According to Platts-Mills, asthma is a chronic inflammatory condition of the bronchus/airways and lungs that causes spasm and periodical dilation of the bronchus thereby narrowing it. The enlargement of the dense oesinophilic line near the bronchus/airways causes the individual to wheeze and gasp for air. The barrier to air flow may be resolved spontaneously but in extreme cases the response may only be achieved after using a wide range of medication. Continued swelling results in extreme sensitivity of the airways to different stimuli such as cold, grime, pollen, stress, nervousness, exercise and pollutants (163).
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Busse and Holgate observe that asthma is mainly caused by inhalation of allergen that exacerbates a chain of biochemical and tissue reactions resulting in bronchial enlargement, bronchoconstriction and gasping/wheezing. The symptoms are further aggravated by rhinitis and sinusitis, gastric acid reflux, viral infection of the respiratory system or cold and the use of drugs such as aspirin and beta-blocker drugs. The known causative agents of asthma include animal fur, mites, fungi, cockroach allergens, chemicals, fumes, air pollutants and smoke. Other causative agents include exercises, inhaling cold air and stress. The environment plays a major role in the development and triggering or exacerbation of asthma attacks. Other causative agents include genetics ( immunity and respiratory aspects), social aspects such as poverty and poor nutrition and the interactions amongst these aspects (153).
Asthma is typified by swelling of the airways with increased secretion of mucus in the tubes. The symptoms experienced by asthmatics are as a result of bronchial muscle tightening, inflammation and mucus secretion. The widely recognized symptoms of the condition include night cough, short breath, chest pains and wheezing. The above symptoms do not apply to all patients as one may undergo various symptoms at separate times and can also be slight during one attack and worse in another. While some asthmatics have been noted to stay for longer durations minus experiencing the symptoms other asthmatics experience the symptoms on a daily basis. While others have been noted to experience severe attacks during exercises, others experience the attacks as a consequence of viral infections such as colds.
Minor asthma episodes have been documented as the most common of the two types and are known to relieve within short durations while acute attacks are rare and may be prolonged thus require immediate emergency medical attention. This makes it significant to diagnose and treat the symptoms of asthma.
Bryan affirmed that there is neither cure nor treatment for asthma and that the asthma medications are administered to manage, stop, and prevent the symptoms. An individual may have to use more than one drug to control asthma due to changes in body response to the drugs. The medications are in various forms and may include inhalers, injections and pills and are meant to reduce severity of attacks and to improve the airflow. Asthma drugs are in two key classes, namely; bronchodilators and anti-inflammatory agents. Anti-inflammatory drugs lessen inflammation and mucus secretion in the bronchus. As a consequence, the airway tends to be insensitive and have reduced chances of probable reaction to the causative agents. The drugs are taken on a daily basis and leads to lesser symptoms, improved airflow, insensitive bronchus, reduced bronchus damage and fewer attacks. Bronchodilators on the other hand are medicines that are used to relax the bronchial muscle bands that constricts around the bronchus during an attack. The drugs are mainly used in the rapid opening of the bronchus to enable airflow into and out of the lungs and also to clear and reduce mucus secretions. Bronchodilators are used in relieving asthma symptoms in the short term and are used to control and prevent asthma attacks in the long run. To manage asthma in children, relieving medicines should be administered to children with mild attacks while those with severe and frequent attacks should undergo preventive therapy while on relieving drugs (26).
Busse and Holgate noted that the following findings in an investigation meant to find the relationship between microscopic and macroscopic findings of gastroesophagael reflux. Gastroesophagael reflux symptoms existed in 65 percent of all asthmatics. This was relative to Simpson’s finding that put the percentage at 66. Gastroesophagael reflux was associated with the existence of microscopic oesophagitis with not consistent histopathologic microscopic changes.The most common symptom of gastroesophagael reflux was abdominal pain which was later confirmed in Turkey where 67 percent of the patients had gastroesophagael reflux symptoms. The findings noted that endoscopy showed increased gastroesophagael reflux disease lesions with increased asthma severity. Another study carried out to find the correlation between breast feeding and asthma revealed that exclusive breastfeeding of infants for the initial four months after birth reduced chances of developing asthma before six years.
The study found that the use of other milk types apart from breast milk before the end of the first four months was a key risk factor for asthma in infants. The study which was carried out in western Australia discovered that in comparison to infants who have undergone exclusive breastfeeding during the initial four months after birth, children who were not exclusively breastfed had 27 percent chances of developing asthma before their sixth birthday, 44 percent chances of wheezing more than three times by age of one year; 44 percent chances off having gasped for air in the previous twelve months; and 74 percent chances of having had sleep disorders in the previous 12 months period. Breast milk was noted to transmit immunity from the mother to the infant and improved forbearance to infection, hence raising the chances of survival (965).
Platts-Mills states that there exists a direct correlation between dental hygiene and asthma, in that asthmatics have a high rate of cavities, bad breath and gum disease due to prolonged use of inhalers. Dental materials such as toothpaste and dentifrices and fissure sealants were possible asthma trigger factors.Dental treatment reduced the lung capacity of asthmatics by 15 percent. A study carried out in Mexico with 1160 participants (children) noted that the occurrence of tooth decay stood at 17.9 percent of the total participants. 19.5 percent of the participants were asthmatic and 73.5 percent of them had asthma symptoms during the day while 60 percent experienced the symptoms both at night and day. The occurrence of dental decay stood at 19.9 percent and was increased in children who exhibited symptoms at night than those who experienced the symptoms during the day. The logistic regression model exhibited that there was no direct correlation between asthma and tooth decay while a vital correlation was noted to exist between asthma symptoms that were experienced at night and dental decay (98).
Busse, William W. and Stephen T Holgate. Asthma and Rhinitis, Volume 2. Hoboken. New Jersey: John Wiley & Sons, 2008.
Bryan, Jenny. Asthma. London (UK): Heinemann Library, 2005.
Platts-Mills, Thomas. Asthma:Causes and Mechanisms of an Epidemic Inflammatory Disease. London: Lewis Publishers, 1999.