Correct use of medication important for controlling asthma

Person using an inhaler.

Asthma affects millions of adults and children worldwide, an estimated 262 million people in 2019, 461 000 of whom died, according to the World Health Organisation. It is the most common chronic disease among children. Although it cannot be cured, its symptoms can be controlled. It affects different people to varying degrees. For some it is a minor nuisance. For others it can interfere with their daily activities and lead to a life-threatening asthmatic attack.

Asthma is a long-term condition in which air passages to or within your lungs narrow and swell due to inflammation and tightening of the muscles around the small airways and may produce extra mucus. This can make breathing difficult and trigger coughing, wheezing when you breathe out and shortness of breath. With some children the asthma disappears during their teenager years, although it may come back in adult life.

Causes

The cause of asthma is unknown. However, there are certain triggers known to set off an asthma attack. These triggers vary from person to person. Genetics may also sometimes be a factor. Allergies play a part for some people. Most people with asthma have allergies to things in the air, such as tree, grass, and weed pollens, or mould, animal dander, dust mites and cockroach droppings. Food allergies and some food additives can also trigger asthma.

Apart from allergies, other known triggers include exercise, heartburn, smoking, sinusitis, certain medications, changes in the weather, smoke, chemical fumes, gases, dust, strong odours and strong soaps and perfumes. Respiratory infections such as the common cold may be a trigger for some asthmatics. Strong emotions and stress can set off an asthmatic attack in so people. Exercise-induced asthma may be worse when the air is cold and dry. Acid reflux is another possible trigger.

Symptoms

Common signs and symptoms of asthma include coughing, wheezing, chest tightness and shortness of breath. Coughing from asthma is often worse at night or early in the morning, making it hard to sleep. If you constantly experience shortness of breath or hear a whistling or wheezing sound in the chest when breathing, it could be asthma.

Signs that your asthma may be getting worse include increased frequency or seriousness of asthma attacks, increased difficulty breathing as measured with a peak flow meter that checks how well your lungs are working and the need to use an inhaler more often.

If you have mild symptoms for up to two days a week and two nights a month, this is considered mild intermittent asthma. If you have symptoms more often than twice a week but only once in a single day this is classified as mild persistent asthma. Symptoms that occur once a day and more than one night a week suggest moderate persistent asthma. If symptoms occur throughout most days and frequently at night this is considered severe persistent asthma.

Treatment

How badly asthma affects an individual varies. With treatment the symptoms can usually be controlled, making it possible to live a healthy and active life. Some people, though, if the asthma is severe, may have persistent problems. Treatment depends on the severity of your asthma. Its severity may change over time, necessitating adjustments in treatment.

Effective treatment requires tracking your symptoms and measuring how well your lungs are working. To assist your doctor, you can record your symptoms and when they occur. Once you start using a quick relief inhaler, record when you need to use it and how many puffs you take.

The most common means of obtaining relief from an asthma attack is the use of an inhaler. Inhaled medication such as corticosteroids may be used daily as a long-term control preventative medication to treat the airway inflammation that leads to asthma symptoms. A quick relief inhaler contains a fast-acting medication such as albuterol. It is used when needed to open your airways and help you breathe more easily.

It is important to know how to use asthma medication correctly. The long-term inhaled medication is the key to keeping your asthma well controlled. If you frequently use a quick relief inhaler, the asthma is not well controlled. You should see your doctor, who may make changes in your treatment.

Prevention

There is no way to prevent asthma. However, if your asthma is triggered by allergies, identifying these and avoiding these triggers should help prevent asthma attacks. You may learn to recognise warning signs or an impending attack. If you act quickly, you may be able to prevent a severe attack. Take your medicine as prescribed. Do not change it without consulting your doctor.

Like everyone else, those with asthma should adopt a healthy lifestyle. That includes a healthy diet and having sufficient exercise. Although exercise can be a trigger for asthma, with the right medication people with asthma can exercise safely.

However, it is advisable, if you suffer from asthma, to consult your doctor on whether it is safe to exercise and which activities it would be best to start with to avoid an attack. Some exercises are better than others for people with asthma. Some are not recommended at all. The severity of the asthma will play a part in determining the most appropriate exercises. The doctor will also be able to explain what to do before exercise and what to do if you have an attack, as well as ensure you are on the most appropriate medication.

Activities that involve short periods of exertion are best, especially when the asthma has been playing up or when you have not done any exercise for a while. Some of these activities include volleyball, gymnastics, baseball, yoga, biking, aerobics, walking, jogging, running and table tennis. Pacing also works. Swimming, although it is a high endurance sport, has been known to be well tolerated by people with asthma. This is usually because it is performed while breathing warm, moist air, which is less likely to trigger an attack.

Team sports such as cricket and netball, which give participants time to rest in between bursts of activity, are also generally safe. Activities that are less recommended are those that involve long periods of exertion such as soccer, long distance running, basketball and field hockey. These may be tolerated less well by people with asthma than by those without it.

Maintaining an active lifestyle is important for both physical and mental health. Besides helping with asthma, exercise helps with overall health. It helps the heart and lungs stay healthy and keeps bones and muscles strong.

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