Asthma is a chronic inflammatory condition involving small airways of lungs, characterised by intermittent yet recurring symptoms due to inflamed airways (small air-way wall edema, mucus collection and smooth muscle spasms).This results in the narrowing of small airways with reversible airway obstruction. 

“Asthma is one of the major non-communicable diseases among children and adults with approximately 339 million cases, across world, up to date” says Dr Sumudu Bandaranayake, Consultant Physician, Teaching Hospital, Kurunegala.

Causative factors
Caused due to interactions between genetic and environmental factors asthma is often found to be running in families. The commonest triggering factors for asthma include infections, excreta of house dust mite and cockroaches, tobacco smoke, pollen, proteins on dried proteins of saliva on animal fur, soaps and detergents.

Presentation
“The usual presentation of asthma include wheezing, chest-tightness, shortness of breathe and dry cough which can sometimes result in infective exacerbations with flu symptoms like phlegm producing cough and a runny nose. Night-time or early morning cough is considered to be one of the initial most symptoms. Asthma can also be associated with eczema and allergic rhinitis and recent studies show that complications of COVID- 19 and the risk of death is higher in asthmatics.

“Asthma often remains un-diagnosed and un-treated especially in middle and low income countries resulting in sleep disturbances and poor exercise tolerance, creating a non-satisfactory quality of life,” the Dr Bandaranayake added. 

Therapeutic approach
Following the diagnosis, asthma can successfully be controlled with inhaled medication which falls into two categories namely 
•Relievers-Bronchodilators (salbutamol), which open up air passages and RELIEVE symptoms
•Preventers- Steroids (beclometasone), which PREVENT inflammation occurring in the air passages, improving symptoms thus reducing the risk of severe asthma attacks and death.

In children, using a spacer device is more effective in ensuring a better penetration of medication into lungs. 

“Creating awareness on the importance of avoiding identified triggering agents, seeking medical advice on time, practicing proper inhaler techniques and being compliant on preventive and relieving medication should be implemented through health care promotional campaigns in order to bring down the incidence of severe and life-threatening cases of asthma,” explains Dr Bandaranayake.

As far as the global outlook of this condition is concerned, asthma is included in the WHO Global Action Plan for the Prevention and Control of NCDs and the United Nations 2030 Agenda for Sustainable Development.

World Asthma day 2021

World Asthma Day was founded by World Health Organization (WHO) in collaboration with Global Initiative for Asthma (GINA) in 1993.

“The theme for year 2021 is ‘Uncovering Asthma Misconceptions’ which owns a motive of addressing those commonly believed myths and misconceptions regarding asthma which prevent asthmatic people from enjoying the optimal benefits of latest advances in the therapeutic aspects of the condition,” Dr Bandaranayake underscores.

Common misconceptions regarding 

Asthma is a childhood disease and individuals grow out of it as they age

No. Although asthma is commoner in children, new-onset asthma during adulthood can often be seen nowadays due to increased exposure to triggering agents like tobacco smoke, fumes and occupational agents. Also, the frequency of attacks in children drops as they reach late-teen-ages and tend to peak again during adulthood. 

It’s infectious
No. Asthma runs in families and occurs as a result of the interaction between environmental and genetic factors. But asthma cannot spread from one individual to another like common cold or flu. However, there is a chance of respiratory infections leading to acute asthma exacerbations in asthmatic individuals.

Asthmatics should not exercise

No. While exercise is one of the commonest triggering factors for asthma-it is now found that well customised exercise helps in strengthening lungs thus helping in asthma control.

Asthma always ends up in cancers
No, it doesn’t. Asthma is clearly not a pre-malignant condition, but long-term exposure to aforementioned allergens like toxic fumes, flames and smoke can alter airway walls, with time resulting in various malignancies.

Asthma results in learning disabilities and low IQ
No. Even though poorly controlled asthmatic attacks can result in poor school attendance which can cause learning disturbances, asthma is not a cause of low IQ.