Asthma is a chronic inflammatory disease of the airways (bronchi). In asthmatic patients, the airways react more strongly to various stimuli (from the environment or from the body itself), compared to people who do not suffer from asthma, resulting in the contraction of the bronchi (bronchospasm).

This causes the narrowing of the airways, which in combination with the already existing inflammation (swelling of the bronchi and production of thick secretions), leads to a decrease in the flow of air through the bronchi.

Asthma can occur at any age and is characterized by flare-ups and remissions. When the disease is in remission, the patient may have no symptoms at all. But this does not mean that asthma has disappeared.

Causes of asthma

The most important causes of asthma are: exposure to allergens or irritants (such as dust, house mites, plant and tree pollens (partridge, olives, poplars), fungi, animal hair, strong smells (bleach), air pollution, smoking, passive smoking, occupational allergens (paints, varnishes, glues), humidity, temperature changes, some medicines, etc.), certain seasons of the year (spring or autumn) ), exercise, respiratory infections, emotional factors (joy, intense laughter or crying, sadness, anxiety) and finally hereditary predisposition.

How is asthma diagnosed?

The diagnosis of asthma is made on the basis of the patient’s individual history (patient’s symptoms, occupation, animals at home, medication intake, concomitant diseases such as allergic rhinitis, etc.), his family history (if there is asthma or allergies in the his family), physical examination and laboratory testing.

The onset and severity of an asthma patient’s symptoms vary. Common symptoms are:

• Cough dry (no sputum) or productive (with white sticky sputum)
• Wheezing=Whistling mainly on exhalation (the so-called “kittens”)
• Heaviness or tightness in the chest
• Dyspnoea (Difficulty breathing)

Asthma can sometimes manifest with just a mild cough. As this has become part of their daily life, patients consider it normal and do not go to a doctor, resulting in a delay in diagnosis.

The tests that will help us diagnose asthma are:

• Spirometry before and after bronchodilation. The examination is done with a special machine called a spirometer, which measures the function of the lungs.
• Measurement of air flow during the day by the patient himself, at home or in the workplace, with a flow meter.
• Metacholine challenge test (in patients with typical symptoms, but non-diagnostic spirometry).
• Ergospirometry (for exercise-induced asthma).
• a chest X-ray in a patient with a chronic cough is necessary, to rule out other diseases.
• Blood tests (immunoglobulin E, General blood for any increase in eosinophils).
• Allergological testing (skin tests or special blood tests (RAST)) can be used to identify triggers for asthma exacerbations (eg pollen, animal dander, etc.).

Asthma treatment includes:

• Fast-acting inhaled bronchodilators, mainly for the immediate relief of the patient’s symptoms.
• Regulatory drugs to control inflammation (Inhaled corticosteroids, long-acting inhaled bronchodilators, leukotriene antagonists, monoclonal antibodies, theophylline, etc.)
• Oral or injectable cortisone for severe flare-ups.

Most asthma patients have allergic rhinitis, with rhinitis exacerbations leading to asthma exacerbations. Treatment for rhinitis is therefore equally important (antihistamines, nasal sprays, etc.).

Smoking cessation is imperative, as medications are less effective in smokers, but also in controlling asthma in general. Vaccination against influenza and pneumococcus is also very important, as well as regular medical monitoring of the patient, as many patients tend to underestimate their symptoms.