Asthma Basics
What is Asthma?
Asthma is a condition that affects the airways-the small tubes that carry air in and out of the lungs. With asthma, the airways become over-sensitive and react to things that would normally not cause a problem, such as cold air or dust. Muscles around the wall of the airway tighten up, making it narrow and difficult for the air to flow in and out. The lining of the airways gets swollen (just like your nose during a cold) and sticky mucus is produced, clogging up the breathing passages. With the airways narrowed like this, you can see why it becomes difficult for air to move in and out and why the chest has to work so much. Tightening of muscle around the airways can happen quickly and is the most common cause of mild asthma. It can be relieved quickly too, with the right inhaler. However, the swelling and mucus happen more slowly and need a different treatment. They take longer to clear up and are a particular problem in serious episodes of asthma.
What causes Asthma?
No one knows exactly what causes asthma. What we do know is:
- Anyone can develop asthma. It is very common in Ireland, where over 470,000 adults and children have asthma.
- It can start at any time of life, although it most often begins in childhood.
- Sometimes it affects several family members e.g. if you have parents or brothers and sisters with asthma or allergy (e.g. Eczema or hay fever) you are more likely to have it yourself.
- Conditions like hay-fever, eczema, or hives, which are usually the result of allergy, may occur along with Asthma.
- Adult onset asthma may develop after a respiratory tract infection.
- Many aspects of modern lifestyles such as changes in housing, diet and a more sterile home environment may have contributed to the rise in asthma over the last few decades.
Asthma Symptoms
The usual symptoms of asthma are:
- Difficulty in breathing/shortness of breath.
- A tight feeling in the chest.
- Wheezing (a whistling noise in the chest).
- Coughing-Hoarse, particularly at night.
You may experience one, several or all of the symptoms above. These symptoms may occur in episodes, perhaps brought on by colds or chest infections, exercise, change of temperature, dust or other irritants in the air, or by an allergy e.g. pollen or animals. Episodes at night are common, often waking the patient. A few people have these complaints all the time. You need to see your doctor, who will check that there is not some other explanation. By examining your chest, doing breathing tests and listening to your description of symptoms, the doctor can usually decide if you have asthma and can prescribe some suitable treatment.
Diagnosing Asthma
Your doctor will record a patient history. He may ask you the following questions;
- How long have you had asthma like symptoms?
- How frequent are the symptoms and how they affect your quality of life?
- Have you had an attack or recurrent attacks of wheezing?
- Do you have a troublesome cough at night?
- Do you wheeze or cough after exercise?
- Does the patient experience wheezing, chest tightness, or cough after exposure to airborne allergens or pollutants?
- Do your colds "go to the chest" or take more than 10 days to clear up?
- Are symptoms improved by appropriate asthma treatment?
- Is there a family history of asthma?
The following tests may be performed by your doctor to confirm the correct diagnosis.
- Spirometry is a simple breathing test that gives measurements of lung function including a reversibility test that measures lung function before and after a dose of reliever to see if it has improved your lung function. This can be helpful with asthma diagnosis.
- Peak Expiratory flow rate measurements (PEFR); another simple breathing test which may be measured over a period of time, when one has symptoms or even when symptom free, performed in a GP surgery, hospital and even at home.
- An exercise test to check if exercise worsens your symptoms.
