Asthma is a chronic respiratory condition characterised by inflammation and narrowing of the airways in the lungs. This narrowing makes it difficult for air to pass in and out, leading to a variety of recurring symptoms that can range from mild to life-threatening. It's a condition that affects people of all ages and often begins in childhood.

Here's a more detailed look at asthma:

Core Characteristics:

• Airway Inflammation: The inner walls of the airways (bronchial tubes) become swollen and inflamed. This inflammation makes the airways more sensitive and reactive to various triggers.
• Airway Narrowing (Bronchoconstriction): The muscles surrounding the airways tighten and constrict, further narrowing the passageway for air.
• Excess Mucus Production: The inflamed airways often produce more mucus than usual. This thick, sticky mucus can clog the airways, further obstructing airflow.
• Airway Hyperresponsiveness: The airways of people with asthma are overly sensitive to various irritants and triggers that may not affect individuals without asthma.

Common Symptoms:

Asthma symptoms can vary in frequency and severity from person to person and even within the same individual over time. Common symptoms include:

• Wheezing: A whistling or squeaky sound, especially when breathing out, caused by air being forced through narrowed airways.
• Coughing: Often worse at night or early in the morning or triggered by exercise, cold air, or other irritants. The cough may be dry or produce mucus.
• Shortness of Breath (Dyspnoea): A feeling of not being able to get enough air, often described as tightness in the chest or gasping.
• Chest Tightness: A feeling of pressure, squeezing, or constriction in the chest.

Asthma Attacks (Exacerbations):

These are episodes where asthma symptoms suddenly worsen. During an asthma attack, the narrowing of the airways becomes more severe, making breathing very difficult. Symptoms during an attack can include:

• Severe shortness of breath: Difficulty speaking in full sentences.
• Rapid breathing: An attempt to compensate for the lack of air.
• Increased heart rate: The body is working harder to get oxygen.
• Use of accessory muscles: Visible straining of neck and chest muscles to breathe.
• Pale or bluish skin (cyanosis): Indicating a lack of oxygen.
• Confusion or decreased level of consciousness (in severe cases).

Asthma attacks can be life-threatening and require prompt medical attention.

Triggers:

Many different factors can trigger asthma symptoms or attacks. Common triggers include:

• Allergens: Airborne substances such as pollen, dust mites, pet dander, mould spores, and cockroach droppings.
• Irritants: Smoke (tobacco, wood smoke), air pollution, strong odours (perfumes, cleaning products), and chemical fumes.
• Respiratory Infections: Viruses like the common cold or flu can inflame the airways and trigger asthma symptoms.
• Exercise: For some individuals (exercise-induced asthma or exercise-induced bronchoconstriction), physical activity can trigger symptoms, especially in cold, dry air.
• Cold Air: Breathing in cold, dry air can irritate the airways.
• Emotions: Strong emotions like stress, anxiety, laughter, or crying can sometimes trigger symptoms.
• Certain Medications: Some medications, such as aspirin and beta-blockers, can worsen asthma in some people.
• Food Allergies: In some cases, food allergies can trigger asthma symptoms.
• Acid Reflux (GERD): Stomach acid backing up into the oesophagus can irritate the airways.

Diagnosis:

Diagnosing asthma typically involves a combination of:

• Medical History: The doctor will ask about symptoms, their frequency and triggers, and any family history of asthma or allergies.
• Physical Examination: Listening to the lungs with a stethoscope to check for wheezing or other abnormal sounds.
• Pulmonary Function Tests (Spirometry): These tests measure how much air a person can inhale and exhale and how quickly they can exhale. They can help determine if the airways are narrowed. A common test involves measuring forced expiratory volume in one second (FEV1) and forced vital capacity (FVC).
• Bronchoprovocation Tests: If spirometry is normal but asthma is still suspected, these tests involve inhaling a substance (like methacholine or histamine) that can trigger airway narrowing in people with asthma.
• Allergy Testing: Skin tests or blood tests can identify specific allergens that may be triggering asthma symptoms.
• Chest X-ray: May be done to rule out other conditions that could be causing similar symptoms.

Management:

There is currently no cure for asthma, but it can be effectively managed with medication and by avoiding triggers. The goals of asthma management are to control symptoms, prevent asthma attacks, and maintain good lung function. Management strategies include:

• Medications:
  • Long-term Control Medications (Preventers): Taken daily to reduce airway inflammation and prevent symptoms. These include inhaled corticosteroids, long-acting beta-agonists (LABAs) (often combined with corticosteroids), leukotriene modifiers, and others.
  • Quick-Relief Medications (Rescue Medications): Used as needed to quickly relieve sudden symptoms. These are typically short-acting beta-agonists (SABAs) that relax the muscles around the airways.
• Asthma Action Plan: A written plan developed with a healthcare provider that outlines daily management, how to recognise worsening symptoms, and when to use rescue medication and seek medical help.
• Trigger Avoidance: Identifying and avoiding individual asthma triggers is crucial for managing the condition.
• Regular Monitoring: Regular check-ups with a healthcare provider to assess asthma control and adjust treatment as needed.
• Proper Inhaler Technique: Using inhalers correctly is essential for the medication to reach the lungs effectively.
• Education and Self-Management: Understanding asthma, its triggers, and how to manage it empowers individuals to take control of their condition.

Living with asthma requires ongoing management, but with proper treatment and awareness of triggers, most individuals with asthma can lead active and healthy lives.