Asthma


Asthma is a common disease of the airways characterized by reversible airflow, obstruction, and bronchospasm. These symptoms are variable in nature and recurring in a person suffering from the same.

This is a clinical condition where the inside walls of airways become sore and swollen making them sensitive and to react to things that cause allergy in a person. In this process the airways become narrower leading to low air flow to the lungs.

In some severe condition the airways can close so much that the other parts of the body do not get sufficient oxygen, which can also result in the death of that person.

Symptoms of Asthma:

  • Wheezing
  • Coughing
  • Chest tightness.
  • Difficulty inbreathing.



Asthma is further classified into two types such as atopic (extrinsic) and non-topic (intrinsic). Usually it is treated by inhaling short acting beta-2 agonist. The allergic triggers like allergens and irritants are to be avoided by inhaling corticosteroids.

Apart from the above mentioned symptoms there are two more symptoms associated with asthma, which are Gastro-esophageal reflux disease (GERD) and sleep disorders.

It is found that GERD and asthma coexist and in every 80% of the people suffering from asthma commonly complain of the similar symptoms. It is usually understood that both facilitate each other.

This condition is due to change in thoracic pressure, that can be alleviated by using anti asthma drugs for facilitating the passage of gastric content way back to the oesophagus by either increasing or decreasing the lower oesophagial sphincter.

While the sleep disorders are associated to the blockade caused by airway constriction due to excessive deposition of fatty tissue, there by leading to the upper airway collapse

Causes for Asthma

  • Gene–environment interactions
  • Genetic
  • Phthalates
  • Volatile organic compounds
  • Hygiene hypothesis
  • Tobacco
  • Environmental
  • Exacerbation
  • Hygiene hypothesis
  • Socioeconomic factors

Differential Diagnosis


Differential diagnoses include:
  • Infants and Children
    • Upper airway diseases

Allergic rhinitis and allergic sinusitis
Obstructions involving large airways
  • Foreign body in trachea or bronchus
  • Vocal cord dysfunction
  • Vascular rings or laryngeal webs
  • Laryngotracheomalacia, tracheal stenosis, or bronchostenosis
  • Enlarged lymph nodes or tumor

Involving small airways
  • Viral bronchiolitis or obliterative bronchiolitis
  • Cystic fibrosis
  • Bronchopulmonary dysplasia
  • Heart disease

Other Causes
  • Recurrent cough not due to asthma
  • Aspiration from swallowing mechanism dysfunction or gastroesophageal reflux
  • Medication induced

Adults
  • COPD (e.g., chronic bronchitis or emphysema)
  • Congestive heart failure
  • ulmonary embolism
  • Mechanical obstruction of the airways (benign and malignant tumors)
  • Pulmonary infiltration with eosinophilia
  • Cough secondary to drugs (e.g., angiotensin-converting enzyme (ACE) inhibitors)
  • Vocal cord dysfunction