Asthma is a severe health condition under which the airways swell and narrow down, leading to a higher production of mucus. This can lead to shortness of breath. In a few cases, asthma might only be a minor nuisance, while for others, it could be a considerable problem that hampers day-to-day activities and might even lead one to a deadly attack. Though there’s no definite cure for asthma, one can still keep a tab on the symptoms. Since asthma keeps evolving, a patient should work closely with their doctors to check on the signs and then change the treatment as needed.

Causes

There’s no clarity on why some people get asthma, while many others don’t. Doctors believe that asthma develops as a combination of two factors—genetic and environmental.

General symptoms

The symptoms of asthma may vary from one person to another. Sometimes, a person will only experience infrequent asthma attacks, or the symptoms might appear only on certain occasions, such as when one engages in some exercise. However, in a few people, the symptoms might occur anytime or all the time.

The common signs and symptoms of asthma include:

• Pain in the chest
• Breathlessness
• Wheezing or coughing attacks that might aggravate with a respiratory virus, such as the flu or cold
• Tightness in the chest
• Trouble sleeping because of coughing, wheezing, or shortness of breath
• Wheezing or whistling sound every time one exhales (more common in children)

General triggers

When exposed to certain substances and irritants, the symptoms of asthma might be triggered. These triggers include:

• Cold air
• Common cold or other respiratory infections
• Air pollutants such as dust or smoke
• Stress or any strong emotions
• High-intensity physical activity or training
• Airborne substances like pet dander, dust mites, pollen, cockroach waste
• Preservatives or sulfites added to some beverages, such as wine, beer, shrimp, dry fruits, and processed potatoes
• Acidity or GERD
• Medications, such as aspirin, naproxen, and ibuprofen

Symptoms of aggravated asthma

• The above-listed symptoms become frequent and bothersome
• Trouble in breathing
• Inhaler needed more often

Triggers that aggravate asthma

Certain triggering agents can flare up the symptoms of asthma, leading to the following:

• Occupational asthma

It is triggered by irritants in the workplace, like dust, gases, or chemical fumes.

• Exercise-induced asthma

When one performs some intensive training, and the air around is dry and cold, they might experience a few symptoms of asthma.

• Allergy-induced asthma

The symptoms flare up when certain allergens or airborne substances are involved. These could be pet dander, pollen, cockroach waste, or mold spores.

Risk factors

There are a bunch of factors that might expose a person to the risk of developing asthma. Some of these are:

• Smoking
• Obesity
• Passive smoking
• Pollutants, significantly exhaust fumes
• Exposure to chemicals used in manufacturing, hairdressing, and farming industries
• Having any other allergic condition like hay fever or eczema
• The first relative, parent or sibling, has asthma

Diagnosis

For a diagnosis of asthma, a person will have to undergo a bunch of tests and examinations. These include:

• Physical examination

The doctor will perform a physical examination for them to ascertain whether one has asthma or any other chronic obstructive pulmonary disease or respiratory infection. Under this, the person will be asked questions relating to their health condition and the signs and symptoms that they are currently experiencing.

• Tests

The physical examination will be followed by a few tests to track the functionality of the lungs. Some of the standard tests include:

• • Peak flow

It is a simple device used to measure a person’s breathing capacity. If the reading is below the lower peak, it means that their lungs aren’t functioning at an optimal level. This could be a clear indication of asthma getting worse.

• • Spirometry

It is a test to examine the amount of air that one can release while exhaling; it also measures the speed at which one exhales.

Both of these tests are performed before and after the dosage of the bronchodilator medication. If the airways open and the lung function improves after the dose of albuterol (a bronchodilator), one probably has asthma.

In addition to this, other tests are conducted to diagnose asthma, including:

• Nitric oxide test

It is a test to check the presence of nitric oxide in the breath. If there is inflammation in the airways, the nitric oxide levels are high, which could be a sign of asthma.

• Methacholine challenge

People who react to methacholine possibly have asthma.

• Allergy testing

It could be done either via a blood test or skin test to examine if one is allergic to the common asthma allergen triggers.

• Imaging tests

A CT scan is performed to check any structural abnormalities in the lungs.

• Provocative testing

It is done to examine the airway obstruction before and after physical activity.

• Sputum eosinophils
  A test is done to check the presence of white blood cells in the mucus and saliva that comes out during coughing. The presence of eosinophils could be a sign of asthma.

Treatment

To stop the attacks, one needs to work toward long-term control and prevention. For proper treatment, one needs to analyze and avoid the triggers, check on one’s breathing patterns, and take regular medications. During a flare-up, one can even use an albuterol inhaler.

• Medications

The medication prescribed would depend on certain factors, such as symptoms, age, triggers, and things that work best for keeping a person’s attacks in check.

Medication is usually of three types:

• Quick-relief medications
• Long-term medications
• Allergy medications

Let’s understand all these types of medication in detail.

• Quick-relief medications

These medications are taken to provide instant relief during an attack. However, if long-term medication is working fine, one should avoid the usage of these medications.

• Oral and IV corticosteroids
  It includes medications such as methylprednisolone and prednisone for relieving the inflammation in the airways. It does have some severe side effects, so long-term usage is not recommended.
• Beta-agonists (short-term)

It includes levalbuterol and albuterol and provides instant relief from the symptoms during an on-going attack.

• Ipratropium

Ipratropium also has an immediate effect and makes breathing easier.

• Long-term medications
  These must be taken every day and help keep asthma under control. Such medications include:
• Theophylline

It is an every-day pill that will ensure that the airways remain open.

• Leukotriene modifiers

It is an oral medication that keeps the symptoms of asthma under control for at least a day.

• Inhaled corticosteroids

To make the most of these drugs, a person will have to continue using it for several days or weeks. Unlike the oral ones, they are safe and can be used on a long-term basis.

• Beta-agonists (Long-term)

These include formoterol and salmeterol that help open the airways. Since they aggravate the risk of a severe attack, one should always take them with an inhaled corticosteroid.

• Combination inhalers

It includes inhalers like formoterol-mometasone, fluticasone-salmeterol, and budesonide-formoterol, which are a combination of corticosteroid and a beta-agonist.

• Allergy medications

These medications are taken when the asthma attack occurs because of an allergy. These include:

• Allergy shots

The allergy shots are prescribed to prevent the reaction of the immune system when exposed to allergens.

• Omalizumab

It is a medication that alters the immune system and is useful for people who get asthma attacks because of certain allergies.

• Bronchial thermoplasty

In case nothing works, the fourth type of treatment is used, which is bronchial thermoplasty. However, this treatment is neither ideal for everyone nor widely accessible.

Natural remedies

Usually, people rely on medications to get rid of the symptoms and the impact of asthma. However, a few changes in one’s lifestyle can work long-term in subsiding the asthma triggers. Certain lifestyle changes and natural remedies can reduce one’s exposure to asthma triggers. These include:

• Using an air conditioner at home to minimize the impact of airborne allergens that find their way indoors
• Using a dehumidifier for maintaining adequate humidity
• Preventing the development of mold spores in the kitchen, bathroom, and around the house
• Cleaning one’s house thoroughly at least once a week
• Wearing a mask while dusting
• If one is allergic to pet dander, they should not pet animals with feathers or fur
• If it is cold outside, one should keep their mouth and nose covered with a mask
• Try to decontaminate the décor every few days

In addition to the stated remedies, one should

• Exercise daily to strengthen one’s lungs and heart health
• Maintain a healthy weight, as being overweight can aggravate the symptoms of asthma
• Try to avoid food that may lead to acid reflux as it can worsen the symptoms of asthma

Diet

There’s no special diet that asthma patients should follow, but there are certain foods that trigger or reduce asthma symptoms.

• What should one eat?

All of these items do not directly control asthma, but certainly help improve the lung function.

• Foods rich in Vitamin D: milk and oranges
• Foods rich in Vitamin A: carrots; broccoli; sweet potatoes; green leafy vegetables, such as kale, lettuce, and spinach; and cantaloupe
• Food rich in magnesium: pumpkin seeds, dark chocolate, spinach, and swiss chard
• Foods with Omega-3 fatty acids: flaxseeds
• Bananas
• Apples
• What should one not eat?

Certain food items might trigger the symptoms of asthma. So, one should keep them out of one’s diet. However, before eliminating any food, one should consult their health-care professional. There are a few foods that may trigger asthma in some people but might not impact others. Thus, it is always good to keep track of the food one eats and closely monitor its after-effect on oneself.

Some regular asthma-triggering food items include:

• • Sulfite: a preservative found in dry fruits, shrimp, wine, pickled food, bottled lime or lemon juice, and maraschino cherries
  • Food that can trigger GERD or acid reflux: cabbage, fried food, onions, beans, garlic, carbonated drinks, salicylates found in spices, herbs, tea, and coffee
  • Foods with Omega-6 fatty acids and trans fat: processed food and margarine
  • Artificial ingredients: food in fast food joints and processed food comprise artificial ingredients, such as artificial flavoring, chemical preservatives, and colorings
  • Other common allergens: wheat, nuts, shellfish, and dairy products

Prevention

As discussed, there’s no definite cure for asthma, but measures can be taken to better one’s condition or prevent extreme asthmatic attacks. These include:

• Keeping a check on one’s breathing

For asthma patients, it is mandatory to have a peak flow meter at home. Using this, one can daily monitor their breathing and note down their peak recordings. This will keep a person prepared for an impending attack.

• Get vaccinations for pneumonia and influenza

Always be updated with one’s flu vaccines to prevent asthma flare-ups.

• Have a workable action plan

Since asthma is a life-long disease, one needs to have an action plan to tackle it. So, the patient and his or her health-care professional must come up with a detailed itinerary of medication and treatment to keep a check on the asthma attack.

• Treat attacks timely

If one knows how to stop an attack from getting severe, it wouldn’t ever become life-threatening. So, as and when one’s peak flow measurements decline, they need to follow the action plan. It could be a sign of an impending attack. If a particular activity is a trigger behind the attack, stop it immediately.

• Be regular with medications

Even if one’s condition is improving, they should not change their dosage without consulting their doctor.

• Keep a close check on one’s dependency on the inhaler

If one is regularly using the inhaler, it means that his or her condition is not under control, in which case, he or she should immediately visit a doctor to alter the treatment plan.

• Avoid triggers as much as possible

Particular food, activity, or exposure to something which can trigger an attack, must be avoided altogether.