ASTHMA AND RESPIRATORY DISEASES
What is asthma?
Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of breathlessness (dyspnoea), 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. Symptoms can vary throughout the day, or week or month. [br]
When we breath, air flows in and out of our lungs freely, but in asthmatic patients inflammation makes the airways swollen and very sensitive to environmental conditions and changes. The airways tend to react strongly to certain inhaled substances. This is what happens during and asthma attack. When the airways react, the muscles around them tighten. This narrows the airways, causing less air to flow into the lungs. The swelling also can worsen, making the airways even narrower. Cells in the airways might make more mucus than usual. Mucus is a sticky, thick liquid that can further narrow the airways.[br]
Asthma is a chronic illness. However, with good treatment and management there is no reason why a person with asthma cannot live a normal and active life, go to school or to work.
What causes asthma?
Asthma occurs in response to one or more triggers especially when a subject predisposed to it, comes into contact with allergens or substances that irritate the airways.
According to various scientific studies, causes or triggers of asthma can be a genetic tendency towards respiratory diseases (increased frequency of the disease within a family with an history suggestive of allergy), allergies, female gender (hormonal changes), specific ethnic groups and obesity. However, a person who has some of the risk factors for asthma will not necessarily go on to develop it later on in life: a person susceptible to asthma who lives in a “risk-free” environment may indeed not ever manifest it. Hence, the importance of good hygiene and a healthy lifestyle, especially during childhood, avoiding exposure to second hand tobacco smoke along with less visible environmental pollutants and allergens.
Seasonal or perennial allergic rhinitis results from inflammation of mucous membranes due to an allergic reaction to inhaled allergens. Itchy nose, nose congestion and sneezing are common symptoms of allergic rhinitis. These symptoms are the way some people respond to outdoor or indoor inhaled allergens, including tree pollen, mould spores and mites, which start an inflammatory process of the nasal mucus. Rhinitis is more widespread than currently thought. Although allergic rhinitis is not considered a serious condition, it nonetheless can interfere with many important aspects of life and impair daily, work or school activities.
Asthma and allergic rhinitis
Subjects affected by allergic rhinitis should be constantly monitored since those with rhinitis are more likely to develop asthma than people without the condition. Various studies showed a close relationship between these two conditions and the evidence suggests that rhinitis is present in most people with asthma, including children, and usually precedes asthma by a few years. Rhinitis can therefore be considered as a sort of “indicator” of asthma.
Allergic conjunctivitis is inflammation of the conjunctiva (the membrane covering the white part of the eye) due, as for the rhinitis, to exposure to allergens chemical agents or infections. Ocular itching, eyelid swelling, tearing, photophobia, watery discharge, and foreign body sensation are its most common symptoms.
Atopic dermatitis is a type of chronic inflammation of the skin. Its symptoms are itchy, red, swollen, and cracked skin, xerosis (dry skin), and lichenification (leathery skin resulting from constant scratching and rubbing. The disease seems to result from a combination of genetic (hereditary) and environmental factors and involves an exaggerated response on exposure to certain environmental stimuli (atopy). Atopic eczema is often associated with other allergic diseases such as asthma, allergic rhinitis, urticaria (nettle rash) and food allergies.
Wheezing is a high-pitched whistling sound made while you breathe. Wheeze is a common presentation in young children aged between 2 and 6. About 30% of children who wheezed early, will go on to develop bronchial asthma but in around 60% of these children symptoms resolve within school age. A case-control study of 1.246 preschoolers divided up children into three categories: transient infant wheeze, atopic wheeze and non-atopic wheeze, on the basis of the relationship between lower respiratory tract infection (within the first 3 years of age) and subsequent development of asthma.
Respiratory manifestations of food allergy
Some people suffering from asthma, also get a type of allergic reaction to certain foods. Exposure to food allergens can trigger asthma attacks or symptoms such as coughing, chest tightness and difficulty in breathing.
A persistent cough (lasting for more than 15 days) or chronic cough (lasting over three to four weeks) may be caused by: a long-term upper respiratory tract infection (especially in young children), rhinosinusitis or sinusitis, bronchopneumonia or infections with atypical pathogens such as Mycoplasma pneumoniae, Chlamydia pneumoniae.