Asthma: What are its risk factors and how to manage it?
In Australia, 1 in 9 people has asthma, totaling nearly 2.5 million people with a diagnosis of the disease. Each year the disease kills just under 450 residents and is twice as likely to affect indigenous as opposed to non-indigenous individuals. Because it varies a great deal in severity and is presented differently by everyone, it can be easy to misunderstand what asthma is, how it affects individuals, and how it can range from being a simple cough to landing individuals in the hospital on life-saving oxygen.
What is asthma?
A long-term lung condition, asthma is a respiratory condition where people have sensitive airways in the lungs, which react to certain products, triggers or circumstances. These reactants range from things within the air, such as particles which may be inhaled and passed through the lungs, to foods we may eat, to stress, or even asthma that is triggered by exercise over-exertion, pollution or a change in air temperature or air pressure.
When an individual is exposed to these triggers and reactants, they may experience a flare up. During this time, the muscles around the airway squeeze tight and become narrower, meaning the mucus that normally lines the lungs is higher in volume due to being confined to a smaller space. When this happens, the combination of the restricted airway and increased mucus makes it hard for the individual to breathe and hence presents with the typical symptoms of shortness of breath, tight chest, coughing and inability to get enough oxygen.
For some people, these flare ups occur over a short period of time, where they are exposed to the trigger and within an hour, are unable to breathe, or can occur over a period of several hours, where the build up of mucus and restriction of airway happens over a longer period of time. Regardless of the trajectory, it can have severe effects on the individual, and when it comes on quickly as an asthma attack, can be very debilitating. Although it cannot be cured it can be well managed, and most asthmatics have a well-monitored treatment plan which serves to minimize the effects of the disease and reduce their symptoms.
How does it present itself?
Asthma comes with a variety of symptoms, but for most people is some combination of these symptoms:
- breathlessness
- wheezing
- a tight feeling in the chest
- coughing
- excess mucus
Symptoms typically occur worse at night or first thing in the morning, or may be triggered by exercise or over exertion. Many people are also easily triggered by the cold and find their asthma is more severe in the winter. Typical day to day symptoms may be very minimal, with the occasional issues of coughing or wheeziness.
When an individual is having an asthma attack however, it usually begins with wheezing and coughing, and quickly turns to a tightness in the chest, shortness of breath, and in many cases the individual will severely struggle to breathe. Sometimes during an attack, one is able to self-manage and take the appropriate medication, but in severe cases, asthmatics often have to go to the hospital to receive oxygen and stronger medication to help them come back to normal breathing and reduce airway restriction.
How is it treated?
While there is no cure for asthma, as mentioned above, the majority of individuals who experience the disease have a system in place for managing their asthma, and for minimizing symptoms and its severe attacks. For most people, this looks like a combination of preventative and treatment specific drugs.
Leukotriene
Most people with asthma will take a daily drug, which acts as a preventative. It typically functions as a leukotriene inhibitor. Leukotriene are the chemicals which your body releases when you breathe in an allergen and they are responsible for causing a tightening in the airways, leading to shortness of breath, and eventually initiating a full blown attack. By keeping these chemicals at bay, it limits their ability to act on the allergen should the individual be exposed to it, and hence drastically reduces the risk of an asthma attack.
Inhalers
The other types of medications typically used by asthmatic individuals are fast acting drugs or inhalers, which are taken at the first signs of an asthma attack. These drugs are typically airway expanding medications which seek to reduce the constriction of the airways, thereby improving breathing and reducing the overall negative impacts of the attack.
While the treatment plan may be different for everyone, and will vary based on the severity of the disease within the individual, most people follow a similar plan to this. For those who develop asthma at a young age, it can take some time before doctors are able to work out a consistent and successful management protocol, but once it is in place, for most people, it is typically well managed with minimal issues.
What are the risk factors for developing asthma?
Asthma can develop at any age, but is the most common chronic disease among children, especially those who are regularly exposed to second hand smoke, or those who have a low birth rate, resulting in a compromised immune system. Most children first present symptoms around 5 years of age, which often appears as regular respiratory infections throughout early childhood. In addition, it is also more common in young boys due to the smaller size of a young male’s airway. It is also worth noting that in individuals who suffer from asthma, there is almost always a co-occurrence of allergies.
Hayfever
Researchers are not sure whether asthma leads to allergies, or allergies are the cause of asthma, but in over 25% of people who have hayfever, asthma is also present. In this particular incidence, this is large because the allergies reactions triggered by hayfever often lead to airway inflammation, and it is this airway inflammation, which characterizes asthma. As such the occurrence of hayfever is considered a risk factor for the development of asthma.
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Eczema
Furthermore, children who have skin conditions such as eczema are also at increased risk of developing asthma. In such condition, the reaction is as a result of the lungs being exposed to a foreign invader, or allergen, which elicits an immune response. In eczema, the same holds true, whereby, the skin is exposed to an invader, which elicits an immune response, which generates the typical rash, and skin discomfort as associated with eczema.
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Genetic Factors
In addition to the allergy connection with asthma, it is important to consider the genetic factor in the development of the disease. Researchers have found over 100 different genes, which are linked to asthma, many of which play roles in managing the immune system and inflammation within the body. These genetic factors may be interacting with environmental factors to produce asthma, and they may also be inherited from the parents, whereby three-fifths of all asthma cases are hereditary. To date, the extent of the role of genes within the development of such disease is not fully understood, and researchers continue to look for links to help better understand it and how to tease it apart at the root, so as to help individuals better treat their condition.
Environmental Factors
Finally, there is an increasing amount of research to support the role the environmental factors play in the development of asthma in individuals. Allergic reactions and asthmatic symptoms are often the result of, or easily triggered by air pollution, mold, fumes, chemicals, household cleaners and pesticides, and just the overall exposure to other airborne particles such as various gases or even severe smog. In individuals who are asthmatic, the airways are particularly sensitive to particles. And while these airborne chemicals may not start out as the trigger or allergen, in the original development of asthma, the more sensitized lungs can develop resistance against said particles, increasing its triggers and increasing the severity of the disease for the individual.
How can I reduce its severity?
In addition to being vigilant about one’s treatment and medication protocol, reducing exposure to air pollution, and common allergens, as well as engaging in regular exercise to keep the lungs healthy and engaged, is the best way to reduce asthma severity and outbreaks. While the diagnosis of it never comes with a cure, it does come with lots of ways to manage the disease to still live a comfortable, uninterrupted life, and is a great reminder of the importance of looking after our body and breathing in clean healthy air as much as possible.
Sources:
Asthma
Asthma Australia
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How eczema might lead to asthma?
