What is asthma?

Asthma is a chronic respiratory condition that narrows the airways in the lungs. It causes inflammation in the airways, often leading to difficulty in breathing, coughing, weezing, and tightness in the chest. These symptoms range from mild to severe and  may vary overtime depending on the patient. Triggers such as allergens, respiratory infections, exercise, and air pollutants could worsen the symptoms that asthma patients experience. Management usually involves medication to control symptoms and avoid triggers to prevent asthma attacks. 

How is asthma diagnosed?

Diagnosing asthma typically involves a combination of medical history, physical examination, and various tests to assess lung function and rule out other possible conditions. Here are the common steps involved in diagnosing asthma:

1.   Medical History: Your doctor will ask about your symptoms, their frequency, and any triggers that seem to worsen them to understand more about your condition and situation. They'll also inquire about your personal and family medical history, including any history of allergies or respiratory conditions.

2.   Physical Examination: A physical exam will be conducted, focusing on your respiratory system. Your doctor will listen to your breathing and check for signs such as wheezing or a prolonged expiratory phase (breathing out).

3.   Lung Function Tests:

4.   Spirometry: This is the most common test used to diagnose asthma. It measures how much and how quickly you can exhale air after taking a deep breath. During this test, you'll blow into a device called a spirometer, which measures the amount of air you can exhale and how fast you can exhale it.

5.   Peak Flow Measurement: This test measures how forcefully you can exhale. You blow into a handheld device called a peak flow meter, and the result is compared to expected values based on your age, height, and sex.

6.   Bronchodilator Reversibility Test: This test is often done after spirometry. You'll inhale a medication (bronchodilator) that relaxes the muscles around your airways, allowing them to open up. After a short time, spirometry is repeated to see if there is a significant improvement in lung function, which suggests asthma.

7.   Other Tests: In some cases, additional tests may be done to assess for allergies (allergy testing), assess airway inflammation (exhaled nitric oxide test), or evaluate for other conditions that can mimic asthma.

8.   Monitoring Response: If asthma is suspected but not confirmed initially, your doctor may suggest monitoring your symptoms and lung function over time to see if patterns consistent with asthma develop.

Based on the results of these tests and assessments, your doctor will determine whether asthma is present and what the appropriate treatment plan should be. It's essential to work closely with your healthcare provider to properly diagnose and manage asthma effectively.

What are the symptoms?

The symptoms of asthma can vary in severity and frequency among individuals. They typically involve the airways in the lungs becoming inflamed, narrowed, and producing excess mucus, which can lead to difficulty breathing. Common symptoms of asthma include:

·      Shortness of Breath: This is often the primary symptom of asthma. It can range from mild to severe, and may occur during physical activity (exercise-induced asthma) or at rest. When triggered the muscle of the airways tighten, allowing less air to come in. 

·      Wheezing: Wheezing is a high-pitched whistling sound that occurs when breathing out (exhaling). It results from air trying to pass through narrowed airways.

·      Coughing: Coughing is a common symptom of asthma, especially at night or early in the morning. It may be dry and persistent.

·      Chest Tightness: People with asthma often describe a feeling of tightness or pressure in the chest. This sensation can range from mild discomfort to severe constriction.

·      Difficulty Sleeping: Asthma symptoms, particularly coughing and shortness of breath, can disrupt sleep patterns, leading to difficulty staying asleep or waking up feeling tired.

·      Increased Mucus Production: The airways may produce more mucus than usual, which can further narrow the air passages and contribute to coughing and wheezing.

·      Symptoms Triggered by Certain Factors: Asthma symptoms can be triggered or worsened by various factors, including allergens (such as pollen, dust mites, pet dander), respiratory infections, cold air, exercise, strong odors or fumes, and emotional stress.

It's important to note that asthma symptoms can vary over time, and not everyone with asthma will experience all of these symptoms. Additionally, the severity and frequency of symptoms can differ greatly among individuals, from mild occasional episodes to more frequent and severe attacks requiring immediate medical attention. Prompt recognition and management of asthma symptoms are crucial for controlling the condition and preventing asthma attacks.

What are normal treatments for asthma?

The treatment of asthma typically involves a combination of medications and lifestyle management strategies aimed at controlling symptoms, preventing asthma attacks, and improving overall quality of life. Here are the main types of treatments for asthma:

1.   Controller Medications (Long-term Control):

2.   Inhaled Corticosteroids (ICS): These are the most effective medications for controlling asthma inflammation. They reduce swelling and mucus production in the airways, thereby preventing asthma symptoms. Examples include beclomethasone, budesonide, fluticasone, and mometasone.

3.   Long-acting Beta-agonists (LABAs): LABAs help relax the muscles around the airways, making it easier to breathe. They are often used in combination with ICS for better asthma control. Examples include formoterol and salmeterol.

4.   Leukotriene Modifiers: These medications block the action of leukotrienes, substances in the body that cause inflammation and tightening of airway muscles. Montelukast is a common leukotriene modifier used in asthma treatment.

5.   Reliever Medications (Quick-relief or Rescue Medications):

6.   Short-acting Beta-agonists (SABAs): These are bronchodilators that quickly relax the muscles around the airways during an asthma attack or to relieve symptoms. Examples include albuterol (salbutamol) and levalbuterol.

7.   Anticholinergics: These medications help relax the muscles around the airways and can be used as relievers in addition to SABAs. Ipratropium bromide is an example.

8.   Combination Inhalers: Some medications combine an ICS with a LABA in a single inhaler, providing both long-term control and quick relief of asthma symptoms. Examples include fluticasone/salmeterol and budesonide/formoterol.

9.   Biologic Therapies: For severe asthma that does not respond well to standard treatments, biologic therapies may be considered. These medications target specific immune pathways involved in asthma inflammation. Examples include omalizumab, mepolizumab, reslizumab, benralizumab, and dupilumab.

10.                 Other Medications: Depending on the individual's asthma triggers and symptoms, other medications such as oral corticosteroids (for short-term use during severe exacerbations), theophylline (a bronchodilator), or oral leukotriene modifiers may be prescribed.

11.                 Lifestyle Management: In addition to medications, managing asthma also involves identifying and avoiding triggers (such as allergens or irritants), maintaining a healthy lifestyle, staying physically active (as tolerated), and monitoring asthma symptoms and peak flow measurements regularly.

Treatment plans for asthma are individualized based on the severity of symptoms, triggers, and response to medications. It's important for individuals with asthma to work closely with healthcare providers to develop and maintain an effective asthma management plan that allows for good control of symptoms and prevention of asthma attacks.

How does acupuncture help asthma patients?

There are several ways acupuncture may help with the condition:

·      Modulation of Immune Response: Acupuncture is believed to influence the immune system and inflammatory responses. In asthma, where inflammation and immune responses play a significant role in airway constriction and symptoms, acupuncture may help regulate these responses.

·      Bronchodilation: Some studies suggest that acupuncture may help relax the muscles around the airways (bronchodilation), which can improve airflow and reduce symptoms such as wheezing, sleep disorder, and shortness of breath in asthma patients.

·      Reduction of Airway Inflammation: Acupuncture may have anti-inflammatory effects that could potentially reduce the inflammation in the airways, making breathing easier for asthma patients.

·      Stress Reduction: Asthma symptoms can be exacerbated by stress and anxiety. Acupuncture is known to promote relaxation and reduce stress levels, which may indirectly help in managing asthma symptoms.

·      Regulation of Neurotransmitters: Acupuncture is thought to affect the release and balance of neurotransmitters and hormones, which could influence various physiological processes related to asthma symptoms.