Danger level: Medium
What is it?
Asthma is a disease which affects the airways, causing attacks in which breathing is difficult.
Who gets it?
In the Unites States, about 5-10% of the population (or 22 million people) are affected by asthma (6 million of them are children).
Around the world, asthma is more common in industrialized countries, such as Canada, England, Australia, Germany, and New Zealand. 2-10% (300 million) of people worldwide have asthma.
Until puberty, asthma is more common in boys than girls (twice as much). From then on there is no difference. About 2/3 of all asthma cases are discovered before age 18.
The following are considered risk factors, meaning they increase your risk of having asthma:
1. A family history of asthma – Asthma is partly genetic, meaning that if someone in your family has it, your chances of getting it are higher.
2. Frequent infections in your airways as a child
3. Living in an urban area, especially one that contains a lot of air pollution
What causes it?
Asthma causes an inflammation in our airways – these are the “tubes” that lead from our mouth to our lungs. This causes 3 things:
1. Airway obstruction – Our airways are surrounded by muscle. Normally, this muscle is relaxed, so air can move freely to our lungs and back out. In asthma, these muscles tighten and also produce a liquid called mucus. Those things cause the airways to get obstructed, so air can’t move freely.
2. Inflammation – Besides the attacks which cause momentary blocks in the airways, there is also an ongoing inflammation, which can cause long term damage to the airways if not treated.
3. Airway irritability – The airways in asthma patients are very sensitive to things healthy people usually don’t react to, such as pollen or dust. These things can bring about asthma attacks, which involve obstruction of the airways.
This video gives a graphic illustration of the process:
The following things are known to trigger asthma attacks in people with the disease (they change among different people):
a. Airborne materials, such as pollen, animal dander, mold, cockroaches and dust mites
b. Respiratory infections – Such as the common cold
c. Exercise
d. Cold air
e. Smoke
f. Certain medications – Such as aspirin, beta blockers and others.
g. Strong emotions and stress
How does it feel?
Asthma attacks include the following things:
1. Shortness of breath
2. Coughing
3. Wheezing – This is a whistling sound characteristic of asthma patients. It’s heard when you take the air out.
4. Chest tightness or pain
The severity of the disease is different for different people. In some people attacks may appear only after exercise, while in others they may come a few times a day, making their lives miserable.
This video shows someone with an attack who unfortunately ran out of medications and was waiting for an ambulance. Notice the coughing and the whistling sounds when he takes out air. (And please don’t try this at home…)
How is it discovered?
If someone comes to the doctor when they are having an attack, it can be pretty simple (as you can see in the video above) to know that they have asthma.
Unfortunately, by the time someone arrives at the doctor’s, the attacks are often gone. Besides, other diseases can have similar symptoms. Therefore these tests were invented which can discover asthma:
1. Pulmonary function tests – These are special tests done to test the patient’s breathing pattern when they breath into a machine. The pattern in asthma patients is pretty characteristic.
2. Challenge tests – Certain substances, when inhaled by people with asthma, can trigger an attack. Using these substances (such as one called metacholine) helps in diagnosing asthma.
3. Chest X-ray – Can be used to rule out other conditions (such as pneumonia).
How is it treated?
There are a few things which can be done to treat asthma:
1. Avoiding triggers
2. Medications – There are short-term drugs and long-term drugs. The short-term ones are used to control attacks. The long-term drugs are used to control the inflammation in the airways, which prevents long-term damage to them.
We won’t go into much detail about the types of drugs available, but some examples of long-term drugs include corticosteroids, beta agonists, and others.
Short-term drugs are drugs that are usually inhaled, and that cause dilatation of the constricted airways, thereby making it easier to breath. These drugs are taken through special inhalers, such as the one in the picture:
An asthma inhaler. Photo by net_efekt.
What happens after treatment?
Except in very difficult cases, these drugs help to live a normal life with asthma.
Also, about 50% of children diagnosed with asthma are asthma-free after 10 years (in adults the disease doesn’t tend to go away as much).
The bottom line – How do I avoid it?
You can’t avoid asthma altogether, since, as mentioned above, the disease is probably genetic.
What you can do is decrease your risk of having attacks, by following these rules:
1. Stick to your medications
2. Identify your triggers and avoid them – One way of doing this is to keep a diary in which you write down factors you encountered before attacks (such as cold air, a virus, cigarette smoke, etc.). Then take measures to minimize your exposure to these things.
3. Treat allergies – Asthma attacks can also be triggered by any allergies you may have. You should avoid or minimize contact with the substance you are allergic to.
Also consider allergy shots (consult your doctor about those).
4. Get a flu vaccine – Every year. The flu almost always makes asthma much worse.
On a final note, we try to give you a personal angle about diseases we cover here. This time, you can get it by visiting The Angry Asthma Mama blog and The Asthma Mom.
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