Anyone who frequently experiences shortness of breath, chest pain, wheezing, panting and/or coughing so that the symptoms intermittently wake you up in the middle of the night, take it as a warning sign that you may be developing the medical condition known as asthma. Let’s find out more about it and seek the care you need.
What is asthma?
Asthma is a medical condition caused by chronic inflammation of the bronchial mucosa that shrinks or squeezes the respiratory system and makes it overly sensitive to stimuli from the environment and foreign objects. This causes difficulty breathing, shallow breathing, coughing and chest pain.
Both children and adults can have asthma. The symptoms can be rather disturbing and those experiencing them may not be able to study, work or play sports. If it occurs in children, it may cause them to develop slowly due to the body not getting enough of the rest it needs to grow fully. If there’s a lot of pollution around, the condition is aggravated and the more severe the symptoms, the more dangerous it is.
Causes of asthma
The many factors leading to asthma, include:
• Genetics – As asthma is a genetically inherited disease, those with a family history of it have more chance to develop it themselves.
• Allergies – Stimulated by various allergens, causes of allergies differ depending on the person. Perhaps cat or dog hair, dust mites, cockroaches, mold spores, flower pollen, grass pollen or certain foods cause the reaction.
• Chemicals – Paint smell, pesticides, hair sprays, smoke, incense, fire, pollution and various chemicals in the home or office may all be triggers.
• Sulfites and preservatives mixed in food and beverages such as dried fruits, beer and wine are also triggers for some.
• Exercise or other activities done too hard, and even laughing too much, can be triggers especially in cold temperatures or when not fit. These can cause difficulty breathing as a result of the respiratory lining being too dry and aggravating the symptoms.
• Emotional conditions – Stressful situations that cause abnormal breathing can also bring on bouts of asthma.
• Sex hormones – This applies to females before menstruation or in weeks 24-36 of pregnancy.
• Acid reflux – Stomach acid that reverse flows to the esophagus giving rise to a burning sensation in the chest can trigger or exacerbate asthma.
• Respiratory diseases – Respiratory viruses, chronic sinusitis, fever, flu, bronchitis, tonsillitis, and other such conditions often go together with asthma.
• Some drugs – Aspirin, beta blocking blood pressure medication and non-steroidal anti-inflammatory drugs such as ibuprofen are known to trigger asthmatic reactions in some.
• Cold temperatures – Chilly air-conditioned rooms or travels to colder weather countries can bring on asthma attacks. When the weather or temperature is cold, the air tends to be dry which stimulates the trachea to shrink causing difficulty breathing in asthma sufferers.
Asthma symptoms
If you find yourself experiencing any of the following symptoms, it could be an indication of asthma:
• Hearing whistling in your breathing more than once a month.
• Being easily fatigued or heavy breathing when physically exerting yourself in any way including exercising.
• Coughing at night without having any respiratory infection or being startled awake so you don’t get enough sleep.
• Chest and breathing tightness, shallow breathing, and repeated racers.
• Having continuous symptoms at age three years old and up.
• Having aggravated breathing when encountering stimuli such as different kinds of smoke, dust mites, fur, pollen, stress, and others.
• Having a cough and cold that drags on ten or more days.
• Repeated colds or other infections of the lower respiratory tract, causing difficulty breathing and flu-like symptoms.
• Having symptoms that are alleviated by asthma medications.
Degrees of severity
The severity of asthma can be measured by the frequency of episodes during the day and night. This can be calibrated using a Peak Flow Meter which gives Peak Expiratory Flow Rate (PEFR) readings in units of liters per minute. A stripe in the meter indicates the degree of severity in three zones: green (PEFR more than 80%); yellow (PEFR 50 – 80%); red (PEFR less than 50%). There are four levels as follows:
1. Intermittent asthma
- Asthma during the day occurs once in a long while.
- Asthma during the night occurs less than twice/month.
- PEFR over 80% (green stripe)
- Volatility – less than 20%
2. Mild persistent asthma
- Asthma during the day occurs more than 8 times/month.
- Asthma during the night occurs more than twice/month.
- PEFR – over 80% (green stripe)
- Volatility – 20-30%
3. Moderate persistent asthma
- Asthma during the day occurs almost every day.
- Asthma during the night occurs more than four times/month.
- PEFR – 50-80% (yellow stripe)
- Volatility – more than 30%
4. Severe persistent asthma
- Asthma during the day occurs almost all the time.
- Asthma during the night occurs frequently.
- PEFR – less than 50% (red stripe)
- Volatility – more than 30%
Asthma complications
In general, there are no severe complications with asthma. However, those with severe or chronic symptoms may have complications.
• Common complications include dehydration, exhaustion and various infections such as of the lungs, bronchitis, sinusitis, and others.
• Serious complications include acute respiration difficulty which often occurs with severe symptoms. This can be fatal.
• Other complications include chronic respiratory tract infection, pulmonary heart disease, perforation of the lungs, air in the chest and under the skin, and fainting from coughing
• Complications in pregnant women – If asthma occurs during pregnancy and the symptoms can’t be controlled, it may raise the risk of toxic pregnancy, premature birth, low birth weight and infant death close to or after birth.
• Complications from side effects of using asthma medications for a long time – This includes breathing problems caused by permanent narrowness of the trachea that make life difficult
Treatment
There is no known cure for asthma. The goal of treatment is therefore to control the symptoms so that the sufferer can live a normal life. Prescribed treatments are according to the severity of the symptoms. Medications comprise two groups:
1. Controller drugs that should be used regularly, even without symptoms, to treat chronic inflammation of the trachea. The most effective drug in this group is the inhalant “corticosteroid”.
2. Reliever drugs target bronchial symptoms by aiding relaxation and expansion of muscles and reducing coughing and racers so that sufferers can breathe more easily. Relievers should only be used when there are symptoms. They don’t reduce inflammation of the trachea.
Selection of medication and dosage according to the symptoms should be prescribed by a doctor who knows the case thoroughly.
Preliminary care
1. Sufferers and their relatives should have knowledge and understanding of asthma symptoms. Those close to the sufferer such as teachers and friends at school or co-workers should also know what to do when the sufferer has an asthma attack.
2. Sufferers and their relatives should seek advice about medications from a doctor.
3. Observe breathing to recognize basic signs that precede an asthma relapse such as coughing and shortness of breath.
4. Asthma sufferers should always carry medication with them to relieve symptoms as they arise. When a relapse occurs, the sufferer should take two-to-four gulps of their inhaler immediately. If the symptoms don’t improve, they should repeat the treatment once or twice every 20 minutes. If the symptoms still don’t subside, they should see a doctor urgently as it can be dangerous.
5. Receive annual flu and pneumonia vaccinations to prevent occurrence of conditions that are known to stimulate asthma.
6. Avoid other asthma stimuli and allergens.
7. Practice regular deep breathing to feel clear and refreshed and ameliorate symptoms.
8. Sufferers with severe symptoms should not take sleeping pills or sputum drugs as they are known to aggravate symptoms.
Sustenance for asthma sufferers
- Eat healthy foods and keep in shape. Obesity can be a trigger factor for worsening symptoms. Those who are severely overweight tend to have difficulty breathing because excess fat accumulates in the lungs causing the airways to narrow.
- Eat a lot of fruits and vegetables as they are sources of antioxidants such as beta carotene as well as vitamins C and E that help reduce pneumonia and inflammation.
- Drink a lot of warm water to avoid dehydration, especially when coughing, phlegm or racers occur.
- Avoid foods and drinks to which sufferers have allergic reactions and that contain sulfites such as wine, dried fruits, pickles, fresh and frozen shrimp, and others.
- Eat high vitamin D foods such as eggs, milk, and fish especially salmon, and get vitamin D from sunlight. Research shows that vitamin D helps prevent severe bouts of asthma.
Patients with asthma symptoms lasting a long time may develop a bronchial condition that changes the shape and function, reducing lung performance to less than normal and making the trachea more sensitive to permanent stimuli. To summarize, looking out for symptoms and early treatment are highly important.
Krungthai-AXA Life Insurance customers can consult a doctor online by downloading the EMMA by AXA application, pressing "TeleHealth" and confirming your policy number when you use it for the first time. For more information, please visit https://www.krungthai-xa.co.th/en/telehealth
References
· Siriraj Piyamaharajkarun Hospital
https://www.siphhospital.com/th/news/article/share/asthma
· Corporate Communications, Faculty of Medicine, Ramathibodi Hospital
https://bit.ly/3NtMl1f
· Bumrungrad Hospital
https://www.bumrungrad.com/th/conditions/asthma
· Mayo Clinic
https://mayocl.in/3JWRNHA
https://mayocl.in/3KkYfYm
· Pobpad website
https://bit.ly/36Ck5sL
https://bit.ly/3KbGc72
· MedThai
https://bit.ly/3LyMoal
· King’s College London
https://bit.ly/36HxnnO
