ASTHMA AND BRONCHOSPASM

ASTHMA AND BRONCHOSPASM

Definition of Asthma

Asthma is defined as a chronic (long-term) lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath,  and coughing. The coughing often occurs at night or early in the morning.  Meanwhile, bronchospasm or bronchial spasm is a sudden constriction of the muscles in the walls of the bronchioles. It is caused by the release (degranulation) of substances from mast cells or basophils under the influence of anaphylatoxins. It causes difficulty in breathing which can be very mild to severe. Bronchospasm is also a feature of asthma. In short, asthma is an example of respiratory disorder. 

Mechanism of Asthma

To understand asthma, we should know the mechanism of asthma. During breathing, the air inhaled through nose and mouth entered the respiratory passages. Then, the air entering the respiratory system passes through the trachea, then splits into bronchi, bronchioles, and finally enters tiny sacs called alveoli, where the exchange of gases takes place. Asthma is a disorder of obstruction to breathing due to inflammation and narrowing of the bronchiole tubes. Initially, the bronchiole tubes become inflamed and produced thick mucus. Later, the muscles surrounding these airways tighten and air cannot move freely. This is called bronchospasm. Bronchospasm causes the airway to narrow further. Chemical mediators and nerves in the bronchial tubes cause the muscles to constrict. Bronchospasm can occur in all humans and can be brought on by inhaling cold or dry air.The result is shortness of breath and the air moving through the tightened airway causes whistling sound known as wheezing. Asthma affects people differently. Each individual is unique in their degree of reactivity to environmental triggers. This naturally influences the type and dose of medication prescribed, which may vary from one individual to another.

Asthma is now the most prevalent chronic illness in children, affecting one in every 15. In North America, 5% of adults suffered asthma. In all, there are about 1 million Canadians and 15 million Americans who are afflicted with this disease. The number of new cases and the yearly rate of hospitalization for asthma have increased about 30% over the past 20 years. Despite the advances in treatment, asthma deaths among young people have doubled.

In patients with asthma, the chronically inflamed and constricted airways become highly sensitive, or reactive, to triggers such as allergens, irritants, and infections. Exposure to these triggers may result in progressively more inflammation and narrowing.

The combination of these three factors results in difficulty with breathing out, or exhaling. As a result, the air needs to be forcefully exhaled to overcome the narrowing, thereby causing the typical "wheezing" sound. People with asthma also frequently "cough" in an attempt to expel the thick mucus plugs. Reducing the flow of air may result in less oxygen passing into the bloodstream, and if very severe, carbon dioxide may dangerously accumulate in the blood.

Inflammation, or swelling, is a normal response of the body to injury or infection. The blood flow increases to the affected site and cells rush in and ward off the offending problem. The healing process has begun. Usually, when the healing is complete, the inflammation subsides. Sometimes, the healing process causes scarring. The central issue in asthma, however, is that the inflammation does not resolve completely on its own. In the short term, this results in recurrent "attacks" of asthma. In the long term, it may lead to permanent thickening of the bronchial walls, called airway "remodeling." If this occurs, the narrowing of the bronchial tubes may become irreversible and poorly responsive to medications. When this fixed obstruction to airflow develops, asthma is then classified in the group of lung conditions known as chronic obstructive pulmonary disease (COPD). Therefore, the goals of asthma treatment are: (1) in the short term, to control airway inflammation in order to reduce the reactivity of the airways; and (2) in the long term, to prevent airway remodeling.

Causes of Asthma

The causes of asthma are not well understood, and the rapid increase in asthma prevalence around the world is one of the biggest mysteries in modern medicine. Ten years ago, scientists thought that diesel exhaust and other pollutants might be causing the asthma epidemic. Now, they believe that the picture is more complex. Many scientists are examining the role of genetic factors in causing asthma, and researchers are also looking at how the immune system develops in early life.

People with asthma have chronic inflammation in their lungs, and airways that narrow more easily than those people without asthma in response to a variety of factors. Both genetic and environmental factors appear to play roles in asthma. New research suggests exposures early in life to things such as tobacco smoke, infections, and some allergens may be among the possible asthma causes. This includes allergens (such as dust mites, pollen, and cat and dog allergens), tobacco smoke, air pollution, exercise, strong emotional expressions (such as crying or laughing hard), chemical irritants, and certain drugs (aspirin and beta-blockers). Each person with asthma reacts to a different set of factors, and identification of these factors and how to avoid them is a major step for each individual in learning how to control their disease.

Cure for Asthma

With all the new findings on alternative medicine and natural remedies, you may wonder if there’s a natural cure for asthma. The reality? Presently, there is no cure for asthma. In fact, it’s highly advisable to avoid any asthma treatment or product -- natural or otherwise -- that claims to be a "cure" for asthma. That’s why some people don’t use inhaler, the chemical inhaled to relieve asthma attack, since it is believed to worsen the disease. Some natural therapies may help to manage symptoms of asthma. For instance, a negative response to emotional stress can cause an asthma attack. Some natural relaxation remedies like deep abdominal breathing, progressive muscle relaxation, guided imagery, and biofeedback can help relieve stress.

Other findings suggest that diet plays a role in alleviating asthma symptoms. For example, it’s thought that omega-3 fatty acids found naturally in high-fat fish such as salmon, mackerel, or cod enable the body to make more products that tend to decrease inflammation. Whether or not this may be of benefit to those with asthma is still unproven. Besides being filled with omega-3s, salmon has protein, calcium, magnesium, some carotenoids, and B vitamins. Vitamin B-6 helps to boost the immune system, which is important in preventing disease.

Drugs Effect and Medications for Asthma

Anti-inflammatory drugs, particularly inhaled steroids, are the most important treatment for most people with asthma. These lifesaving medications prevent asthma attacks and work by reducing swelling and mucus production in the airways. As a result, the airways are less sensitive and less likely to react to asthma triggers and cause asthma symptoms

Bronchodilators relieve the symptoms of asthma by relaxing the muscle bands that tighten around the airways. Short-acting bronchodilator inhalers are used to quickly relieve the cough, wheeze, chest tightness, and shortness of breath caused by asthma (they dilate or widen the bronchial tubes). These should not be used daily in the treatment of asthma. The most commonly prescribed short-acting bronchodilator is albuterol. However, albuterol only lasts for a few hours. If you need to use a short-acting bronchodilator more than twice a week, then your asthma is not optimally controlled. Ask your doctor about improving your asthma controller medication. Long-acting bronchodilators are often combined with inhaled steroids for long-term control of asthma symptoms or when someone has asthma symptoms daily and frequent nighttime awakenings despite treatment with a daily inhaled steroid alone. Long-acting bronchodilators are never used alone as long-term therapy for asthma. 

Asthma inhalers are the most common and effective way to deliver asthma drugs to the lungs. There are some combination asthma inhalers, which contain two different medications: an inhaled steroid and a long-acting bronchodilator. These combination asthma inhalers are popular due to their convenience, and the medications last for at least 12 hours.

Asthma attacks rarely happen without warning. Knowing the signs of a pending attack could help you prevent an asthma emergency. In fact, acting quickly could save your life. Asthma early warning signs are a lack of appetite, fatigue, headache, or coughing often precedes an asthma attack. Some people also experience trouble sleeping and feeling before an asthma attack. Besides that, presence of dark circles under the eyes and less tolerance for exercise are the other signs before asthma. Signs of an asthma attack vary from one attack to the next. One time there may be little or no coughing before an attack. The next time, there may be a persistent cough, especially at night. The cough is typically dry and hacking. A chronic or persistent cough that doesn't disappear after other cold symptoms have disappeared could point to asthma. The patients should avoid taking cough medicine. Cough medicine won't help the asthma.

Islamic Reflection

In conclusion, let’s us reflect, why does Allah made some people healthy and some people unhealthy. This is because, everyone is tested with different things. Some people are tested by Allah with disease like asthma. And those healthy people, they may be tested with other things such as wealth, children and various things. Therefore, we have to be grateful with what we have, and always be prepared by whatever Allah will test us.

REFERENCES:

1. http://www.naturalnews.com/028512_HRT_drugs_asthma.html

2. http://en.wikipedia.org/wiki/Asthma

3. http://www.medicinenet.com/asthma/article.htm

4. http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/

5. http://www.nlm.nih.gov/medlineplus/asthma.html

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7. http://www.webmd.com/asthma/guide/asthma-medications

8. http://www.mayoclinic.com/health/asthma-medications/AP00008

9. http://www.health.harvard.edu/fhg/updates/update1103c.shtml

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