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     Volume 8 Issue 92 | October 30, 2009 |

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Living with Asthma

Asthma is a disease that affects the breathing passages of the lungs (bronchioles). Asthma is caused by chronic (ongoing, long-term) inflammation of these passages. This makes the breathing passages, or airways, of the person with asthma highly sensitive to various "triggers."

-When the inflammation is "triggered" by any number of external and internal factors, the passages swell and fill with mucus.
-Muscles within the breathing passages contract (bronchospasm), causing even further narrowing of the airways.
-This narrowing makes it difficult for air to be breathed out (exhaled) from the lungs.
-This resistance to exhaling leads to the typical symptoms of an asthma attack.

Because asthma causes resistance, or obstruction, to exhaled air, it is called an obstructive lung disease. The medical term for such lung conditions is chronic obstructive pulmonary disease or COPD. COPD is actually a group of diseases that includes not only asthma but also chronic bronchitis and emphysema.

Like any other chronic disease, asthma is a condition you live with every day of your life. You can have an attack any time you are exposed to one of your triggers. Unlike other chronic obstructive lung diseases, asthma is reversible.

Quick facts
-Asthma cannot be cured, but it can be controlled.
-You have a better chance of controlling your asthma if it is diagnosed early and treatment is begun right away.
-With proper treatment, people with asthma can have fewer and less severe attacks.
-Without treatment, they will have more frequent and more severe asthma attacks and can even die.

Treatment of asthma can be divided into long-term control and quick-relief medications.

Long-term control medications are taken daily to maintain control of persistent asthma. They primarily serve to control airway inflammation. The quick-relief medications are taken to achieve prompt reversal of an acute asthma “attack” by relaxing bronchial smooth muscle.

Many asthma medications can be administered orally or by inhalation. Metered-dose inhalers (MDI's) are the most widely used method, but dry powder inhalers are becoming popular.

Asthma is on the rise in the world, especially in developed countries. Scientists are not sure exactly why this is, but these factors may contribute.

-We grow up as children with less exposure to infection than did our ancestors, which has made our immune systems more sensitive.
-We spend more and more time indoors, where we are exposed to indoor allergens such as dust and mould.
-The air we breathe is more polluted than the air most of our ancestors breathed.
-Our lifestyle has led to our getting less exercise and an epidemic of obesity. There is some evidence to suggest an association between obesity and asthma.

Asthma is a very common disease in Bangladesh. A third of those affected are children.

Facts about the prevalence of asthma
-Asthma affects all ages, although it is more common in younger people. The frequency and severity of asthma attacks tend to decrease as a person ages.
-Asthma is the most common chronic disease of children.
-Asthma has many costs to society as well as to the individual affected.
-Many people are forced to make compromises in their lifestyle to accommodate their disease.
-Asthma is a major cause of work and school absence and lost productivity.
-Asthma is one of the most common reasons for emergency department visits and hospitalisation.
-Approximately an estimated 7 million people including 4 million children suffer from asthma-related symptoms in Bangladesh.

The good news for people with asthma is that you can live your life to the fullest. Current treatments for asthma, if followed closely, allow most people with asthma to limit the number of attacks they have. With the help of your health-care provider, you can take control of your care and your life.

Adapted from the International Journal of Epidemiology


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