To mark the occasion of World Asthma Day in May, here’s a lowdown on all you need to know about adult asthma.
All you need to know about adult asthma on World Asthma Day
Asthma is still thought of as a childhood disease. But asthma can develop even in late adulthood, and by all indications the condition is becoming more common at all ages. Late-onset asthma often goes unrecognized because asthma symptoms overlap with those of other respiratory conditions. There is a strong feeling that asthma is more prevalent now than it was 10 or 20 years ago, according to the pulmonary function laboratory at The Cleveland Clinic. Multiple factors probably are involved. We’ve been more aggressive in looking for it, the environment has changed, and we’ve pushed the envelope in treating milder cases because we’re concerned about what will happen on a long-term basis if we don’t.
What Is Asthma?
Asthma is a chronic inflammatory disorder of the airways. It is characterized by coughing, tightness in the chest, shortness of breath, and/ or wheezing. In asthma, inflammation makes the airways, or bronchial tubes, extra-sensitive to allergycausing substances (allergens) and other irritants. When the bronchial tubes react, they become narrower, making it more difficult to breathe. As asthma worsens, muscles around the tubes tighten, the airways become more inflamed and cells with the tubes produce large amounts of mucus. The result is even narrower airway passages and more breathing difficulty. Asthma attacks can be provoked by a variety of triggers, including allergens, irritants (such as smoke from a fireplace), gastroesophageal reflux disease (GERD), exercise, respiratory infections and even a blast of cold air. In some people, certain medicines can cause an airway reaction, including eye drops used to treat glaucoma, angiotensin-converting enzyme (ACE) inhibitors taken for hypertension, aspirin, ibuprofen and naproxen. Stress can make asthma symptoms worse.
Getting The Right Diagnosis
If you have persistent coughing, wheezing, or shortness of breath, talk with your doctor. Asthma can be difficult to diagnose in people with co-existing bronchitis or emphysema, and it’s possible to have these conditions at the same time. An asthma specialist will take a detailed medical history, including information about your home environment. You will likely be given a pulmonary function test called spirometry, which measures how much air you can blow out of your lungs after a deep breath. Other tests may be necessary to pin down the diagnosis. These may include a bronchial challenge test (to provoke airway narrowing and then measure the effect on your breathing), allergy testing, or use of a peak flow meter to check your breathing over the course of a week or two.
Medication And Self-Care
Treatment is tailored to the severity of your asthma and your personal health history. Successful treatment also requires that you take an active role in your care. This includes learning your asthma triggers and trying to avoid them. You also need to know your body well enough to detect the early warning signs of airway narrowing so that you can use your inhaled medication immediately to head off a major attack. Asthma medications can be classified into two broad types: Rapid-acting and long-acting. Rapid-acting agents, such as inhaled bronchodilators, are used to prevent an impending attack. They are taken at the first sign of breathing trouble and work within minutes to open your airways. Long-acting medications, such as inhaled corticosteroids (‘steroids’), typically are taken daily to keep airway inflammation under control. Inhaled steroids are the mainstay of asthma control, and they have potent anti-inflammatory effects. Other types of long-
With the risks, of osteoporosis, it’s especially important to eat calciumrich foods, such as dairy products and to take calcium supplements.
Regular exercise, such as brisk walking and breathing exercises, are good for overall health and will help reduce the risk of osteoporosis.
acting medications may be added if your asthma is difficult to control. Inhaled corticosteroids are very effective, but they have two types of side effects. The first type is local. Breathing medication in through the mouth can result in an accumulation on the back of the throat, which can cause a sore throat or hoarseness. But learning proper inhaler technique and rinsing the mouth afterward can minimize these problems. The other side effects are systemic and can occur when a small amount of the steroid gets into the bloodstream. Over time, osteoporosis, cataracts, and thinning of the skin are all possibilities, but the benefits far exceed the risks. We want to use as little of the drug as possible to get the good effects without getting the bad side effects. With the risk of osteoporosis, it’s especially important to eat calcium-rich foods, such as dairy products, broccoli, turnip greens, salmon, and sardines and to take calcium supplements. The suggested total calcium intake for those at risk of developing osteoporosis is at least 1,500 mg per day. Increasing your fluid intake will help thin the mucus in your lungs and reduce asthma symptoms. Regular exercise, such as brisk walking and breathing exercises, are good for overall health and will help reduce the risk of osteoporosis. Your doctor may recommend that you use your inhaler before you exercise. Late-life asthma can be a serious condition, but it is highly treatable. It’s important to recognize the symptoms, get an accurate diagnosis, and then stick to your individualized treatment programme.