What is asthma?

Element - - Cover Story - Dr Bob Han­cox Asthma Foun­da­tion med­i­cal di­rec­tor and res­pi­ra­tory spe­cial­ist Visit the NZ Asthma Foun­da­tion web­site at asth­mafoun­da­tion.org.nz for more in­for­ma­tion.

A dis­ease in­volv­ing the nar­row­ing of the ‘air­ways’ (the bronchial tubes) caus­ing wheez­ing and breath­less­ness. The un­der­ly­ing prob­lem is usu­ally that the air­ways are in­flamed; of­ten this is a form of al­ler­gic in­flam­ma­tion. Be­cause the air­ways are in­flamed they re­act to trig­gers, mean­ing nar­rower in­flamed air­ways get even nar­rower – set­ting off an asthma at­tack.

Symp­toms

Wheez­ing – a whistling noise heard when breath­ing, breath­less­ness, cough­ing, tight chest. These symp­toms come and go, vary­ing in sever­ity.

At what age do you de­velop asthma?

Asthma can de­velop at any stage. Most peo­ple de­velop it in child­hood, but around 75% of chil­dren who have asthma be­fore they are seven will have grown out of it by the time they are 16. Ba­bies can get ‘wheezy bron­chi­tis’. It’s very dif­fi­cult to know whether this is asthma or whether they’re just get­ting lots of chest in­fec­tions. Many ba­bies will grow out of it, but symp­toms will per­sist in some and be­come asthma.

How is it caused?

No-one knows for sure. We un­der­stand that it is a mix­ture of ge­net­ics and en­vi­ron­men­tal ex­po­sures, but it is still un­known how they in­ter­act to cause asthma. Re­search has shown that boys are more likely to get asthma than girls, but are more able to grow out of it, mean­ing women are more likely to have asthma than men. For new adult suf­fer­ers asthma could be re­lated to their job. Some oc­cu­pa­tions are as­so­ci­ated with caus­ing asthma, such as jobs deal­ing with dust, like bak­ers, wood­work­ers, those with ex­po­sure to cer­tain chem­i­cals e.g. iso­cyanates in car paints, peo­ple work­ing in alu­minium smelters. Even so, in most cases of adult-on­set asthma we can’t iden­tify the cause.

What are the trig­gers?

We need to dis­tin­guish be­tween what trig­gers asthma and the causes. If I had asthma and I got a cold, my asthma might de­te­ri­o­rate. That doesn’t mean that the cold caused my asthma – it just made my symp­toms worse. Key trig­gers in­clude: The house dust mite – prob­a­bly the most com­mon al­ler­gen and asthma trig­ger in New Zealand. Dust mites are found in most houses due to the damp, warm en­vi­ron­ment. Their pres­ence is not re­lated to the clean­li­ness of the house. Also pollen – like privet and grass, cats and dogs, cold air and ex­er­cise.

How to man­age your asthma?

Ob­vi­ously don’t smoke and avoid smoky places. Smoke is an ir­ri­tant to the air­ways and chil­dren with asthma don’t need to be ex­posed to it. Keep your house warm and dry through in­su­la­tion, heat­ing and dou­ble-glaz­ing – liv­ing in a cold, damp house makes asthma symp­toms worse. Talk to your doc­tor about treat­ment. If you get symp­toms on a reg­u­lar ba­sis you need to be on a mix of in­halers to keep your asthma un­der con­trol. Peo­ple with fre­quent symp­toms should have a pre­ven­ter in­haler, to pre­vent symp­toms from com­ing on. Have an asthma ac­tion plan, which you can get from the Foun­da­tion web­site, so you can un­der­stand your asthma and take con­trol of symp­toms be­fore they be­come a real prob­lem.

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