The Sunday News
With Lee-Anne
ASTHMA is a more common, more serious and more manageable condition than generally thought. There has been many studies that prove that this life-threatening condition has claimed lives because people, their relatives and doctors do not see asthma as a potentially deadly disease, nor grasp the importance of prevention, nor recognise deterioration.
According to the World Health Organisation (WHO), asthma is defined as a chronic inflammatory condition of the airways, characterised by airway narrowing and obstruction. To get an accurate diagnosis, medical doctors need to take a history of recurrent attacks, then confirmed by respiratory function tests.
What are the causes?
There are a few factors that can lead to one acquiring asthma namely, poverty, smoking parents, anxious parents, history of a stressful birth, lack of breast feeding or a gene that causes atopy (tendency of being hyper allergic). Sometimes viral infections can contribute to the pathogenesis of the disease or trigger an attack.
Contributing factors include sleep, thunderstorms, pre-menstruation and pollution.
The body responds to attacks in two phases:
1 The sensitisation stage: is common in atopic people (hyper allergic): after an exposure to allergens, especially in childhood.
2 The hyper-reactive stage: this is a continued exposure to allergens, or response to other stimuli. Here, a chronic low-grade inflammation damages the surface epithelial layer, causing bronchial hyper-reactivity.
Once asthma is established, hyper-reactive airways develop bronchospam causing airway narrowing thereby increasing the work of breathing. Some factors may be the cause, effect and in most cases both. Anxiety, depression and social isolation are associated with asthma.
The following can trigger an asthma attack:
Allergic foods, eg dairy products, eggs, wheat, nuts, fish
Exercise without warm-up
Change in temperature
Drugs
Stress
Chest infection, especially in infants
Pollen
Car exhaust
Frustrated expression of emotion
Active or passive smoking
Classification of Asthma
Mild chronic asthma — this manifests as a dry cough, often at night, or a morning wheeze once or twice a week.
Severe chronic asthma-this means frequent exacerbations and symptoms that affect quality of life.
Acute asthma — this reflects failure of preventative management and/or exposure to a relevant stimulus. The large airways are obstructed by bronchospasm and the small airways by oedema and sometimes mucus plugging. Unfortunately, work of breathing is increased by airflow resistance.
Severe acute asthma — this usually develops slowly, sometimes after several weeks of wheezing. Medical help should be seeked if the person shows the following signs: paleness or sweating, loss of wheeze and cyanosis (blue lips and fingers).
Nocturnal asthma — this occurs in 80 percent of people with asthma. Possible trigger factors are an exaggerated bronchial response to cold bedrooms, reduced lung volume when lying on their back, allergens in bedding. Once available factors are removed, treatment consists of a slow-release bronchodilator (asthma pump).
Education and Prevention of Asthma
People with asthma may benefit from pulmonary rehabilitation, including education, exercise training, breathing techniques and relaxation.
Prevention by education is central because the characteristics of asthma discourage patients from adhering to treatment.
Asthmatic patients need to regularly visit a doctor especially during weather changes. Most asthma patients need to always have an inhaler (bronchodilator) on them. These usually have different medical properties adjusted to the type of asthma a patient has.
For those people that have chronic asthma, accurate monitoring and a stepwise protocol are advocated. These patients need a high frequency of bronchodilator.
If one has asthma or has a child with asthma its very important to understand the course of the condition and its various requirements.
TAKE CARE OF YOUR BUSY BODY, YOU OWE THAT TO YOUR FAMILY.
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Lee-Anne Hall
BSc Physiotherapy
