What to know about asthma

Asthma is a respiratory condition where breathing becomes difficult due to constriction of the airways. In this article, a consultant in respiratory medicine explains what causes asthma and how it is managed.

What is asthma?

Asthma is a chronic condition that can manifest at any age, and its impact on patients’ lives can range from a mild nuisance to a serious concern that, at times, can prove to be fatal. The severity of asthma can and is expected to change throughout a patient’s life. An asthma attack is a disruption of regular, relaxed breathing, where the airway can spasm and tighten, become inflamed, and overproduce mucus. All of these symptoms obstruct the airway and make it very difficult to breathe. People undergoing an asthma attack may begin wheezing, and coughing, and experience chest tightness and shortness of breath.

Asthma can be intermittent, where attacks are occasional and breathing is normal in between them, or persistent, meaning a constant difficulty with breathing properly. An attack can be triggered by overexertion, exposure to irritants like chemicals, dander, or pollens, stress, and even changes in weather.

Asthma is thought to be caused by a combination of environmental and genetic factors, such as:

• Allergies
• Exposure to allergens, toxins, fumes, or smoke
• Prior respiratory infections and diseases

How is asthma diagnosed?

To diagnose asthma, it is likely that the doctor will perform a full physical exam and review of medical history to rule out other conditions that could be interfering with breathing capabilities, like pneumonia or chronic obstructive pulmonary disease. A lung function test, such as spirometry or a peak flow test, may be conducted to understand the extent and depth of the patient's breathing abilities.

How can asthma be managed?

Asthma attacks may be avoided by keeping away from the known triggers, however, it is not possible to avoid contracting it.

Asthma cannot be definitively cured. It can be managed to the point that attacks are few and far between, and the method that is utilised differs for each patient, with consideration of their asthmatic trigger. This includes using medications such as:

• Bronchodilators, which are relaxants for the muscles around the airway thus facilitating normal breathing.
• Anti-inflammatories, which help by reducing the swelling and mucus
• Biologic therapies, which work by disrupting the cells that cause the throat to constrict during an attack.

Asthma medication is typically administered via an inhaler, which may be prescribed to the patient after consulting with their doctor. Medications can be taken daily to stifle future attacks (a preventor), or during an active attack to help relax the muscles and restore breathing (a reliever).

Patients with asthma are recommended to avoid exposure to pollen, mould, and dust by maintaining an environment that is well-ventilated, clean, and not too damp.

For severe cases of asthma where medications are not fruitful, some patients may benefit from bronchial thermoplasty, a procedure in which the insides of the airways and lungs are heated with an electrode that is inserted via the throat. The thermal energy burns away some of the excess muscles, leaving the patient’s lungs with more room to expand and less opportunity to restrict.