Asthma

Asthma is a common respiratory condition described as a chronic inflammatory disorder that results in obstruction of airways. Asthma is a condition in which the airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) and shortness of breath. For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack. Asthma can't be cured, but its symptoms can be controlled.

An asthma attack occurs when the symptoms become severe. Attacks can begin suddenly and range from mild to life-threatening. In some cases, swelling in the airways can prevent oxygen from reaching the lungs. This means that oxygen cannot enter the bloodstream or reach vital organs. Therefore, people who experience severe symptoms need urgent medical attention. A doctor can prescribe suitable treatments and advise a person on the best ways to manage their asthma symptoms

Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

· Shortness of breath

· Chest tightness or pain

· Wheezing when exhaling, which is a common sign of asthma in children

· Trouble sleeping caused by shortness of breath, coughing, or wheezing

· Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is probably worsening include:

· Asthma signs and symptoms that are more frequent and bothersome

· Increasing difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter)

· The need to use a quick-relief inhaler more often

For some people, asthma signs and symptoms flare up in certain situations:

·Exercise-induced asthma, which may be worse when the air is cold and dry

·Occupational asthma, triggered by workplace irritants such as chemical fumes, gases, or dust

·Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander)

It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and inherited (genetic) factors.

Asthma triggers

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

· Airborne allergens, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste

· Respiratory infections, such as the common cold

· Physical activity

· Cold air

· Air pollutants and irritants, such as smoke

· Certain medications, including beta-blockers, aspirin, and Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)

· Strong emotions and stress

· Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer, and wine

· Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

There’s no single test or exam that will determine if you or your child has asthma. Instead, your doctor will use a variety of criteria to determine if the symptoms are the result of asthma.

The following can help diagnose asthma:

• Health history. If you have family members with a breathing disorder, your risk is higher. Alert your doctor to this genetic connection.
• Physical exam. Your doctor will listen to your breathing with a stethoscope. You may also be given a skin test to look for signs of an allergic reaction, such as hives or eczema. Allergies increase your risk of asthma.
• Breathing tests. Pulmonary function tests (PFTs) measure airflow into and out of your lungs. For the most common test, spirometry, you blow into a device that measures the speed of the air.

Doctors don’t typically perform breathing tests in children under 5 years of age because it’s difficult to get an accurate reading. Instead, they may prescribe asthma medications to your child and wait to see if symptoms improve. For adults, your doctor may prescribe a bronchodilator or other asthma medication if test results indicate asthma. If symptoms improve with the use of this medication, your doctor will continue to treat your condition like asthma.

There is no cure for asthma, but symptoms can be controlled with effective asthma treatment and management. This involves taking your medications as directed and learning to avoid triggers that cause your asthma symptoms. Your allergist will prescribe the best medications for your condition and provide you with specific instructions for using them.

Medications

The right medications for you depend on several things — your age, symptoms, asthma triggers, and what works best to keep your asthma under control.

Preventive, long-term control medications reduce the swelling (inflammation) in your airways that leads to symptoms. Quick-relief inhalers (bronchodilators) quickly open swollen airways that are limiting breathing. In some cases, allergy medications are necessary.

Physiotherapy treatment

Asthma is a chronic disease that requires treatment and management. Although a cure is not known but physiotherapy treatment can play an important role in:

· Control the symptoms of asthma and prevent further aggravation

· Remove excess sputum and maintain a normal breathing pattern

· Prevent the occurrence of asthmatic attack

· Keep pulmonary function as normal as possible

Breathing exercise

Diaphragmatic breathing exercises and pursed-lip breathing techniques are widely used in asthma to prevent breathing abnormalities. It will increase air redistribution to the lungs, maximize oxygenation, and relieve dyspnea.

Pursed lip breathing – this technique prevents the trapping of air into the lungs. It enhances the distribution of air in all lobes of the lungs and reduces the difficulties of breathing. The patient should be comfortable in the position. The patient should breathe in through the nose and breathe out through the mouth as pursed-lip or whistling. It creates vibrations of the air which cause positive back pressure and maximizes oxygenation.

Removal of secretions

There are various techniques available for mobilizing and removing secretions. Percussions, vibrations, huffing, and shaking techniques are used to mobilize the secretion and move these secretions to central airways to evacuate them. Postural drainage, suctioning and coughing techniques are used to remove mobilized secretions. Active cycles of breathing and autogenic drainage are also used for this purpose.

Posture

The patient should be in tripod position while asthmatic attack. Both hands should be on the ground with a wide base and the neck should be in forwarding flexion. It relieves breathing difficulties. Chest expansion exercise also improves air redistribution and oxygenation.

Breathing control techniques

This technique maintains a normal carbon dioxide level, eliminate hyperventilation of the lungs through breath control, and breathe holding.

The above-stated technique management helps to eliminate hyperventilation of lungs, reduces the use of bronchodilator and anti-inflammatory drugs, air trapping, and dyspnea. It also improves the quality of life.