Asthma

\n\nAsthma is a condition in which your airways becomes narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.\n\nFor some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.\n\nAsthma can’t be cured, but its symptoms can be controlled. Because asthma often changes over time, it’s important that you work with your health care provider.\n\n Symptoms\n\nAsthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.\n\nAsthma signs and symptoms include: \n

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• Shortness of breath
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• Chest tightness or pain
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• Wheezing when exhaling, which is a common sign of asthma in children
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• Trouble sleeping caused by shortness of breath, coughing or wheezing
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• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu
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\n For some people, asthma signs and symptoms flare up in certain situations:\n

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• Exercise-induced asthma, which may be worse when the air is cold and dry.
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• Viral illness Triggered: Most common in Children.
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• Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust.
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• Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander).
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\n Prevention\n\nWhile there’s no way to prevent asthma, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks.\n

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• Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan. Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life.
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• Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.
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• Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.
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• Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath. But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter. A peak flow meter measures how hard you can breathe out. Your doctor can show you how to monitor your peak flow at home.
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• Identify and treat attacks early. If you act quickly, you’re less likely to have a severe attack. You also won’t need as much medication to control your symptoms. When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed. Also, immediately stop any activity that may have triggered the attack. If your symptoms don’t improve, get medical help as directed in your action plan.
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• Take your medication as prescribed. Don’t change your medications without first talking to your doctor, even if your asthma seems to be improving. It’s a good idea to bring your medications with you to each doctor visit. Your doctor can make sure you’re using your medications correctly and taking the right dose.
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• Pay attention to increasing quickrelief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn’t under control. See your doctor about adjusting your treatment.
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\nDiagnosis\n\n Physical exam\n\nYour doctor will perform a physical exam to rule out other possible conditions, such as a respiratory infection or chronic obstructive pulmonary disease (COPD). Your doctor will also ask you questions about your signs and symptoms and about any other health problems.\n\nTests to measure lung function\n\nYou may be given lung function tests to determine how much air moves in and out as you breathe. These tests may include\n

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• Spirometry. This test estimates the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath and how fast you can breathe out.
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• Peak flow. A peak flow meter is a simple device that measures how hard you can breathe out. Lower than usual peak flow readings are a sign that your lungs may not be working as well and that your asthma may be getting worse. Your doctor will give you instructions on how to track and deal with low peak flow readings.
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\nAdditional tests\n\n Other tests to diagnose asthma include:\n

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• Methacholine challenge. Methacholine is a known asthma trigger. When inhaled, it will cause your airways to narrow slightly. If you react to the methacholine, you likely have asthma. This test may be used even if your initial lung function test is normal.
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• Imaging tests. A chest X-ray can help identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems.
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• Allergy testing. Allergy tests can be performed by a skin test or blood test. They tell you if you’re allergic to pets, dust, mold or pollen. If allergy triggers are identified, your doctor may recommend allergy shots
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\nTreatment \n\nPrevention and long-term control are key to stopping asthma attacks before they start. Treatment usually involves learning to recognize your triggers, taking steps to avoid triggers and tracking your breathing to make sure your medications are keeping symptoms under control. In case of an asthma flare-up, you may need to use a quick-relief inhaler.\n\nMedications \n\nThe right medications for you depend on a number of things — your age, symptoms, asthma triggers and what works best to keep your asthma under control.\n\nPreventive, long-term control medications reduce the swelling (inflammation) in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary.\n\nLong-term asthma control medications, generally taken daily, are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you’ll have an asthma attack. Types of long-term control medications include:\n\nCont. in next edition\n\n