07.08.2024

Asthma and its crisis: causes, treatment methods and prevention of the crisis

By Lilias

Asthma is a condition in which the airways narrow and swell and produce phlegm or more mucus. This can make breathing and coughing difficult and cause wheezing and shortness of breath.

For some people, asthma is a minor inconvenience, while for others it can be a major problem that interferes with daily activities, and an asthma attack can be life-threatening.

Asthma cannot be cured, but its symptoms can be controlled. The causes of asthma often change over time, so it’s important to work with your doctor to track signs and symptoms and adjust treatment as needed.

Here is an encyclopedia about asthma, its causes, symptoms, treatment methods, and dealing with the crisis.

Symptoms of asthma:

Asthma symptoms vary from person to person. You may have infrequent asthma attacks, and symptoms may only appear at certain times – such as when exercising.

Signs and symptoms of asthma include:

shortness of breath
chest tightness or pain
Sleep disturbances due to shortness of breath or coughing
Wheezing or whistling sound when breathing out (breathing noise is a sign of asthma in children)
Cough or difficulty breathing that is made worse by a respiratory virus such as a cold or flu

Signs that your asthma attack is severe include:

Asthma signs and symptoms are more frequent and bothersome.
Increased difficulty breathing (measured with peak flow, a device used to check how well your lungs are working)
The need to use inhalers for quick relief more often

For some people, asthma signs and symptoms flare up in certain situations:

Exercise, which makes the condition worse when the air is cold and dry.
Occupational asthma, which is caused by workplace irritants such as chemical fumes, gases, and dust.
Allergic asthma, caused by airborne substances, such as pollen, mold spores, skin particles, and pet dander.

When you need to see a doctor:

You should seek emergency treatment, as severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms get worse. Signs of an asthma emergency include:
Rapidly worsening shortness of breath and wheezing
No improvement even after using your inhaler
Shortness of breath with minimal physical activity

See your doctor:

1. If you think you have asthma:
If you have a recurring cough or wheezing that lasts for more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from getting worse over time.

2. Monitor asthma after diagnosis:
If you know you have asthma, you should work with your doctor to keep the condition under control. Good long-term control helps you feel better and can prevent life-threatening asthma attacks.

3. If your asthma symptoms get worse:
Contact your doctor immediately if the medicine does not relieve your symptoms, or if you need to use quick-relief inhalers more often. Do not try to solve the problem by taking more medicine without consulting your doctor, as overuse of asthma medications can cause side effects and can make your asthma attack worse.

4. To review treatment:
Asthma often changes over time, so you should see your doctor regularly to discuss symptoms and make any necessary adjustments to treatment.

the reasons:

It’s not clear why some people develop asthma and others don’t, but it’s likely the result of a combination of environmental and genetic factors.

Asthma triggers:
Exposure to various irritants and allergens can lead to asthma signs and symptoms. Asthma triggers vary from person to person and can include:

Airborne substances, such as pollen, dust, mold spores, and pet dander.
Respiratory infections, such as the common cold.
Physical activity
cold air
Air pollutants and irritants such as smoke
Certain medications, including beta blockers, aspirin, ibuprofen, and naproxen
Stress
Sulfites and preservatives added to some foods and beverages, including shrimp, dried fruits, processed potatoes, beer, and wine.
Gastroesophageal reflux disease (GERD), a condition in which stomach acids reflux into the throat

Risk factors:
It is believed that there are a number of factors that increase the chances of developing asthma, including:

Blood relatives (such as a parent or sibling) who have asthma
Having another allergic condition, such as dermatitis or allergic rhinitis (hay fever)
overweight
Being a smoker
Exposure to passive smoking
Exposure to exhaust fumes or other types of pollution
Exposure to occupational stimulants, such as chemicals used in agriculture, hairdressing and manufacturing

Asthma complications:
Asthma complications include:

Signs and symptoms that interfere with sleep, work, or recreational activities
On sick days it is difficult to work or go to school.
Permanent narrowing of the airways affects the ability to breathe.
Visiting the emergency room and hospitals for severe asthma attacks
Side effects of long-term use of some medications to stabilize severe asthma

Note:
Proper treatment makes a big difference in preventing both short-term and long-term complications from asthma.

Preparing for your appointment with the doctor:

You will probably start by seeing your family doctor or general practitioner, however when you call for an appointment you may be referred to an allergist or pulmonologist.
Because doctor visits can be short, here is some information to help you prepare for your visit, as well as what to expect from your doctor.

What you can do:
These steps can help you make the most of your time with your doctor:

Write down any symptoms you are experiencing, including any that may seem unrelated to the cause of your symptoms.
Note when a symptom bothers you more – for example, if your symptoms are worse at certain times of day, during certain seasons, or when you are exposed to cold air or pollen – tell your doctor.
Write down key personal information, including any major recent life changes.
Provide a list of all medications, vitamins, and supplements you are taking.
Take a family member or friend with you to the doctor if possible, as sometimes it can be difficult to remember all the information given to you during the appointment, and having someone accompany you may remind you of something that you missed or forgot.

Write down the questions you need answered by your doctor:
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time with him. Arrange your list of questions from most important to least important in case you run out of time. To treat asthma, there are some basic questions that you can ask your doctor:

Is asthma the most likely cause of my breathing problems?
Other than the most likely cause, what are other possible causes for my symptoms?
What types of tests do I need?
Is my condition likely to be temporary or chronic?
What is the best treatment for my condition?
I have these other health conditions, what is the best way to manage them together?
Are there any restrictions I need to follow?
Should I see a specialist?
Is there an alternative to the medication you prescribed for me?
Are there any brochures or other printed materials I can take home with me?

In addition to the questions you’ve prepared to ask your doctor, don’t hesitate to ask other questions during your visit.

What to expect from your doctor: He or
she will likely ask you a number of questions, and you should be prepared to answer them. Your doctor may ask:

What exactly are your symptoms?
When did you notice these symptoms?
How severe are your symptoms?
Do you have breathing problems at certain times or in certain situations?
Do you have allergies, such as dermatitis or hay fever?
Do allergies or asthma run in your family?
Do you have any chronic health problems?

Tests and Diagnosis:

First, other possible conditions — such as a respiratory infection or chronic obstructive pulmonary disease (COPD) — must be ruled out. Your doctor will do a physical exam and ask you questions about your signs and symptoms and any other health problems you have.

Tests to measure lung function:
You can have lung function tests to determine how air moves in and out of your lungs. These tests may include:

1. Spirometry:
This test checks how much air you can exhale after a deep breath, and how fast you can breathe out.

2. Peak flow measurement:
A simple device that measures how hard you are exhaling. Readings that are lower than normal flow are a sign that your lungs may not be working as well as that your asthma may be getting worse. Your doctor will give you instructions on how to deal with low airflow readings.

Additional tests:
Other tests to diagnose asthma include:

1. Methacholine challenge:
Methacholine is a substance that causes asthma when inhaled, which causes mild constriction of the airways. If there is a response to methacholine, it is more likely that you have asthma. This test can be used even if lung function tests are normal.

2. Nitric oxide test:
This test is done, but not widely, and measures the amount of nitric oxide gas, which is found in the respiratory system. When the airways are inflamed, this is a sign of asthma, and you may have higher than normal levels of nitric oxide.

3. Imaging tests:
Chest X-rays and computed tomography (CT) scans to examine the lungs and sinuses can identify any structural abnormalities or diseases such as infections that could be making breathing problems worse.

4. Allergy testing:
This cannot be done through skin testing or blood testing. Allergy tests can identify allergies to pets, dust, mold, and pollen. If allergens are identified, this can lead to the initiation of allergy immunotherapy.

5. White blood cell test:
This test checks for some white blood cells in a mixture of saliva and mucus (sputum) that is coughed up.

6. Exercise provocation test for cold-induced asthma:
In these tests, the doctor measures airway obstruction before and after performing vigorous physical activity or taking a deep breath of cold air.

How asthma is classified:
To classify the severity of your asthma, your doctor considers your answers to questions about your symptoms (such as how often you have asthma attacks and how bad they are), along with results of a physical exam and diagnostic tests.
Determining your asthma severity helps your doctor choose the best treatment, and asthma severity often changes over time, requiring adjustments in treatment.

Asthma is classified into four general categories:
1. Mild with mild intermittent symptoms up to two days a week, up to two nights a month.
2. Mild persistent symptoms more than twice a week, but not more than once a day.
3. Moderate persistent symptoms once a day and night more than once a week.
4. Severe persistent symptoms all day on most days of the week, often occurring at night.

Treatments and medications:

Prevention and long-term control are key to stopping asthma attacks before you start treatment. Treatment usually involves knowing what triggers your attack, taking steps to avoid it, and tracking your breathing to make sure your medications are working and keeping your symptoms under control. In the event of an asthma attack, you may need to use quick-relief inhalers, such as albuterol.

Medications:
The right medications for you depend on a number of things, such as your age, symptoms, asthma triggers and what works best to keep your asthma under control.
Preventive treatment and long-term monitoring of medications reduce airway inflammation, quick-relief inhalers (bronchodilators) work quickly to open the airways and reduce swelling that restricts breathing, and in some cases, allergy medications are necessary.
Long-term asthma control medications, which are generally taken daily, are the cornerstone of asthma treatment. These medications keep your asthma under control on a day-to-day basis and make it less likely. Types of medications include:

1. Inhaled steroids:
These include anti-inflammatory drugs (fluticasone), budesonide, flunisolide, and beclomethasone.
You may need to use these medications for several days to weeks before you get their full benefit. Unlike oral corticosteroids, these corticosteroids have a relatively low risk of side effects and are generally safe for long-term use.

2. Leukotriene levels:

These oral medicines – including montelukast – help relieve asthma symptoms for up to 24 hours.
In rare cases these medicines have been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thoughts, and you should seek medical advice immediately if any unusual reaction occurs.

3. Long-acting beta agonists:
These are inhaled medications, which include salbetamol and formoterol to open the airways.
Some research shows that they may increase the risk of severe asthma attacks, so they are taken in combination with inhaled corticosteroids, because these medications can mask worsening asthma, and should not be used for a severe asthma attack.

4. Theophylline:
Theophylline is a daily pill that helps keep the airways open, by relaxing the muscles around the airways, but it is not used as often now as it was in years past.

There are some medications that are used to provide quick, short-term relief of symptoms during an asthma attack – or taken before exercise if your doctor recommends it. Types of medications for quick relief include:

1. Short-acting beta-blockers:
These medications are inhaled, quick-relief bronchodilators that work within minutes to quickly relieve symptoms during an asthma attack, and include albuterol.
Short-acting beta-blockers can be taken using a hand-held inhaler or a nebulizer, a device that turns asthma medications into a fine mist that can be inhaled through a face mask.

2. Ipratropium (Atrovent):
Like other bronchodilators, ipratropium works quickly to relax the airways immediately, making breathing easier. Ipratropium is mostly used for emphysema and chronic bronchitis, but it is sometimes used to treat asthma attacks.

3. Oral or intravenous corticosteroids:
These medications include prednisone, which relieves bronchitis caused by severe asthma, and can cause serious side effects when used long-term.

If you have an asthma attack, quick-relief inhalers can relieve symptoms right away, but you need to monitor your long-term use of the medication to make it work properly.

Lifestyle and Home Remedies:

Although many people with asthma rely on medications to prevent and relieve symptoms, you can do many things on your own to stay healthy and reduce the likelihood of asthma attacks.

Avoid asthma triggers:
Take steps to reduce asthma attacks, including:
Use air conditioning:
Air conditioning reduces the amount of airborne pollen from trees, grasses, and weeds that finds its way into the air. Air conditioning also lowers indoor humidity and can reduce exposure to dust mites. If you don’t have air conditioning, keep your windows closed during pollen season.
Disinfecting home decor:
Reduce dust that may exacerbate symptoms at night by replacing some items in the bedroom, for example, covering pillows and mattresses with dust-proof covers, removing carpets, and washing curtains.
Maintaining humidity:
If you live in a humid climate, talk to your doctor about using a method to remove humidity.
Prevent Mold Spores:
Keep damp areas clean in the bathroom, kitchen, and around the house to keep mold spores from forming, and dispose of moldy leaves or wet firewood in the yard.
Reduce pet dander:
If you are allergic to dander, you should avoid pets, and if you have pets, you should bathe them regularly, which reduces the amount of dander in your environment.
Maintain regular hygiene:
Clean your home at least once a week. If it is prone to dust, wear a mask while cleaning.
Cover your nose and mouth if the air is cold, and if your asthma is made worse by cold or dry air, wear a face mask.

Staying healthy:
Taking care of yourself can help keep symptoms under control, including:

Get regular exercise. Having asthma doesn’t mean you have to be less active. Treatment can prevent asthma attacks and control symptoms during activity.
Regular exercise can improve heart and lung function, which can help relieve asthma symptoms. If you exercise in cold temperatures, wear a face mask to warm the air you breathe.
Maintain a healthy weight, as being overweight can make symptoms worse, putting you at higher risk for other health problems.

Alternative medicine:
Some alternative treatments may help relieve asthma symptoms. However, keep in mind that these treatments are not a substitute for medical treatment – especially if you have severe asthma. Talk to your doctor before taking any herbs or supplements, as some may interact with medications you are taking.
While some alternative treatments are used for asthma, in most cases more research is needed to see how well they work and to measure the extent of potential side effects. Alternative treatments for asthma include:

Breathing exercises, as these exercises may reduce the amount of medication you need to keep your asthma symptoms under control.
Herbs and natural remedies: There are a few herbs and natural remedies that can help improve asthma symptoms, including black seed, caffeine, and choline.

Coping and support:
Asthma can be a very stressful challenge, and it can sometimes become a source of frustration, anger or depression because you need to cut back on your usual activities to avoid environmental triggers.
But asthma doesn’t have to be a limiting condition, and the best way to overcome anxiety and feelings of helplessness is to understand your condition and take control of its treatment. Here are some suggestions that may help you manage your condition:

Take breaks between tasks and avoid activities that make symptoms worse.
Make a daily list of tasks you need to do, as this may help you avoid feeling overwhelmed, and reward yourself for achieving simple goals.
If your child has asthma, focus on what your child can do, not what he or she cannot do, and involve teachers, school nurses, coaches, friends, and relatives in helping your child control an asthma attack.

Prevention:
While there is no way to prevent asthma, by working together, you and your doctor can design a step-by-step plan to live with your condition and prevent asthma attacks.

Follow an asthma plan with your doctor and health care team, write a detailed plan for taking your medications and managing an asthma attack, and then make sure you follow your plan.
Asthma is an ongoing condition that needs regular monitoring and treatment, and controlling your treatment can make you feel more in control of your life in general.
Get vaccinated against influenza and pneumonia, as vaccinations that can prevent influenza and pneumonia from triggering an asthma attack.
Identify and avoid asthma triggers. There are a number of outdoor allergens and irritants — from pollen to cold air to air pollution — that can trigger asthma attacks. Find out what triggers or worsens your asthma, and take steps to avoid these triggers.
Monitor your breathing, and learn to recognize signs of an impending attack, such as a slight cough or shortness of breath. Because lung function may decline before you notice any signs or symptoms, regularly measure and record your peak airflow and expiratory flow.
Identify and treat attacks early, and if you act quickly, you are less likely to have severe attacks and you also do not need as much medication to control your symptoms.
Pay attention to increasing the use of quick-relief inhalers. If you find that your reliance on quick-relief inhalers, such as albuterol, is not working to control your asthma, you should consult your doctor about adjusting your treatment.