Asthma

Asthma is a chronic disease (in other words, it lasts a long time) of the airways. It cannot be cured, and it can be fatal. However, there are plenty of Olympic athletes who suffer from it. It is an unpleasant disease to have, but it can be controlled.

In a person with asthma, the lining of the airways becomes inflamed and produces excess mucus, which narrows the airways. There may also be muscular contractions that make the condition worse.

The end result is that the patient finds it difficult to breathe, and may cough or make wheezing noises as the air tries to force its way through. The chest will feel tight during an attack. An episode can last for about an hour, or persist for a day or longer, especially if it is untreated. After the attack subsides, the airways return to their normal state and the sufferer feels perfectly OK.

Some people get an attack only once every week or so, whereas others can suffer daily attacks. In the worst cases, patients can suffer asthma symptoms for much of the day, every day, and their quality of life is affected very seriously. Night-time attacks are experienced by most sufferers, but again the frequency varies considerably from patient to patient. The frequency of attacks is not normally related to their severity; a very severe attack can be suffered by someone who only gets them rarely.

Asthma is a common complaint, without about 20 million of the current population of the United States having a diagnosis of it. It can begin at any age, but it is usual for it to start in childhood. In developed countries, around 15% of children of school age are likely to have asthma attacks of a greater or lesser severity. Although there is no cure for asthma, many children “grow out of it” as they get older.

In most people, asthma is a severe form of allergy, as the attacks are brought on by the presence of one or more “triggers” to which the patient is sensitive. However, asthma also tends to run in families, so there are probably genetic causes as well.

The substances to which the sufferer is allergic are typically such things as dust mites, animal fur and pollen. But attacks can also by triggered by tobacco smoke, bad air, perfumes and strong cooking smells.

Attacks can also arise from taking exercise, or viral infections.

It is therefore the case that asthma varies considerably from patient to patient, in terms of causes, triggers, frequency and severity of attacks. It is therefore vital that the individual’s condition be analysed carefully, so that the treatments are correct and the sufferer is able to adjust their lifestyle so as to make attacks as infrequent and mild as possible.

People who are liable to suffer an attack should always carry an inhaler with them. This delivers a shot of a relieving drug directly to the airways, acting very quickly to relax the muscles that are constricting the flow of air into the lungs. A typical drug for this purpose is salbutamol or terbutaline. Teachers of children with asthma need to be able to recognize the symptoms and make sure that a child can use an inhaler when they need to.

There are also inhalers that can be used on a daily basis to help prevent an attack. These are steroid-based and work by reducing the inflammation in the airways, thus making the chance of mucus blockage much less likely.

Tablets can be prescribed in addition to inhaler use, as a preventative measure.

Proper diagnosis of an asthmatic condition is necessary so that the correct treatment can be offered. Diagnosis includes measuring the rate of airflow into and out of the lungs, and testing for allergic reactions.

Apart from medication, treatment includes the avoidance of potential triggers and making lifestyle adjustments. For example, bedsheets may need to be changed more often than normal, and mattresses and pillows covered in material that is impermeable to dust mites. Carpets in bedrooms can harbour mites, and may need to be removed.

It cannot be denied that living with asthma is a thorough nuisance, but, with careful management, the symptoms can be controlled and the frequency and severity of attacks reduced to a minimum.

© John Welford