Asthma

Asthma is one of the widespread respiratory disorders that interferes with daily life and makes it hard sometimes. It could also reduce the quality of life of the patient if it’s not managed properly.

Mechanism of action of asthma and its prevalence

• It occurs as a result of the airflow obstruction because of a specific pattern of inflammation in it resulting from a specific trigger, and this obstruction is usually reversible in most cases, but in some severe chronic cases, it’s irreversible.
• Asthma could be intermittent, which means that it comes as attacks that come and go and the patient is normal between these attacks, or it could be persistent, which means that the patient suffers from the symptoms most of the time, and these symptoms could be mild, moderate, or severe.
• Asthma is one of the most widespread chronic diseases, and it affects about 300 million people around the world, with a rate of 10-12% in adults and 15% in children.
• It could manifest at any age, with a peak at the age of 3 years old. In childhood, twice as many males as females are asthmatic, but this percentage becomes equal in adulthood.

Risk factors that lead to asthma

Asthma is the result of an interaction of several genetic and environmental factors. However, risk factors must be distinguished from triggers, because risk factors make people more susceptible to having asthma if they don’t have it, while triggers cause an asthmatic attack in people who already have asthma.

Risk factors include:

Atopy

It’s the main risk factor for asthma, and it means the genetic tendency of a person to have allergic diseases like allergic dermatitis, allergic rhinitis, and asthma. Asthma patients often suffer from other atopic diseases, especially allergic rhinitis, which is present in about 80% of asthma patients.

Genetic predisposition

Family history increases the risk of having asthma, and it could determine its severity.

Infections

It’s been noticed that getting infected with some viral and bacterial infections in childhood could increase the risk of asthma.

Diet

The role of diet in asthma is still controversial. Some studies noticed that foods that are low in antioxidants (like vitamins C and A), magnesium, selenium, and omega 3 in addition to foods that are rich in sodium and omega 6 could increase the risk of asthma. Moreover, vitamin D deficiency might increase the risk of asthma as well.

Air pollution

Air pollution in closed places (like gas and smoking) often affects more than open places.

Allergens

Inhaling allergic materials in childhood, like house dust and the presence of pets, increases the risk of asthma.

Occupational exposure

It means that people could be exposed to allergic materials in their job places, like chemicals, laboratory materials, bakeries, and others, and it’s a relatively dangerous factor.

Obesity

The risk of asthma increases in obese people, especially those who have a BMI (body mass index) greater than 30 kg/m², and these cases are usually harder to manage.

Other factors

Lower maternal age, duration of lactation, preterm birth and low-weight birth, and inactivity.

Intrinsic asthma

It occurs in a minority of patients whose tests are normal in terms of common inhalant allergens and whose serum concentrations of IgE are normal, which is an antibody that is secreted from the immune system when there is an allergy.

Asthma triggers and inducers

• Dermatophagoides species (dust mite): They’re found abundantly in house dust, and they’re one of the most important factors that cause asthma.
• Viral infections in the upper respiratory tract.
• Some medications, such as beta blockers, which worsen asthma and can be fatal, some medications that lower the blood pressure, and aspirin.
• Exercise: It’s a common trigger, especially in children. The attack usually starts after finishing the exercise and resolves spontaneously within 30 minutes. It’s worse in cold weather, and it could be avoided with certain medications.
• Physical factors: Like cold air, hyperventilation (deep or rapid breathing), strong laughter, hot weather, and some strong smells.
• Food and diet: Some foods could trigger asthma in some patients, like shellfish and nuts.
• Air pollution.
• Certain substances in the workplace.
• Hormones: Thyroid gland disturbances could worsen asthma. Moreover, asthma could be worse in some women before the menstrual period because of the progesterone decrease.
• Gastroesophageal reflux: It occurs when the stomach contents move up into the esophagus, and it’s a common condition in asthma patients because it’s triggered by bronchodilators.
• Stress: Asthma could worsen when the patient is stressed.

Symptoms of asthma

• Dyspnea, wheezing when exhaling, chest tightness, cough, and sputum accumulation.
• Symptoms are usually worse at night and in the early morning.

Asthma diagnosis

The specialist takes the patient’s medical history and performs a spirometry, and sometimes blood tests, skin tests, and imaging tests (x-rays).

Asthma management

There isn’t a specific treatment for asthma, but it can be managed though:

• Bronchodilators, which can be inhaled or taken orally.
• Anti-inflammatory medications.
• Biologic therapies in severe cases.
• Avoid asthma triggers in general.