2013 was observed on was observed on May 7, 2013. The  year’s theme was  “You Can Control Your Asthma” and the sub-theme for the year is It's Time to Control Asthma.

 

 

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