Bronchial asthma, commonly referred to as asthma, is a chronic respiratory condition characterized by inflammation and narrowing of the airways, leading to recurrent episodes of wheezing, shortness of breath, chest tightness, and coughing. These symptoms typically occur in response to triggers such as allergens, respiratory infections, exercise, cold air, air pollution, or irritants like smoke.
The inflammation in asthma affects the lining of the airways, causing them to become swollen and sensitive. Additionally, the muscles surrounding the airways may tighten (bronchoconstriction), further narrowing the passages through which air flows into and out of the lungs.
Why does asthma develop?
Researchers and doctors do not know the exact cause of asthma, but they are confident that genetics and environmental factors play a role in the onset of the disease. Triggers of bronchial asthma:
- genetic predisposition;
- allergens (lead to the development of atopic bronchial asthma);
- respiratory tract infections. Viral or bacterial infections of the respiratory tract can cause inflammation and narrowing of the bronchi;
- uncontrolled use of medications (for example, beta blockers or antibiotics);
- exposure to respiratory tract fumes and toxins;
- active and passive smoking.
Extreme conditions such as dust storms, wet or cold weather, intense exercise, and stress can trigger an asthma attack. Gastroesophageal reflux disease (a condition in which stomach acid flows back into the throat) also increases the risk of cough-related asthma.
Types of asthma
Asthma manifests in various forms, with allergic asthma, non-allergic asthma, exercise-induced asthma, and occupational asthma representing distinct subtypes, each with its unique triggers and clinical characteristics.
| Characteristic | Allergic Asthma | Non-Allergic Asthma | Exercise-Induced Asthma | Occupational Asthma |
| Triggers | Allergens such as pollen, pet dander, dust mites, etc. | Irritants (e.g., smoke, pollution, strong odors), respiratory infections | Physical exertion, exercise | Workplace substances or irritants |
| Onset | Typically starts in childhood or adolescence, often associated with a family history of allergies | Can develop at any age, may be triggered by environmental factors or respiratory infections | Often occurs during or after vigorous physical activity | Develops due to exposure to specific substances or irritants in the workplace |
| Symptoms | Wheezing, coughing, shortness of breath, chest tightness, triggered by exposure to allergens | Wheezing, coughing, shortness of breath, chest tightness, triggered by non-allergic factors | Wheezing, coughing, shortness of breath during or after exercise | Wheezing, coughing, shortness of breath, triggered by workplace exposures |
| Diagnostic Tests | Allergy testing (skin prick test, blood test), lung function tests (spirometry), medical history | Lung function tests (spirometry), medical history, assessment of exposure to irritants | Exercise challenge test (monitoring symptoms during exercise), lung function tests | Assessment of workplace exposures, lung function tests, medical history |
| Treatment | Allergy management (avoidance of allergens), inhaled corticosteroids, bronchodilators, immunotherapy | Inhaled corticosteroids, bronchodilators, avoiding triggers (e.g., smoke, pollution), allergy testing and management if applicable | Pre-exercise bronchodilators, warm-up exercises, avoidance of cold air or high pollen levels during exercise | Avoidance of workplace triggers, respiratory protection (e.g., masks), changes in work environment or duties, medications (similar to non-allergic asthma) |
Signs of asthma in adults
A characteristic symptom of bronchial asthma is shortness of breath (a feeling of lack of air or difficulty breathing). It can manifest as mild shortness of breath or a serious attack of suffocation. Other symptoms of bronchial asthma in adults:
- wheezing (produced when breathing, sounds like a whistle or squeak);
- a feeling of tightness or constriction in the chest;
- fast fatiguability;
- nocturnal attacks;
- attacks of suffocation (breathing becomes extremely difficult and immediate medical attention may be required).
A cough in asthma can be dry or mucous and manifests itself as a reaction to irritants in the environment. Sputum in bronchial asthma usually does not appear at an early stage, but as the pathology progresses it can be sticky and viscous, sometimes containing traces of blood.
Symptoms of asthma in a child
Signs of asthma in children may vary depending on age. Symptoms of asthma in children:
- newborns: shortness of breath and wheezing in the chest, pallor, sweating and fatigue (signs may appear after feeding);
- preschool children: frequent coughing attacks (especially at night or early in the morning), whistling sounds when breathing, complaints of chest pain, increased irritability.
Signs of asthma in schoolchildren and adolescents can also cause coughing attacks, shortness of breath during physical activity, and wheezing. Children may also experience constant fatigue and trouble sleeping.
How is asthma diagnosed?
At the appointment, the pulmonologist collects anamnesis, analyzes complaints and conducts a physical examination. Diagnosis of bronchial asthma:
- Asthma challenge tests (used to induce asthmatic symptoms through controlled exposure of the airways to various irritants);
- blood and sputum tests for asthma (used to detect inflammatory changes in the airways and to exclude other diseases).
The doctor also conducts functional breathing tests, which allow you to evaluate lung volume and air flow rate when exhaling. Such tests include spirography, manometry and peak flowmetry. Spirography for bronchial asthma helps to measure lung volumes, the speed and volume of air exhaled in one second and other parameters, which is important for determining the degree of airway obstruction and the severity of bronchial asthma, as well as monitoring the effectiveness of treatment.
Can asthma be cured?
Treatment for asthma depends on its type, severity and individual characteristics of the patient. Treatment for asthma may include:
- bronchodilators (open the airways, improving air flow);
- glucocorticosteroids (reduce inflammation in the airways, reduce swelling and mucus secretion. These can be in the form of an inhaler or tablets;
- combination drugs (contain bronchodilators and glucocorticosteroids). May improve control of asthma symptoms;
- immunomodulators (support the immune system and reduce inflammation).
Your doctor can also prescribe medications to control your symptoms: cough, shortness of breath, and itchy throat. Short-acting beta-agonists and anticholinergics prescribed by a pulmonologist will help relieve an asthma attack. To relieve an acute attack, your doctor may also give you an asthma injection containing corticosteroids.
Vaccination for asthma is not contraindicated, but is necessary due to the increased risk of developing respiratory tract infections in people with bronchial asthma. If you are allergic to vaccine components, you should discuss the possibility of using another drug with your doctor. Exercise therapy for bronchial asthma can be done, but it is important not to use intense physical activity or go to the gym.
You should not smoke if you have asthma because of the increased risk of exacerbation of the disease, the development of chronic bronchitis and emphysema. If you have bronchial asthma, staying in dusty rooms with dry air is prohibited; it is also important to avoid triggers (pollen, wool, toxins).
How to prevent the development of asthma?
While asthma cannot always be completely prevented, especially in cases where genetic predisposition plays a significant role, there are several strategies that can help reduce the risk of developing asthma or minimize its severity:
- Avoidance of tobacco smoke. Avoiding exposure to tobacco smoke, both during pregnancy and after birth, can reduce the risk of asthma development in children.
- Breastfeeding. Breastfeeding infants exclusively for the first few months of life has been associated with a reduced risk of developing asthma and other allergic conditions.
- Reduce exposure to allergens. Minimizing exposure to common allergens such as pollen, dust mites, pet dander, and mold can help reduce the risk of sensitization and asthma development. This may involve using allergen-proof covers on bedding, vacuuming regularly, and keeping pets out of sleeping areas.
- Maintain healthy indoor air quality. Good ventilation and air filtration can help reduce indoor air pollutants such as smoke, dust, and volatile organic compounds (VOCs), which can exacerbate asthma symptoms.
- Prevent respiratory infections. Practicing good hygiene, such as frequent handwashing, and staying up to date on vaccinations, especially for influenza and respiratory syncytial virus (RSV), can help reduce the risk of respiratory infections that can trigger asthma exacerbations.
- Avoid occupational exposures. For individuals in high-risk occupations, taking steps to minimize exposure to workplace irritants or allergens, such as wearing protective equipment and following safety protocols, can help prevent occupational asthma.
- Maintain a healthy lifestyle. Eating a balanced diet, maintaining a healthy weight, and staying physically active can help support overall lung health and reduce the risk of asthma development.
- Manage stress. Stress management techniques such as relaxation exercises, mindfulness, and regular physical activity may help reduce the risk of asthma exacerbations triggered by stress.
While these strategies can help reduce the risk of asthma development, it’s important to remember that asthma can still occur despite these measures. Regular medical check-ups and early intervention for symptoms are key to managing asthma effectively and minimizing its impact on quality of life.