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Asthma

Asthma

Asthma is a globally common and significant health issue that affects everyone, young and aged. Its prominence is still on the rise in numerous countries. Increasing air pollution, global warming, urbanization, industrialization, changes in dietary habits, technological advancements, lifestyle changes, and decreased physical activity all factor into the increased prominence. Even though it is becoming more and more common in today’s ever-changing world, it has always been one of the most significant airway diseases known and fought since ancient ages. Currently notable advancements have been achieved in treatment options offered to treat asthma, which is actually a group diseases. Categorized in accordance with their etiologies, outcomes and associated methods of treatment, subtypes of asthma include:

  • Allergic asthma;
  • Non-allergic asthma;
  • Late-onset asthma; and
  • Obesity-associated asthma.

The disease manifests itself with symptoms like wheezing, rale, coughs and dyspnea, which are all triggered by a long-term non-microbial inflammatory condition in the airways. Severity of symptoms may fluctuate over time. An asthma patient might wake up in quite a fine condition in the morning, but still experience sudden bursts of coughing and episodes of wheezing once exposed to smells, known allergens, air pollution, stress, exercise, cold air or viruses. These undesirable events may even cause a sleeping patient to wake up at night in the middle of sleep.

These uncertainties and the fact that asthma is an entirely controllable disease make it possible to concentrate medical services on three main areas in order to make sure asthma patients continue their lives as if the disease did not even exist: 

1. First and foremost, asthma subtype and triggering factors specific to that subtype and the patient should be determined:
    - Hearing an account of the patient’s detailed history from childhood to the present is the first step to be taken. Respiratory and allergy tests may need to be performed as well.

2. A treatment plan aimed at the patient’s complaints and any inflammatory condition the disease may have caused should be planned:
    - To tailor a suitable treatment plan specific to the individual, it is essential to be informed in detail even about the patient’s daily routine, needs, occupation, home life and household circumstances. Anti-inflammatory therapies and medication that takes complaints under control are the basic treatment options. It should nevertheless be noted that asthma patient may still have swollen and edematous airways even when they do not suffer from dyspnea. Therefore, after configuring therapy to levels sufficient to render the disease unnoticeable, physicians should be very cautious in terms of gradually reducing dosage. Reductions too steep may lead to attacks. In this regard, dosage reduction should definitely be undertaken by specialized physicians who initially prescribed the relevant medication.
    - Education is the most important building stone of treatment. Most asthma drugs are inhaled rather than “swallowed” like traditional pills. It is normally a bit difficult to use them on some occasions. Physicians who tend to asthma patients should prescribe the most convenient type of drug and remind the patient how the drug should be taken on every possible occasion. Dosages and content of drugs need to be modified periodically. A patient well-educated about asthma and factors that trigger its symptoms will be able to easily decrease severity of disease.

3. Control of additional diseases and factors is the final important consideration a physician should heed:
    - Protective and preventive treatment approaches targeting other diseases and factors such as allergic rhinitis, stomach disorders, sleep apnea syndrome, viral respiratory diseases and smoking addiction are also an integral part of asthma treatment. A persisting and uncontrollable case of asthma may be suddenly diminished through a simple intervention aimed at another condition.

Asthma and Obesity

Asthma is currently recognized as a disease with different subtypes (allergic asthma, late-onset asthma, aspirin-sensitive asthma etc.) as well as different underlying reasons and outcomes, just like rheumatism. Obesity-asthma is one of the aforementioned subtypes.  

Increasing air pollution, industrialization, technological advancements, lifestyle changes, and decreased physical activity all factor into the increased prominence of this disease. It should also be noted that whereas obesity is known to lay the groundwork for diseases such as gastric reflux, diabetes, cardiovascular diseases, sleep apnea and some types of cancer, its correlation to asthma has only recently started being inquired.   

There are two primary mechanisms causing obesity-asthma. First of all, the immune system perceives obesity as a mild inflammatory event that should be fended off, which confuses white blood cells, warriors of the immune system. This is basically triggered by the increased number of inflammatory cells, which produce more secretion, fill airways with a thick layer of phlegm and constrict them. The second mechanism involves increased strain on airways that develops secondary to weight gain, which renders muscles in this area inadequate for normal respiration.

Currently, there is no specific medication that can be prescribed for obesity-asthma other than the conventional inhalers (or puffers) used in regular asthma cases for control and relief purposes. Personalized weight loss and exercise programs coupled with airway relief and anti-inflammatory medication are particularly more convenient for such cases. Eligible patients may also benefit from sleeve gastrectomy surgery as well as from an effective weight loss regimen in order to fight immunity problems and overweight strain, which are factors leading to this specific type of asthma. Research has proven that treatment programs ensuring significant weight loss contribute vastly to control of obesity-asthma. Regardless, it is essential to remember that asthma patients may still be suffering from swollen and edematous airways even at times they don’t feel dyspnea. It is therefore essential to reduce drug dosages cautiously once an effective weight loss program has been practiced with results indicating symptomatic improvements. Dosage reduction should only and definitely be configured by the physician who originally prescribed such medication. Despite specific differences between the various types of asthma, the patient should still be advised to quit smoking, regularly use inhalers in the correct manner, get vaccinated for flu and practice methods of stress management, just like any other asthma patient. Individual factors triggering symptoms should also be identified and avoided.

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