Asthma

Asthma is a long-term inflammatory disease that affects the airways, causing them to narrow and become highly reactive to various stimuli. This can lead to episodes of breathing difficulties, wheezing, coughing, and tightness in the chest. The triggers for asthma symptoms can vary from one person to another and may include allergens, respiratory infections, or environmental factors. Asthma attacks can range from mild to severe and may last for varying durations. 

The exact cause of asthma is still not fully understood, but both genetic and environmental factors play significant roles. Genetics are a strong indicator; if both parents have asthma or allergies, their child has a 70% chance of developing asthma. If only one parent is affected, this risk drops to around 50%. 

Environmental factors, such as repeated exposure to allergens or irritants, can also contribute to the development of asthma, especially if there is a genetic predisposition. The likelihood of developing asthma is higher when the body's immune system reacts abnormally to these external substances.

Asthma can be classified into several types, which may overlap in some cases: 

• Allergic asthma: This is the most common form and occurs when the immune system reacts to allergens such as pollen, dust mites, animal dander, mold, certain foods, or occupational triggers like chemicals used in specific professions. In response to these allergens, the body releases histamines, leading to symptoms like wheezing and shortness of breath. 
• Non-allergic asthma: This type is triggered by irritants such as tobacco smoke, strong odors, temperature changes, viral infections, or air pollution. Unlike allergic asthma, non-allergic triggers do not involve the immune system's histamine response. 
• Exercise-induced asthma: This occurs when physical activity leads to airway constriction, causing symptoms like wheezing, coughing, and shortness of breath. Warm-up exercises and medication can help alleviate symptoms. Cold and dry air can worsen this condition. 
• Severe asthma: This is a rare and more complex form of asthma that is difficult to manage with standard medication. It often requires specialized treatment and frequent hospital visits due to persistent symptoms. 

Asthma can manifest in several recognizable symptoms, although these may also indicate other respiratory conditions. Key symptoms include: 

• Shortness of breath: The sensation of being unable to breathe properly can be alarming. It often occurs when the lungs become hyperinflated, making it difficult to exhale. Sitting upright and clearing any tight clothing can help during an asthma attack. 
• Wheezing: This high-pitched whistling sound occurs due to narrowed airways, typically when exhaling. 
• Fatigue: Chronic asthma can cause fatigue due to poor sleep quality, increased respiratory effort, and constant coughing. 

Asthma is sometimes confused with COPD, but the two have important differences: 

• Genetics vs. lifestyle: Asthma often has a genetic basis, while COPD is frequently linked to smoking. 
• Age of onset: Asthma can appear at any age, whereas COPD typically affects individuals over 40. 
• Symptoms: Asthma symptoms fluctuate, while COPD symptoms are more constant. 
• Disease progression: Asthma can be well-controlled with medication, whereas COPD gradually worsens over time. 
• Lung function: With proper asthma management, lung function can remain normal, unlike in COPD, where it is reduced even with treatment. 

Lifestyle changes can significantly reduce the frequency and severity of asthma attacks. Maintaining a healthy diet, avoiding known triggers, and following prescribed medication regimens can help manage symptoms. 

Asthma treatment typically begins with lifestyle recommendations, such as weight management and physical activity. If symptoms are frequent, the doctor may prescribe medication, which can be adjusted based on the response: 

• Occasional symptoms: Short-acting bronchodilators (e.g., salbutamol) can relieve symptoms when needed. 
• Frequent symptoms: Inhaled corticosteroids (e.g., beclomethasone, fluticasone) help reduce airway inflammation. 
• Persistent symptoms: Combination therapy with a long-acting bronchodilator (e.g., salmeterol) may be required. 
• Specialized care: If symptoms persist despite treatment, referral to a specialist may be necessary. 

These methods should complement standard medical care, not replace it: 

• Homeopathy: Remedies aim to support the immune system. 
• Acupuncture: This traditional practice may help balance energy in the body. 
• Breathing therapy: Learning proper breathing techniques can benefit asthma management. 
• Naturopathy: Herbal remedies and dietary changes may alleviate symptoms. 
• Yoga: This practice combines breathing exercises with relaxation to reduce stress, which can trigger asthma.

A proactive approach can greatly enhance asthma management: 

• Inform others: Make sure those around you are aware of your asthma so they can offer support. 
• Avoid smoking and smoke-filled environments. 
• Limit exposure to known allergens or irritants, such as pollution or strong scents. 
• Stay fit: Improved physical condition helps lessen the severity of attacks. 
• Maintain a healthy weight: Obesity is linked to poor asthma control and reduced lung function. 

Dutch Care Institute (z.j.) Astma, consulted on 26 April 2019, at https://www.farmacotherapeutischkompas.nl/bladeren/indicatieteksten/astma

Longfonds (s.a.), Asthma, consulted on 26 April 2019, at https://www.longfonds.nl/astma

Medworq (s.a.), Asthma & COPD, consulted on 26 April 2019, at https://www.astma-copd.nl/astma/

RIVM (2019) consulted on 1 May 2019, Asthma / figures & context / current situation, at https://www.volksgezondheidenzorg.info/onderwerp/astma/cijfers-context/huidige-situatie