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Wheezing, shortness of breath, beware of asthma ! This disease is a health problem caused by chronic inflammation of the bronchial tubes, causing patients to have difficulty breathing, chronic coughing, and a feeling of tightness in the chest. The risk of exacerbation increases when exposed to allergens or changes in the weather. To prevent and take care of your health effectively, you should understand the causes and how to take care of yourself to reduce the risk of exacerbation and be able to live a normal life.
Interesting facts about asthma
- What is asthma?
- What causes asthma?
- Asthma triggers
- How to initially observe symptoms
- Degree of symptoms and severity
- Is asthma dangerous or not?
- Diagnosis
- Treatment methods
- Is asthma curable?
- How to relieve an asthma flare-up
- Asthma prevention
What is asthma?
Asthma is a disease caused by chronic inflammation of the bronchial tubes. Patients often have wheezing, chronic coughing, shortness of breath, and chest tightness. Symptoms are related to triggers such as allergens, viral infections, changes in weather, exercise, etc. , which lead to acute exacerbations.
What is the difference between asthma and bronchitis?
It is the name of the same disease. Asthma is a chronic inflammatory disease of the bronchial tubes. Later, when there are wheezing symptoms, it is called asthma. In some patients with asthma, there may be no wheezing symptoms. Wheezing symptoms occur in patients with severe bronchial stenosis.
Are asthma and allergies the same?
Asthma is a disease caused by chronic inflammation of the bronchial tubes. Respiratory allergies are diseases caused by inflammation of the nasal mucosa, resulting in nasal congestion or runny nose . Both diseases are caused by triggers that are allergens in the air. However, the pathology of the disease occurs in different locations of the respiratory tract. Respiratory allergies are often associated with the development of asthma. Therefore, the two diseases are often found together.
What causes asthma?
Asthma is caused by chronic inflammation of the bronchial tubes, causing the bronchial walls to narrow or contract, allowing less air to enter the body. Patients experience wheezing, chronic coughing, shortness of breath, and chest tightness . Wheezing occurs in patients with severe bronchial stenosis.
- Dust mite allergens
- Cigarette smoke, smoke
- Certain types of exercise, such as swimming
- Air pollutants such as toxic gases
- Viral infection, colds, or respiratory infections
How to observe symptoms initially
- Symptoms include shortness of breath, difficulty breathing, difficulty breathing, chest tightness, and wheezing , and may present with only one of the above symptoms.
- Symptoms appear intermittently , usually occurring at night or early in the morning, or are associated with viral infections, allergens, cold weather, etc.
- When the doctor examines the respiratory system, he hears a whistling or wheezing sound.
- Have a history of allergic diseases such as allergic rhinitis, allergic dermatitis, or a family history of asthma or allergies.
- There are no clinical symptoms that suggest another disease.
- There was a response after at least 4 weeks of inhaled steroid therapy, indicating clinical symptoms consistent with asthma.
Degree of symptoms and severity
Assess the severity of symptoms before treatment based on initial symptoms.
- Level 1: Very mild, with less than 2 episodes of shortness of breath per month, no nocturnal symptoms, and normal lung function tests.
- Level 2: Mild severity, with shortness of breath less than 4-5 days per week, no nocturnal symptoms, and normal lung function tests.
- Level 3: Moderate severity: Shortness of breath almost every day, with nocturnal symptoms more than once a week.
- Level 4: Severe: Daily shortness of breath, more than once a week at night, abnormal lung function test results.
Assess the severity of the disease after treatment
It is recommended to assess the severity of asthma after receiving appropriate medication for at least 3-6 months. The severity of the disease can change with time and treatment, and is divided into:
- Mild disease means the disease is controlled with regular low-dose inhaled corticosteroids (low dose ICS) or inhaled ICS/ formoterol when an exacerbation occurs.
- Moderately severe disease means the disease is controlled with low to medium-dose inhaled steroids and long-acting bronchodilators (low to medium-dose ICS/LABA).
- Severe disease refers to a disease that requires the use of inhaled steroids and long-acting bronchodilators in high doses (high dose ICS/LABA) and the disease is still not well controlled, even though the drugs are used correctly and continuously.
Is asthma dangerous or not?
In cases of acute exacerbation and severe symptoms, it can be life-threatening because the bronchial tubes become narrowed or constricted, allowing less air to enter the body, resulting in reduced blood oxygen levels, respiratory failure, and death. It is necessary to receive treatment at the hospital quickly.
Diagnosis
In making a diagnosis, the doctor will rely on the patient’s history, clinical symptoms, physical examination, or lung function test. There is no single symptom or test that can provide a specific diagnosis. The doctor will make a combined assessment of the tests mentioned above. Asthma symptoms change over time, so each assessment may provide different results.
| Chest X-ray in asthma Most often, no obvious abnormalities are found. Therefore, doctors often use lung function tests. To help in diagnosis
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Treatment methods
Drug treatment is divided into two main groups:
- Controllers include inhaled steroids, which reduce inflammation in the airways, control asthma symptoms, and help reduce acute exacerbations. They are daily controllers.
- Reliever medications include inhaled steroids and short-acting bronchodilators, which are used only when symptoms flare up, commonly known as emergency inhalers.
Medication adjustment and dispensing should be under the supervision of a physician. Do not self-purchase or stop taking medication on your own. All asthma patients should receive regular control medication and symptom relief medication when symptoms flare up. Patients should use their inhalers in the correct way as instructed by their doctor, nurse, or pharmacist.
An example of a case that has been encountered is a 15-year-old male who came for treatment for recurrent asthma over a period of 1 year. He received a bronchodilator every time, but his asthma still recurred. When questioning the patient, it was found that he had bought the medicine himself without seeing a doctor, and had inhaled the medicine incorrectly. He only had one emergency medicine, which he bought for his own use. He had never received an inhaler to control his symptoms and use it at home.
The doctor adjusted the treatment by adding medication to control the symptoms and teaching the correct method of inhaling the medication. After that, the symptoms improved. The following month, the asthma flared up less and less. Until the following year, there were almost no flare-ups.
This case shows that the main problem of the patients is that some patients think that asthma can be self-medicated without seeing a doctor. In fact, a doctor should assess both before and after treatment. In addition, patients who do not use their inhalers correctly will continue to have recurring symptoms. If this can be fixed, the patients will respond to treatment more.
– Nonlapan Pitaksalee, MD clinic physician –
Is asthma curable?
This disease may not be curable, but it can be controlled to prevent recurrence. Patients who do not have recurrence can live their daily lives normally, but should be aware of risk factors that trigger recurrence. The goals of treatment include:
- Controlling symptoms of the disease The patient does not have shortness of breath during the day or at night. There is no use of emergency inhalers. The patient can do daily activities normally.
- Preventing future risks such as exacerbation of the disease, deterioration of lung function, and possible treatment side effects.
How to relieve an asthma flare-up
When a patient has an acute exacerbation , the patient must use an emergency inhaler to relieve symptoms immediately. It can be repeated 2-3 times. If the symptoms do not improve after inhaling the bronchodilator, the patient should go to the hospital as soon as possible for a doctor to assess the symptoms.
What should you do if you don’t have any medicine at that time?
Patients should immediately leave the area where the allergen or respiratory irritant may be present and take the patient to the nearest hospital or health care facility.
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Asthma prevention
- Avoid contact with allergens in your daily life, such as avoiding household dust, animal hair, pollen, etc.
- Professionals who have to come into contact with allergens should wear a mask and avoid direct contact with allergens.
- Quit smoking and e-cigarettes.
- Avoid certain medications or foods that may trigger an asthma attack. For example, if you have a food allergy, avoiding that food can help reduce asthma symptoms.
- Annual vaccination These include the influenza vaccine and the pneumonia vaccine.
summarize
Asthma is a health problem caused by chronic inflammation of the bronchial tubes, causing people to have difficulty breathing, shortness of breath, wheezing, chronic coughing, and chest tightness. Exacerbations often occur when exposed to allergens or changes in weather conditions, such as dust, pollen, viral infections, and cold air.
“Prevention and self-care are important to control symptoms. Avoid allergens, keep your home clean, stop smoking, and get vaccinated against related diseases. In addition, patients should use steroid inhalers regularly and always have emergency relief medication with them to deal with possible flare-ups.”
Reference documents
- Ish P,Malhotra N, Gupta N. GINA 2020 (Global Initiative for Asthma)
- Guidelines for diagnosis and treatment of asthma in adults for general practitioners and physicians in Thailand 2023, Thai Thoracic Society under Royal Patronage, Royal College of Physicians of Thailand
Hot Line 
Nonlapan Pitagsalee ,M.D.
General Practitioner
Last modified: 20/07/2024
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