It is one of the most frequent diseases internationally, with significant variations in incidence rates per country, reaching up to 20% of the population in some of them.

About 358 million people worldwide suffer from asthma, with the percentage in Greece ranging from 8% to 9%. The disease can occur at any age and in any gender and is related to both genetic factors, such as heredity and family history, and environmental factors, such as smoking, inhaling pollutants, allergies, infections, exercise and stress. At the same time, in childhood, asthma is the most widespread chronic disease and occurs in 1 in 10 children, with this frequency constantly increasing worldwide.

What are the symptoms of asthma?

“Asthma symptoms vary from person to person, depending on their age and the environment they live in. However, the most common symptoms include wheezing, shortness of breath, tightness and pain in the chest, and coughing. Also, there are cases of rhinitis or itching in the throat and chest.

These symptoms are usually paroxysmal in nature, since they appear suddenly and after exposure to a trigger, and treatment is essential for their resolution. They usually vary within the same day and become more intense during the night and may resolve automatically or require appropriate treatment,” points out Mr.. Eleftherios Vrouvakis Director Pulmonologist at Metropolitan Hospital.

What factors make asthma worse?

The above symptoms may worsen depending on the area in which the patient is, as for example some people may inhale chemicals, smoke, dust or gases at work, indoors or outdoors. Also, there may be an exacerbation of symptoms in the presence of cold or dry air, pollen, mold, dander or animal saliva. At the same time, conditions such as viral infections, weather changes, exposure to allergens, can also trigger asthma symptoms, which are mainly related to the patient’s respiratory function with the appearance of expiratory airflow limitation.

How is asthma diagnosed?

Many patients fail to recognize that they have asthma mainly because of their chronic coexistence with it.

“The diagnosis of asthma is made by an appropriately qualified doctor, which is usually the pulmonologist. The diagnosis process includes a series of clinical examinations, such as history taking, physical examination, paraclinical examination, hematological tests, challenge and exercise tests, allergy tests and CT scans, in order to record the symptoms and their severity”, he says and continues to analyze the clinical diagnostic tests.

Tests that are usually required include:

• Spirometry: This test assesses the narrowing of the bronchial tube by measuring how much air a person can exhale after a deep breath and the speed of their breathing.
• Maximum flow measurement: With a special device, difficulty in exhalation is assessed. If the results are lower than expected, this indicates lung function problems and worsening asthma.
• NO (exhaled nitric oxide)

What is the difference between bronchial asthma and severe allergic asthma?

Bronchial asthma and severe allergic asthma are two different categories of asthma, with different characteristics and frequency of occurrence:

• The bronchial asthma is the most common form of asthma and is usually mild or moderate in severity. Its symptoms can be episodic and appear intermittently. It is usually associated with allergies, but can also be caused by other factors, such as viruses or increased levels of a multicellular bacterium in the environment.
• Severe allergic asthma is a more severe form of asthma that, while the patient is on high doses of inhaled corticosteroids, the medication cannot be tapered off, or the patient receives oral cortisone at intervals.

How we approach the management and treatment of asthma;

“The basic approach is to treat the symptoms from the beginning, seeking an early and accurate diagnosis and planning with the doctor the appropriate and individualized treatment. Immediate treatment of symptoms ensures optimal lung function with the minimum possible dose of medication.

In addition, it helps the patient to be properly informed and educated about the disease, thereby ensuring a normal life with little or no symptoms during the day, daily activity, no symptoms at night, little or no need for medication and finally normal respiratory operation.

Treatment mainly involves drugs that are inhaled through appropriately selected devices, determined by the doctor for each patient. These drugs act directly on the lung and are effective and safe when used as directed. More recent treatments, which include monoclonal antibodies and biological agents, are aimed at patients with a more severe form of asthma and aim to reduce the need for corticosteroids”, explains Mr. Vrouvakis and concludes by listing the goals of asthma treatment.

What are the main goals of asthma treatment?

The main objectives include:

• To prevent the appearance of asthma symptoms.
• Allow the patient to return to their daily activities, have a normal sleep and significantly improve their quality of life.
• To prevent the recurrence of seizures that may affect the person’s productivity at work or school.
• To reduce the possibility of a visit to the emergency room or even hospitalization in more serious cases.

*The Pulmonology Department of Metropolitan Hospital operates daily and has the most modern and advanced medical technology equipment, covering the entire range of tests necessary for the complete investigation, accurate diagnosis and proper monitoring of all respiratory diseases, while the professionals who make it up are experienced and specialized in their field. At the same time, the department works closely with other units and laboratories of the hospital, such as the Intensive Care Unit, the Departments of Cardiology, Oncology, Radiology, Infectiology and many others, with the aim of providing customized medical services to each patient, taking into account the unique needs and their specific ailments.