The Healthy House Ltd | Allergy Information

What is Asthma?
Asthma is a common chronic inflammatory condition of the lung airways. Symptoms are cough, wheeze, chest tightness and shortness of breath, often worse at night. (Clinical Medicine 4th edition, Kumar and Clark).

Bronchospasm is the key event in asthma; a sudden, but reversible, tightening of the bands that surround the airways. The narrowed airways stop the air from leaving the lungs at the normal speed. This means that the lungs are still half full when it is time for the next inhalation. Taking more air in produces pain and tightness in the chest. Insufficient oxygen reaches the bloodstream because there is so much stale air in the lungs. This causes a feeling of breathlessness. Even when the muscles relax after an asthma attack, the underlying inflammation still remains. This may be caused or partially caused by allergy. Among asthmatic children, allergies are detected in 80-90%. Inflammation makes the lining of the airways swell up. The inflamed airway lining often makes more mucus than usual which can clog up the airways even more. The inflamed airways send nerve impulses direct to the airway muscles telling them to contract.

What causes Asthma?

Predisposition
A predisposition to asthma is partly inherited and partly due to lifestyle. A poor diet and too much cleanliness makes asthma more likely.

What starts it off?
Inflammation of the airways often begins with an allergic reaction to something in the air; such as house-dust mite or pet allergens. It could also start with a viral infection or a large dose of an irritant such as chlorine.

What triggers asthma?
Once inflammation of the airways has begun, they become oversensitive and may contract at the smallest provocation. Triggers vary from one asthmatic to another and could include one or more of the following:
Cold or dry air
Strong smells including perfume and fragrant flowers
Irritants in the air (cigarette smoke, traffic fumes, indoor pollutants such as gas, industrial pollutants)
Sulphur dioxide used as preservatives in some foods and drinks
Weather conditions particularly thunderstorms
Any altered breathing pattern (laughing, coughing etc.)
Stress and anxiety
Strong emotions
Exercise
Allergens
Colds, flu and chest infections.

Diagnosis of Asthma
If you think you may have asthma you should go for a consultation with your doctor. In order for a diagnosis of asthma to be given two tests need to be carried out. The peak flow test is the top speed of the outgoing air from your lungs measured with a peak flow meter. Because of inflamed airways, asthmatics have a lower than normal peak flow. The reversibility test measures peak flow before and after inhaling a beta-2 reliever drug which relaxes the airway muscles. If the improvement is more than 15%, this strongly suggests asthma.

Asthma may be affected by and combined with other diseases which include allergic problems in the nose, sinusitis, the fungi causing athlete's foot and gastro-oesophageal reflux, emphysema and bronchitis.

Your doctor may send you for skin prick tests to determine which airborne allergens are the basic cause of airway inflammation. Alternatively you can use simple detective work to determine which allergens may be affecting your asthma. Keeping a diary to record your symptoms can help with this. In some cases food sensitivity is the initiating cause of asthma but because the reaction is delayed the link may not be obvious and an elimination diet may be necessary to identify the offending food. It has been found that as many as 60% of brittle asthmatics have a food sensitivity. Asthma that is unstable and difficult to manage is described as brittle asthma. Despite extensive and careful treatment with drugs, it can very easily develop into a severe asthma attack. Professor Jonathan Brostoff and Linda Gamlin: Asthma The Complete Guide. (If you have brittle asthma you must get your doctor's consent for an elimination diet.)

Treatment
The most important factor in the treatment of asthma is environmental control minimising contact with allergens and irritants.*

The airways must be calmed down so that they are less sensitive. You can prevent exposure to the basic source or, if necessary, preventer drugs can be used. Treating associated diseases such as sinusitis, hay fever, etc. and also eating a better diet can help reduce the inflammation in the airways.

Bronchospasm needs to be addressed with the use of reliever drugs such as Ventolin and Atrovent. Note that these only relieve the symptoms of an asthma attack, and do not address the underlying problem of inflammation. What is more, if used too frequently (more than once a day) they may increase the risk of a fatal or near-fatal asthma attack.

Exercise and Asthma
Exercise-induced asthma is best tackled, paradoxically, by taking exercise. As you build up your fitness you wont pant so much when exercising so the airways will not dry out as much.

* At The Healthy House we suggest that avoidance of irritants could include barrier covers on bedding to protect against the house dust mite, using an efficient air purifier, a vacuum cleaner with an S-class filter, monitoring the humidity in the air with a Climate Check and if necessary using a dehumidifier to combat both mould and dust mites. If your drinking water is heavy chlorinated you may wish to drink filtered water.