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Asthma: symptoms, diagnosis and treatment

Asthma is a chronic condition that causes temporary and reversible narrowing of the airways in the lungs. The disease results in inflammation and swelling of the mucous membrane lining the bronchi and the contraction of the bronchial wall. The consequence of this inflammatory state is a decrease in the caliber of the bronchi and an alteration of the regular airflow.

Asthma: symptoms

The symptoms of bronchial asthma are particularly variable in frequency and severity. The manifestations of an asthma attack can range from mild episodes of shortness of breath, which are rare and of short duration, to coughing, wheezing, and severe attacks resulting from viral infections, physical activity, or exposure to other triggering factors.

Episodes of bronchial asthma can be triggered suddenly and cause coughing, wheezing, and shortness of breath, or they can present with a gradual worsening of symptoms. The duration of the episodes is also highly variable; they can cease within a few minutes or persist for hours or days.

In some cases, especially in children, itching in the neck or chest may be the first symptom, while in other individuals, the only warning sign may be nighttime dry coughing. Additional symptoms of asthma may occur following severe episodes that cause severe shortness of breath, with the individual tending to strain the muscles of the neck and chest to breathe and experiencing increased sweating, heart rate, and a sensation of chest tightness.

In cases of particularly severe attacks, asthma symptoms may include confusion, drowsiness, and bluish discoloration of the skin (cyanosis), a sign of significantly reduced oxygen intake. For such cases, emergency treatment is necessary, which in most cases can resolve the situation.

Depending on the severity of asthma symptoms, this condition is classified into four distinct levels:

Intermittent asthma: Symptoms occur approximately two days a week (or less) and do not interfere with daily activities. Mild persistent asthma: Symptoms occur more than two times a week and only minimally interfere with daily activities. Moderate persistent asthma: Symptoms occur daily and significantly limit some daily activities. Severe persistent asthma: Symptoms occur throughout the day and greatly interfere with all daily activities.

Allergic Asthma: causes

Often, allergic asthma is discussed, despite the causes of this disease not being fully understood. Recent studies seem to demonstrate that the condition is due to the interaction of three distinct factors: a genetic component, environmental conditions, and diet.

Among the environmental conditions contributing to the onset of asthma are exposure to allergens typically found at home (such as dust mites or pet dander), which may be associated with the development of the condition in older children and adults.

Furthermore, it is demonstrated that diets low in vitamin C and E and omega-3 fatty acids are correlated with the onset of asthma, as well as obesity. Since asthmatic individuals have hyperactive airways, in many cases, a slight stimulus is sufficient to trigger an attack, such as the action of allergens, irritants, exhaust fumes, dust, strong odors, smoke, temperature and humidity changes. This often leads to the inaccurate classification of asthma as allergic asthma.

Asthma Diagnosis

To diagnose asthma, spirometry is used, an examination capable of measuring lung function. The practice involves verifying whether a bronchodilator can improve the condition if the examination reveals bronchial obstruction, through a specific test. If the examination does not show alterations in lung function, it is necessary to confirm the diagnostic suspicion with a bronchodilation test, which involves inhaling increasing doses of a substance irritating to the bronchi and evaluating the reaction.

To refine the diagnosis, subsequent investigation is carried out to identify triggering causes. For this purpose, the medical history is examined, and allergy tests are prescribed, including skin tests and the search for specific antibodies.

Asthma treatments

To treat asthma, it is crucial to discuss with the specialist the most suitable therapy. The available therapies are usually pharmacological:

Short-acting bronchodilators Long-acting inhaled corticosteroids Long-acting bronchodilators Oral medications

The importance of continuous asthma monitoring

Asthma is a common disease that, if correctly and early diagnosed, has a very positive outcome, allowing the individual to lead a normal life (including engaging in physical activities). Diagnosis necessarily requires evaluation of respiratory function, as mentioned. The currently available treatment allows for complete control of the disease even with minimal doses of inhaled medications, and can be adjusted over time, sometimes even suspended, always according to the indications of a physician experienced in managing this condition.

Regular monitoring of the disease’s progress (symptoms and respiratory function) is therefore necessary to adjust medication dosage and maintain good asthma control with the lowest possible medication dose. In less than 10% of cases, asthma proves difficult to control with traditional medications, even at high dosages. However, in these cases, highly effective and safe biological medications are available, allowing these patients to achieve a good quality of life, with minimal or no symptoms, and without episodes of exacerbation.

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