Asthma

Asthma also may be caused by hypersensitive bronchi or chronic lung disease resulting from smoking. Attacks in this type of asthma also may be triggered by environmental factors or other causes such as bacterial infections. Asthma also may occur in people with congestive heart failure or pulmonary edema (fluid in the lungs).

Attacks vary widely in duration, intensity and frequency. While milder cases are often more of a nuisance than a threat to health, prompt investigation and treatment are advisable if future complications are to be avoided. In typical cases, an attack comes on suddenly and is characterized by distressful efforts to exhale, and as air is taken in, there are spells of coughing and wheezing.

These attacks occur because of the abnormal reaction of the windpipe (trachea) and the bronchial tree to a precipitating stimulus, which constricts the airway passages in the following way: The smooth muscles go into spasmodic contractions; there is a swelling of the membranes that line the bronchioles, and the secretion of mucus increases. Because this bronchial mucus is abnormally sticky, coughing does not expel it, and it therefore plugs up the smaller air passages.

Since greater difficulty is experienced in breathing out than in breathing in, increasing amounts of stale air are retained as new breaths are taken. In a severe attack, this leads to a feeling of near suffocation. An attack may be brief or it may last long enough to demand emergency measures.

Causes of Asthma

Well over half a million people suffer from allergic asthma, and in a majority of cases, the specific and immediate cause cannot be identified. Where the disorder runs in the family, and especially when onset occurs in childhood, a particular allergen may be identified as the cause, thus simplifying and hastening treatment. Among the more common offenders are house dust, mold spores, dander from the hair or feathers of house pets, and dairy products, especially eggs and milk.

At any age, a first attack may occur as a result of a respiratory infection, strenuous exercise or other non-allergic factors such as sensitivity to cold air. For a significant number of adults, onset may occur because of exposure to occupational hazards, such as chemical fumes or other industrial air pollutants. Sensitivity to tobacco smoke is another major precipitating factor.

Much has been made of the role of emotional stress as a prime cause of the disorder, but most specialists now agree that in both children and adults, emotional complications are likelier to be a result of the condition rather than the cause.

Treatment of Asthma

While there is not yet a cure for asthma, more effective medications have recently become available that help control symptoms. When a particular substance has been identified as the cause of the disorder, treatment may involve desensitization by injection. Avoidance of the offending allergen is also recommended, but is often difficult, especially when a beloved pet, on-the-job pollution or very common substances, such as house dust, are involved. In these instances, drug therapy may be recommended as an alternative to life-style change. For all asthma patients, smoking should be avoided.

Drugs to treat Asthma

The most widely used preparations contain ingredients that act as bronchodilators, meaning they relax and widen the airways which link the windpipe and lugs. To treat severe attacks known to originate in an allergic response, an inhalant may be prescribed.

When these medications, separately or in combination, fail to produce the desired results of relaxing bronchiolar muscles, reducing inflammation and swelling of mucous membranes and loosening the obstructive plugs of viscous mucus a corticosteroid may be prescribed in aerosol form, so that it can be inhaled directly to the airways instead of being absorbed into the body, as would be the case with cortisone preparations taken by mouth or by injection. Steroid drugs should be used under close medical supervision and are usually reserved to treat the more severe asthmatics.

Breathing exercises and biofeedback techniques are among the more unconventional methods now being used to forestall attacks, minimize their unpleasantness and shorten their duration. However, to avoid falling victim to quackery, make sure these approaches are taught by recognized medical authorities.

Complications and Precautions

Untreated asthma can lead to emphysema, because the continued stretching of the bronchial sacs during attacks by accumulations of stale air can eventually enlarge the delicate tissues to the point where they lose their elasticity and cease to function. However, self-treatment is inadvisable and especially dangerous for older people who attribute their chronic shortness of breath to asthma when, in fact, they may be suffering from progressive heart failure. Anyone who experiences breathing difficulty should consult a doctor.

Summing Up

Asthma, especially if untreated, can be a disabling disease that afflicts both children and adults. Efforts should be made to identify precipitating causes, especially in children, because effective treatment is then easier to prescribe.

A variety of therapeutic approaches may be tried to control asthma; effective therapy usually involves combinations of treatments that may include drugs, avoidance of precipitating causes and desensitization shots. Although many people have the mistaken notion that asthma is an emotional disorder, this does not seem to be the case. However, asthma--like any chronic disease--can produce emotional problems that involve not only the victim but other family members as well. Emotional support, for both the patient and family members, is an important element in the overall treatment of asthma.