Bronchial Asthma Essay Example

bronchodilators may help relieve airway constriction, people might still face mild symptoms and prolonged shortness of breath during physical exertion. The severity of asthma symptoms varies but can be controlled through a combination of medication and modifications in daily life.

Approximately 5.2 million people in the UK receive asthma treatment, affecting approximately 1 in 10 children and 1 in 12 adults. Asthma is the most common chronic health issue among children, resulting in around 4.1 million visits to general practitioners each year.

With an annual allocation of ?1 billion by the NHS, the UK is among the countries that have high expenses on asthma-related issues. The country's prevalence of this condition is significant and results in many hospital admissions and mortality rates. Asthma mainly affects people aged 5 to 15 years old, with its occurrence decreasing until ages 55-64 when it starts to rise again. There are also gender differences as males experience higher childhood asthma rates while females have a higher chance of developing it during early adulthood.

Despite challenges posed by changes in patient reports of respiratory symptoms and doctor diagnosis methods, there are observable patterns in asthma prevalence over time. Notably, asthma diagnoses have notably increased since the 1950s, particularly in childhood where it has doubled or tripled. However, current evidence suggests that this trend may have stabilized or even decreased while remaining steady in adults. The incidence of new asthma diagnoses from GP consultations rose across all age groups until the 1990s before declining again; hospital admission rates peaked between the 1960s and late 1980s before decreasing.

During the 1960s, there was a significant increase in asthma-related deaths, particularly among children and young adults due

to changes in treatment. Mortality rates reached their peak again between the 1970s-1980s and had a greater impact on adults; however, they have since declined. As of February 2004, the Global Initiative for Asthma (GINA) reported that certain countries including the United Kingdom, New Zealand and Australia have a higher prevalence of asthma among children. Depending on data collection methods used, approximately 30% of children from these countries along with Peru were diagnosed with asthma while around 25% of adults from Great Britain, Australia and Canada have this condition.

The prevalence of asthma in the United States is high, with a diagnosis rate exceeding 6% among children. This represents an increase of 75% in recent decades, and certain urban populations report rates as high as 40%. Symptoms associated with bronchial asthma include dyspnea, chest tightness, wheezing, excessive coughing, and disrupted sleep. The severity of these symptoms can range from chronic respiratory impairment to episodic occurrences triggered by factors such as upper respiratory infection, stress, allergens, air pollutants or exercise. Common indications of asthma include dyspnea, wheezing, stridor, coughing, chest tightness/itching and impaired physical exertion.

An acute exacerbation of asthma, commonly known as an asthma attack, is identifiable by shortness of breath and either stridor or wheezing. Although wheezing is generally considered the hallmark symptom of asthma, certain patients may mainly manifest coughing. In severe occurrences, airflow constriction may be so intense that audible wheezing fails to occur. Symptoms during an attack can include chest tightness, breathing difficulties and abrupt onset of wheezing. Furthermore, clear sputum can result from coughing.

The symptoms of an asthma episode are diverse and can include wheezing, prolonged expiration, rapid heart rate, rhonchous

lung sounds, weakened pulse during inhalation and strengthened pulse during exhalation, and chest over-inflation. In more severe cases, individuals may experience oxygen deficiency resulting in the turning blue of skin or lips alongside chest pain or loss of consciousness. Moreover, prior to fainting, people suffering from asthma episodes might feel numbness in their limbs while experiencing sweating palms and extremely cold feet. It is crucial to treat severe asthma episodes using standard methods as failure to do so can cause respiratory arrest or even death.

The causes of asthma are diverse, ranging from issues with the stomach and gastrointestinal tract resulting in indigestion, constipation or diarrhea to complex interactions between environmental and genetic factors that affect the response to medication. Although numerous potential triggers for asthma have been proposed, not all have been verified. Asthma's pathophysiology is characterized by an immune system overreaction and has two components: "patho-" and "-physiology."

Pathophysiology is the study of abnormal bodily functions, combining "physiology" and "patho". It investigates how the body malfunctions. In relation to asthma, pathophysiology examines how the body responds abnormally to this condition.

Asthma affects the airways, particularly the bronchial tubes, lungs, and alveoli. Bronchoconstriction and inflammation cause the narrowing of airways resulting in wheezing. Environmental triggers such as smoke, dust or pollen can worsen asthma by increasing mucus production and making breathing difficult during an episode.

Asthma occurs due to an immune response in the bronchial airways, making them sensitive to certain triggers or stimuli. The result is contraction and spasms that can lead to inflammation, narrowed airways, coughing and excess mucus production. Allergic asthma is the most recognized cause.

Both asthmatics and non-asthmatics commonly consume

inhaled allergens through antigen presenting cells (APCs) located in the inner airways. These APCs present fragments of the allergen to other immune system cells, which usually scrutinize and ignore the allergen molecules. In asthmatics, however, these cells convert into TH2 cells for unknown reasons. Consequently, these TH2 cells activate a crucial aspect of the immune system called the humoral immune system that produces antibodies against the inhaled allergen.

Asthma is caused by various inflammatory factors and an abnormal immune response when allergens are breathed in. This triggers the production of chemicals that narrow airways and increase mucus, as well as activating the cell-mediated immune system which brings about asthma attack symptoms.

The immune response in asthma relies on the interaction between antigen and immunoglobulin E (IgE) located on cell surfaces. This interaction triggers the release of histamine and other inflammatory factors causing bronchospasm, increased protein and fluid leakage from venules, airway secretions, activation of irritant receptors in airway walls resulting in reflex vagal release near smooth muscles leading to further constriction of the bronchi. Although antihistamines are useful for treating other allergic disorders like allergic rhinitis, they are not effective for treating asthma.

The development of bronchial asthma is a complex process that involves the interaction of inflammatory cells, mediators, and neurogenic factors. Histamine and leukotrienes - which are products derived from arachidonate via lipoxygenase - contribute to the pathogenesis of this condition. Additionally, substances like platelet activating factor, bradykinin, substance P, oxidants and complement fragments may also cause bronchospasm. Despite this complexity, medications that suppress the synthesis of leukotrienes or their receptors have shown improvement in some patients with asthma.

Research has revealed that individuals with asthma

who have a greater degree of airflow obstruction may have increased levels of eosinophil counts detected in their bronchoalveolar lavage fluid. Moreover, decreased airway resistance and eosinophil counts are associated with responsiveness to steroids. The presence of mast cells within lung tissues is also significant during the initial stages leading up to an asthmatic episode. When irritant receptors within airways are stimulated, it can lead to the reflexive release of acetylcholine from cholinergic nerves which could result in coughing and bronchospasm.

Anticholinergic drugs may provide relief for airway obstruction in certain asthmatic patients, although they are less effective than ?-adrenergic agents. The diagnosis of asthma is characterized as reversible airway obstruction that can occur spontaneously or with proper treatment. Peak flow rates are the primary measurements used, and the British Thoracic Society follows specific diagnostic criteria, including a ?20% difference for at least two weeks on at least three days and a ?20% improvement in peak flow following treatments such as inhaling ?-agonist for at least 10 minutes.

The following treatments can be used for respiratory issues: a seven-day course of a bronchodilator such as salbutamol, a six-week period of inhaled corticosteroids such as beclometasone, or a 14-day course of 30mg prednisolone. If there is a 20% decrease in peak flow due to exposure to a trigger, these treatments may be necessary.

If a patient has a family history of asthma or allergies, diagnosing asthma involves reviewing their medical history and conducting an examination. Airway function tests may not be practical for children with asthma, so diagnosis is based on careful analysis of medical history and improvement in symptoms with bronchodilator medication.

Diagnosing asthma in adults involves using a

peak flow meter to test airflow restriction and analyzing diurnal variation and reversibility after using an inhaled bronchodilator medication. Current treatment protocols suggest using preventative medications, like inhaled corticosteroids, to reduce airway inflammation and swelling. These medications should be used by individuals with frequent reliance on relievers or severe symptoms. If symptoms persist, additional preventive drugs are added until asthma is controlled. Proper use of prevention drugs can prevent complications that arise from overusing relief medications. However, asthmatics may stop taking their preventative medication if they feel well and have no breathing difficulties.

The occurrence of additional attacks without any long-term improvement is a common consequence. To prevent this, various agents can be utilized, such as:

• Inhaled glucocorticoids, which are commonly delivered through inhaler devices.
• Leukotriene modifiers, which provide an anti-inflammatory effect similar to inhaled corticosteroids and act as a preventive measure.
• Mast cell stabilizers
• Antimuscarinics/anticholinergics, which serve a dual purpose of relieving symptoms and preventing future attacks. They are often recommended when inhaled steroids do not provide sufficient relief.

When inhaled glucocorticoids and long-acting ?-agonists are insufficient, methylxanthines may be considered. To address chronic inflammation caused by allergies, antihistamines can help. Hyposensitization is recommended for asthma patients suspected to have allergy-related triggers. For severe allergic asthma unresponsive to other treatments, Omalizumab, an IgE blocker, is used. Methotrexate is prescribed for challenging cases. Treating GERD (chronic acid indigestion) that contributes to asthma is important in preventing prolonged respiratory issues.

Asthma, a chronic bronchopulmonary disease caused by an allergic inflammatory process, can result in airway obstruction leading to respiratory difficulties and coughing. Acute bronchi constriction

may cause breathlessness and asphyxia. The best approach to managing asthma is to identify potential triggers such as pets or aspirin and minimize exposure to them. Medical treatment may be necessary when trigger avoidance alone isn't enough.

Relief medication, prevention medication, long-acting ?-agonists, emergency treatment, and desensitization are all treatment options for asthma. The severity and frequency of symptoms will determine the specific medical treatment recommended for each patient. Asthma treatments are categorized as relievers, preventers, and emergency treatment. Fast-acting bronchodilators in pocket-sized, metered-dose inhalers (MDIs) are typically used to control wheezing and shortness of breath during asthma episodes.

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