Asthma is a widespread disease and millions of people across the globe suffer from this ailment. In simple words, asthma may be portrayed as a reversible impediment of the lungs air passages attributable to either mucus blocking or muscle contraction or both. People suffering from chronic or persistent asthma may experience their airways narrowing down physically owing to scarring. The latest approach to treating asthma focuses on averting this type of alteration of the patient’s airways.
Wheezing is known to be the most common attribute, but not a widespread symptom of asthma. In fact, most people who suffer from asthma wheeze, producing a faint whistle, something akin to a musical note, while they breathe out. The other symptoms of this ailment include shortness of breath, coughing, pulling up mucus from the respiratory tract and a sensation of constriction in the chest.
It may be noted here that the air passages of the lungs are akin to the boughs of a tree – precisely speaking, an upturned tree. The air inhaled travels through the principal trunk of the tree, actually, the trachea, which is also known as the windpipe, into two major branches (read, the left and right bronchi) to enter the lungs. The bronchi are comparatively big tubes, which again sub-divide into smaller and even minor branches. The smallest of these branches is known as the bronchioles and they connect to a bunch of minute sacs in the lungs, which are known as alveoli. Each lung encloses millions of such alveoli and these alveoli help in passing on the air they carry to the blood. This way oxygen enters our blood, while carbon dioxide is eliminated and breathed out.
The most characteristic response of asthma involves the constriction of the lung muscle tissues enveloping the little breathing tubes, an increase in the production of mucus in the lining of the cells, and inflammation and swelling of the bronchial walls. Occasionally, the mucus develops small plugs that congest the airways of the lungs and even assume the form of the air passages. As these mucus plugs are coughed up, they look like small pieces of string or rope, whose size may vary from the width of spaghetti to the diameter of a pencil.
As such things take place, the usual flow of air is decreased and especially exhalation or breathing out remains deficient. This, in turn, gives rise to a feeling of dyspnea (difficult breathing) and at times it also results in a sensation that the individual is unable to breathe at all. It may be noted here that the word ‘asthma’ has been derived from the Greek term denoting ‘breathlessness’ or ‘panting’. An asthma attack may erupt anytime during the day or night. There are several asthma patients who wake up in the morning hours of the day enduring trouble in breathing.
Even to this day scientists and doctors have not been able to completely comprehend the fundamental mechanisms and functioning of an asthma attack. However, several types of research hint that the mucous membrane cells in individuals who are prone to asthma may possibly not be a compactly packed as is the case with normal people. This, in effect, enables allergens as well as other molecules to get through the membrane to reach the location of the mast cells. When this happens, the mast cells may possibly discharge chemical mediators, such as histamine, resulting in the symptoms of asthma.
Asthma patients also suffer from an insufficient supply of a chemical substance known as CAMP (cyclic adenosine-3′,5′-monophosphate). CAMP occurs naturally in the cells of our body and it works to thwart constriction or tightening of the lung muscles. Additionally, this chemical also slows down the inclination of the mast cells to discharge histamine as well as other chemical mediators which result in inflammation and allergic reactions, counting production of mucus.
One hypothesis regarding the cause of asthma, says that individuals who have a tendency to develop this ailment are generally influenced by the malfunctioning of one section of their nervous system. The autonomic nervous system, which actually controls the organs of our body, is divided into two differing sub-systems – the sympathetic system and the parasympathetic system. These two sub-systems in the autonomic nervous system act opposite to each other and, therefore, ought to balance one another. For instance, while one inhibits the heart, the other makes it beat faster; one clears the airways to the lungs while the other blocks them and the list continues. The sympathetic nervous system encloses the purported beta-adrenergic receptors that react to stimulation by epinephrine or adrenaline and helps to unwind the airways as well as augmenting the supply and levels of CAMP in the lungs. It is thought that in an asthma patient these beta-adrenergic receptors may possibly not work appropriately, enabling the opposing reaction of the parasympathetic nervous system. In other words, it denotes that when the beta-adrenergic receptors do not function in the right manner, the parasympathetic nervous system may cause the lungs airways to constrict unhindered and unrestricted.
In order to control asthma, it is essential to keep inflammation under control. In effect, inflammation can be described as a usual physical response to any shock or stress, a reaction that can normally be cured. However, at times and in some cases, inflammation may result in acute problems. The most common types of inflammation may include swelling or distension, reddishness and the pain that accompanies them, for instance like a cut on the hand by a knife or too much exposure to the sun. Although inflammation may be extremely excruciating for a couple of days, it is actually an essential part of the curative process.
Injury to the skin tissue prompts specific cells to release chemical substances that employ inflammatory cells to dash to the injured area and start the healing process. The curative or healing process entails growth of new tissue, frequently with scarring. Inflammation in the lungs air passages, as in the case of asthma, is definitely an unwarranted type of tenderness and/ or swelling. This process initiates ignoring the lining of the cells in the air passages. In this case, a substance produced by the body for the formation of scar and other purposes and called collagen is set down the length of the exterior surface of the airways. In addition, edema or swelling also has an adverse impact on the airways as well as the adjoining tissues.
The mast cells are liable to such reactions. In effect, the mast cells have a vital role in the actions of the immune system as well as a range of white blood cells. Precisely speaking, the white blood cells mentioned here include neutrophils, particularly in the case of acute asthma, eosinophils, which are concerned with allergic as well as associated reactions, and perhaps the TH2-type lymphocytes.
It may be noted here that apart from asthma, there are several other diseases where inflammation has a role. For instance, hepatitis entails inflammation of the liver, rheumatoid arthritis denotes inflammation of the joints, and diabetes may have its roots in inflammation that harms the pancreas. In fact, inflammation is also related to heart attack and the stroke that follows. Precisely speaking, inflammation as well as swelling during the initial 48 hours after a heart attack is vital to the consequences.
When an individual suffers from asthma, inflammation of the lungs air passages makes these airways oversensitive to any type of exasperation and they are likely to narrow down as well as reduce the flow of air into the lungs. In addition, swelling of the air passages as well as the production of mucus not only block the airways but also reduce the flow of air into the lungs. What is of most importance is the fact that scarring may actually alter the arrangement of the airways making matters worse.
Whether treating asthma patients with anti-inflammatory medicines is effective in avoiding detrimental scarring and altering of the lungs airways is among the most important areas of research being done currently in the field of asthma. When a comparison is made with the treatment of other ailments that are related to inflammation, we get an indication that it is possible to treat asthma by giving anti-inflammatory medication to the patients suffering from this ailment. If we are able to keep inflammation under control, it is possible to avoid the lungs air passages from being restructured.
Patients may suffer asthma attacks owing to a number of reasons. For instance, workouts, taking aspirin or non-steroidal anti-inflammatory medications, exposure to cold air, pollution of the environment, various irritants or odors, infection, smoking or exposure to cigarette smoke, and even laughing may trigger asthma attacks. In addition, asthma attacks may also be implicated to gastro-esophageal reflux (GERD), a quite widespread ailment wherein persistent symptoms or harm caused by the anomalous reflux in the esophagus, particularly among the aged people. When a person suffers from GERD, they experience acidic liquids from the stomach traveling into the esophagus, which results in the deterioration of asthma in some cases.
When the asthma attacks occur more often than not and generally affect elderly people, it may be diagnosed that the ailment is caused due to gastro-esophageal reflux. It may be noted that when such patients are lying down, the contents of the stomach can move more easily into the esophagus and this does not help in retaining the acidic fluid in the stomach. However, there is another cause for asthma attacks occurring during nights and this is even more common. In this case, the asthma attacks are a result of the functioning of the pulmonary system. While this type of asthma attack usually occurs during the night and also in the early mornings, it is usually overstated in asthmatics.
Often the symptoms of asthma may be mistaken for common cold, bronchitis or even hay fever. While exercise may result in the symptoms in the case of asthma patients, they may often think that this is occurring because they are terribly unhealthy. It is really unfortunate that when an asthma attack occurs while a person is doing any physical activity or soon after it, in most cases it is expected that the individual would be further dampened in his/ her efforts for undertaking measures for physical conditioning.
Often people do not call a doctor when they have an asthma attack and this is primary because often they confuse their health condition with other common ailments. Here are a few guidelines when you ought to seek medical help. For instance, if you notice any symptom of breathlessness, after a physical workout anytime, whether in the morning or in the middle of the night or you are wheezing, it is important for you to call your doctor right away. In addition, you should call a doctor if you are suffering from a chronic cough or coughing up phlegm, particularly if the mucus thrown out is bloody or discolored. Also, call your doctor if you experience any constriction or pain in the chest.
When a doctor notes down the medical history of such a patient, he ought to always ask the patient if he/ she had ever experienced such respiratory episodes earlier. In many cases, patients provide details of a history of recurrent ‘bronchitis’ during their growing up the stage. However, the doctor will ask the patient to undergo physical tests, CT scan, chest X-ray and other examinations before diagnosing whether the breathing problems are caused due to asthma, emphysema (a health condition wherein the air sacs of the lungs are harmed and distended, resulting in breathlessness), heart ailments, cystic fibrosis (especially in infants), lung tumor, infection, hypersensitivity pneumonia (a perilous and progressive health condition that affects the lungs in some instances of untreated allergy) or any other reason.
At times, during physical examinations, particularly with children, an enlargement of the chest is seen. This type of distension is caused by asthma. To be precise, the enlargement of the chest is primarily owing to the asthma patient’s inability to breathe out air properly from the lungs. When the physician has his/ her ear on the chest of the patient, they can also hear a wheezing sound. When the nose of such patients is examined, there is a likelihood of nasal polyps (plump puffiness that build up in the nose lining and paranasal sinuses) or proof of allergic rhinitis (a health condition marked by the congestion of the head, tearing, swelling and sneezing of the nasal mucous membranes, as a result of an allergic reaction).
Often the test of the functioning of the pulmonary system is vital in determining whether an individual is suffering from asthma. This examination generally helps in finding out whether the individual is facing difficulty in breathing out or exhaling air from the lungs. When the problem in breathing out or exhaling is cured following treatment with a bronchodilator, it almost becomes certain that the person is suffering from asthma. It may be noted here that people suffering from emphysema generally do not get much relief using a bronchodilator.
However, in case the diagnosis is still not obvious, the doctor may recommend a Mecholyl challenge test. This medical examination entails inhaling or breathing in augmented concentrations of methacholine while the doctor monitors the functioning of the pulmonary system. When the concentration is less than a specific concentration, people who are not suffering from asthma would not display any reaction. However, if the individual is suffering from asthma and some other specific health conditions, for instance, hay fever, they would start wheezing and their pulmonary system would exhibit decreased functioning.
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