Asthma is a chronic, obstructive disease of the lungs of varying severity affecting 6-7% of the UK population. It is most common in Western populations, and appears to be on the increase. Around 20 per cent of children of primary school age are affected, with boys being twice as likely to be sufferers than girls. However, adult women are slightly more prone to the condition than adult men.

What are the Symptoms of Asthma?

The breathing difficulties linked with asthma are caused by constriction of the bronchial tubes or airways, and are compounded by the inflammation and accumulation of secretions in these passages. During an asthma attack, the muscles around the airways and lung branches tighten and go into spasm. The tissues swell, causing air to be trapped making it difficult to breathe.

The main symptoms of asthma are dyspnoea (shortness of breath) wheezing, chest tightness, and coughing with or without sputum production. Others include fatigue or drowsiness.

What are the Causes of Asthma?

In many cases, asthma seems to run in families, and is often the other side of the coin to the skin disease eczema. However, whilst a large component can be said to be hereditary, much is down to individual allergic sensitivity to animal fur, house dust mite, pollens, grasses and air pollutants from the combustion engine or the chemical industry.

Smoking when pregnant is thought to be a contributory factor to the development of asthma in an unborn child, as is passive exposure to cigarettes during childhood. Cold air, central heating and double-glazing can be triggering factors.

Emotional factors such as excitement, stress and grief are also known to be triggers. The 'hayfever season' i.e. the months of April to June when pollen is high can be a particularly problematic time for some.

Types of Asthma

Nocturnal asthma can be a common problem, and in many may be a sign of overall poor control. Drugs that are long-acting are sometimes helpful in these cases.

Exercise-induced asthma often becomes apparent in children when they perform games at school or run around at home. The child is often found to be wheezy after exertion. Preventative measures may involve the sufferer having to take an inhaled 'puff' of steroid before a games lesson.

Occupational asthma is said to affect around 5% of the working population. This is often difficult to diagnose, but may involve continued exposure to certain substances or conditions such as cellulose paints or dusty atmospheres.

Treatment for Asthma

Some asthma sufferers may manage their condition without the aid of medication. This might involve replacing certain triggering substances in the home (i.e.feathered pillows with polyester filling) avoiding smoky or cold atmospheres, and perhaps keeping the cat or dog out of the bedroom. Others may need longterm treatment with inhaled corticosteroids. Asthma drug treatment can be split into three groups: relievers, preventers and reserve/emergency.

Reliever Drugs:

·  Salbutamol

·  Terbutaline

·  Fenoterol

·  Salmeterol

·  Eformoterol

·  Ipratropium

·  Oxitropium

Reliever drugs work by relaxing airway muscles thus allowing more air entry to ease breathing. These are known as bronchodilators and are taken in inhaled form. They are also referred to by the colour of their container i.e. blue, green or grey.

Preventer Drugs:

·  Beclomethasone

·  Budesonide

·  Fluticasone

·  Cromoglycate

·  Nedoromil

·  Leukotriene (new)

Preventer drugs work by reducing inflammation in the airways and soothing irritability. Unlike reliever drugs, these need to be taken at a regular frequency such as twice a day. Again, colour coding plays its part with these being mostly brown, orange, red and yellow. The Leukotriene drugs are new to the market and so are still in an experimental stage in regard to their efficacy in some sufferers.

Emergency Drugs:

·  Salbutamol

·  Ipratropium

Emergency treatment for asthma can be taken either orally via nebuliser (air compressor) or injection. Often in acute attacks, patients need to contact their GP or attend a hospital Casualty department without delay. Sometimes nebulisers need to be obtained for home use, though these are not always available on the NHS.

Using asthma devices can take some time to master, though inhaler techniques are taught at doctors' surgeries and clinics, where regular clinical monitoring is initiated using a 'stepwise' approach to management. This will include measuring the 'peak flow' (lung capacity) of the sufferer to help determine the degree or severity.

Step 1 is a category in which most cases will fit. This means that they will usually need to use their relief inhaler at less than 1 puff per day with no other treatment being necessary.

Step 2 is for those who require more than 1 puff daily for relief but may also require a preventative inhaler to help limit the frequency of relief 'puffs.'

Step 3 is reserved for those on higher doses of preventative medication perhaps with an additional drug. Other steps may include a combination of higher doses involving inhaled preventative medication with oral steroids and nebulisers.

Complementary Medicine in Asthma

These days there is considerable interest in alternative treatments for asthma. Particularly as conventional treatment involves longterm use of steroid drugs. However, many of these complementary approaches have not been assessed, and so have not been accepted as a viable alternative by the medical establishment. However, there are many people around who will sing their praises!

Acupuncture Treatment for Asthma

Acupuncture has had some benefits in treatment of minor conditions of asthma, but not so much in severe cases.

Homeopathy Treatment for Asthma 

The methods of Homeopathy differ radically with conventional medicine, and in the case of asthma involve withdrawing conventional medication altogether. This is seen as too controversial for many practitioners of accepted medicine. If thinking of trying this method, you should not stop taking your usual medication without first consulting your GP.

Hypnosis Treatment for Asthma

Hypnosis has claimed some success, particularly in helping sufferers cope with acute asthmatic attacks.

Herbal Treatment for Asthma

Herbal treatments are often aimed at treating symptoms rather than conditions such as reducing sputum production or complementing diet.

Useful addresses:

National Asthma Campaign (NAC)
Providence House
Providence Place
Islington N1 0NT
Asthma Helpline: 08457 010203
www.asthma.org.uk

The British Allergy Foundation (BAF)
Deepdene House
30 Bellegrove Road
Welling, Kent DA16 3PY
Allergy helpline: 0181 303 8583
www.allergyfoundation.com

Dr. A. Bose © Allcures.com September 2011