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createdon: 16 Mar 2023
updatedon: 06 Apr 2023

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Author: Khoa Tran
Published Mar 16, 2023
Updated Apr 06, 2023

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Asthma

Etymology and Pronunciation

Asthma (AZ-muh)
ástma (spelt "ἅσθμα") - Greek for "panting" or "shortness of breath"

History of Asthma

The history of asthma dates back to ancient times, with references to respiratory distress and wheezing in the Ebers Papyrus, an Egyptian medical document written around 1550 BC.

In ancient Greece, Hippocrates and Galen described a condition resembling asthma, which they called "panting" or "shortness of breath".

In 1812, a British physician named John Bostock published a paper on "catarrhus aestivus" which described seasonal attacks of wheezing, coughing, and difficulty breathing that were triggered by pollen allergies. Bostock's paper is considered to be the first modern description of asthma.

In the late 19th century, French physician Henri Salter introduced the term "asthma" to describe the condition. Salter recognized that asthma was a chronic disease that could be triggered by a variety of factors, including allergens, exercise, and emotional stress. He also described the characteristic wheezing sound that occurs during an asthma attack.

In the 1920s and 1930s, allergists discovered that asthma attacks were often triggered by exposure to airborne allergens such as pollen, dust, and animal dander.

In the 1950s and 1960s, researchers used a variety of immunological techniques to identify the specific immune responses that cause allergic reactions and asthma symptoms. One of the key techniques was the use of skin tests to identify allergens that trigger allergic reactions. In skin testing, a small amount of a potential allergen is injected into the skin, and the skin's reaction is observed. Another technique was the use of immunoassays to measure the levels of specific antibodies, such as IgE, that are associated with allergic reactions. Researchers also used animal models, such as guinea pigs and mice, to study the immune response to allergens and to test new treatments. The development of these immunological techniques allowed researchers to better understand the underlying mechanisms of asthma and to develop more effective treatments for this chronic disease.

Modern Understanding of Asthma

Asthma is a chronic respiratory condition that affects millions of people worldwide. It is a condition in which the airways in the lungs become inflamed and narrow, making it difficult to breathe. The symptoms of asthma can range from mild to severe and can include coughing, wheezing, chest tightness, and shortness of breath. In this article, we will explore the causes, symptoms, and treatment options for asthma.

The symptoms of asthma can vary from person to person and can range from mild to severe. Some of the most common symptoms of asthma include:

- Shortness of breath: Asthma can cause a feeling of tightness in the chest and shortness of breath. This symptom can occur during physical activity or at rest.
- Wheezing: Wheezing is a high-pitched whistling sound that is heard when breathing. It is caused by air passing through narrowed airways.
- Coughing: Asthma can cause a persistent cough that is worse at night or early in the morning. This symptom can also be triggered by physical activity or exposure to allergens or irritants.
- Chest tightness: Asthma can cause a feeling of tightness or pressure in the chest. This symptom can be accompanied by shortness of breath or wheezing.
- Difficulty breathing: Asthma can make it difficult to take deep breaths or to breathe in and out normally. This symptom can occur during physical activity or at rest.
- Rapid breathing: Asthma can cause rapid breathing, which can make it difficult to catch one's breath. This symptom can be accompanied by shortness of breath or wheezing.
- Fatigue: Asthma can cause fatigue due to the extra effort required to breathe. This symptom can be exacerbated by poor sleep due to nighttime coughing or wheezing.

The severity and frequency of asthma symptoms can vary from person to person. Some people may experience symptoms only occasionally, while others may experience symptoms on a daily basis.

Diagnosis of Asthma

The diagnosis of asthma is based on a combination of medical history, physical examination, and diagnostic tests. Some of the most common diagnostic tests used to diagnose asthma include:

- Medical History: The doctor will take a detailed medical history to understand the symptoms and potential triggers of the patient's breathing difficulties. The medical history will also include questions about family history of asthma or allergies, previous respiratory illnesses, and medication use.
- Physical Examination: The doctor will perform a physical examination, which may include listening to the lungs with a stethoscope to check for wheezing, observing the patient's breathing pattern, and checking for signs of allergies, such as nasal congestion or skin rashes.
- Pulmonary Function Tests: Pulmonary function tests (PFTs) measure the amount of air the patient can exhale and inhale, how quickly the air is moving, and how much air is left in the lungs after exhaling. These tests are used to diagnose and monitor asthma.
- Bronchoprovocation Tests: Bronchoprovocation tests are used to measure the response of the airways to various triggers, such as exercise, cold air, or allergens. These tests are done to see if the patient's airways are hyper-responsive, which is a hallmark of asthma.
- Allergy Tests: Allergy tests may be performed to identify allergens that can trigger asthma symptoms. These tests may include skin prick tests or blood tests.
- Chest X-ray: A chest X-ray may be done to rule out other conditions that can cause similar symptoms, such as pneumonia or heart failure.

Causes of Asthma

Here are some of the common causes of asthma:

1. Genetics: Asthma tends to run in families, suggesting that there is a genetic component to the condition. Researchers have identified several genes that may contribute to the development of asthma, including genes that control inflammation and airway responsiveness.
2. Environmental factors: Exposure to certain environmental factors can trigger or worsen asthma symptoms. These include:
	- Allergens: Common allergens that can trigger asthma symptoms include pollen, dust mites, animal dander, and mold.
	- Irritants: Irritants such as air pollution, cigarette smoke, strong odors, and chemicals can irritate the airways and trigger asthma symptoms.
	- Respiratory infections: Respiratory infections such as the common cold, flu, and bronchitis can trigger asthma symptoms.
3. Early childhood factors: Early childhood factors can also contribute to the development of asthma. These include:
	- Childhood respiratory infections: Children who experience respiratory infections in early childhood may be more likely to develop asthma later in life.
	- Premature birth: Premature birth is a risk factor for asthma, possibly because premature babies have underdeveloped lungs and immune systems.
	- Low birth weight: Low birth weight is also a risk factor for asthma, possibly because low birth weight babies have underdeveloped lungs.
4. Obesity: Obesity is a risk factor for asthma, possibly because excess weight can put pressure on the lungs and make it harder to breathe.
5. Hormones: Hormones may also play a role in the development of asthma, particularly in women. Asthma symptoms may worsen during menstruation or pregnancy, and some women may develop asthma for the first time during pregnancy.

It's important to note that while these factors may increase the risk of developing asthma, not everyone who is exposed to these factors will develop the condition. Additionally, there may be other factors involved in the development of asthma that have not yet been identified.

Treatments for Asthma

The treatment of asthma involves a combination of medications, lifestyle changes, and monitoring to manage and control symptoms. Here are the most common treatments for asthma:

1. Medications: Medications are the mainstay of asthma treatment and are used to relieve symptoms, reduce inflammation in the airways, and prevent flare-ups. There are two main types of medications used to treat asthma: quick-relief medications and long-term control medications.

Quick-relief medications, also called rescue medications, are used to provide immediate relief of asthma symptoms, such as shortness of breath, wheezing, and chest tightness. These medications include short-acting bronchodilators, such as albuterol, which work by relaxing the muscles in the airways and making it easier to breathe.

Long-term control medications, also called maintenance medications, are used to prevent asthma symptoms and reduce the frequency and severity of flare-ups. These medications include inhaled corticosteroids, which reduce inflammation in the airways, as well as other medications, such as leukotriene modifiers, long-acting bronchodilators, and immunomodulators.

2.Lifestyle Changes: Lifestyle changes can also help manage and control asthma symptoms. These include:
	- Avoiding triggers: Identifying and avoiding triggers, such as allergens, irritants, and exercise-induced asthma, can help reduce the frequency and severity of asthma symptoms.
	- Regular exercise: Regular exercise can improve lung function and overall health, but it's important to work with a healthcare provider to develop an exercise plan that's safe for people with asthma.
	- Smoking cessation: Smoking can worsen asthma symptoms and increase the risk of flare-ups. Quitting smoking is one of the most important things people with asthma can do to manage their symptoms.
	- Managing stress: Stress can trigger asthma symptoms, so learning stress-management techniques, such as deep breathing, yoga, or meditation, can help reduce the frequency and severity of symptoms.

3.Monitoring: Regular monitoring of asthma symptoms and lung function is important to ensure that treatment is effective and to adjust treatment as needed. This may involve:
	- Peak flow monitoring: Peak flow monitoring involves using a handheld device to measure how fast air can be expelled from the lungs. It can help people with asthma and their healthcare providers determine how well their lungs are functioning and whether their treatment plan needs to be adjusted.
	- Symptom tracking: Keeping a diary of asthma symptoms can help people with asthma and their healthcare providers identify triggers and adjust treatment as needed.
	- Regular check-ups: Regular check-ups with a healthcare provider can help ensure that asthma symptoms are under control and that treatment is appropriate and effective.

Overall, the treatment of asthma is a lifelong process that requires careful management and monitoring. With the right medications, lifestyle changes, and monitoring, most people with asthma can manage their symptoms and lead active, healthy lives.

Symptoms

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Wheezing
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Coughing
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Rapid breathing
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Shortness of breath
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Chest tightness
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Fatigue

Confirmation Tests

- Lung (pulmonary) function tests
- Bronchoprovocation test
- Allergy test
- Chest X-ray

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