Asthma

Asthma is a chronic disease that affects the airways. Asthma sufferers experience swelling of the airways and excess mucus production, resulting in narrowing of the airways.

Causes

The exact cause of asthma is unknown. It appears, however, that having a family history of asthma and factors such as allergies may play a role.

Asthma is an exaggerated reaction by the airways to a foreign substance (allergen), including dust and pollen, resulting in airway swelling. Other factors that may cause such swelling are smoke, pollution and respiratory infections.

The airways are surrounded by muscle. These muscles, made more sensitive when the airways are inflamed, react by constricting. This is known as bronchospasm. Exposure to cold air, exercise, and stress can trigger constriction.

Symptoms

Bronchial inflammation and bronchospasm obstruct airflow, causing the following symptoms:

• difficulty breathing;
• shortness of breath;
• coughing;
• wheezing;
• chest tightness;
• bronchial secretions;
• rapid breathing in young children.

The intensity of symptoms can vary among individuals and over time.

Diagnosis

The first step in diagnosing asthma involves a medical examination, and a questionnaire about your symptoms. The doctor may also want to test your pulmonary function to see how well your lungs are working. Additional tests, such as allergy skin tests, blood tests or chest x-rays, may also be ordered.

Treatment

There are two categories of asthma medications: Controllers and Relievers.

Controllers are anti-inflammatories that prevent and reduce inflammation inside the air passages. Control medications are the cornerstone of asthma management. They work slowly and should be taken regularly, even when asthma symptoms are not present. They help prevent asthma symptoms, reduce exacerbations as well as asthma-related hospitalizations and deaths. While corticosteroids are the most commonly prescribed controller medication, other controllers may be added to the treatment plan. They are administered using an inhaler (puffer), or as a liquid or a pill.

Relievers are bronchodilators. They are also known as "rescue" medications because they are used in emergency situations. Their effects are felt within minutes as they relax the muscles around the airways. They are used as needed in the treatment of asthma attacks and to prevent exercise-induced asthma. Using a reliever 2 times a week or less is a sign that asthma is controlled.

Proper technique

Using a proper inhaling technique will ensure better efficacy. Your pharmacist can show you, and may also recommend the use of a spacer and metered dose inhaler, making it easier for you to take your medication.

Prevention

The key to prevention is avoiding triggers:

• Allergens;
• Respiratory infections including colds and the flu (yearly flu vaccine recommended);
• Big changes in air temperature;
• Cold air (asthmatics should cover their nose and mouth when exercising outdoors in cold weather);
• Emotional and stressful situations;
• Smoking;
• Exposure to smoke, strong odours and air pollution (purify indoor air);
• Certain medications (speak to your pharmacist or doctor before taking any medications, even if they are natural or over-the counter products).

For more information:

• Canadian Lung Association
• Asthma Canada