Asthma: when it’s hard to breathe

Posted on 2 May 2017

World Asthma Day on 2 May is an initiative to improve awareness of this under diagnosed disease that is believed to be on the increase globally.

Asthma is an incurable, chronic lung disorder that affects an estimated 334 million people globally, and 5% of adults in South Africa (the Global Asthma Report). The condition causes difficulty in breathing, tightness in the chest/wheezing and sometimes coughing as a result of inflammation in the lungs. This leads to constriction or narrowing of the airways, mucus production and swelling that, left untreated, can result in death.

Why is it sometimes difficult to diagnose?

Asthma symptoms can resemble other respiratory problems like bronchitis, so it can go undiagnosed. Many people may not know they have it, especially if it just presents as a cough during exercise or at night. To diagnose it, doctors need to take a full medical history and perform a medical exam. Important tests includes lung function testing often with X-rays, blood and allergy tests in addition.

‘Anyone can develop asthma – although it tends to occur in younger children, those with a family history of asthma, and those with other allergy-type disorders like eczema and allergic rhinitis,’ says Prof Richard van Zyl-Smit, head of the Lung Clinical Research Unit at the University of Cape Town and executive committee member of the National Asthma Education Programme.

What causes asthma?

The cause is unknown but asthma is not a psychosomatic/psychological condition even if it can be aggravated by stress. In the 1950s, a child’s wheeze was considered a cry for a mother’s help, and asthma was seen as a psychological problem. Researchers in the US claim the global increase in asthma could be because fewer childhood infections lead to an under-developed immune system. Prof van Zyl-Smit says that some children outgrow their asthma in adulthood but adds that it can’t be cured otherwise.

Diet and lifestyle

With the medication available today, asthma is easily treated. Prof van Zyl-Smit says if your asthma is controlled, you can lead a completely normal life. ‘However, poorly controlled asthma will result in daily symptoms, frequent need for hospital visits and could even kill you.’

A large proportion of asthmatics have allergies, and people with allergies can have asthma – but they don’t necessarily occur together. Where there is an associated food allergy, says Prof van Zyl-Smit, diet may be important – but this is in a minority of cases. ‘Reducing exposure to air pollution including tobacco smoke, aero-allergens such as pollen, cat and dog fur, and so on, will reduce the risk of having an asthma attack.’

Asthma triggers  

Asthma can be induced by exercise or occupation (workplace irritants like chemicals, gases or dust) or be allergy-related (pollen, mould, cockroach waste or pet dander).

Other triggers can vary but commonly include:

  • Cold air
  • Smoke
  • Respiratory infections
  • Certain medications

Treatment options

The most important aspect of asthma treatment is to reduce the inflammation ‘burning’ in the airways with inhaled corticosteroids, called controllers. Then, to relieve the spasm in the airway muscles, a bronchodilator (reliever) is used. For those with severe symptoms, a combined controller/reliever pump may be prescribed. ‘The most import part of controlling asthma is to use your medication regularly and make sure you are using the pump in the correct way,’ Prof van-Zyl Smit concludes.

Famous asthmatics

  1. Elizabeth Taylor
  2. Bill Clinton
  3. Martin Scorsese
  4. Charles Dickens
  5. Ludwig von Beethoven
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In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.

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