| Asthma |
Asthma is an immunological disease which causes difficulty in breathing. It is a form of Type I hypersensitivity in which the bronchioles in the lungs are narrowed by inflammation and spasm of the lining of the airway wall. A person with asthma may experience wheezing and shortness of breath, particularly after exercise or when emotional. Sudden attacks of breathlessness may require hospitalization. Asthma is treated with drugs, whether inhaled or in the form of tablets.
Signs and symptoms
The main symptom of asthma is wheezing caused by obstruction of the airways. A cough, sometimes with clear sputum, may also be present. Typically the symptoms are very variable, often with rapid onset, and associated with the triggers listed above. Symptoms are often worse during the night or on waking. Increasing airway obstruction will cause shortness of breath. Asthma sometimes occurs with acid indigestion, especially amongst older patients.
Signs of asthma are wheezing, rapid breathing, expiratory phase of breathing longer than inspiratory, in-drawing of tissues between ribs and above sternum & clavicles, over-inflation of the chest and rhonchi (wheezy noises heard with a stethoscope). In severe attacks the asthma sufferer may be cyanosed (blue), may have chest pain and can lose consciousness. Between attacks a person with asthma may show no signs at all.
Diagnosis
In most cases the physician can make the diagnosis on the basis of typical symptoms and signs. The typical rapid changes in airway obstruction can be demonstrated by a fall in pulmonary function tests spontaneously, after exercise or inhalation of histamine or methacholine, and subsequent improvement with an inhaled bronchodilator medication. Many people with asthma have allergies; positive allergy tests support a diagnosis of asthma and may help in identifying avoidable triggers. Some people with asthma have been diagnosed with gastroesophageal reflux disease (GERD). Other tests (for example chest X-ray or chest CT scan) may be required to exclude other lung disease.
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