Dr Usama Fouad Shaalan – من دفاتر الدكتور / أسامه فؤاد شعلان
Ever hear the term "bronchial asthma" and wonder what it means? When people talk about bronchial asthma, they are really talking about asthma, a chronic inflammatory disease of the airways that causes periodic "attacks" of coughing, wheezing, shortness of breath, and chest tightness.
According to the CDC, more than 22 million Americans, including 6.5 million children under 18, suffer with asthma today. Allergy clearly plays an important role in many asthma cases but not in all. As with allergy, you can blame your family history; there’s certainly a strong genetic component for asthma.
Because of asthma symptoms, asthma is associated with mast cells, eosinophils, and T lymphocytes. Mast cells are the allergy-causing cells that release chemicals like histamine. Histamine is the substance that causes nasal stuffiness and dripping in a cold or hay fever, constriction of airways in asthma, and itchy areas in a skin allergy. Eosinophils are a type of white blood cell associated with allergic disease. T lymphocytes are also white blood cells associated with allergy and inflammation.
These cells, along with other inflammatory cells, are involved in the development of airway inflammation in asthma that contributes to the airway hyperresponsiveness, airflow limitation, respiratory symptoms, and chronic disease. In certain individuals, the inflammation results in the feelings of chest tightness and breathlessness that’s felt often at night (nocturnal asthma) or in the early morning hours. Others only feel symptoms when they exercise (called exercise-induced asthma). Because of the inflammation, the airway hyperresponsiveness occurs as a result of specific triggers.
Allergies are strongly linked to bronchial asthma and to other respiratory diseases such as chronic sinusitis, middle ear infections, and nasal polyps. Most interestingly, a recent analysis of people with asthma showed that those who had both allergies and asthma were much more likely to have nighttime awakening due to asthma, miss work because of asthma, and require more powerful medications to control their symptoms.
Bronchial Asthma Triggers
Asthma triggers may include:
Infections such as colds, flu, or pneumonia
Allergens such as food, pollen, mold, dust mites, and pet dander
Air pollution and toxins
Weather, especially extreme changes in temperature
Drugs (such as aspirin, NSAID, and beta-blockers)
Food additives (such as MSG)
Emotional stress and anxiety
Singing, laughing, or crying
Smoking, perfumes, or sprays
Signs and Symptoms of Bronchial Asthma
With bronchial asthma, you may have one or more of the following signs and symptoms:
Shortness of breath
Tightness of chest
Excessive coughing or a cough that keeps you awake at night
Diagnosing Bronchial Asthma
Because asthma does not always happen at the doctor’s visit, it’s important for you to describe your asthma signs and symptoms to your doctor. You might also notice when the symptoms occur such as during exercise, with a cold, or after smelling smoke. Asthma tests may include:
Spirometry: A pulmonary function test (PFT) to measure your breathing capacity and how well you breathe. You will breathe into a device called a spirometer.
Peak Expiratory Flow (PEF): Using a device called a peak flow meter, you forcefully exhale into the tube to measure the force of air you can expend out of your lungs. Peak flow monitoring can allow you to monitor your how well your asthma is doing at home.
Chest X-Ray: Your doctor may do a chest X-ray to rule out any other diseases that may be causing similar symptoms.
Treating Bronchial Asthma
Once diagnosed, your asthma doctor will recommend asthma medication (which can include asthma inhalers and pills) and lifestyle changes to treat and prevent asthma attacks. For example, long-acting anti-inflammatory asthma inhalers are often necessary to treat the inflammation associated with asthma. These inhalers deliver low doses of steroids to the lungs with minimal side effects if used properly. The fast-acting or "rescue" bronchodilator inhaler works immediately on opening airways during an asthma attack.
If you have bronchial asthma, make sure your doctor shows you how to use the inhalers. Be sure to keep your rescue inhaler with you in case of an asthma attack or asthma emergency. While there is no asthma cure yet, there are excellent asthma medications that can help with preventing asthma symptoms and asthma support that can help you live a normal, active life.