Asthma: Symptoms, Causes, and Diagnosis

Asthma is a condition when your airways become narrow and swell and start producing extra mucus. It makes breathing difficult, triggers coughing, and makes a whistling sound when you breathe out. Also, it might even cause shortness of breath. It is considered a minor condition by some people. However, those majorly affected by asthma find it difficult to carry on with their day-to-day activities. In addition, it may also prove to be life-threatening. 

According to the World Health Organisation (WHO), there were 262 million people affected by asthma in 2019. Unfortunately, for over 4.6 million people, the condition became fatal. 

Asthma is chronic and has no cure. Nevertheless, you can control its symptoms by bringing some changes to your lifestyle. However, it is imperative to consult your doctor and check the signs and symptoms because it changes over time. Hence the treatment can adjust according to your health status.

You need to understand your breathing patterns to get a grasp of asthma. Usually, air passes through your nose or mouth and your throat. It then goes through your airways and reaches your lungs. That is because your lungs are full of tiny air passages to ensure oxygen delivery from the air to the bloodstream. 

Asthma tightens the muscles of your airways. Excess mucus blocks the airways that do not let the required amount pass through. It can trigger an asthma attack which causes coughing and tightness in the chest.

Early Symptoms of Asthma

Early warning signs are the changes you experience at the beginning of an asthma attack. These are the earliest signs that your condition is worsening. People with asthma have obvious symptoms which resemble many respiratory infections.

• Chest tightness, pain, or pressure
• Coughing, especially at night
• Shortness of breath
• Wheezing
• Easily upset, irritable, or moody
• Changes in lung infection when measured on a peak flow meter.

When experiencing an asthmatic issue, you may not have all the above-stated symptoms. In addition, signs may vary at different times. The symptoms may also change between the attacks. Please note that these signs do not stop you from carrying on your daily activities. But by knowing them, you can stop or prevent them from getting worse.

It is likely to be asthma when:

• Happens often and keeps coming back
• Becomes worse at night and early in the morning.
• Occurs in response to a trigger like an exercise and allergies.

Symptoms of Asthma Attacks

When asthma worsens for a short time, it is an asthma attack. It happens suddenly or gradually over a few days. 

Signs of a severe asthma attack are many. For example:

• Severe and constant wheezing, which causes a whistling sound when you exhale. 
• Coughing (especially at night or early morning)
• Chest tightness
• Shortness of breath
• Fast heartbeats
• Drowsiness, confusion, exhaustion, or dizziness
• Blue lips or fingers
• Fainting

Causes and Triggers of Asthma

The exact cause of asthma is not known. However, asthma is often the result of a strong response of the immune system to a substance in the lungs. Normally, the body’s immune system helps to fight infections. Sometimes a person’s immune system responds to a substance in the environment called an allergen. When someone breathes in an allergen, such as ragweed, the immune system in the airways may react strongly. Other people exposed to the same substance may not react at all. The immune system reacts to an allergen by creating Inflammation. Inflammation makes your airways swell and narrow and possibly produce more mucus. This can make it harder to breathe. The muscles around the airways may also tighten, which is called a bronchospasm. This can make it even harder to breathe.

Over time, the airway walls can become thicker. The image below shows how airways narrow during asthma.

Given below are some of the most common triggers.

1. Tobacco Smoke

Tobacco smoke is hazardous for everyone. If you smoke and have asthma, quit it immediately before it is too late. Passive smoke is when another person inhales the smoke created by a smoker. It can trigger an asthma attack. So making your home a smoke-free zone is essential. People around you should also avoid it.

2. Dust Mites

Dust mites are microscopic bugs found in your homes. If you are allergic to dust mites, it can trigger an asthma attack. It will help if you use allergen-proof mattresses and pillowcase covers at your home. They act as a barrier between dust mites and you. Similarly, you should never have down-filled pillows, quilts, or comforters.

3. Other Triggers

• Outdoor air pollution
• Pests like cockroaches and mice
• Pet allergy

Diagnosis and Types of Asthma

To diagnose asthma, your doctor will need to know your medical history. Furthermore, he will perform a physical exam. A lung infection test and other tests such as a chest or sinus X-ray may also be required. If you have breathing problems regularly, you should contact a doctor right away. When you know what to expect, the diagnostic process becomes easy.

Common Ways to Diagnose Asthma

Personal and medical history: 

You need to answer some questions so that it becomes easy to understand your symptoms and their causes. You can make notes too. These questions are primarily related to observing your symptoms. If you have any signs that indicate asthma, you should be careful. In addition, you should make notes to understand the trigger points.

Physical exam: 

The doctor can conduct a physical exam on asthma. They will check your ears, eyes, nose, throat, skin, chest, and lungs. 

During the physical exam, your doctor may:

• Listen to your breathing and look for symptoms of asthma
• Look for allergic skin conditions, such as eczema

There are four lung function tests commonly used to diagnose asthma.

• Pulmonary function tests such as Spirometry
• Peak airflow
• FeNo tests or exhaled nitric oxide
• Provocation tests
• Allergy skin or blood tests

Types of Asthma

Based on its severity, there are four levels of asthma. The situation depends on how often you have symptoms and your lung function.

• Intermittent Asthma- Intermittent asthma is when you have symptoms less than twice a week and wake up less than two nights a month.
• Mild Persistent Asthma- Mild persistent asthma is when you have symptoms two or more days a week and wake up three to four nights a month.
• Moderate Persistent Asthma- Moderate persistent asthma is when you have symptoms at least every day and wake up one or more nights a week.
• Severe Persistent Asthma- Severe persistent asthma is when you have symptoms during the day and wake up every night due to asthma.

When to See a Doctor?

Home treatment may improve your symptoms and peak expiratory flow (PEF). However, if no changes occur due to home treatment, then emergency care becomes the need of the hour. Therefore, you should immediately follow the treatment plan you and your doctor make when asthma flares up. 

Checking Asthma Control Steps

Periodic adjustments in your treatment plan are routine as asthma symptoms change over time. If they do not get controlled in time, you can have an asthma attack. Lingering lung infection is a sign that asthma may flare up anytime. You should schedule a doctor’s appointment as soon as the symptoms change.

Situations of Emergency Medical Treatment

Emergency medical treatment is needed if you have these severe signs and symptoms.

• Severe breathlessness or breathing, especially at night or in the early morning
• The inability to speak more than short phrases due to shortness of breath
• Having to strain your chest muscles to breathe
• Low peak flow readings when you use a peak flow meter
• No improvement after using a quick-acting or rescue inhaler

Asthma Specialists

Here are some asthma specialists you should consider before following a treatment.

• Allergists are paediatricians or internists and specialists in allergy and immunology.
• An internist is a doctor with a specialisation in internal medicine.
• A paediatrician is a doctor with special training in caring for children from birth through college.
• Pulmonologists: They qualify as a specialist in respiratory diseases.
• Pulmonary Rehabilitation Therapist: Pulmonary Rehabilitation Therapist is a nurse or respiratory therapist. They can provide asthma support and information on exercise and asthma, lung function, and stress and asthma.

Risk Factors

Given below are the risks which may trigger a severe asthma attack.

• Severe asthma attack in the past
• Any incident of admission to the hospital or emergency room for asthma
• Previously required intubation for an asthma attack
• Using more than two-quick acting or rescue inhalers a month
• Your attack flares up even before you begin noticing the symptoms
• Other chronic health conditions, such as sinusitis or nasal polyps, or cardiovascular or chronic lung disease

Prevention of Asthma

There is no cure for asthma. But there are steps to control and prevent it. First, you need to cut your exposure to asthmatic triggers.

1. Identify Asthma Triggers

You should maintain an asthma diary to keep track of your symptoms. Notice all the environmental and emotional things that affect it. You can look at the log in case of an emergency to check the factors leading to it. Triggers like moulds and cockroaches are not obvious ones. You can consult an asthma specialist to identify the allergens.

2. Avoid Smoke of Any Type

Smoke and asthma are arch-enemies. Limit your exposure to any source of smoke. These might be tobacco, incense, candles, fires, and fireworks. Do not allow smoking in your home or car. You also need to avoid going to places that permit it. If you smoke, it is high time you quit it now. These arch-enemies worsen your health immensely.

3. Allergy-proofing Your Home

You can allergy-proof your environment and reduce the chances of an asthma attack when you’re at work, home, or even travelling. Avoid having food in restaurants that permit smoking. You should bring your bedding and pillows if possible. It is unhealthy for you to use feather pillows and down comforters supplied by the hotel.

4. Vaccinate Yourself

It would help if you got a flu shot once every year. If you contract the flu virus, it can worsen your asthma for days or weeks. It can further lead to complications like pneumonia. It can even cause hospitalisation. An adult over 19 should get a pneumonia shot called Pneumovax. One can take it once every 5 to 10 years.

5. Asthma Treatment

Prevention and long-term control are the keys to stopping asthma attacks before they start. The usual treatment involves learning to recognise your triggers. It also includes taking steps to avoid them and observing your breath. 

6. Medications

There are long-term and quick relief or rescue medications.

Long-term Asthma Control Medications

• Inhaled corticosteroids
• Leukotriene modifiers
• Combination inhalers
• Theophylline

Quick Relief or Rescue Medications

• Short-acting beta-agonists
• Anticholinergic agents
• Oral and intravenous corticosteroids

Allergy Medications

• Allergy shots or immunotherapy
• Biologics

7. Bronchial Thermoplasty

If severe asthma conditions do not improve with inhaled corticosteroids or other long-term asthma medications, doctors use this treatment. During the procedure, the doctor heats the airways in the lungs with the help of an electrode. As a result, it limits the ability of the airways to tighten.

Recommended Diet for People with Asthma

People with asthma should add the following foods to their diet:

• Vitamin D-rich foods
• Beta Carotene-rich Vegetables
• Magnesium-rich foods

Vitamin D

Research proves that vitamin D reduces asthma attacks in 6 to 15-year-old children. Some important sources of vitamin D are:

• Salmon
• Milk and fortified milk
• Fortified orange juice
• Eggs

Beta Carotene

Beta-carotene is considered an asthma superfood. It lowers rates of asthma and reduces lung inflammation or swelling. Some important sources of beta carotene are:

• Carrots
• Spinach
• Lettuce
• Tomatoes

Magnesium

Magnesium sulfate is known as a bronchodilator. It calms the bronchial muscles and expands the airways. Therefore, it allows more air to flow in and out of the lungs. Some important sources of magnesium are:

• Dark chocolate
• Avocados
• Nuts
• Legumes

Conclusion

Asthma is a lifestyle disease with no cure. It is chronic. So, there is no option but to keep it in check to live a harmonious life. Chest tightness, coughing, and shortness of breath are the early symptoms of asthma.

They may worsen and lead to faster breathing, drowsiness, and blue lips or fingers. Tobacco smoke, dust mites, and outdoor air pollution are common triggers. But remember, they vary individually.

Personal and medical history, physical exam, and lung function tests are the ways to diagnose it. Hence, you have grasped almost everything there is to know about it. It is time to bring some lifestyle changes not to affect you in the long run.