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Asthma, Causes & Treatment

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For the last 2 weeks our discussion has been around lung health, this week we focus on asthma and the lung connection, what causes it, the different types and the treatment options.

Asthma is characterised by inflammation of the bronchial tubes with increased production of sticky secretions inside the tubes. People with asthma experience symptoms when the airways tighten, inflame, or fill with mucus. Common asthma symptoms include:

  • Coughing, especially at night
  • Wheezing
  • Shortness of breath
  • Chest tightness, pain, or pressure

Still, not every person with asthma has the same symptoms in the same way. You may not have all of these symptoms, or you may have different symptoms at different times. Your asthma symptoms may also vary from one asthma attack to the next, being mild during one and severe during another. Some people with asthma may go for extended periods without having any symptoms, interrupted by periodic worsening of their symptoms called asthma attacks. Others might have asthma symptoms every day. In addition, some people may only have asthma during exercise, or asthma with viral infections like colds.

It is important to recognise and treat even mild asthma symptoms to help you prevent severe episodes and keep asthma under better control.

Know The Symptoms Of An Asthma Attack

An asthma attack is the episode in which bands of muscle surrounding the airways are triggered to tighten. This tightening is called bronchospasm. During the attack, the lining of the airways becomes swollen or inflamed and the cells lining the airways produce more and thicker mucus than normal.

All of these factors, bronchospasm, inflammation, and mucus production cause symptoms such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Other symptoms of an asthma attack include:

  • Severe wheezing when breathing both in and out
  • Coughing that won’t stop
  • Very rapid breathing
  • Chest pain or pressure
  • Tightened neck and chest muscles, called retractions
  • Difficulty talking
  • Feelings of anxiety or panic
  • Pale, sweaty face
  • Blue lips or fingernails

The severity of an asthma attack can escalate rapidly, so it’s important to treat these asthma symptoms immediately once you recognize them.

Without immediate treatment, such as with your asthma inhaler or bronchodilator, your breathing will become more laboured. If you use a peak flow meter at this time, the reading will probably be less than 50%. Many asthma action plans suggest interventions starting at 80% of normal.

As your lungs continue to tighten, you will be unable to use the peak flow meter at all. Gradually, your lungs will tighten so there is not enough air movement to produce wheezing. You need to be transported to a hospital immediately. Unfortunately, some people interpret the disappearance of wheezing as a sign of improvement and fail to get prompt emergency care.

If you do not receive adequate asthma treatment, you may eventually be unable to speak and will develop a bluish colouring around your lips. This colour change, known as cyanosis, means you have less and less oxygen in your blood. Without aggressive treatment for this asthma emergency, you may lose consciousness and eventually die. It is important to understand your body. Talk with your asthma doctor and others with asthma. Be aware that asthma may not always have the same symptoms in every person.

Asthma Risk Factors

There are usually reasons or risk factors that predispose you too asthma and respiratory problems. Asthma can happen to anyone without any risk factors, but it is less likely if there are no risk factors present.

Blame Mom or Dad or both for your asthma. Your inherited genetic makeup predisposes you to having asthma. In fact, it’s thought that three-fifths of all asthma cases are hereditary. According to a CDC report, if a person has a parent with asthma, they are three to six times more likely to develop asthma than someone who does not have a parent with asthma.

Environmental Factors & Asthma

Indoor air pollution such as cigarette smoke, mould, and noxious fumes from household cleaners and paints can cause allergic reactions and asthma. Environmental factors such as pollution, sulphur dioxide, nitrogen oxide, ozone, cold temperatures, and high humidity are all known to trigger asthma in susceptible individuals. In fact, asthma symptoms and hospital admissions are greatly increased during periods of heavy air pollution. Ozone is the major destructive ingredient in smog. It causes coughing, shortness of breath, and even chest pain — and can boost the susceptibility to infection. Sulphur dioxide, another component of smog, also irritates the airways and constricts the air passages, resulting in asthma attacks. Gas stoves are the primary source of indoor nitrogen dioxide, a common indoor pollutant.

Weather changes can also result in asthma attacks in some people. For instance, cold air causes airway congestion and an increase in mucus production. Increases in humidity may also cause breathing difficulty in a certain population.

Allergies Linked To Asthma

Allergies with asthma is a common problem. 80% of people with asthma have allergies to things in the air, like tree, grass, and weed pollens; mould; animal dander; dust mites; and cockroach droppings. In one study, children with high levels of cockroach droppings in their homes were four times more likely to have childhood asthma than children with low levels. An allergy to dust mites is another common asthma trigger.

If you have asthma that’s hard to control, see an allergist to find out if you have allergies. Treating your allergies with medication and avoiding your triggers can help lower the odds of a severe asthma attack.

Pollen Can Be Dangerous

The weekly pollen counts use a “traffic light system” to warn of high and very high pollen counts in the monitored regions of South Africa

Pollen allergy sufferers – particularly asthmatics – should take action when counts are RED. Outdoor activities should be limited and medications used. Knowing the pollen counts may even allow you to identify specific pollens you are allergic too as these can differ from person to person. See weekly featured pollen.

On November 21st 2016, an unusual thunderstorm occurred in Melbourne Australia during the peak of grass pollen season. Within 30 hours there were more than 8000 excess chest-related presentations to emergency departments, 35 intensive care admissions and ten asthma-related deaths.

Asthma Risk Factors

There are usually reasons or risk factors that predispose you to asthma and respiratory problems. Asthma can happen to anyone without any risk factors, but it is less likely if there are no risk factors present.

Let’s look at some asthma risk factors and see how they increase the chance that a person will have the asthma symptoms of cough, wheezing, and shortness of breath associated with the disease. After determining your personal risk factors for asthma, decide on the ones you can control and try to make some lifestyle changes. Avoidance of the risk factors you can control is crucial in preventing asthma symptoms. While you cannot change your gender or family history, you can avoid smoking with asthma, breathing polluted air, allergens, and taking care of your general health so you don’t become overweight. Take control of your asthma, by controlling your asthma risk factors. By understanding all the risk factors, you may be able to prevent or control your asthma.

Types Of Asthma

Learn more about the most common types of asthma:

Adult-Onset Asthma

Some people don’t show signs of having asthma until they are adults. This is known as adult-onset asthma. Sometimes, people just manage to essentially avoid their asthma triggers for years. When they are then exposed to that trigger as an adult, it can bring on asthma symptoms. For example, they may move in with a roommate who has a pet, or they may work around certain chemical fumes for the first time. An allergist can determine if you have adult-onset asthma by doing tests that will help in making a diagnosis.

Exercise-Induced Bronchoconstriction (EIB)

EIB, is the preferred term for what was known for years as exercise-induced asthma. Symptoms develop when airways narrow as a result of physical activity. As many as 90% of people with asthma also have EIB, but not everyone with EIB has asthma. Many elite and world-class athletes have EIB – including Olympic medal winners in sports like cross country skiing, figure skating and ice hockey. EIB didn’t hold them back, and it shouldn’t hold you back either. An allergist will customise a treatment plan that allows you to get back to the exercise you love, and feel better while doing it.

Allergic Asthma

There is often a link between allergies and asthma.

Not everyone who has allergies has asthma, and not everyone with asthma has allergies. But allergens such as pollen, dust and pet dander can trigger asthma symptoms and asthma attacks in certain people. This is called allergic asthma. An allergist can determine if you have allergic asthma by doing tests that will help in making a diagnosis.

Non-allergic Asthma

Do your asthma symptoms flare up in extreme weather, either in the heat of summer or the chill of winter? When you get sick, does it often lead to an asthma attack? Does stress bring on breathing problems? If this is the case, it’s possible you’re suffering from nonallergic asthma.

An allergist can determine if you have nonallergic asthma by doing tests that will help in making a diagnosis.

Asthma – COPD overlap

Chronic obstructive pulmonary disease (COPD) is a collection of lung diseases that cause breathing problems and obstruct airflow. This group of diseases can include refractory (severe) asthma, emphysema and chronic bronchitis. Most people with asthma will not develop COPD, and many people with COPD don’t have asthma. However, it’s possible to have both. Asthma-COPD overlap syndrome (ACOS) occurs when someone has these two diseases at once. People with asthma may not realise they also have COPD. Sometimes COPD isn’t diagnosed until it’s in the “moderate” stage, meaning they are experiencing frequent shortness of breath, coughing and heavier-than-normal mucus. Misdiagnosis can occur because the symptoms of COPD mimic those of asthma.

Occupational Asthma

People with this condition usually work around chemical fumes, dust or other irritants in the air. If you’ve been diagnosed with asthma that has another cause, it can be worsened by airborne irritants at work. If you have asthma and suspect that your workplace is causing or worsening your symptoms, your allergist can help you manage your disease.

Asthma Diagnosis & Treatment

Your doctor will use tests to diagnose asthma. Some measure how well your lungs work. Others can tell if you’re allergic to mould, pollen, or other things.

  • Lung function tests are a way to check how well your lungs are working. Doctors use them to diagnose asthma and to monitor its progression. Monitoring asthma with lung function tests is helpful, because you may not always be able to tell just from your symptoms whether your asthma is under control.
  • Gas and diffusion tests can measure how well your blood absorbs oxygen and other gases from the air you breathe. You breathe in a small amount of a gas, hold your breath, then blow out. The gas you exhale is analysed to see how much your blood has absorbed.
  • X-rays may tell if there are any other problems with your lungs, or if asthma is causing your symptoms. High-energy radiation creates a picture of your lungs. You may be asked to briefly hold your breath while you stand in front of the X-ray machine.

Asthma Treatment Options

You might need to use fast-acting rescue medicines, long-term treatments, or both.

Rescue inhalers (or quick-relief inhalers)

Short-acting beta-agonists

These are the first choice for quick relief of asthma symptoms. They include albuterol (Ventolin HFA), epinephrine, and levalbuterol.


such as ipratropium (Atrovent) lessen mucus in addition to opening your airways. They take longer to work than short-acting beta-agonists.

Oral corticosteroids

such as prednisone and methylprednisolone lower swelling in your airways.

Combination quick-relief medicines

have both an anticholinergic and a short-acting beta-agonist.

Preventive long-term medications

Inhaled corticosteroids

These are the most effective long-term control medicines. These aren’t the same as anabolic steroids that people use to grow muscle. They include beclomethasone , budesonide (Pulmicort), ciclesonide, fluticasone and mometasone (Asmanex).

Inhaled long-acting beta-agonists

These open your airways by relaxing the smooth muscles around them. You’ll take this medication along with an inhaled corticosteroid. They include formoterol, salmeterol, and vilanterol.

Combination inhaled medicines

These have an inhaled corticosteroid along with a long-acting beta-agonist. This is an easy way to take them together. They include Advair and Symbicort.


Biologics target a cell or protein in your body to prevent airway inflammation. They may be shots or infusions you get every few weeks. They can be expensive, so you usually get them if other medications don’t work. Biologics include benralizumab, dupilumab, mepolizumab, omalizumab, and reslizumab.

Leukotriene modifiers

These relax the smooth muscles around your airways and ease swelling. You can take them as pills or liquids. These include montelukast (Singular), zafirlukast (Accolate), and zileuton (Zyflo).


prevents your airways from swelling when they come into contact with an asthma trigger. It’s a non-steroid medicine that comes in an inhaler.


relaxes the smooth muscles that narrow your airways. It comes as a tablet, capsule, solution, or syrup.

Long- acting bronchodilators.

You might use tiotropium (Spiriva) along with corticosteroids if you have ongoing asthma symptoms even though you take a daily inhaled steroid. Never use long-acting bronchodilators alone as a long-term asthma treatment.


If no other medicine can get your asthma attacks under control, your doctor might have you take these medications for a couple of weeks. They come in pills or liquids.

Create An Asthma Action Plan

You and your doctor or health care practitioner will work together to create an action plan. It can be on paper or online. Either way, it will boost your efforts to control your condition with information and directions on:

  • How to know if your symptoms get worse
  • Medicines to take when you’re doing well and when symptoms get worse
  • What to do in an emergency
  • Doctor contact info for an emergency
  • How to control asthma triggers

You might need to keep track of your symptoms as part of your asthma action plan. Plans usually include three sections:

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You don’t notice any symptoms, or you have them under control. You can use your regular medications.

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Your symptoms happen more often or are worse. You might need to change treatments or use more medicine.

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You have severe symptoms that need treatment right away, usually with several medicines.

Asthma Lifestyle Home Remedies

In addition to following your treatment plan, you can try:

  • Breathing exercises. These can lower the amount of medication you need to control your symptoms.
  • Herbal and natural remedies. Things that may help improve asthma symptoms include:

Black seed oil (Nigella sativa)

Some studies have shown that it can help open airways.


It’s a mild bronchodilator, meaning it can open your airways, but it doesn’t work as fast as medications. Avoid caffeine for several hours before any medical appointment that might include a lung function test.


This helps your body work the way it should. You can get it in meat, liver, eggs, poultry, fish, shellfish, peanuts, and cauliflower, or from a supplement.


You can get this pine bark extract as a supplement.

Lastly Avoid asthma triggers as mentioned above. Many things in the world around you can set off an asthma attack. By keeping them under control, you can lower your chances of problems. Talk to your asthma specialist. If you’ve been diagnosed with asthma but your treatment doesn’t seem to work anymore, it’s time to see your doctor again. Likewise, if you’re having to use your rescue inhaler too often, see your doctor. You may need to change your asthma treatment for better control.

Though asthma is common, it’s a serious condition that needs a diagnosis and treatment. Talk to your doctor or local healthcare practitioner for asthma support, and find the medications and treatment options that work best for you.


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