Life Health Sciences – Science Rules it All

It is a condition resulting from chronic inflammation of airways and increased reaction of airways to certain agents; producing symptoms of wheeze(whistling sound), cough, tightness in the chest and dyspnoea (awareness of respiration that normally goes on without our notice). There is airflow obstruction due to narrowing of airways. In some people symptoms of asthma can be well controlled with medication while in others medication has less effect and disease progresses to irreversible obstruction of airways.
Prevalence
Asthma is most common in New Zealand, Australia and UK. In UK 7% of adult population and 15% of children have asthma. It is less common in Asian countries. The prevalence of asthma is increasing with time.
Factors causing asthma
There are genetic and environmental factors interact to cause asthma.

Genetic factors
Asthma is a family disease. The children more prone to allergies have more chances of having asthma at an early age. First degree relatives of asthmatics also have more chances of having asthma. People who become asthmatic at adult life are usually less prone to allergies. Possibly a genetic association between allergy and asthma exist and multiple genes are involved.
Environmental Factors
During early childhood, children get exposed to a number of indoor allergens in the carpet dust like mites, fungal spores, cockroach body parts and pet animal hair. Other household allergens include gases produced by gas cookers including Nitrous Oxide, Sulphur Dioxide and cigarette smoke. Outdoor allergens include nitrogen dioxide, sulphur dioxide, ozone, smoke from vehicle exhaust and pollens. Work related factors include resins, wood dust and other industrial dust.
Others factors related to asthma include drugs, infection, smoking and psychological factors.
Drugs like aspirin, beta-blockers and non-steroidal anti- inflammatory drugs can worsen or induce asthma in predisposed individuals. Bacterial and viral infections can also cause asthma. Smoking during pregnancy is considered to increase incidence of allergies for children. Anxiety and stress can also induce asthma attack in asthmatic people.
Symptoms
Wheeze, breathlessness, cough and sensation of tightness in the chest. Asthma occurs as episode due to exposure to allergens or infection in children. It can be persistent with continuous wheeze and breathlessness in adults.
Investigations

• Peak Expiratory Volume (PEV) is reduced in the morning and increases during day. Increase in PEV with bronchodilators.
• Blood tests show increase in number of eosinophils and IgG
• Pulmonary function tests including ratio PEV/ VC, FEV1 increases with bronchodilators.
• X-Ray Chest shows increased air in the lungs.
• Blood gas analysis for acute attack of asthma

Management
Education about disease and use of inhalers
Avoid factors that initiate the asthma
Drug treatment of chronic persistent asthma includes using bronchodilators and corticosteroids in inhaler form and add oral forms if inhalers are no sufficient.
Drug treatment of acute severe asthma includes oxygen inhalation, high doses of beta adrenoceptor agonist inhalers and systemic steroids.

Prognosis
Good for individual attacks, occasionally severe attack can be fatal if untreated. Remissions are common.

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