Asthma Disease:What you need to know-Prof Joyce Akwe explains

Asthma is a common and potentially serious chronic disease which is caused by airway narrowing (Bronchoconstriction), airway wall thickening and increase mucus secretions in the air ways. It is characterized by the history of breathing problems like wheeze, difficulties breathing, chest tightness and cough that vary over time in their occurrence, frequency and intensity.
Asthma is one of the most common chronic diseases worldwide with an estimated 300 million affected individuals.


Our airways are like a water pipe, through which air flows in and out. If the airways narrow, there is an obstruction in air flow. People with asthma have more difficulties with air flowing out of the lungs when their air ways narrow down.  
People with asthma have difficulties breathing out air from the lungs because of airway narrowing, airway wall thickening and increased mucus. These changes in the air ways are what cause the symptoms of asthma
Symptoms of asthma are usually worse at night or early in the morning. The symptoms may be very severe or less severe, may resolve by themselves or may need medications. Asthma symptoms may be serious enough to warrant hospital admission with various levels of care.
People with asthma usually have airways that over react when stimulated with factors like viral infections, tobacco smoke, dust, pollens, exercise, stress, changes in temperature and air irritants. They also have chronic airway inflammation. These features usually persist, even when symptoms are absent or lung function is normal, but may normalize with treatment
What causes Asthma?
Several factors may increase the chances of developing Asthma. These factors include:  
#    Close blood family members who have asthma
#    Smoking
#    Exposure to second hand smoke
#    Overweight
#    Having another allergic condition, such as atopic dermatitis (skin rash due to some form of allergy or allergic rhinitis ((running and itchy nose due to something they breathe in also known as hay fever)
#    Exposure to air pollutants like exhaust smokes
#    Exposure to some chemicals at work such as some chemicals used by farming, some chemicals used by hairdressers and some chemicals used manufacturing industries




People can be diagnosed with asthma for the first time as children or as adults.
Asthma in Children:
Several things can cause wheezing in children, so if a child is wheezing, medical attention should be sort after right away. Diagnosing a child with asthma is a careful process that starts by excluding all the other causes of wheezing.  The clinician will always take a thorough history which will include symptoms like cough and wheeze, typical symptom patterns, and response to asthma therapy. Knowing if the child has tendencies to developing allergic diseases such as allergic rhinitis (running and itchy nose due to something they breathe in, also known as hay fever) or allergy to some foods is very important. It is also very important to know if some family members have asthma, if the child has other medical issues and if asthma triggers could be present in the environment where the child spends time.
How do I avoid Asthma?
There is no cure for asthma, but you can reduce or completely avoid asthma attacks or flares by avoiding the things that trigger asthma attacks. It is important to identify the main factors that trigger your asthma attack and avoid them. It is also important to have a written action plan from your doctor on what to do if you are having a flare or starting to have a flare. The written asthma action plan should include:
• The patient’s usual asthma medications
• When and how to increase medications, or start some medications by mouth
• How to access medical care if symptoms fail to respond
What causes Asthma flares?
Factors that may trigger or worsen asthma symptoms include:
#    Viral infections,
#    House dust mite
#    Pollens
#    Cockroach
#    Tobacco smoke
#    Exercise
#    Stress
#    Some Medicines like aspirin
#    Changes in weather
#    Kitchen smoke (from wood-burning stove or fireplace)

Some common steps to avoid the triggers of an Asthma attack include:
#    Cleaning your living environment regularly, avoid breathing in any dust during cleaning by putting a face mask on.
#    Cover your nose and mouth well if it is cold
#    Clean up any areas where mold can grow
#    Clean window blinds or other decorating objects
#    If possible, use air conditions and also maintain optimal humidity
#    Control your diet and exercise frequently so as to maintain a healthy weight
#    If you have acid reflux, make sure it is well treated. It could worsen asthma
#    Take your medications as prescribed by your doctors
#    Don’t forget to ask about the pneumonia vaccine or the annual flu vaccine (influenza vaccine)

What to watch out for:
Regularly measure and record your peak airflow with a home peak flow meter. Also learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath. If your peak flow measurements decrease, it is a warning of an oncoming attack. Take your medication as instructed and immediately stop any activity that may have triggered the attack. If possible leave the environment that may be triggering your attack.  If you act quickly, you may end up not having a severe attack and your symptoms won't be that difficult to get under control. If your symptoms don't improve, sick medical help. Remember to activate your written action plan if you have one.
If you are relying on your quick-relief inhalers, your asthma is not well controlled. Talk to your doctor about adjusting your treatment.
Asthma in special populations
Pregnancy: Asthma control often changes during pregnancy. Exacerbations should be treated aggressively.

Obesity: Asthma is more difficult to control in obese people. Weight reduction should be included in the treatment plan for obese patients with asthma.

Smokers and ex-smokers: Asthma and COPD may co-exist or overlap (asthma-COPD overlap syndrome, ACOS), particularly in smokers and the elderly. ACOS has worse outcomes than asthma or COPD alone.

The elderly: They may have other medical problems which may complicate asthma management

Anxiety and depression: Patients should be assisted to distinguish between symptoms of anxiety and of asthma

Occupational asthma and work-aggravated asthma: In these patients asthma is better when they are away from work. It is important to confirm the diagnosis objectively and to eliminate exposure as soon as possible.

Aspirin-exacerbated respiratory disease (AERD): Need to be under the care of a specialist

Acid reflux (GERD), Rhinitis and sinusitis:  are commonly seen in asthma.

Good to Know!
You cannot get asthma from another person who has an asthma attack
Asthma is not contagious
Asthma does not attack only children
Kitchen smoke (from wood-burning stove or fireplace) can cause or worsen asthma
Different things may trigger asthma flare in different people
Shortness of breath is not normal in old age. Elderly people who are short of breath should seek medical attention.

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