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Definition

Asthma is a chronic respiratory condition  that makes it difficult to breathe by causing inflammation and narrowing of the airways.

Pathophysiology

Pathophysiology of asthma in simplest form — It consists of three major abnormalities, bronchoconstriction , airway inflammation and mucous impaction leading to difficult or laboured breathing. 

Due to  swelling, the air passages become narrow and less amount of air can pass through to and from the lungs. The swelling also makes the air passage sensitive due to which one can become susceptible to allergies. 

The narrowing of the airway cause wheezing or hissing sound while breathing, coughing, shortness of breath, chest constriction and chest pain.

Four main categories of asthma

1. Intermittent — Symptoms are mild and do not interfere with normal activities of daily living.

Symptoms occur less than twice a week.

Nocturnal symptoms occur less than twice a month

Asthma attacks are infrequent

Lung functioning tests are within normal ranges when one is not having an attack.

2. Mild persistent — Symptoms occur three to six times a week.

Nocturnal symptoms occur three to four times a month.

Asthma attack interferes with daily activities.

Lung functioning tests are normal when not in an attack.

3. Moderate persistent — Symptoms occur daily and they interfere with normal daily activities.

Night time symptoms are more than once  per week but not daily.

Lung functioning tests are abnormal.

4. Severe persistent — Symptoms throughout the day and severely affect and limit daily activities.

Lung functioning tests are abnormal.

Other classification:

Asthma can also be classified by whether it is allergic or non-allergic.

Allergic asthma or Extrinsic is triggered by exposure to an allergen, such as pollen or pet dander.

Non-allergic asthma or intrinsic is triggered by factors such as stress, illness, extreme weather and some medications

What triggers asthma?

It is idiopathic or the cause is unknown but it usually results from a strong immune system response to a substance in the lungs however, there are common triggers for asthma symptoms which  include; but not limited to:

1. Allergies — an allergy is a damaging  response of immune system to substances such as, pollen grains, animal danders, dust mites, fur and cockroach droppings.

2. Irritants in the air both indoors and outdoors such as cigarette smoke. 

Air pollution, for example, car exhaust fumes, smoke and gas fumes.

Strong fumes, aerosol sprays, odours such as paint scented soaps and perfumes.

Dust particles in the air.

Chemicals.

Gas stoves,  wood fire places, charcoal and cooking odours. 

3. Respiratory illnesses:  this is the most common trigger of asthma in children. Flue, colds, throat infections, sinusitis and pneumonia cause inflammation of the airways and cause severe asthma.

4. Exercises — strenuous physical activities leads to breathe harder and trigger asthma — it is also called exercise induced asthma.

5. Strong emotions — sudden emotional outbursts can trigger asthma such as : anger, fear, crying, shouting, laughter and excitement.

6. Medicines — there are certain medicines that may trigger asthma but can not be discussed on this platform but consult own health provider to advice. 

7. Menstrual cycle — a number of women complain of worsening symptoms of asthma during menstrual period and it is known as premenstrual asthma and is said to be caused by hormonal changes.

8. Changes in weather — sudden changes in weather such as excess rainfall, dry winds or cold winds may trigger asthma.

9. Food additives 

10. Obesity.

11. Stress.

12. Genetics — children born to parents who have asthma are at higher risk of  having asthma.

13. Babies born by caesarian-sections have risk of developing asthma compared to babies born through normal vertex delivery .

Symptoms of asthma

Difficulty breathing.

Laboured short breaths.

Wheezing.

Chest tightness and pain

Difficulty in walking or  talking.

Coughing — early morning or especially at night, during exercise or when laughing.

NB: Asthma symptoms may come and go over time

Worsens in the morning or at night.

Worsens with viral infections such as a cold.

What does an asthma patient needs?

Quick relief  bronchodilators to open airways.

Allergic medications are necessary in some cases.

Long term asthma control medications generally taken daily, timeously and religiously. These are the corner stone of asthma treatment.

NB: Treatment of asthma is individualised hence we can not discuss treatment regime. 

Dos

Always keep your medication with you.

Take medication regularly and without fail.

Keep the house and work  place clean and dust free.

Visit your health facility regularly.

Know your medication by names.

Keep records of treatment.

Always put on medical alert bracelet.

Don’ts

Do not forget medication when travelling.

Do not default treatment.

Do not smoke and avoid alcohol consumption.

Do not over eat and avoid spicy foods.

Do not stop exercising, instead seek medical advice on how to exercise.

Do not know your medications by colours and presentation — it is very dangerous,  know  your medicines by name,   dose, route and frequency  for in cases of emergency.

Is asthma curable

NO, it can only be controlled to the point that the symptoms  become negligible  if patient has professional support . Chronic conditions are not curable.

Complications of asthma

Pneumonia.

Constant fatigue.

Frequent leave from work or school due to constant attacks.

Respiratory failure.

Severe chest pain.

Thickening and narrowing of the bronchial tubes.

Clearing myth and misconceptions

Asthma is not curable, it can only be controlled.

Asthma  does not come as a result of evil spirits.

Asthma does not worsen by using inhalers.

 Physical contact or sharing things with someone with asthma does not pre-dispose to asthma.

Smoking mbanje or any form of preparation using mbanje does not cure asthma rather it will further compromise the respiratory centre and it may cause serious complications.

Asthma does not go aware  but symptoms may be dormant until triggered. There may be periods where asthma symptoms do not affect day to day life and these periods could last for years or even decades.

For more information:  Contact [email protected] or 0772224231