Asthma: An Overview Essay

Asthma

Asthma is a disorder that affects the respiratory system, which causes the narrowing of the passages that allow air to pass out of and into the lungs. Basically, asthma is the inflammation of the airways. WHO indicates that asthma affects almost 235 million people globally and 80% of the deaths occur in low-income nations (World Health Organisation, 2018). Asthma is a big problem in Australia as one in every nine Australians are asthmatic, which is approximately 2.7 million people (Asthma Australia, 2018). Indigenous Australians are twice as much affected as non-indigenous Australians.

Diagnosis and Symptoms

The diagnosis of asthma involves three steps: medical history, spirometry, and the exclusion of alternative diagnoses. The physician should first ask the patient if they have experienced repeated symptoms of airway hyper-responsiveness or obstruction. The symptoms include chest lightness, dyspea, cough, wheezing (polyphonic or whistling sounds) and worsening of the mentioned symptoms during night time or after exposure to specific environmental stimuli. Spirometry should only be used for patient five years or older to check whether the airflow obstruction can be reversed after using a bronchodilator. In every patient, the condition is reversible if the FEV increases by at least 12% from the baseline (Kaiser Permanente, 2015, p. 2). In adults, asthma is reversible if FEV increases by more than 200ml from the baseline. Spirometry should be used as an initial asthma diagnosis, checking the response to treatment after changing medication, and analysing asthma regulation in people with persistent asthma. The physician can also conclude that the patient has asthma after ruling out other diagnoses such as upper airway conditions (vocal cord dysfunction, chronic allergic sinusitis, etc.), GERD, pulmonary infections (bronchiectasis, COPD, etc.), and cystic fibrosis (Kaiser Permanente, 2015, p. 2).

Pathophysiology and Causes

Asthma entails various pathophysiologic factors such as airway constriction and bronchiolar inflammation, which usually manifests as wheezing and shortness of breath. Asthma can affect the bronchioles, trachea, and bronchi. Inflammation can occur although the obvious symptoms of the condition may not occur in all cases. Oedema, excessive mucus, epithelial muscle damage, and bronchospasms may result in bronchoconstriction and bronchospasm (Lynn & Kushto-Reese, 2015, p.49). Bronchospasm refers to sharp contractions experienced by the bronchial smooth muscle and causes the narrowing of the airways. The oedema from the micro-vascular leakage increases the narrowing of the airways, capillaries dilate and leak. The increasing secretions cause oedema and impairs the clearance of mucus. Asthma can also cause the expansion of mucus-secreting glands and an increase in the number of cells secreting mucus. Epithelium injuries may result in epithelial peeling, which may extremely impair the airway (Lynn & Kushto-Reese, 2015, p.49).

Risk Factors

Some conditions increase the risk of getting asthma among individuals. People who suffer from wheezing respiratory tract infections during infancy due to rhinovirus infection and syncytial virus have a high possibility of developing childhood asthma. There are also links between asthma development and pertussis infection, more so for infants who are not immunised (Beasley, Semprini, & Mitchell, 2015, p.1078). Epidemiological and experimental evidence shows the protective role of geohelminths and their potential to lower the risk of developing asthma. Another significant factor in the development of asthma is the body mass index (BMI), especially among children. Sedentary lifestyle such as television viewing highly contribute to obesity (Beasley et al., 2015, p.1078).

Treatment

Asthma has no cure. However, the patients have various options to manage the condition such as bronchodilators, anti-inflammatory medicine, and corticosteroids. Bronchodilators control sudden attacks and those caused by exercise (Binuyo, 2014, p. 4). They attach themselves to the beta-receptors, relax the muscles, then the airways dilate. Corticosteroids suppress the immune response and decrease the airways' sensitivity to various common triggers. Immunotherapy increases the patients' tolerance to allergens (Binuyo, 2014, p. 4).

References

Asthma Australia, 2018. Statistics. [Online]

Available at: https://www.asthmaaustralia.org.au/national/about-asthma/what-is-asthma/statistics

Binuyo, M., 2014. Asthma; Causes and Treatment, s.l.: s.n.

Kaiser Permanente, 2015. Asthma Diagnosis and Treatment Guideline, s.l.: s.n.

Richard Beasley, A. S. a. E. A. M., 2015. Risk Factors for Asthma: Is Prevention Possible?. Lancet , Volume 386, p. 1075–1085.

Shari J. Lynn, a. K. K.-R., 2015. Understanding Asthma Pathophysiology, Diagnosis, and Management. American Nurse Today, pp. 49-51.

World Health Organisation, 2018. Asthma. [Online]

Available at: https://www.who.int/respiratory/asthma/en/