Articles
Asthma - FAQ's
2/6/2009
ROUTINE QUESTIONS ASKED BY PATIENTS REGARDING COUGH AND ASTHMA
Dr. Jose Raj R
MBBS, MD(TB & Respiratory Diseases), FCCP
Specialist Chest Physician, Chest and Allergy Diseases Clinic at New Dr. Sunny Medical Centre, Rolla, Sharjah
Q. What are the possibilities – In a patient with cough persisting on and off for sometime?
A. Asthma, Chronic Bronchitis, TB, Lung Cancer, Interstitial Lung Disease.
Q. What are the basic investigations in patients with cough?
A. (i) Sputum examination of AFB (TB Bacilli) (ii) Chest Xray – PA view.
Q. No family history of Asthma. Is it possible to have Asthma, though no wheezing is present?
A. Yes- It is called Cough Variant Asthma. Such symptoms are common in children as well as elderly patients. Cough usually follows viral infections.
Q. What is ASTHMA?
A. ASTHMA is a disease of the airways. Airways are large passages extending from the nose down to the depth of the lungs. You have tubes of large sizes and small sizes. Like branches of a tree, it divides many times.
The tubes (inside the neck and chest) are Larynx, Trachae, Bronchi, Bronchilis. These tubes have circular muscles around the Lumen. They constrict during an attack of Asthma. Hence patient feels breathlessness. When patient takes proper medication, these tubes attain back normal diameter and symptoms are relieved.
But most important problem in asthma is the injury occurring inside the airways – known as inflammations. Many types of injurious cells accumulate inside airways and produces damage to the structure and function. This problem has to be treated and permanent damage must be avoided. The hyper reacting airways can be brought to normal function.
Q. What causes ASTHMA?
A. (1)Allergic Agents – DUSTS – House dust, Paper dust, Cotton dust, Dust in kitchen, Rice grain dust, Pollens, Fungus, Dander, Food antigen, Drugs. They have protein compounds and react with certain substances (Immunoglobulin) in the patient and produce the disease.
(2)Non Allergic Agents – Cold, environment, exercise, chemicals –agarbattis, sambrani & other incenses, perfumes, psychological factors (emotional) like crying, laughing etc.
(3)Both Allergic & Non Allergic factors can be present in the same patient.
Q. Is ASTHMA a Genetic disease?
A. Yes – Asthma is a Genetic disease. You may be the first patient in your family. No body in the family may be having the problem. But they can develop later. Asthma can be present at any age for the first time. Sometimes you will get history of recurrent colds and respiratory infections in the childhood. Such a history has to be obtained from the parents.
Q. Is ASTHMA curable or not?
A. Asthma is a genetic disorder. Genetic element will be inside the body.
Genetic + Precipitating factors = Disease (Asthma / Sinusitis).
Exposure to precipitating factors has to be avoided, as much as possible. Proper treatment of inflammation and bronchial constriction will bring back the function normal. Hence the chance of airway reacting abnormally comes down and the patient can lead a normal life. But it can come back at any time if exposed to agents in severe amounts.
Q. How many types of Inhalers are available for the management of Asthma?
A. The choice of Inhalers depends on the type of asthma, severity of asthma. The severity of Asthma can be assessed by pulmonary function tests. It measures large airway function and small airway function. Non allergic asthmas requires mainly anti cholinergic drug containing inhalers, besides managing inflammation. There are various modes of delivery devices available in the market. The choice of delivery device also depends upon the age of the patient, compliance besides the type of asthma. Altogether, nearly 25 varieties of inhalers are available.
Q. What happens if Asthma is not properly treated?
A. There will always be injury inside the airway in all asthmatic patients. Patients may not have any symptoms but injury will go on inside the airway. There is always attempted healing. During this process, an abnormal tissue accumulates (unlike the circular muscles) and distorts the function permanently.
Q. A child with Asthma – will it subside as he reaches teenage or adulthood?
A. No. The injurious process inside the airway continues, if not properly assessed and treated. Sometimes, symptoms may subside during teenage period, but his airways are undergoing damage and limits function without the knowledge of the patients.
Q. During treatment, which parts of airways are taken care of?
A. It includes Nasal passages, large airways and small airways. Management of small airway problem is different.
| | 3/6/2009
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