Dealing with asthma

Dr Douglas Street, Contributor

Bronchial asthma is a fairly common illness, and despite advances in the types of treatment and knowledge of how best to use these treatments, the number of cases continues to rise, and people still die from it.

We all should take it seriously as we probably all know someone with it - a friend, colleague, or even a family member.

Asthma is an incurable condition and there is no specific cause for it. As with most chronic illnesses, there are genetic and environmental factors which contribute to its development. Asthma is an atopic (allergy-related) condition like eczema, allergic rhinitis, allergic conjunctivitis, and food and medicinal allergies. These conditions tend to run in families. It is more common in boys than girls, but the prevalence evens out in adulthood.

In asthma, the small airways in the lungs are narrowed by contraction of the muscle surrounding them, excessive production of thick mucus, and the swelling of the walls of the airways from inflammation.

SYMPTOMS

The symptoms of asthma include wheezing, coughing, shortness of breath, chest tightness, and use of accessory respiratory muscles (breathing muscles that are not usually used). The wheezing is usually reversible (either on its own or with asthma treatment), and is usually worse at nights and early morning, during exercise, inhalation of cold air, and with heartburn.

Other triggers include smoke, dust, chemicals in air and food, cockroaches, mould, respiratory tract infections (like the cold), strong emotions (positive/negative), pollen, some medications (like some painkillers and anti-hypertensives), and furry animals.

Diagnosing asthma can be tricky as it may not have all the features that are checked for. It usually starts at around two years old and isn't usually diagnosed before that, except under unusual circumstances.

It can develop at any stage of life, though. It is often confused with other conditions such as panic disorder, emphysema, and congestive cardiac failure. The pattern of past symptoms is important in making the diagnosis. Repeated assessments over time, with a device called a peak flow meter, may also help.

A family history of allergic conditions is very suggestive of asthma when the symptoms are present. Having an episode of wheezing doesn't necessarily mean you have asthma. For diagnosis, the symptoms must be recurrent and respond to asthma treatments.

Asthma treatments usually either aim to relieve the symptoms of an attack, or prevent them. Most asthmatics need both types for optimal control in varying combinations.

Dr Douglas Street is a general practitioner and has private practices at Trinity Medical Centre, Trinity Mall at 3 Barnett Street in Montego Bay, and Omega Medical Centre at Plaza de Negril, Negril. Send feedback to drdougstreet@yahoo.com.