Asthma is a common long-term inflammatory disease of the airways of the lungs. Asthma is thought to be caused by a combination of genetic and environmental factors.
There is no cure for asthma. Inasthma and respiratory pain, million people globally had asthma, up from million in Asthma is characterized by recurrent episodes of wheezingshortness of breathchest tightness, and coughing.
A number of other health conditions occur more frequently in those with asthma, asthma and respiratory pain, including gastro-esophageal reflux disease GERDrhinosinusitisand obstructive sleep apnea. Asthma is caused by a combination of asthma and respiratory pain and incompletely understood environmental and genetic interactions.
Exposure to indoor volatile organic compounds may be a trigger for asthma; formaldehyde exposure, for example, has a positive association.
There is an association between acetaminophen paracetamol use and asthma. Asthma is associated with exposure to indoor allergens. The hygiene hypothesis attempts to explain the increased rates of asthma worldwide as a direct and unintended result of reduced exposure, during childhood, to non-pathogenic bacteria and viruses.
Use of antibiotics in early life has been linked to the development of asthma. Family history is a risk factor for asthma, with many different genes being implicated. Even among this list of genes asthma and respiratory pain by highly replicated studies, results have not been consistent among all populations tested. Some genetic variants may only cause asthma when they are combined with specific environmental exposures.
Endotoxin exposure can come from several environmental sources including tobacco smoke, dogs, and farms. A triad of atopic eczemaallergic rhinitis and asthma is called atopy. There is a correlation between obesity and the risk of asthma with both having increased in recent years. Beta blocker medications such as propranolol can trigger asthma in those who are susceptible. Some individuals will have stable asthma for weeks or months and then suddenly develop an episode of acute asthma.
Different individuals react to various factors in different ways. Home factors that can lead to exacerbation of asthma include dustanimal dander especially cat and dog haircockroach allergens and mold.
Both viral and bacterial infections of the upper respiratory tract can worsen the disease. Asthma is the result of chronic inflammation of the conducting zone of the airways most especially the bronchi and bronchioleswhich subsequently results in increased contractability of the surrounding smooth muscles. This among other factors leads to bouts of narrowing of the airway and the classic symptoms of wheezing.
Asthma and respiratory pain narrowing is typically reversible with or without treatment. Occasionally the airways themselves change. Other cell types involved include: T lymphocytesmacrophagesand neutrophils. There may also be involvement of other components of the immune system including: Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms. Obstruction of the lumen of a bronchiole by mucoid exudate, goblet cell metaplasiaand epithelial basement membrane thickening in a person with asthma.
While asthma is a well-recognized condition, there is not one universal agreed upon definition. The chronic inflammation is associated with airway hyper-responsiveness that leads to recurrent episodes of wheezing, breathlessness, asthma and respiratory pain tightness and coughing particularly at night or in the early morning.
These episodes are usually associated with widespread asthma and respiratory pain variable airflow obstruction within the lung that is often reversible either spontaneously or with treatment". There is currently no precise test for the diagnosis, which is typically based on the pattern of symptoms and response to therapy over bacon and cholesterol. Spirometry is recommended to aid in diagnosis and management.
It however asthma and respiratory pain be normal in those with a history of mild asthma and respiratory pain, not currently acting up.
The methacholine challenge involves the inhalation of increasing concentrations of a substance that causes airway narrowing diabetes and strong immune system those predisposed.
If negative it means that a person does not have asthma; if positive, however, it is not specific for the disease. Other supportive evidence includes: It may be useful for daily self-monitoring in those with moderate to severe disease and for checking the effectiveness of new medications.
It may also be helpful in guiding treatment in those with acute exacerbations. Asthma is clinically classified according to the frequency of symptoms, forced expiratory volume in one second FEV 1and peak expiratory flow rate. Although asthma is a chronic obstructive condition, it is not considered as a part of chronic obstructive pulmonary diseaseas this term refers specifically to combinations of disease that are irreversible such as bronchiectasischronic bronchitisand emphysema.
An acute asthma exacerbation is commonly referred to as an asthma attack. The classic symptoms are shortness of breathwheezingand chest tightness. Signs occurring during an asthma attack include the use of accessory muscles of respiration sternocleidomastoid and scalene muscles of the neckthere may be a paradoxical pulse a pulse that is weaker during inhalation and stronger during exhalationand over-inflation of the chest, asthma and respiratory pain.
Acute severe asthmapreviously known as status asthmaticus, asthma and respiratory pain, is an acute exacerbation of asthma that does not respond to standard treatments of bronchodilators and corticosteroids.
Brittle asthma is a kind of asthma distinguishable by recurrent, asthma and respiratory pain, severe attacks. Type 2 brittle asthma is background well-controlled asthma with sudden severe exacerbations. Exercise can trigger bronchoconstriction both in people with or without asthma. Asthma as a result of or worsened by workplace exposures is a commonly reported occupational disease.
A few hundred different agents have been implicated, with the most common being: The employment associated with the highest risk of problems include: Alcohol may worsen asthmatic symptoms in up to a third of people. There is negative skin test to common inhalant allergens asthma and respiratory pain normal serum concentrations of IgE.
Often it starts later in life, and women are more commonly affected than men. Usual treatments may not work as well. Many other conditions can cause symptoms similar to those of asthma. In children, asthma and respiratory pain, other upper airway diseases such as allergic rhinitis and sinusitis should be considered as well as coumadin and black cherry supplements causes of airway obstruction including foreign body aspirationtracheal stenosislaryngotracheomalaciavascular ringsenlarged lymph nodes or neck masses.
In both populations vocal cord dysfunction may present similarly. Chronic obstructive pulmonary disease can coexist with asthma and can occur as a complication of chronic asthma. After the age of 65, most people with obstructive airway disease will have asthma and COPD. In this setting, asthma and respiratory pain, COPD can be differentiated by increased airway neutrophils, abnormally increased wall thickness, and increased smooth muscle in the bronchi.
However, this level of investigation is not performed due to COPD and asthma sharing similar principles of management: The evidence for the effectiveness of measures to prevent the development of asthma is weak.
Early pet exposure may be useful. Dietary restrictions during pregnancy or when breast feeding have not been found to be effective and thus are not recommended. While there is no cure for asthma, symptoms can typically be improved. This plan should include the reduction of exposure to allergens, testing to assess the severity of symptoms, and the usage of medications. The treatment plan should be written down and advise adjustments to treatment according to changes in symptoms. The most effective treatment for asthma is identifying triggers, such as cigarette smokepets, or aspirinand eliminating exposure to them.
If trigger avoidance is insufficient, the use of medication is recommended. Pharmaceutical drugs are selected based on, among other things, the severity of illness and the frequency of symptoms. Specific medications for asthma are broadly classified into fast-acting and long-acting categories. Bronchodilators are recommended for short-term relief of symptoms. In those with occasional attacks, no other anemia and skin allergies is needed.
If mild persistent disease clindamycin and enteroccocus present more than two attacks a weeklow-dose inhaled corticosteroids or alternatively, an leukotriene antagonist or a mast cell stabilizer by mouth is recommended. For those who have daily attacks, asthma and respiratory pain, a higher dose of inhaled corticosteroids is used.
In a moderate or severe exacerbation, corticosteroids by mouth are added to these treatments. People with asthma have higher rates of anxiety and depression. Avoidance of triggers is a key component of improving control and preventing attacks.
The most common triggers include allergensasthma and respiratory pain, smoke tobacco and otherair pollution, non selective beta-blockersand sulfite-containing foods. Medications used to treat asthma are divided into two general classes: Medications are typically provided as metered-dose inhalers MDIs in combination with an asthma spacer or as a dry powder inhaler.
The spacer is a plastic cylinder that mixes the medication with air, making it easier to receive a full dose of the drug. A nebulizer may also be used, asthma and respiratory pain. Nebulizers and spacers are equally effective in those with mild to moderate symptoms.
However, asthma and respiratory pain, insufficient evidence is available to determine whether a difference exists in those with severe disease. Long-term use of inhaled corticosteroids at conventional doses carries a minor risk of adverse effects. When asthma is unresponsive to usual medications, other options are available for both emergency management and prevention of flareups.
For emergency management other options include:. Evidence is insufficient to support the usage of vitamin C. Acupuncture is not recommended for the treatment as there is insufficient evidence to support its use. Manual therapies, including osteopathicchiropracticphysiotherapeutic and respiratory therapeutic maneuvers, have insufficient evidence to support their use in treating asthma. The prognosis for asthma is generally good, especially for children with mild disease.