Asthma is a chronic lung disease that inflames and narrows the airways.
ASTHMA CAUSES
- recurring periods of wheezing (a whistling sound when you breathe),
- chest tightness,
- shortness of breath, and
- coughing.
The coughing often occurs at night or early in the morning.
Asthma affects of all ages, but it most often starts in childhood. About 300 Million people worldwide affect with asthma while in Pakistan it’s about 10 Million. In Asia only 5% of patients control on asthma. In Pakistan, prevalence of asthma symptoms in children was between 10 and 20 per cent.
Asthma can’t be cured. Even when you feel fine, you still have the disease and it can flare up at any time.
But with today’s knowledge and treatments, most people who have asthma are able to manage the disease. They have few, if any, symptoms. They can live normal, active lives and sleep through the night without interruption from asthma.
CAUSES
The exact cause of asthma isn’t known. Researchers think a combination of factors (family genes and certain environmental exposures) interact to cause asthma to develop, most often early in life. These factors include:
- An inherited tendency to develop allergies, called atopy (AT-o-pe)
- Parents who have asthma
- Certain respiratory infections during childhood
- Contact with some airborne allergens or exposure to some viral infections in infancy or in early childhood when the immune system is developing
SIGNS AND SYMPTOMS
Common asthma symptoms include:
- Coughing. Coughing from asthma is often worse at night or early in the morning, making it hard to sleep.
- Wheezing. Wheezing is a whistling or squeaky sound that occurs when you breathe.
- Chest tightness. This may feel like something is squeezing or sitting on your chest.
- Shortness of breath. Some people who have asthma say they can’t catch their breath or they feel out of breath. You may feel like you can’t get air out of your lungs.
Not all people who have asthma have these symptoms. Likewise, having these symptoms doesn’t always mean that you have asthma. A lung function test, done along with a medical history (including type and frequency of your symptoms) and physical exam, is the best way to diagnose asthma for certain.
The types of asthma symptoms you have, how often they occur, and how severe they are may vary over time. Sometimes your symptoms may just annoy you. Other times they may be troublesome enough to limit your daily routine.
Severe symptoms can threaten your life. It’s vital to treat symptoms when you first notice them so they don’t become severe.
With proper treatment, most people who have asthma can expect to have few, if any, symptoms either during the day or at night.
DIAGNOSED
Your primary care doctor will diagnose asthma based on your medical history, a physical exam, and results from tests. He or she also will figure out what your level of asthma severity is—that is, whether it’s intermittent, mild, moderate, or severe. Your severity level will determine what treatment you will start on.
Medical History
Your doctor may ask about your family history of asthma and allergies. He or she also may ask whether you have asthma symptoms, and when and how often they occur. Let your doctor know if your symptoms seem to happen only during certain times of the year or in certain places, or if they get worse at night.
Physical Exam
Your doctor will listen to your breathing and look for signs of asthma or allergies. These signs include wheezing, a runny nose or swollen nasal passages, and allergic skin conditions such as eczema.
Keep in mind that you can still have asthma even if you don’t have these signs on the day that your doctor examines you.
DIAGNOSTIC TESTS
Lung Function Test
Your doctor will use a test called Spirometry to check how your lungs are working. This test measures how much air you can breathe in and out. It also measures how fast you can blow air out. Your doctor also may give you medicines and then test you again to see whether the results have improved
Other Tests
Your doctor may order other tests if he or she needs more information to make a diagnosis. Other tests may include:
- Allergy testing to find out which allergens affect you, if any.
- A test to measure how sensitive your airways are. This is called a bronchoprovocation test. Using spirometry, this test repeatedly measures your lung function during physical activity or after you receive increasing doses of cold air or a special chemical to breathe in.
- A chest X-ray or an EKG (electrocardiogram). These tests will help find out whether a foreign object or other disease may be causing your symptoms.
DIAGNOSING ASTHMA IN YOUNG CHILDREN
Most children who have asthma develop their first symptoms before 5 years of age. However, asthma in young children (aged 0 to 5 years) can be hard to diagnose. Sometimes it can be difficult to tell whether a child has asthma or another childhood condition because the symptoms of both conditions can be similar.
Also, many young children who have wheezing episodes when they get colds or respiratory infections don’t go on to have asthma after they’re 6 years old. These symptoms may be due to the fact that infants have smaller airways that can narrow even further when they get a cold or respiratory infection. The airways grow as a child grows older, so wheezing no longer occurs when the child gets a cold.
A young child who has frequent wheezing with colds or respiratory infections is more likely to have asthma if:
- One or both parents have asthma
- The child has signs of allergies, including the allergic skin condition eczema
- The child has allergic reactions to pollens or other airborne allergens
- The child wheezes even when he or she doesn’t have a cold or other infection
A lung function test along with a medical history and physical exam is the most certain way to diagnose asthma. However, this test is hard to do in children younger than 5 years. Thus, doctors must rely on children’s medical histories, signs and symptoms, and physical exams to make a diagnosis. Doctors also may use a 4 to 6 week trial of asthma medicines to see how well a child responds.