WORLD ASTHMA DAY
Uncovering Asthma Misconceptions
Asthma is a condition in which airways narrow, swell, and may produce extra mucus thus, makes difficult breathing, a whistling sound during breathing, and shortness of breath. Asthma is a major non-communicable disease affecting both children and adults. It is the most common chronic disease among children.
For some people, it is a minor whereas for others; it can be a major problem as it interferes with daily activities and may lead to a life-threatening attack.
It can't be cured, but symptoms can be controlled as asthma changes over time, it's important to follow up with a doctor to track signs and symptoms and adjust treatment accordingly.
Data of Asthma
- Worldwide, it is estimated that approximately 334 million people currently suffering from asthma, and 250,000 deaths are attributed to the disease each year.
- The prevalence of the disease is continuing to grow, and the overall prevalence is estimated to increase by 100 million by 2025.
- Approximately 25 million people in the U.S. have asthma. This equals about 1 in 13 people.
- About 20 million U.S. adults age 18 and older have asthma.
- Around 9.8% of female adults have asthma, compared to 6.1% of male adults.
- It is a leading chronic disease in children. Currently, there are about 5.1 million children under the age of 18 with asthma.
- Black children are nearly three times more likely to have asthma compared to white children.
- Around 8.4% of male children have asthma, compared to 5.5% of female children.
- According to the latest data published by W.H.O in 2018, Asthma Deaths in Nepal reached 4,434 or 2.66% of total deaths.
- The age-adjusted Death Rate is 22.69 per 100,000 population ranks Nepal 7 in the world.
Classification of Asthma
- Mild intermittent asthma: Mild symptoms less than twice a week. Night-time symptoms less than twice a month. Few asthma attacks.
- Mild persistent asthma: Symptoms three to six times a week. Night-time symptoms three to four times. Asthma attacks might affect activities.
- Moderate persistent asthma: Daily asthma symptoms. Night-time attacks five or more times a month. Symptoms may affect activities.
- Severe persistent asthma: Ongoing symptoms throughout day and night. You have to limit your activities.
- Family history (genetic)
- Gender (more common in males than females)
- Age (most common in children than adults)
- Allergens (pollen, dust, pets, and so on)
- Viral respiratory infections
- Air pollution, Smoking
- Occupational exposure (bakers, drug and detergent manufacturers, farmers, plastic and metal workers, woodworkers, millers and so on)
- Infections like sinusitis, colds, and the flu
- Allergens such as pollens, mold, pet dander, and dust mites
- Irritants like strong odors from perfumes or cleaning solutions
- Air pollution
- Tobacco and smoke
- Cold air or changes in the weather, such as temperature or humidity
- Gastroesophageal reflux disease (GERD)
- Strong emotions such as anxiety, laughter, sadness, or stress
- Medications such as aspirin
- Food preservatives called sulfites are found in things like shrimp, pickles, beer and wine, dried fruits, and bottled lemon and lime juices
Signs and symptoms
- Coughing, especially at night or in the morning
- Shortness of breath
- Trouble sleeping because of breathing problems
- Severe wheezing while breathing
- Very rapid breathing
- Chest pain or pressure
- Tightened neck and chest muscles, called retractions
- Difficulty talking
- Feelings of anxiety or panic
- Pale, sweaty face
- Blue lips or fingernails
Symptoms in children
Symptoms can vary from episode to episode in the same child.
- Coughing often, especially during play, at night, or while laughing. This may be the only symptom.
- Weakness or fatigue or pause to catch their breath while playing.
- Fast or shallow breathing.
- Chest pain or feels tight.
- Whistling sound while breathing.
- Seesaw motions in their chest because of trouble breathing.
- Shortness of breath
- Tight neck and chest muscles
- History taking related to any allergy, genetic, working area, and so on accordingly to find out the risk factors for developing asthma.
- Physical examination of the respiratory system thoroughly.
- Lungs Function test by spirometry (simple breathing test measures how much air you blow out and how fast).
- Peak flow to measure how well your lungs push out air.
- Methacholine tests involve using triggers or challenges to find out do you develop any symptoms or not.
- Exhaled nitric oxide test is used to rule out if the lungs or airways are inflamed or not by connecting a breathing tube to a machine that measures the amount of nitric oxide in breath, but levels could be high if airways are inflamed.
- Chest X-ray
- CT scan
- Allergy test by blood or skin.
- Sputum eosinophils
- Beta-2 agonists, ( salbutamol, salmeterol, formoterol and vilanterol)
- Anticholinergics, (ipratropium, tiotropium, aclidinium, and glycopyrronium)
General side effects of bronchodilators include:
- Trembling, particularly in the hands
- ough and dry mouth
- Muscle cramps
- Nausea and vomiting
- Inhaled corticosteroids: Commonly inhaled corticosteroids include
- Budesonide and formoterol
- Fluticasone and salmeterol
- Fluticasone and vilanterol
- Mometasone and formoterol
Oral and intravenous corticosteroids: Common oral steroids includes
General side effects of inhaled corticosteroids include
- Oral thrush, Hoarseness
- Weakness, Upset stomach
- Weight gain
- Mood or behavior changes
- Bone loss, Slow growth
- Eye change
- Leukotriene modifiers: Common leukotriene modifiers includes
General side effects of Leukotriene modifiers include
- Nausea & vomiting
Medication will probably control asthma, but some remedies at home might be helpful to minimize the symptoms.
- Avoid triggering factors i.e. GERD, cold, dust, and so on.
- Exercise regularly i.e. yoga, acupuncture, and biofeedback.
- Maintain a regular healthy weight.
- Do breathing exercises to ease symptoms so you need less medication.
- Balance diet and use of supplements like vitamin A, C, D and minerals and so on.
Diet and Nutritional requirements:
- Vitamin D-rich foods, such as milk and eggs.
- Beta carotene-rich vegetables, such as carrots and leafy greens.
- Magnesium-rich foods, such as spinach and pumpkin seeds.
Impact of certain foods and medicines (Foods to avoid)
- Sulfites are found in wine and dried fruits.
- Foods that can cause gas, include beans, cabbage, and onions.
- Artificial ingredients, such as chemical preservatives or other flavorings.
- Common allergens such as dairy products, shellfish, wheat, and tree nuts.
- Medicines such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Beta-blockers.
- Know triggers, and try to avoid them.
- Follow doctor’s instructions on taking medications.
- Keep track of conditions and learn the signs that might get worse.
- Avoid cold, smoke, alcohol, and allergens.
- Avoid such occupational situations that may lead to or aggravate the attack.
- Get vaccinated against COVID-19, flu, pneumonia, shingles, or whooping cough.
- Infectious diseases specialist
- Lung diseases (pulmonologist)
RN. Luswang Shrestha