ASTHMA BY AMANULLAH BISMIL
- March 19, 2015
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Asthma is characterized as an inflammation of the bronchial tubes (airways) that cause swelling and narrowing (constriction) of the airways. The result is difficult breathing. The bronchial narrowing is usually either totally or at least partially reversible with treatments. During asthma attacks (exacerbations of asthma), the smooth muscle cells in the bronchi constrict, the airways become inflamed and swollen, and breathing becomes difficult.
Asthmatics produce an excess of thick mucus in their bronchial tubes, which are also often very sensitive to external triggers (such as dry air and cigarette smoke). These external triggers can cause the airways to constrict and the bronchial muscles to tighten, rendering difficulty in breathing. This is called an “asthma attack,” and it can be quite serious—if the internal organs don’t get enough oxygen, an asthma attack can be fatal.
Bronchial tubes that are chronically inflamed may become over sensitive to allergens (specific triggers) or irritants (nonspecific triggers). The airways may become “twitchy” and remain in a state of heightened sensitivity. This is called “bronchial hyperactivity”. It is likely that there is a spectrum of bronchial hyper reactivity in all individuals. However, it is clear that asthmatics and allergic individuals (without apparent asthma) have a greater degree of bronchial hyperactivity than no asthmatic and no allergic people. In sensitive individuals, the bronchial tubes are more likely to swell and constrict when exposed to triggers such as allergens, tobacco smoke, or exercise. Amongst asthmatics, some may have mild symptoms while others may have severe and chronic symptoms.
Asthma affects people differently. Each individual is unique in their degree of reactivity to environmental triggers. This naturally influences the type and dose of medication prescribed, which may vary from one individual to another.
A genetic role in asthma has long been suspected, primarily due to the clustering of cases within families and the concordance for asthma in identical twins. Several studies conclude that heredity increases ones chances of developing asthma, particularly if allergies or other allergic conditions are present. Moreover, one may pass this tendency to asthma to the next generation. So, what are the chances that a child will develop asthma?
6.5% of families in which neither parent has asthma have a child with asthma.
28% of families in which one parent has asthma have a child with asthma.
63% of families in which both parents have asthma have at least one child with asthma.
TYPES OF ASTHMA
There are several types of asthma, which are classified in part by the event that triggers the attack.
COMMON TYPES OF ASTHMA INCLUDE:
- Allergy-triggered asthma: A vast majority of asthmatics have allergies that trigger asthma attacks.
Common allergies include cigarette smoke, peanuts, shellfish and pollen, which cause itching, sneezing, and a runny nose. In many cases, allergens can also trigger the bronchial tubes to inflame, resulting in an asthma attack.
- Exercise-induced asthma (EIA): One of the most common types of asthma in children, EIA is triggered by physical activity, like running.EIA can generally be controlled with proper treatment.
OTHER ASTHMA TRIGGERS, WHICH ARE LESS COMMON, INCLUDE:
- Certain medications
- Stressful or emotional situations.
Asthma is clinically classified according to the frequency of symptoms.
Asthma may also be classified as atopic (extrinsic) or non-atopic (intrinsic), based on whether symptoms are precipitated by allergens (atopic) or not (non-atopic).
HOW DOES ASTHMA AFFECT BREATHING.
Over 100 genes have been associated with asthma in at least one genetic association study.
Many of these genes are related to the immune system or to modulating inflammation. However, even among this list of highly replicated genes associated with asthma, the results have not been consistent among all of the populations that have been tested. This indicates that these genes are not associated with asthma under every condition, and that researchers need to do further investigation to figure out the complex interactions that cause asthma.
Studying the prevalence of asthma and related diseases such as eczema and hay fever have yielded important clues about some key risk factors. The strongest risk factor for developing asthma is a family history of atopic disease; this increases one’s risk of hay fever by up to 5 times and the risk of asthma by 3-4 times. In children between the ages of 3-14, a positive skin test for allergies and an increase in immunoglobulin E increases the chance of having asthma. In adults, the more allergens one reacts positively to in a skin test, the higher the odds of having asthma.
One theory for the cause of the increase in asthma prevalence worldwide is the so-called “hygiene hypothesis” — that the rise in the prevalence of allergies and asthma is a direct and unintended result of the success of modern hygienic practices in preventing childhood infections.
This seems to run counter to the logic that viruses are often causative agents in exacerbation of asthma. Additionally, other studies have shown that viral infections of the lower airway may in some cases induce asthma, as a history of bronchiolitis or croup in early childhood is a predictor of asthma risk in later life. Studies which show that upper respiratory tract infections are protective against asthma risk also tend to show that lower respiratory tract infections conversely tend to increase the risk of asthma.
The incidence of asthma is highest among low-income populations (asthma deaths are most common in low to middle income countries. Additionally, asthma has been strongly associated with the presence of cockroaches in living quarters, which is more likely in such neighborhoods.
WHAT TRIGGERS (CAUSES) AN ASTHMA ATTACK
Asthma is caused by environmental and genetic factors, which can influence how severe asthma is and how well it responds to medication. Some environmental and genetic factors have been confirmed by further research, while others have not been. Underlying both environmental and genetic factors is the role of the upper airway in recognizing the perceived dangers and protecting the more vulnerable lungs by shutting down the airway.
Many environmental risk factors have been associated with asthma development and morbidity in children, but a few stands out as well-replicated or that has a meta-analysis of several studies to support their direct association.
Environmental tobacco smoke, especially maternal cigarette smoking, is associated with high risk of asthma prevalence and asthma morbidity, wheeze, and respiratory infections. Low air quality, from traffic pollution or high ozone levels, has been repeatedly associated with increased asthma morbidity and has a suggested association with asthma development that needs further research.
Recent studies show a relationship between exposure to air pollutants (e.g. from traffic) and childhood asthma. This research finds that both the occurrence of the disease and exacerbation of childhood asthma are affected by outdoor air pollutants.
Caesarean sections have been associated with asthma when compared with vaginal birth; a meta-analysis found a 20% increase in asthma prevalence in children delivered by Caesarean section compared to those who were not. It was proposed that this is due to modified bacterial exposure during Caesarean section compared with vaginal birth, which modifies the immune system (as described by the hygiene hypothesis).
Psychological stress has long been suspected of being an asthma trigger, but only in recent decades has convincing scientific evidence substantiated this hypothesis. Rather than stress directly causing the asthma symptoms, it is thought that stress modulates the immune system to increase the magnitude of the airway inflammatory response to allergens and irritants.
Viral respiratory infections at an early age, along with siblings and day care exposure, may be protective against asthma, although there have been controversial results, and this protection may depend on genetic context.
Antibiotic use early in life has been linked to development of asthma in several examples; it is thought that antibiotics make one susceptible to development of asthma because they modify gut flora, and thus the immune system (as described by the hygiene hypothesis). The hygiene hypothesis is a hypothesis about the cause of asthma and other allergic disease, and is supported by epidemiologic data for asthma. For example, asthma prevalence has been increasing in developed countries along with increased use of antibiotics, c-sections, and cleaning products. All of these things may negatively affect exposure to beneficial bacteria and other immune system modulators that are important during development, and thus may cause increased risk for asthma and allergy.
WHO IS AT THE RISK OF DEVELOPING ASTHMA
Asthma affects people of all ages, but it most often starts in childhood.
Young children, who have frequent episodes of wheezing with respiratory infections, as well as certain other risk factors, are at the highest risk of developing asthma that continues beyond 6 years of age. These risk factors include having allergies, eczema (an allergic skin condition), or parents who have asthma.
6.5% of families in which neither parent have asthma have a child with asthma.
28% of families in which one parent has asthma have a child with asthma.
63% of families in which both parents have asthma have at least one child with asthma.
Among children, more boys have asthma than girls. But among adults, more women have the disease than men. It’s not clear whether or how sex and sex hormones play a role in causing asthma.
Some people are more likely to develop asthma than others. This includes those who:
- Are frequently exposed to secondhand smoke, harsh chemicals or air pollution
- Are overweight
- Have a family history of asthma
- Have a history of breathing problems and respiratory infections
- Were born underweight
TYPICAL SYMPTOMS AND SIGNS OF ASTHMA
Asthma symptoms range greatly in severity from person to person. Some asthmatics can go weeks without a flare-up or attack, while others struggle with asthma symptoms every day. Asthma exists in two states: the steady-state of chronic asthma, and the acute state of an acute asthma exacerbation. The symptoms are different depending on what state the patient is in.
The following are the four major recognized asthma symptoms:
- Shortness of breath, especially with exertion or at night. You may feel like you can’t get air out of your lungs.
- Wheezing is a whistling or hissing sound when breathing out
- Coughing may be chronic, is usually worse at night and early morning, and may occur after exercise or when exposed to cold, dry air
- Chest tightness. This may feel like something is squeezing or sitting on your chest may occur with or without the above symptoms
ACUTE ASTHMA ATTACK
An acute exacerbation of asthma is commonly referred to as an asthma attack. The cardinal symptoms of an attack are shortness of breath (dyspnea), wheezing, and chest tightness. Although the former is often regarded as the primary symptom of asthma, some patients present primarily with coughing, and in the late stages of an attack, air motion may be so impaired that no wheezing may be heard. When present the cough may sometimes produce clear sputum.
During very severe attacks, an asthma sufferer can turn blue from lack of oxygen and can experience chest pain or even loss of consciousness. Just before loss of consciousness, there is a chance that the patient will feel numbness in the limbs and palms may start to sweat. The person’s feet may become cold. Severe asthma attacks which are not responsive to standard treatments, called status asthmaticus, are life-threatening and may lead to respiratory arrest and death. Though symptoms may be very severe during an acute exacerbation, between attacks a patient may show few or even no signs of the disease.
Currently, there isn’t a way to prevent asthma from starting in the first place. However, you can take steps to control the disease and prevent its symptoms.
- Learn about your asthma and how to control it.
- Follow your written asthma action plan.
- Use medicines as your doctor directs.
- Identify and avoid things that make your asthma worse
- Keep track of your asthma symptoms and level of control.
- Get regular checkups for your asthma.
- Homoeopathic medicines have proven their efficacy in curing Asthma and help in preventing any further attacks
It is often difficult to certify an individual to be suffering from asthma the conclusion usually depends upon
- The symptoms (wheezing, coughing, chest heaviness, dyspnoea)
- What triggers the symptoms and how they get worse
- Medications if taken previously and if it improved the condition
- Any family history of asthma or allergic conditions in many cases, a physician can diagnose asthma on the basis of typical findings in a patient’s clinical history and examination. Asthma is strongly suspected if a patient suffers from eczema or other allergic conditions suggesting a general atopic constitution or has a family history of asthma. While measurement of airway function is possible for adults, most new cases are diagnosed in children who are unable to perform such tests.
In children, the key to asthma diagnosis is the sound of wheezing or a high-pitched sound upon exhalation. Other clues are recurrent wheezing, breathing difficulty, or chest tightness, or a history of coughing that is worse at night.
Other information important to diagnosis is the age at which symptoms began and how they progressed, the timing and pattern of wheezing, when and how often a child had to visit a clinic or hospital emergency department because of symptoms, whether the child ever took bronchodilator medication for the symptoms and the nature of the response to medication.
Although pediatricians may tend to ask parents for information about their children’s symptoms, studies suggest that children themselves are reliable sources as early as age 7 and perhaps even as early as age 6.
Homoeopathy follows an individualistic approach towards patients suffering from Asthma we believe that every individual is different and thus a full in-depth case study is the first step. Then referring to the risk factors the individual was subjected too, a particular line of treatment is adopted.
Broad criteria of how the homoeopathic medicines act in cases of asthma is mentioned below. The response to treatment can differ from one individual to another patients are advised to consult so that the mode of treatment can be discussed pertaining to their particular case.
HOMOEOPATHIC MEDICINES ACT
Relieving Symptoms Like
- Shortness of breath,
- Chest tightness
PREVENTING EXACERBATIONS (ATTACKS):
Homoeopathic medicines prevent any exacerbations at fist prolonging the time between episodes and later preventing their occurrence leading to permanent cure. Controlling and curing the disease process: Homoeopathic medicines offer permanent cure in asthma they act by helping in decreasing the hyperactivity of immune cells, curtailing the individual’s immune response against allergens, thus decreasing their hyper-sensitivity towards triggering stimuli. The development of allergic conditions is multi-functional and depends upon interaction between susceptible genes and environmental factors. Thus homoeopathy with its deep acting constitutional remedies offers excellent results.
Our medicines have not to be taken for life time. Once cured the patients develops immunity towards the triggering stimulus which is maintained even after medication is stopped.
We provide our patients with diet charts, exercise schedules and guide them how to modify their lifestyle so that better results can be achieved. Our medicines can be started with conventional treatment depending upon the disease state and case.
Homoeopathic medicines if taken under proper guidance from a well qualified professional are extremely safe and have no side effects.