It is one of the most agonising and exhausting diseases which torment the sufferer for a lengthy period of life. Its onset is generally in the childhood and occurs more in atopic patients, i.e. who are sensitive to certain allergens. It is caused by hypersensitivity to a particular ingredient, or weather condition and the list is quite lengthy to spell out. Generally, multiple allergens are the culprits and, thus, a single allergen cannot be held responsible for onset of disease.
Asthma patients are either children or old people but, if its onset is right from the childhood, it may continue until old age. When it starts in the middle age, it can be controlled but some latent symptoms may reappear at any time thereafter. But, once the basic contributory cause has been discerned and also when the same occurs, at what time and due to which condition, preventive treatment is possible, if preventive treatment is taken before the anticipated appearance of symptoms, much of the crisis can be averted, and intensity of disease also reduced.
Specific & Non-Specific causes
1. Animal dander, feathers of birds, house dust that contains mite, organic materials (pollens etc), fungal spores etc.
2. Hypersensitivity to certain eatables, drinks, fumes, scents, fragrances, smoke, certain colours, woollen clothes, mattersses and cushions, quilts, bed-sheets, pillows and pillow-covers, industrial chemicals.
3. Weather conditions that change suddenly, or even transition of one climate to another.
4. Cold air, tobacco smoke, acrid fumes and emotional stress and disturbances.
5. (Some of these factors are, though, common to both groups).
6. Exposure to cold.
7. Asthma induced by strenous exertion (Exercise induced asthma).
8. Drug-induced asthma (as from aspirin and nonsteroidal antiinflammatory drugs, beta-antagonists etc.
9. Occupational asthma which develops as a result of working at a factory/place whose chemical substances, organic materials, gases, fumes etc arc causati ves for triggering asthma.
Chemical Features
Asthma could cither be chronic or episodic, though it is immaterial to lay much emphasis on either variety, yet distinction is necessary for treatment and management of asthma. General Iv non-atopic patients develop chronic asthma whereas atopic patients have tendency to develop episode asthma. 1 ,et us now look for the distinctive symptoms of both the said varieties Severe Acute Asthma
It was known as ‘status asthmaticus’ also and patient’s life is threatened in this condition. Cough is often unproductive which worsens/aggravates respiratory distress which is accompanied by fast pulse (Tachycardia) and cold sweating. In addition, there may be cyanosis (blueness) in severe cases.
Chronic Asthma
Sudden onset of breathlessness, even on slight exertion; panting, wheeze, tight chest, cough and wheeze more at/during night.
Episodic Asthma
Breathlessness and wheeze are either sudden or might surface at any time. Common contributory causes are exercise, viral infections (eg, due to common cold), attacks might last for some hours/days/weeks even.
Prevention
If only a single agent (allergen, so to say) is the cause of asthma, it can be controlled by taking safeguards. Such causes may include industrial chemicals, grass pollens, house dust, mite, any dietary article. It is a fact that it is not practical to avoid exposure/ contact to allergens, though established causes like cigarette smoking, exercise, exposure to cold, and allergy caused by a dietary article can be managed. Like food allergies, drug allergies are also many and cannot be controlled overnight.
Symptoms of Acute/Severe Asthma
Patient is unable to speak in sentences, as pulse rate is quite high. When the patient can”t speak, there is confusion, level of consciousness is reduced, there is exhaustion, confusion or when there is bradycardia (slow, pulse rate) life is endangered. Care at home cannot and shall not yield desired outcome; hence the patient should be hospitalished where suitable treatment can be given, after proper and requisite investigations.
Attempt should be made to normalise breathing to expel stuck up sputum to clear air-passage and relax agitated and overtaxed respiratory system. For immediate control of symptoms, oral course of prednisolone or hydracostisone may be required, in addition to oxygen and/or inhalation of anti-inflamatory agents and bronchodilators, but nothing should be done without advice of a qualified doctor. ‘Crisis period’ must be managed quickly and without any delay because, here, very life of the patient is in peril. It is claimed that when asthma is severe or when there is vomiting hydrocortisone (I.V.) 200 mg may be required, followed by 40 mg daily oral dose of prednisolone.
Breathlessness (Dyspnoea)
Laboured breathing can have its origin in the cardiac region. Since there is a close relation between heart and lung functioning, the symptoms quite often overlap. Short breath is a consequence of congested lungs when expansion is difficult. The malady is also termed as ‘effort onset dyspnoea’ which implies that even a slight effort/labour, walking faster, scaling stairs, running, fast speech etc trigger the problem. Dyspnoea can also occur in severe anaemia or diabetes (especially in ketoacidosis).
Limitation of breath can be described in many ways which vary from disease to disease. In Uraemic coma also dyspnoea surfaces. Asthma, Bronchitis, Nasal obstruction, obstruction of blood vessels due to cholesterol deposition and/or hardening thereof, some extra physical effort, airway obstruction or due to accumulation of sputum therein which is difficult to expectorate.
Causative factor will often point as to which organ, heart or respiratory system, is at fault when heart is the affected organ there is chest pain, sweating, nausea, palpitation or orthopnoea (a state of breathlessness that prevents the patient from lying down so that he prefers to sit in a chair or to sleep propped up in bed) but, when respiratory apparatus is involved, there is cough, wheeze, haemoptysis etc. In the latter stage pattern of breathing, respiratory rate, position of trachea, breath sounds on each side of chest, crepitations etc.
Should be taken into view. When children are the victims extra caution is called for, because effects of certain factors cannot be detected through x-ray. Problem and its cause is more difficult to locate in a toddler who himself cannot relate his problem. Removal of basic cause will itself be sufficient to lead to cure. No medicine can or should be given unless the organ, at fault, and cause have been isolated and established beyond doubt. 500 mg Vitamin-C tablet- once daily – will help to build up general resistance of body.
Normal respiration can also be restored by resorting to Pranayam and open air exercises. Main effort should be directed towards general improvement of health and building up of proper and requisite defence machenism and resistance to withstand the onslaught of leading symptoms.
Smoking and wrong eating pattern can also cause dysponea. Certain foodstuffs, exercises, weather changes, grass pollens, accumulation of sputum, various allergens etc are the probable causes. The patient, quite often, is aware as to which allergen is responsible in causing onset of dyspnoea but, then, each case needs to be individualised properly. Dust, certain gases, fumes, industrial chemicals, environs also account for onset of dyspnoea.