Asthma

Understanding Asthma

Asthma is a chronic condition of the lungs where the swollen bronchial tubes (airways) cause a narrowing of the air passages resulting in difficulty in breathing.

Symptoms

During an asthma attack, muscles surrounding the airways in the lungs are tightened, resulting in limited airflow. Thick mucus is also produced during the attack and further blocks the air passages. When a person tries to breathe, air is forced through the narrowed bronchial passages and produces a wheezing sound.

Image source: National Heart, Lung and Blood Institute

Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway.Figure C shows a cross-section of an airway during asthma symptoms. A person suffering from an asthma attack may experience the following symptoms:

• Wheezing - a whistling sound that occurs during breathing.
• Coughing - tends to be recurring and worsens particularly at night or in the early morning, causing difficulty in sleeping.
• Chest tightness - patient will experience pressure on the chest.
• Shortness of breath - feeling out of breath.

Asthema can be life threatening if the symptoms are severe.

Causes

The fundamental causes of asthma are not completely understood. Asthma is believed to be triggered by a combination of factors such as:

• Inheritance of family genes
• Outdoor allergens (e.g. moulds, pollen and dust mites)
• Certain medications (e.g. aspirin, beta blockers)
• Smoke from tobacco
• Air Pollution
• Changes in weather and temperature
• Strenuous physical activities
• Emotional outbursts

Diagnosis

Since asthma shares similar symptoms with other respiratory illnesses, such as emphysema, bronchitis, and respiratory infections, asthma is often not diagnosed. There are many who are unaware that they may be suffering from asthma for years. Most of them are usually under the impression that they are merely experiencing recurring coughs which occurs often at night, having difficulty breathing properly when they feel cold or experiencing severe panting after a strenuous session of exercise. When assessing if a patient is suffering from asthma, the doctor will refer to the patient’s medical history, laboratory test results such as spirometry (a method of measuring the amount of air inhaled and exhaled), peak flow monitoring (a method of measuring the amount of air a patient can exhale) and physical examinations such as X-rays, blood or allergy tests.

Treatment

Asthma can be treated with two types of medicines:

• Long-term medication helps to reduce airway inflammation and prevent symptoms of asthma.
• Quick-relief or "rescue" medication helps to ease symptoms of asthma that may intensify.

Medication for asthma can either be taken orally or through inhalers (devices which ease and regulate patients’ breathing). The types of medication or treatment one requires depend on how well the individual is able to control his/her asthma. This may gradually change over time.

Prevention

To prevent further asthma attacks, patients need to learn how to control them well. Below are some suggested steps to manage your asthma:

• Follow the asthma action plan that you have discussed with your doctor.
• Take asthma medicines as prescribed.
• Know what trigger your asthma attacks and avoid them.
• Keep track of your asthma control level, and attend quickly to worsening symptoms.

Resources

Find out more information from:

Health Promotion Board  

1. How can I control my asthma condition?

Avoid asthma triggers. Common forms of triggers include house dust mites, air pollutants, viral infection, a change in the ambient temperature, food and drug allergies. It is also important to understand the two types of asthma medication available and how they work in controlling asthma. The first type helps to control your condition and needs to be consumed daily. The second type is consumed only when the symptoms worsen. You should also ask your doctor for a written Asthma Action Plan, which will guide you on the type of medication needed, the dosage required and the appropriate time to consume the medication. You should understand and adhere to the action plan. Also, you may adjust the medication according to the plan and consult your doctor if your asthma symptoms do not improve.

2. How do I know my asthma is under control?

You can refer to the Asthma Control Test, which consists of seven questions, to assess if your asthma is under control. Questions for patients to assess the symptoms:

• How is your asthma today?
• Does your asthma affect you greatly or act up easily after a run or a game of sports?
• Are your coughs recurring? If so, are they most lifely acting up because of your asthma?
• Do you have trouble sleeping at night because you have difficulty breathing?

Questions for caregivers to monitor occurrence in the past month:

• How many days did the patient experience daytime asthma symptoms?
• How many days did the patient wheeze during the day because of asthma?
• How many days did the patient wake up in the middle of the night because of asthma?

3. Can patient, who has asthma, engage in physical activity?

If the patient is unwell and shows any indicating symptoms of asthma, he should avoid strenuous exercises. If the asthma attacks are usually caused by exercises, the patient should take medication for quick relief before exercising to allow the airways to open up. However, if the patient’s asthma is under control, he is able to engage in most physical activities.

4. Will the use of inhalers affect the patient's growth and development?

Many caregivers are worried about the side effects of inhaled medication on the patient’s growth and development. However, such side effects usually result from the inappropriate use of oral medication rather than inhaled medication. The dosage of inhaled medication is usually small and does not normally affect a person’s growth. Moreover, the doctor prescribes the dosage required by the patient according to his/her condition. Excessive use of inhaled medication might lead to white spots in the mouth, although they are not common. Caregivers can prevent this from happening by getting the patient to rinse his/her mouth after inhalation.

5. Are traditional remedies useful in alleviating asthma symptoms?

Traditional remedies are passed down from generation to generation. This practice is widespread, especially among the Chinese. While there is no harm in consuming these foods (as long as they do not pose any health hazards), there is no medical evidence to prove that these remedies are effective in preventing or alleviating asthma. Patients should check with their doctor before consuming traditional remedies.