Asthma
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Asthma

Respiratory Medicine

Asthma is a common chronic lower respiratory disease that affects the functioning of the lungs and airways of patients. For people with asthma, the airways may become inflamed and constricted, preventing them from breathing normally.

According to the Hong Kong Asthma Society around 5% of the adult population and 10% of children have asthma symptoms.

Asthma is a common chronic lower respiratory disease that affects the functioning of the lungs and airways of patients.


 

Symptoms

More commonly seen symptoms include 

  • Out of breath
  • Feeling of pressure on chest
  • There is a "pulling sound" in the airway when exhaling and inhaling
  • A persistent, recurring cough after exercise, a change of season, or a cold

Causes and risk factors

Asthma is a common condition where the bronchioles tighten and get inflamed, however to date the medical community has not found an exact reason behind why some people have this condition. The follow are a few indicators that someone may have asthma:

  • family history of asthma
  • Allergy Occupational factors, some occupations are prone to exposure to irritants, such as : chemicals, dust, etc., which can increase the risk of developing asthma smoking or exposure to second-hand smoke
  • Obesity

In addition, risk factors that tend to trigger asthma attacks in patients include:

HouseholdDust, mold, mites, pet hair, pollen from potted plants
Sudden and drastic changes in temperatureSudden change in temperature; entering and leaving air-conditioned spaces
Air pollutantsSecond-hand smoke, construction site dust, vehicle emissions
Allergic reactionsFoods or medications to which you are known to be allergic
Physical conditionNervousness or depression
Excessive exercise

Diagnosis

  • The doctor will take the patient's medical history, especially about asthma symptoms, such as auscultation for wheezing, family history, and other diseases that may cause asthma. Lung function test and peak expiratory flow test will also be conducted.
  • Skin and blood tests may also be conducted to test the patient’s reactions to different allergens.
  • In some cases, the doctor may order other tests, such as a respiratory provocation test, to aid in the diagnosis.


 

Treatment

Currently there is no curative treatment for asthma, however there are still methods to control, relieve and prevent asthma attacks. Medications to do so include: 

  • Controller medications: Long-acting controller medications (eg, inhaled steroids, long-acting bronchodilators, etc.) to reduce symptoms and prevent asthma attacks
  • Emergency medicines: such as short-acting bronchodilators; used immediately at the first sign of an attack to relieve acute asthma attacks, it is recommended to carry with you at all times

Impact

Asthma is a chronic respiratory disease that affects the daily life and health of patients:

  • Dyspnea (Breathing difficulties) triggered by asthma triggers
    • Affecting work, sports, going out, traveling, etc.
  • Psychological effects: Anxiety, fear and restlessness, especially during the attack period
  • If asthma is not effectively managed, patients may often have acute asthma attacks, and  serious consequences such as wheezing suffocation may occur

Prevention

It is recommended that patients take the following measures to control and prevent asthma exacerbations,  while reduce symptoms:

Reduce Exposure to Asthma Triggers
  • Such as air pollution, pollen, pets, tobacco, etc.
Changing unhealthy habits
  • Smoking, unbalanced diet or lack of exercise for example
Minimize chance of contracting upper respiratory infections
  • Maintain good personal hygiene and keep up on influenza vaccinations as the flu can cause significant complications in those with asthma

Asthma patients should also avoid nasal spray vaccinations, as they have a tendency to trigger asthma attacks by irritating the nasal passages. For people at high risk of develop asthma, such as those with a family history of asthma, and consistent exposure to asthma risk factors, preventative screenings such as allergen testing can help detect asthma earlier and reduce asthma attacks and deterioration. In case of a severe asthma attack where it does not improve with reliever medication, seek medical attention immediately.  

If you suspect you have asthma, it is recommended to seek the help of a medical professional for diagnosis and treatment.


 

FAQ

The doctor will assess the patient’s situation and a decision is made. Factors such as the severity, number of attacks etc, they may also suggest prescription medications like an inhaler, and request you use it consistently to mitigate an asthma attack happening.
Some types of asthma may have nocturnal cough symptoms, it is recommended to consult a doctor for further examination.
You could consider adding changes to lifestyle habits and environments, aiming to avoid potential triggers, such as dust mites, animals that shed, smoke and pollen.
Typically, continued use of steroids will not cause a drug dependence, moreover asthma attacks are very serious situation, patients can experience breathing difficulties which may be life threatening. Furthermore, inhaled steroids have relatively few side effects. Common side effects such as hoarseness and oral infection can generally be avoided by rinsing the mouth after use. Therefore, the benefits of using inhaled steroids to control asthma outweigh the risks presented to asthma patients.

References

  1. Asthma in Hong Kong| The Hong Kong Asthma Society from https://hkasthma.org.hk/hk/about-asthma/哮喘在香港 
  2. Non-Communicable Diseases Watch July 2017 - Asthma Awareness from https://www.chp.gov.hk/files/pdf/ncd_watch_july_2017.pdf
  3. Asthma in Hong Kong | The Hong Kong Asthma Society from https://hkasthma.org.hk/en/about-asthma/asthma-hong-kong
  4. Asthma - What Is Asthma? | NHLBI, NIH from https://www.nhlbi.nih.gov/health/asthma
  5. Student Health Service - All You Need to Know About Asthma from https://www.studenthealth.gov.hk/english/health/health_ophp/health_ophp_ast.html
  6. Children's Health Strategy - Asthma from https://www.healthbureau.gov.hk/pho/files/child_2-10_Asthma.pdf

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