Asthma is one of the most common chronic diseases in the world and it is characterized by recurrent breathing problems and symptoms such as breathlessness, wheezing, chest tightness, and coughing. However, these symptoms vary over time and from individual to individual.
Talking to APP here on Monday Eminent Pulmonologist and Dean of the Faculty of the Paleontology Department of the Liquat University of Medical Health Sciences, LUMHS, Jamshoro, Dr Rashid Ahmed Khan said on the World Asthma day would be observed across the globe on Tuesday (Tomorrow), and this year the theme of the year is, `You Can Control Your Asthma'.
He said that Asthma is a serious but treatable condition. Asthma is the most common serious chronic disease of childhood, affecting millions of children across the globe. He said that even though asthma cannot be cured, it can almost always be controlled.
Dr. Rashid Ahmed Khan said that asthma experts are emphasizing the need for increased awareness of asthma and healthcare workers and governments should provide better treatment and control this common respiratory illness.
He said that this is a fact that there are no reliable statistics about the prevalence of allergic diseases or asthma in Pakistan.
Dr Rashid Ahmed Khan said that the nose and airways also trap large particles dust, pollen, molds, bacteria, and chemical smoke, sprays and odors, which could cause serious injury to the lungs.
Dr Rashid Khan said the studies show that almost 20 percent of 13 to 14 year old schoolchildren are asthma patients, which means that one out of every five children in Pakistan is asthma patient. The studies also reveal that two out of every five children may have a respiratory allergy and out of these less than a third are properly diagnosed. Moreover, those who are diagnosed do not receive proper treatment, he added.
Giving the possible reasons for the rise in asthma in Pakistan, he said that the modern lifestyle, atmospheric pollution, smoking, increased use of carpets, were some of the reasons for the rise in asthma cases in this country.
Inhalers are the safest way to deliver asthma medication to the lungs, and these are not habit forming as commonly perceived by the patients in this country." It is wrong to think that inhalers are given only in the advanced stage of the disease, he explained.
He stressed that doctors should check the inhaling techniques of their patients on every visit to the clinic. At the end, a question and answer session was also held with a panel of experts.
He said that asthma is an inflammatory condition of the bronchial airways. This inflammation causes the normal function of the airways to become excessive and over-reactive, thus producing increased mucus, mucosal swelling and muscle contraction.
Dr Khan said that in child the changes produce airway obstruction, chest tightness, coughing and wheezing. If severe this can cause severe shortness of breath and low blood oxygen.
He said that each individual suffers a different level of severity. Virtually, all children with asthma, however, do enjoy a reversal of symptoms until something triggers the next episode, he added.
About the Causes of Child Asthma Rashid Ali Khan explained that inflammation of the airways is the common finding in all asthma patients. Recent studies indicate that this inflammation is virtually always causative in the asthmatic condition. Allergy, viral respiratory infections, and airborne irritants among others produce this inflammation.
Dr. Rashid Ahmed Khan said that Childhood asthma is a disorder with genetic predisposition and a strong allergic component. Approximately 75 to 80 percent of children with asthma have significant allergies.
Regarding smoking he said that if any of the parents is a smoker then their children have an increased risk of developing asthma. Dr Khan stressed that children should be protected from environment tobacco smoke at all costs.
He said that studies indicate that allergic reactions produce both immediate and late phase (delayed) reactions. Research indicates that approximately half of the immediate allergic reactions to inhaled allergens are followed by a late phase reaction.
Dr Rashid Ahmed Khan informed that any child who has frequent coughing or respiratory infections (pneumonia or bronchitis) should be evaluated for asthma. He said that the child who coughs after running or crying might have asthma. Recurrent night cough is common, as asthma is often worse at night.
Dr Rashid Ahmed Khan defined that infants who have asthma often have a ratty cough, rapid breathing and may have an excessive number of "pneumonias," episodes of bronchitis or "chest colds." Obvious wheezing episodes might not be noted until after 18 to 24 months of age 4.
He said that in Child case chest tightness and shortness of breath are other symptoms of asthma.
There might be exceptions, such as prolonged running, especially during cold weather, allergy season or illness from a "cold." Swimming seems to be the least asthma-provoking form of exercise, added.
Dr Rashid said about the causes of the respiratory infections, including the flu, frequently trigger severe episodes of asthma. Research indicates that viruses, rather than bacteria most frequently produce these infections.
He said that antibiotics are of no benefit for viral infections and thus may be of little value in asthma. It is important for all children with asthma to get vaccinated for the flu each year.
He said that chronic sinusitis in childhood due to bacteria can be a very stubborn chronic trigger for asthma. Treatment for 10 days with antibiotics may not be effective. In these children, sinus x-rays are frequently required to diagnose the underlying conditions.
He said that antibiotic treatment for 3 to 4 weeks or longer may be required to completely eradicate these infections. Asthma may also be triggered by an ear infection or bronchitis, which would also require antibiotic therapy.
Dr Rashid elaborated about asthma allergy that a asthma symptoms of many children with asthma are triggered by allergies. Allergic children suffer reactions to ordinarily harmless material included pollen, mold, food, and animals and during an allergic reaction; chemicals such as histamine are released from specialized cells. This may produce swelling of the lining of the airway, excessive mucus secretion and muscle contraction in the airways. In this way, an allergy can provoke an asthma prolong. He said that allergy may be the cause of unrecognized or hidden asthma, he added.
He said that cigarette smoke, air pollution, strong odors, aerosol sprays and paint fumes are some of the substances which irritate the tissues of the lungs and upper airways. The reaction (cough, wheeze, phlegm, runny nose, watery eyes) produced by these irritants can be identical to those produced by allergens, he added.
Dr Khan said that cigarette smoke is a good example, because it is highly irritating and can trigger asthma. Most people are not allergic to cigarette smoke but that is there is no known immunology reaction. Nevertheless, this irritant can be more significant than any allergen.
Dr Khan also explained about the further common condition of the asthma patients, its a common misbelieve is that children with asthma have a major psychological problem that's caused the asthma. Emotional factors are not the cause of asthma; however, emotional stress can infrequently trigger asthma.
He said that a child's asthma might only be noticeable after crying and laughing in response to an emotional situation. These normal "emotional" responses involve deep rapid breathing, which in turn can trigger asthma, as it does after running.
Dr Rashid khan said that Asthma is a disease characterized by inflammation in the lungs that difficulty breathing that usually results from some sort of triggers that may include viral infections such as colds, house dust mites, smoke, pollen or other allergens in the air, animals, exercise, air pollution, and changes in weather.
Dr.Rashid Ahmed Khan further said that the emotional stress itself anxiety, frustration and anger also can trigger asthma, but the asthmatic condition precedes the emotional stress.
He said that emotions are associated with asthma for another reason. Many children with asthma suffer from severe anxiety during an episode as a result of suffocation produced by asthma. The anxiety and panic can then produce rapid breathing or hyperventilation, which further triggers the asthma, he added.
Dr Rashid Khan suggested that treatment should be aimed at controlling the asthma. When asthma is controlled, emotional stress will be reduced and other emotional factors can then be dealt with more effectively. Any chronic illness, especially if uncontrolled, can have associated secondary psychological problems. More severe psychological problems require a specialist to help the child and his or her family, he added.
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