What is Asthma? Symptoms, Causes, and Treatment Methods

Asthma is a non-communicable chronic respiratory disease. It is characterized by increased mucus production, muscle constriction, obstruction, and shortness of breath in the airways due to certain causes. It may be confused with other respiratory conditions or may not show symptoms for a long time. It usually develops in childhood but can manifest symptoms in adulthood. The frequency and intensity of symptoms can vary from person to person. While it may be quite mild for some, it can be a health problem that disrupts daily life for others. In severe cases, asthma attacks can cause life-threatening situations or lead to permanent damage. There is no known cure for asthma yet, but it is possible to alleviate and manage the findings.

What is Asthma?

Asthma is an inflammatory and chronic health problem that affects the airways. Inflammation in the airways can lead to bronchial hyperresponsiveness and airway obstruction. Muscles in the airways, encountering various triggers, constrict, fill with mucus, and swell. This condition can cause symptoms such as shortness of breath, wheezing, and coughing, leading to an asthma attack. Triggers can primarily include pollen, cold air, infections, and exercise. Furthermore, the severity of asthma can depend on genetic and environmental conditions. Asthma, which is one of the respiratory diseases, can be seen in every age group. It can be divided into different types depending on the causes of its emergence. Common types of asthma are as follows:

Allergic asthma: Asthma seen as a result of exposure to environmental allergens.

Non-allergic asthma: Asthma usually affected by factors other than allergens, such as environmental conditions and medications.

Occupational asthma: Asthma caused by non-allergic substances found in the work environment, such as gases, smoke, and aerosols.

Exercise-induced asthma: The type where airways become obstructed during exercise, creating asthma symptoms.

Asthma-COPD Overlap syndrome: A health problem seen as a result of a person developing both asthma and COPD at the same time. Just as COPD is not seen in every individual with asthma, asthma may not be seen in every individual with COPD.

Cough-variant asthma: In some asthma cases, the only symptom may be a cough, and this condition is explained as cough-variant asthma.

The 3 stages of asthma can be seen as mild, moderate, and severe clinical pictures. There is no definitive medical cure for asthma, but interventions for symptoms are possible.

What Are the Symptoms of Asthma?

Asthma symptoms can vary from person to person. While some individuals experience milder symptoms, others may experience severe ones. This can be explained in the form of asthma attacks. Asthma attacks can be triggered by certain situations such as exercise, stress, etc. However, they can also occur at any time in some individuals. Symptoms of asthma often include:

Wheezing while breathing,

Shortness of breath,

Coughing (often at night and early in the morning),

Chest tightness or pain,

Wheezing attacks that worsen with respiratory infections,

Sleep problems,

Tachycardia (palpitations),

Rapid and shallow breathing,

Difficulty speaking,

Discomfort when lying flat on the back.

Symptoms can recur within the same day or over time. In some cases, they can be triggered and worsened by viral infections such as the flu or the common cold. Situations requiring rapid breathing, such as cold air, exercise, running, laughing, or crying, can trigger symptoms. Symptoms may be severe in the morning and at night. Asthma can manifest differently in children than in adults. Increased reliance on medications, frequent waking due to attacks, and difficulty performing daily activities can indicate that asthma is worsening.

How Does Asthma Occur?

Although there is no single definitive source for asthma, it is thought that hereditary and environmental conditions play a role together. Many different factors can be effective in the development of asthma. A family history of asthma, a strong immune response to a new substance in the lungs during respiratory infections, and allergens can play a role in the development of asthma. Often starting with the shaping of the immune system in childhood, asthma may not show symptoms for years. These individuals may show symptoms in adulthood, which is called “adult-onset asthma.” Environmental exposures encountered during childhood and adulthood can be risk factors. These risk factors generally include:

Allergens such as pollen, pet dander, mites, mold spores, and foods,

Respiratory infections,

Physical activity,

Cold air,

Irritants such as chemicals, industrial dust, and smoke,

Stress and intense emotional states,

Obesity,

Gastroesophageal reflux disease (GERD),

Chronic sinusitis,

Certain medications such as NSAIDs,

Premature birth, low birth weight,

Use of or exposure to cigarettes and tobacco products during pregnancy,

Malnutrition and vitamin deficiencies during pregnancy.

Knowing the risk factors and the source of asthma can make it possible to prevent or alleviate asthma attacks.

How is Asthma Diagnosed?

Multiple tests and methods may be used during diagnosis. To reach a definitive diagnosis, medical history, family history, evaluation of symptoms, physical examination, lung function tests, imaging methods, and additional tests may be needed. The capacity of respiratory activities, the underlying cause of symptoms, and the frequency and severity of symptoms are evaluated. Common methods used during diagnosis include:

Spirometry: Measures how fast air is exhaled after taking a deep breath. Dizziness, fatigue, etc., may be felt during the test.

Peak flow meter (PEF): The test measures how hard air is exhaled with maximum effort. It can determine the obstruction status of the airways during certain activities.

Bronchodilator response test: Relaxing and opening the muscles in the airways is achieved with drugs called bronchodilators. The test measures how well air is exhaled as a result of bronchodilator use.

Methacholine challenge test: Inhaling methacholine, an asthma trigger, can lead to airway constriction. The response to methacholine can be effective in diagnosing asthma.

Allergy tests: Allergy tests performed via skin or blood are used to identify allergy triggers.

Blood tests: Measurement and evaluation of allergies, infections, white blood cells, etc., can be provided with blood tests.

Imaging tests: X-ray and computed tomography (CT) tests can determine airway thickening, the presence of infection, and structural anomalies.

Additionally, provocation tests, where airway activity is examined before and after exercise and cold air exposure, may be applied.

How is Asthma Treated?

Asthma treatment consists of practices aimed at managing symptoms and keeping the airways open. Since there is no definitive cure, avoiding trigger substances and alleviating symptoms are the methods resorted to. Asthma step therapy is applied in the management of mild, moderate, and severe asthma. A treatment plan is usually created based on the person's age and physiology, medical history, response to medications, and asthma severity. Medication use may be recommended for asthma attack treatment and prevention of attacks. During the treatment of allergic asthma in adults, symptom relief can be achieved with fast-acting medications. In mild asthma cases and attacks linked to exercise, fast-acting medications may be recommended. These are inhaler medications that should be carried at all times. Among fast-acting relievers, beta-2 agonists and anticholinergics can be effective in opening the airways, and orally taken corticosteroids can be effective in reducing swelling.

Long-term control medications can be used to prevent attacks. Various regulatory medications can be prescribed to reduce inflammation in the body, bring resistant asthma under control, reduce swelling, and keep the airways open. Mast cell stabilizers can be used to prevent swelling in the airways in environments where asthma triggers are present. Additionally, subcutaneous immunotherapy consists of vaccines that help minimize the body's response to allergens and is used within the scope of allergic asthma treatment. In some cases, your doctor may carry out multiple drug treatments together, and combination therapy may be necessary.

Frequently Asked Questions

Asthma can start at any age, but it may be more likely to begin in childhood when the immune system is still developing. In children with asthma, symptoms manifest by about age 5. Symptoms can be triggered by environmental conditions, genetic predisposition, and other stimuli, and medical intervention may be necessary. Asthma cannot be diagnosed directly with a lung film or X-ray, but they can be used to detect structural abnormalities that may cause problems in the respiratory tract, non-asthma diseases, and infections. Ruling out non-asthma diseases can be important for asthma diagnosis. The tests used in asthma diagnosis are primarily spirometry, peak flow meter, bronchodilator response test, methacholine test, and blood and allergy tests. In the frequently used spirometry test, the individual is seated and a clip is placed on their nose. After taking a deep breath, they blow hard into the tube connected to the spirometer device. Usually, 3 or more attempts can be made for consistent results. Asthma may not manifest the same way in children. At the same time, symptoms in the same child can vary over time. However, the most common symptoms caused by asthma can include frequent coughing fits, fatigue, rapid breathing, chest pain, loss of appetite and weakness, and irritability. Since asthma is a chronic disease, it lasts a lifetime. Asthma symptoms can appear spontaneously over time and disappear. However, they can also be seen at certain times and in certain environments every day. Asthma, which lasts a lifetime, may be mild when exposure to stimuli does not occur. Asthma, which is usually classified according to its source, has various subtypes. These can be divided into 6 classes: allergic asthma, non-allergic asthma, cough-variant asthma, occupational and exercise-induced asthma, and nocturnal (nighttime) asthma. Asthma treatment in children may include reliever medications used for immediate symptom relief. In addition to relievers such as short-acting bronchodilators, inhaled corticosteroids are long-term medications. Additionally, removing asthma triggers such as irritants and allergens from indoor environments can be effective in controlling asthma. Asthma is treated by a chest diseases specialist. However, family physicians, pulmonologists, allergy and immunology specialists, and internal medicine specialists are doctors who perform asthma examinations and diagnosis. The information that “asthma turns into COPD on its own” is incorrect, but the use of cigarettes and tobacco products along with asthma can cause an increase in the risk of developing COPD. Most individuals with asthma do not develop COPD, and most people with COPD do not have asthma. Still, in some cases, it is possible to have both asthma and COPD. This condition is called asthma-COPD overlap syndrome. In children, asthma-triggering substances can easily lead to inflammation in the airways. This can lead to severe and dangerous asthma attacks in some children. Asthma that cannot be brought under control and is not treated can lead to the restriction of school and daily activities, frequent hospitalizations, and permanent lung damage in children.

Asthma can significantly affect quality of life. If you are experiencing a persistent cough, shortness of breath, or chest tightness, you can contact Hisar Hospital Chest Diseases Specialists and make an appointment for an accurate diagnosis and your personalized treatment plan.

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