Asthma: Symptoms, Diagnosis, Treatment & Management Strategies

Asthma is a chronic respiratory condition that affects millions of people worldwide. It is characterised by inflammation and narrowing of the airways, leading to difficulty in breathing. Asthma can affect anyone, regardless of age or gender, and can significantly impact daily life.

Asthma is a chronic disease that affects the airways in the lungs. These airways, or bronchial tubes, allow air to come in and out of the lungs. In people with asthma, these airways are inflamed and sensitive, leading to a narrowing of the airways and difficulty in breathing.

Symptoms

The key symptoms of asthma include shortness of breath, chest tightness, wheezing, and coughing. These symptoms can vary in intensity and frequency, and they often worsen at night or early in the morning.

Causes

The exact cause of asthma is unknown, but it is believed to be a combination of genetic and environmental factors. Exposure to allergens, such as dust mites, pollen, and pet dander, as well as irritants like tobacco smoke, can trigger asthma symptoms.

"Asthma is a chronic disease that affects the airways in the lungs." - Mayo Clinic

Impact and Complications

If left untreated, asthma can lead to serious complications, including decreased lung function, respiratory failure, and in severe cases, death. It can also significantly impact a person's quality of life, limiting their physical activity and causing frequent absences from school or work.

At risk groups

• Individuals with a family history of asthma
• People with allergies or other atopic conditions such as eczema
• Smokers
• Individuals exposed to secondhand smoke
• People with a history of viral respiratory infections as children
• Overweight individuals

Importance of Treatment

It is crucial to seek treatment for asthma to manage symptoms, prevent serious complications, and improve quality of life.

Diagnosis

The diagnosis of asthma typically involves the following steps:
1. Medical History and Physical Examination: The doctor will discuss the patient's symptoms, medical history, and perform a physical examination.
2. Spirometry: This test measures how much air you can breathe in and out, and how fast you can blow air out. It's often used to diagnose and monitor asthma.
3. Peak Flow Test: This measures how fast you can blow air out of your lungs. It can be done at home with a handheld device to monitor changes over time.
4. Fractional Exhaled Nitric Oxide (FeNO) Test: This test measures the level of nitric oxide, a marker for inflammation, in your breath.
5. Methacholine Challenge Test: Methacholine is a known asthma trigger. If your airways narrow when you inhale methacholine, you likely have asthma.
6. Imaging Tests: A chest X-ray or CT scan may be used to rule out other conditions that can cause similar symptoms.

"With proper management, most people with asthma can lead normal, active lives." - NHS

Treatment Options

The treatment of asthma generally includes the following:
1. Inhaled Corticosteroids: These are the most commonly used long-term control medications for asthma.
2. Long-Acting Beta Agonists (LABAs): These are often used in combination with inhaled corticosteroids.
3. Leukotriene Modifiers: These oral medications can help prevent asthma symptoms for up to 24 hours.
4. Quick-Relief Medications: These include short-acting beta agonists, which are used to quickly relieve asthma symptoms.
5. Allergy Medications: If allergies trigger your asthma, medications such as antihistamines and decongestants, or allergy shots, may be helpful.
6. Biologics: These newer medications are used for severe asthma that doesn't respond to other treatments.

Doctors and Specialists Likely To Be Involved In The Patient’s Care

• General Practitioner (GP): The GP can provide initial assessment, treatment, and referrals to specialists.
• Allergist/Immunologist: These specialists diagnose and treat allergies, which often coexist with asthma.
• Pulmonologist: A pulmonologist specialises in diseases of the lungs and respiratory tract, including asthma.
• Respiratory Therapist: A respiratory therapist can provide education and training on using inhalers and other asthma devices.

Related Conditions or Complications

Asthma can lead to complications such as pneumonia, collapsed lung, and respiratory failure. It can also co-occur with conditions like gastroesophageal reflux disease (GORD) and sleep apnea.

"All people with asthma (and/or their parents or carers) should be offered self-management education, which should include a written personalised asthma action plan and be supported by regular professional review" - British Thoracic Society (BTS) Guidelines on the Management of Asthma

Outlook and Prognosis

With proper management, most people with asthma can lead normal, active lives. However, severe asthma can be life-threatening and requires more intensive treatment.

Practical Tips & Coping Strategies

• Follow your asthma action plan
• Take your medications as prescribed
• Avoid known triggers
• Monitor your symptoms and lung function. Make a note of your best peak flow readings to compare to times of exacerbation.
• Get regular exercise, but be aware of exercise-induced asthma
• Maintain a healthy weight
• Get vaccinated for influenza and pneumonia