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Asthma

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Asthma

Asthma can be a very frustrating disorder. It affects so many people of all ages. There are many different types of asthma with many different symptoms. The way asthma affects one person may be very different from how it affects another person.
Etilology
Asthma is when your airways become narrow and inflamed. There’s extra mucus that is produced which makes it very difficult for someone to breath. Causes of asthma are unknown but heredity seems to play a role along with allergens and environmental factors. The strongest factor for developing asthma is Atopy, which is the genetic development of an IgE-mediated response to common aeroallergens. There happens to be two categories of asthma: allergic and idiosyncratic. With allergic asthma there is an antigen/antibody reaction on cells in the respiratory tract, which causes inflammation. Idiosyncratic asthma is a result from neurological imbalances in the autonomic nervous system. Asthma in people between the ages of 5 to 15 years usually have an allergic asthma and people that get asthma later in life are more likely to get idiosyncratic asthma. Mild asthma attacks are more common and the airways usually open up anywhere from a few minutes to a few hours. Severe asthma attacks are less common but they last longer and end up requiring immediate medical help.
Pathophysiology
Asthma is considered an airway disease. It can be classified physiologically as a variable and partially reversible obstruction to airflow. Pathologically there is an over development of mucus glands and thickened airways due to inflammation and scarring. There is also bronchospasm which is the narrowing of the lung’s airways due to the tightening of the smooth muscle. You may also have narrowing due to swelling caused by an immune response to allergens.
Signs & Symptoms There are many different signs and symptoms for asthma. Some symptoms include frequent coughing especially at night, wheezing, shortness of breath, chest tightness, pain or pressure. Other symptoms may include feeling very tired, grouchy or moody can also be symptoms of asthma. A sign of asthma can be a decrease or change in lung function as measured on a peak flow meter. An asthma attack is when bands of muscle surrounding the airways are triggered to tighten. During an attack, the lining of the airways become swollen and the cells that line the airway produce more and thicker mucus than normal. This is what actually causes the symptoms. Signs and symptoms of an asthma attack are wheezing severely, very fast breathing, coughing that won’t stop, difficulty talking, feelings of panic or anxiety, pale and sweaty face and blue lips or fingernails.
Diagnostic Tests When it comes to diagnosing asthma it can be difficult. Signs and symptoms can range from mild to severe and tend to be similar to other conditions, such as emphysema, early congestive heart failure, or vocal cord problems. Your doctor will do a physical exam and will ask you about your signs and symptoms. Your doctor will also probably do a test to determine how much air moves in and out when you breathe. This test is called a lung or pulmonary function test. Tests that measure your lung function are spirometry and peak flow tests. Another test that can help to diagnose asthma is a methacholine challenge test, which is inhaling methacholine which is known to trigger asthma. Your doctor may also do a nitric oxide test which measures how much nitric oxide measures how much nitric oxide you have in your breath, higher than normal levels would indicate that your airways are inflamed.
Treatment
Treatment usually involves learning to recognize your triggers and taking steps to avoid them, and tracking your breathing to make sure that your medications are working and keeping symptoms under control. Some medications for treatment are albuterol inhalers which are bronchodilators that help to open up the airway. Long-term control medications that need to be taken everyday are inhaled corticosteroids such as Flovent, leukotriene modifiers which are oral medications such as Singulair and Zyflo. Some other medications include LABA’s which are inhaled medications and normally combined with combination inhalers such as Advair and Symbicort. Some people may even have to take a daily pill called Theophyline which helps to keep the airways open. If people have allergy-induced asthma they may need to be on allergy medications or shots. Researchers have also been doing studies on vitamin D supplements and are finding that a deficiency in vitamin D has been linked to increased airway reactivity, worse asthma control, and lower lung functions. So it’s very important to make sure you are getting enough of this vitamin.
Prognosis
Even though asthma is usually chronic, it can occasionally go into remission. Long-term outlook depends on severity. With mild to moderate cases, asthma can improve within time and even become symptom free. Even with severe cases people may improve. However, in severe persistent cases, the wall’s structure of the airways can change and lead to irreversible problems in lung function. Death is very rare when it comes to asthma and most of asthma deaths could’ve been prevented. Asthma can be treatable but it’s very important to follow your doctor’s orders and to take your medications as directed.

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