~ Weekly Health Advice from PMGH – Asthma – Part 1 of 4 ~

Welcome to another health update from the Port Moresby General Hospital, this week we are focusing on Asthma, what are the symptoms of asthma and when is it a medical emergency?

What is Asthma?
Asthma is a chronic condition that causes inflammation and narrowing of the bronchial tubes, the passageways that allow air to enter and leave the lungs. According to Asthma Australia, the causes of asthma are not fully understood, although people with asthma often have a family history of asthma, eczema, and hay fever. Research has shown that exposure to tobacco smoke (especially as a baby or young child), obesity and some workplace chemicals can increase the risk of developing asthma. Although there is currently no cure for asthma, with the right knowledge and good management, most people with asthma can lead full and active lives. According to the National Asthma Council of Australia, many people think they have asthma only when they have asthma symptoms. In fact, the airways are sensitive all the time, and most people with asthma have permanently irritated (inflamed) airways when not taking regular preventer treatment. From time to time, the airways tighten or become constricted, so there is less space to breathe through, leading to asthma symptoms. Asthma causes three main changes to the airways inside the lungs, and all these can happen together:
– the thin layer of muscle within the wall of an airway can contract to make it tighter and narrower – reliever medicines work by relaxing these muscles in the airways
– the inside walls of the airways can become swollen, leaving less space inside, preventer medicines work by reducing the inflammation that causes the swelling
– mucus can block the inside of the airways; preventer medicines also reduce mucus.

Asthma symptoms can be triggered by different things for different people however, common triggers include colds and flu, allergies, and cigarette smoke. An asthma flare-up is when asthma symptoms start up or get worse compared to usual. These flare-ups can happen quite quickly (e.g. if you are exposed to smoke) but they can also come on gradually over hours or days (e.g. if you get a cold). An asthma flare-up can become serious if not treated properly, even in someone whose asthma is usually mild or well controlled. A severe flare-up needs urgent treatment by a doctor or hospital emergency department.

Asthma Triggers
Triggers can cause the airways to become narrow and inflamed, leading to asthma symptoms. Avoiding triggers, if possible, can help to control asthma. Anything that causes a reaction can set off your asthma symptoms, these triggers differ between individuals. It is not always possible to avoid your triggers, however, reducing exposure to your asthma or allergy triggers may make your symptoms easier to manage. Work with your doctor to work out what your triggers are and get some helpful advice on how to avoid these.

Common Asthma Triggers:
Colds and flu: Colds and flu are the most common trigger for asthma flare-ups, while you can’t always avoid them you can reduce your risk by washing your hands regularly and talking to your doctor about a flu shot.

Cigarette smoke: People with asthma have even more reason to avoid smoking than those without asthma. Your lungs are extra sensitive when you have asthma and they are especially vulnerable to the damaging effects of cigarette smoke. In the short term, smoking and asthma makes you more likely to have asthma attacks or flare-ups. In the long term, you’re at higher risk of developing smoking-related diseases like emphysema. If you smoke, please talk to your doctor about quitting.

Allergies: Allergy occurs when a person’s immune system (the body process that protects against disease) reacts to substances in the environment that are usually harmless to most people. These substances are known as allergens. Examples of allergens include house dust mites, pollen, mould, and pet dander. If you have asthma that is triggered by allergens, you may have asthma symptoms when you vacuum or dust (as this causes house dust mite allergens to become airborne), visit a house where a pet lives, are outdoors in late spring and early summer, and when there are high levels of pollen in the air or are exposed to mould.

Exercise: is a common asthma trigger however exercise is great for your health. If exercise triggers your asthma symptoms, talk with your doctor so you can find the treatment that works best for you.

Other triggers: There are a number of other triggers that may affect individuals at various times such as weather e.g. cold air, change in temperature, thunderstorms, work-related triggers e.g. wood dust, chemicals, metal salts, irritating substances breathed in the air such as burning wood or grass, certain medicines, e.g. aspirin, some blood pressure drugs, stress and high emotions, such as crying.