Asthma is a lower respiratory track disease; it is an pulmonary obstructive disease. It is also called as “REACTIVE AIRWAY DISEASE”. Asthma is a common chronic inflammatory disease of the airways characterized by variable and recurring symptoms, reversible airflow obstruction and bronchospasm.
Asthma is a disease that affects your lungs. It causes repeated episodes of wheezing, breathlessness, chest tightness, and night-time or early morning coughing. Asthma can be controlled by taking medicine and avoiding the triggers that can cause an attack. You must also remove the triggers in your environment that can make your asthma worse. Is very important to note that asthma can be present in any age and in any sex (gender). 26 million people are diagnosed with asthma every year, 10.6 million people are affected worldwide. Asthma is a significant health and economic burden to patients, their families and society.
Nevertheless, According to the latest WHO data published in 2017 Asthma Deaths in Ghana reached 1,704 or 0.81% of total deaths. The age adjusted Death Rate is 11.82 per 100,000 of population ranks Ghana #51 in the world. People with asthma have inflamed airways which are sensitive to things which may not bother other people. For some people asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life threatening asthma attack.
There are two types of asthma:
• Allergic (caused by exposure to an allergen, seasonal winter, sudden change in weather or non-seasonal like dust, mites)
• Non/no allergic (caused by stress, smoking, exercise, illnesses like a cold or the flu, or exposure to extreme weather, irritants in the air or some medications).
Pathology of Asthma: asthma involves inflammation of the airways (narrowed airway, tightened muscles constrict airway, inflamed thickened airway wall, muscles and mucus).
Although the actual cause of asthma is not known, many studies have shown that several factors can lead to the development of asthma.
• Epigenetics ( inherited epigenetic changes and genetic mutation can cause a predisposition for developing asthma).
• Environmental factors (environmental factors can trigger asthma in those genetically predisposed).
• Genetics (environmental factors can cause new genetic mutations). Asthma often runs in families; according to the World Health Organization, about half the cases are due to genetic susceptibility.
Common allergens that cause allergic asthma and symptoms include:
1) Pollen (each spring, summer and fall, plants release don’t pollen grains to fertilize other plants of the same species. Most of the pollen’s that cause allergic reactions comes from trees, weeds and grasses. These plants make small, light and dry pollen grains that travel by the wind). Some people knows pollen allergy as “Hay fever.” Experts refers to pollen allergy as “Seasonal allergic rhinitis.” People with pollen allergies only have symptoms when the pollens they are allergic to, are in the air and they inhale it.. Symptoms like sneezing, swelling around the eyes, runny nose and mucus production, itchy ears and nose/eyes, stuffy nose (nasal congestion), red and watery eyes and nose.
2) Dust mites (dust mites are microscopic organisms that feed off of house dust and the moisture in the air. They are one of the most common indoor allergens, and symptoms can be present year round. In addition to allergic rhinitis, dust mite allergy can also trigger asthma and flares of eczema). dust mite allergy can also trigger asthma and flares of eczema. People with dust mite allergies often suffer the most inside their own homes or in other people’s homes. Oddly enough, their symptoms often worsen during or immediately after vacuuming, sweeping and dusting. The process of cleaning can stir up dust particles, making them easier to inhale. Dust mite allergy symptoms include; sneezing, runny or stuffy nose, red, itchy or teary eyes, wheezing, coughing, tightness in the chest and shortness of breath, itching.
3) Cockroaches. Cockroaches live in all types of buildings and neighbourhoods. Some people develop allergy symptoms when they are around cockroaches. Tiny particles from the cockroach are a common component of household dust and may be the true cause of a dust allergy. Cockroach allergy symptoms entails the following; Rashes, fatigue, cough, allergy headache, runny nose, sneezing, nausea and vomiting.
4) Animal hair, fur and feathers. Pets can cause problems for allergic patients in several ways. Their dander (skin flakes), saliva and urine can cause an allergic reaction, especially when combined with household dust. In households with birds, feathers and bird droppings can also become embedded in household dust and cause problems for people who are allergic to them.
5) Mold (this is a fungus that makes spores that float in the air. When people with a mold allergy inhale the spores, they get allergy symptoms). There are many different kinds of mold—some kinds you can see, others you can’t. Molds live everywhere—on logs and on fallen leaves, and in moist places like bathrooms and kitchens. Tiny mold particles and spores are a common component of household dust and may be the true cause of a dust allergy. Mold allergy symptoms can be similar to those of other respiratory allergies: nasal congestion, runny nose, sneezing, irritated eyes, coughing, wheezing, itchy throat. Mold can also trigger or aggravate asthma symptoms.
6) Exercise-Induced Bronchoconstriction (EIB) (If you start wheezing or coughing during exercise, or if physical exertion makes it difficult for you to breathe, you may have exercise-induced bronchoconstriction, or EIB (also known as exercise-induced asthma). Symptoms typically appear within a few minutes after you start exercising and may continue for 10 or 15 minutes after you finish your workout. Anyone can experience these symptoms (especially someone who is out of shape), but with EIB, they are more severe than would be considered normal. Exercise-Induced Bronchoconstriction (EIB) Symptoms include shortness of breath or wheezing, decreased endurance, tightness in the chest, shortness of breath, Cough, upset stomach, sore throat.
Risk factors include:
• Hereditary/ Genetic characteristics
• Air pollutants
• Drug over dosage
• Psychological factors
• Occupational exposures
• Environmental factors
• Upper respiratory tract infections
• Management and Treatment
Note: If you suspect you might have any of the allergy, or if you have similar symptoms that continue to persist, consult an allergist. Skin or blood testing can help pinpoint the allergy.
Management and treatment for Asthma can be classified into two
Behavioral adjustment on asthma management which includes
• Quickly clean up any spills or leaks to prevent mold from growing.
• Use dehumidifiers or exhaust fans — or crack open a window — to help reduce moisture and humidity in bathrooms or other rooms in your home.
• Regularly clean garbage cans and refrigerator drip pans.
• Regularly clear your gutters, and ensure that drainage flows away from your home’s foundation.
• Consult a professional, or follow the guidelines from the Environmental Protection Agency, to clean up existing environmental issues in your home.
• Get in the habit of using a hygrometer to measure the humidity in your home; keep the humidity level below 55 percent. If you live in a humid or sticky climate, you may find it helpful to use a dehumidifier. You may use a vent fan for removing moisture in bathrooms and the kitchen. Repairing all water leaks will also help keep moisture away.
• Keep pets out of the allergic person’s bedroom at all times.
• Keep all unrefrigerated food covered; dispose of food waste in a tightly sealed garbage can.
• If cockroaches are a known problem, use roach traps and schedule regular visits by a professional pest control service.
• Warm up with gentle exercises for about 15 minutes before you start more intense physical activity.
• Cover your mouth and nose with a scarf or face mask when you exercise in cold weather.
• Try to breathe through your nose while you exercise. This helps warm the air that goes into your lungs.
• If your efforts to reduce exposure to indoor dust don’t provide adequate relief, your allergist may recommend a prescription or over-the-counter medication. An allergist will work with you to determine which medications are best for you and how often and how much of them you should take. There are two types of medicines used to treat asthma are prescribed to prevent and treat EIB symptoms. They are most frequently administered through an inhaler, although some are available in tablet form:
• Short-acting inhaled beta2-agonists (bronchodilators) stop symptoms right away. They may be taken 15 to 30 minutes before vigorous exercise and generally prevent symptoms for two to four hours. These medications are extremely effective in treating or preventing EIB symptoms, so if symptoms do not improve, then consider alternative diagnoses.
• Long-term control asthma medicines are taken every day to prevent symptoms and attacks. Inhaled corticosteroids. These help to relieve narrowing and inflammation of the bronchial tubes and are the most commonly prescribed type of long-term asthma medication. It may two to four weeks before these drugs reach their maximum effect.
Long-acting inhaled beta2-agonists (bronchodilators). Taken 30 to 60 minutes before exercise starts, these medications help prevent symptoms for 10 to 12 hours. They should be used only once within a 12-hour period, and they should be taken only in combination with an inhaled corticosteroid.
Note: Asthma can’t be cured but can be effectively managed and be prevented from either occurring or being too severe.
BY Okoene Chinenye Cynthia.