Asthma: Types, Causes, Symptoms, Diagnosis, and Treatment

Asthma is a chronic, inflammatory disease that affects the lungs and airways. The condition arises from non-microbial inflammation and is characterized by shortness of breath. Asthma is a chronic illness, and achieving complete recovery can take many years. However, if the necessary treatments are applied, symptoms can be controlled, improving the quality of life. Asthma can occur in both adults and children, with the most common causes being allergies and environmental factors. Certain allergens can trigger asthma, while smoking, secondhand smoke, coal exhaust, and chemical substances can also contribute to the disease. Asthma may not present the same way in everyone; for some patients, it can be mild, while for others, it can significantly impact daily activities and even be life-threatening. To ensure a positive progression of the disease, it is essential not to neglect medication treatment and to maintain regular doctor check-ups.

What is Asthma and What Causes It?

Asthma is a chronic disease characterized by shortness of breath, leading to inflammation in the airways. This inflammation is not caused by any microbes or infections; rather, it is a disease response produced entirely by the body. Symptoms of asthma can affect individuals of all ages, including children, teenagers, and adults. The condition can manifest as episodes of abnormalities in the airways. These episodes can occur at short intervals, such as weekly or monthly, or at longer intervals, such as once a year or every few years. When examining the causes of asthma, it becomes evident that they range from adverse environmental factors to stress or being overweight. Commonly encountered causes of asthma include:

• Maternal smoking during pregnancy
• Spending excessive time in places with mobile phones or wireless internet at a young age, or exposure to cigarette smoke
• A family history of asthma or atopy
• Being born prematurely
• Having hay fever, food allergies, or eczema
• Living in moldy and damp environments
• Long-term use of certain medications
• Being overweight

What is an Asthma Attack?

An asthma attack is a condition that occurs in individuals who suffer from severe asthma, either spontaneously or triggered by specific factors. During an asthma attack, the muscles in the airways tighten, leading to inflammation and swelling of the airways and bronchi. The mucous membranes in the tubes begin to produce thick mucus that further obstructs the airways. In this situation, patients may become unable to breathe and experience severe shortness of breath. These symptoms may be accompanied by wheezing sounds from the lungs. During attacks, interventions can quickly open the airways. While the shortness of breath experienced during an attack can be alleviated with inhaler medications, the presence of more severe respiratory distress may require emergency medical assistance. It is crucial for the patient to have a good understanding of themselves and their condition. Early warning signs may precede asthma attacks. Monitoring these signs and taking necessary precautions can reduce the severity or prevent the attacks altogether. Some early signs of asthma attacks may include:

• Frequent and intermittent coughing at night
• Feeling breathless while talking
• Quick fatigue and weakness during exercise
• Wheezing or coughing after exercise
• Quick fatigue and lack of motivation in daily tasks
• Decreased lung function according to respiratory tests
• Allergy symptoms such as sneezing, runny nose, or nasal congestion
• Sore throat
• Headache
• Sleep disturbances

If the early signs of asthma attacks are not recognized and necessary precautions are not taken, the attack can become severe. The main symptoms that can be observed during asthma attacks include:

• Severe wheezing while breathing
• Persistent coughing
• Rapid breathing
• Tension in the neck and chest
• Difficulty speaking
• Color changes resembling cyanosis in the lips and nails
• Pale skin appearance and sweating
• Panic and anxiety disorders

Types of Asthma

Asthma can be classified based on symptoms, genetic factors, and individual sensitivities. Although all types of asthma have some similar symptoms, they also possess distinguishing characteristics. Common types of asthma include:

• Allergic Asthma: This is the most common type of asthma. Symptoms appear as a response to allergens and include nasal swelling and redness, watery eyes, throat itching, and frequent sneezing.
• Exercise-Induced Asthma: This type of asthma occurs after physical activities and efforts. The most common symptoms are shortness of breath and wheezing cough.
• Occupational Asthma: This type develops due to inhalation of trigger substances present in the workplace. Symptoms of occupational asthma occur only in the work environment and typically include nasal congestion, runny nose, and coughing. Professions frequently affected by this type of asthma include miners, nurses, farmers, animal caretakers, hairdressers, and those working with wood and paint.
• Bronchial Asthma: Over time, asthma can irritate and sensitize the bronchi, leading to excessive reactions to external triggers. Bronchial asthma occurs when the bronchi react excessively to these triggers due to this sensitivity.
• Seasonal Asthma: Symptoms and complaints of this type of asthma arise at certain times of the year. For instance, during winter, conditions like influenza, colds, and air pollution can trigger asthma. Other seasonal triggers include pollen allergies in spring, storms, or sudden weather changes.

What are the Symptoms of Asthma?

The symptoms and signs associated with asthma vary from person to person. Factors such as the patient's living conditions, work environment, and adherence to medication treatments can influence this variability. However, the most characteristic symptoms of asthma are coughing and shortness of breath. Shortness of breath arises from the tightening of the muscles in the airways, mucus buildup in the lungs, and swelling in the bronchi. Symptoms may worsen during influenza, colds, exposure to sharp odors, smoke, steam from cooking, or during exercise. Additionally, complaints may increase due to other agents such as chemical fumes, exhaust gases, pet dander, cockroach droppings, skin flakes from pets, saliva, or microorganisms in the air. Generally, the symptoms of asthma may include:

• Coughing
• Shortness of breath
• Wheezing or whistling sounds
• Chest tightness and pain

How is Asthma Treated?

The main goal of asthma treatment is to control the disease. This can be described as keeping the complaints related to asthma at a level that does not impair the person's quality of life. Thanks to the regular use of prescribed medications, patients can continue their lives with minimal complaints. Asthmatic patients should be monitored through regular doctor check-ups in addition to medication treatments. These check-ups are usually conducted at periodic intervals such as 1, 3, or 6 months from the time of diagnosis. During these check-ups, in addition to physical examinations, asthma control assessments are performed to gather information about the disease's course, and respiratory tests are conducted. Doctors generally start stepwise treatment based on the medical history and the tests performed. Stepwise treatment involves adjusting therapy according to the severity of the disease. As first-line treatment, medication and inhaler (a medical device used to deliver medication to the lungs via the airways) therapy are provided to try to bring the disease under control. If there is a reduction in asthma symptoms with this initiated treatment, the dosage of the medications may be decreased. However, if there are triggering factors such as allergen exposure, adverse environmental conditions, or stress that exacerbate asthma, the medication dosage may be increased. Sometimes, doctors may prescribe oral steroids (corticosteroids) to their patients to achieve maximum improvement in a short period.

In cases where complaints do not improve or show a tendency to decrease, patients may be hospitalized for treatment for a certain period. In inpatient treatments, since medications are often administered intravenously, recovery can be achieved more quickly. Additionally, in advanced and severe asthma cases, some patients may undergo a surgical procedure called "bronchial thermoplasty." In this procedure, a thin wire is inserted into the narrowed airways through the nose or mouth, and thermal treatment is applied. Bronchial thermoplasty can reduce the thickness of smooth muscle tissue that has thickened due to inflammation in the airways, making it easier to breathe.