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Asthma is a respiratory disease that affects millions of people worldwide. People who suffer from asthma experience three main symptoms:  

  1. Recurrent episodes of coughing
  2. Wheezing (a whistling sound produced by narrowed air passages in the lungs)
  3. Shortness of breath. 

These symptoms are brought about by reduced flow of air into and out of the lungs, due to narrowing of the air passages.

Normal breathing is made possible by a network of elastic and open air passages which ensure smooth flow of air into the every part of our lungs. However, in asthma, a progressive narrowing of the air passages develops primarily because their walls get thicker and less elastic, while their internal surfaces become plugged by increased amounts of mucus. When this culminates in a profound limitation of airflow, breathing becomes very difficult and the person is said to be experiencing an asthma attack or severe asthma.

There are remarkable variations in the severity and the triggering factors in asthma. This is because asthma is not a homogenous disease entity, and differs remarkably from person to person. The different kinds of asthma fall under two broad classifications; allergic asthma and non-allergic asthma.

Allergic asthma, as its name implies, denotes a type of asthma in which symptoms in an individual (described as allergic) are triggered by exposure to a specific particle found in the environment. Such a particle is known as an allergen. Examples of common allergens include hay, pollen, cat droppings, house dust mite and mould. Allergic asthma usually begins in childhood, and parents of allergic children can easily observe that symptoms develop at particular times of the year, or within particular environments.

The underlying reason why people develop an allergy is not completely understood. However, emerging evidence from recent research points to defects in the way our body senses inhaled harmless particles or molecules derived from the environment. While such molecules are perceived as innocuous by the immune system in most of people, they presence is interpreted as evidence of danger in allergic people, and therefore, an inappropriate immune response is mounted by the body.

The symptoms of non-allergic asthma are similar to those of the allergic type. However, the triggers in allergic asthma differ significantly. Inhalation of cold air, exercise, exposure to smoke from a variety of sources and obesity are some of the factors linked to non-allergic asthma. Furthermore, there is a delay in the onset of symptoms in non-allergic asthma, with symptoms beginning from around the second decade of life in many patients.

An asthma diagnosis is made by a combination of examining the patient’s symptoms, physical examination findings and an evaluation of the patient’s lung function using a peak flow meter. Allergy testing is also carried out in order to identify specific allergens that require avoidance.

The treatment modalities in asthma are aimed at reduction in the frequency of attacks, providing immediate relief of narrowed air passages and, in the long term, reducing the elevated sensitivity of the lungs to environment-derived triggering factors.  Bronchodilators and anti-inflammatory drugs are the mainstay of treatment.

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