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Asthma: causes, symptoms and main treatments
According to the World Health Organization (WHO) asthma is one of the most common chronic diseases in the world, and even the most common in pediatric age.
Worldwide, 235 million people suffer from asthma and in Portugal alone, more than 600,000 people have this disease. About 80% of asthma patients also suffer from allergic rhinitis.
Asthma is not a common cause of death, but it can significantly impair the quality of life of sufferers and cause significant absenteeism from school and work, as well as numerous visits to the doctor or hospital. Learn how to diagnose and treat it.
What it is
Asthma is a chronic obstructive inflammatory disease of the airways. This process causes inflammation and narrowing of the pulmonary airways (i.e., the bronchial tubes), resulting in bronchoconstriction and, consequently, a limitation of the flow of inspired air. Difficulty in breathing is therefore one of its main symptoms.
Causes and risk factors
The origin of asthma is not yet completely known. However, it is always characterized by mechanisms of exacerbated hyperreactivity when the asthmatic is exposed to certain stimuli.
Some of these allergens may be: environmental and occupational; dust mites; pollens; tobacco; animals; pollution; strong emotions; weather conditions (sudden changes in temperature); medications; foods; sports; among others.
Asthma and sports
Although 40-90% of asthma patients experience worsening asthma symptoms after participating in exercise, especially if it is long-distance, continuous, or outdoor training (such as track and field or cycling), people with asthma should also participate in sports.
For this, certain precautions should be taken, such as keeping the disease under control, including taking the correct medications prescribed by the doctor, as well as adopting certain measures such as:
- Doing warm-up exercises before training;
- Perform post-workout stretches; Breathe through your nose;
- wear a mask;
- And avoid allergens.
Of course, some sports are more suitable because they develop the respiratory muscles and improve the patient’s respiratory capacity. This is the case for swimming, rowing, handball and basketball.
In general, the most commonly described symptoms in asthmatic patients are difficulty breathing, exertional intolerance, fatigue, rapid breathing, and wheezing.
However, in moderate to severe asthma, a number of other symptoms may occur, such as:
- Polypnea (increased breathing cycles);
- Peripheral desaturation (decreased oxygen levels in the blood);
- Cyanosis (bluish hue of the tongue, lips, and mucous membranes);
- Nasal tachycardia or nasal clinging (sign of respiratory distress);
- Wheezing on pulmonary auscultation (sign of bronchial constriction);
- Difficulty finishing sentences;
- Tachycardia (increased heart rate);
- Excessive drowsiness;
- Daytime Fatigue;
- Tightness in the chest;
- Low levels of concentration;
- Decreased performance at school or work.
Suspicion of asthma may arise when there is a manifestation of some of the symptoms listed above and when this symptomatology can be associated with exposure to certain stimuli.
In the face of this suspicion, the physician may recommend that certain tests be performed, namely:
Test to identify the existence or not of airflow obstruction and its reversibility, before and after inhalation of a short-acting bronchodilator ;
test performed with methacholine, a substance capable of causing bronchial obstruction in an asthmatic individual;
Skin sensitivity tests
Tests used to confirm possible allergies.
Carbon monoxide diffusing capacity (DLCO) test:
May be useful in differentiating asthma from chronic obstructive pulmonary disease;
Indicated to exclude underlying causes of asthma or other pathologies.
Asthma is a chronic disease and is therefore incurable. However, it is possible to control it in order to prevent attacks and to ensure the quality of life of these patients.
One way to do this is to avoid exposure to the allergen(s) that cause flare-ups. In addition, in some cases, immunotherapy may be offered to desensitize the individual to a particular allergen.
At the same time, medications are recommended in two main groups: medications for control treatment and medications for acute treatment.
This type of treatment is primarily aimed at preventing inflammation and symptoms of asthma, reducing the risk of acute attacks. This treatment is based on the following medications:
- Inhaled corticosteroids;
- Systemic Corticosteroids;
- Long-acting bronchodilators;
- Leukotriene receptor antagonists.
Acute treatment is aimed at relieving events associated with airflow limitation and exacerbated body response. In these situations, the asthma patient should use:
- rapid-acting bronchodilators;
- systemic corticosteroids.
Avoidance of triggers
Avoiding exposure to the allergen or allergens is a very effective way to control asthma attacks.
If you have allergies to dust mites, pollen, animal dander, or other allergens, it is important to take certain steps such as:
- Clean up dust frequently, to avoid its accumulation;
- Vacuum the bed mattress regularly;
- Avoid accumulating items that collect a lot of dust, such as books;
- Wash curtains frequently;
- Avoid the use of rugs and carpets;
- Wear a mask, when airborne pollen levels are higher;
- Do not have pets, if you are allergic to dogs or cats;
- Do not consume products that potentiate an attack.
Asthma and children
As mentioned, asthma is the most common chronic disease in pediatric age. It can usually be diagnosed from the age of 5 years.
Unlike in adults, in children the symptoms of asthma can vary widely or be very non-specific.
Some of its manifestations may be wheezing or coughing, which may be associated with other viral respiratory infections, also very recurrent in children.
Thus, unlike in adults, respiratory function tests have little effect and are not very conclusive when performed in children.
Therefore, the diagnosis of this disease in pediatric age usually occurs when respiratory symptoms appear without being associated with a respiratory infection; when there are other allergic pathologies already detected, such as allergic rhinitis or atopic eczema; when the father, mother, or both are asthmatic; or when there is an improvement in the symptoms presented with the administration of medications indicated for asthma cases.
As with adults, treatment of pediatric asthma is aimed at controlling the symptoms of the disease and relieving its symptoms when an attack occurs.
For children, the recommended devices vary by age group, as follows:
Children between 0 and 3 years:
Pressurized metered dose aerosols associated with an expansion chamber with face mask;
Children between 4 and 5 years old:
Children over 5 years of age:
treatment similar to that of adults, with age-appropriate doses.
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