How dangerous is asthma? This article answers questions about asthma

If early intervention is carried out on asthma patients in a timely manner, it will effectively prevent their condition from worsening and greatly reduce their risk of disease and death.

Produced by | Science Popularization China

Author | Zhao Shiyun (Tsinghua University)

Producer | China Science Expo

We often see scenes of people having asthma attacks on TV - the patient has difficulty breathing, is in great pain, and the situation is very urgent. At this time, someone quickly puts a small tube of spray into the patient's mouth, and after the spray is applied, the patient's symptoms are quickly relieved; if not treated in time, the patient will soon fall into a coma, or even die. Indeed, asthma attacks need to be taken seriously and timely measures should be taken, but there is no need to panic as long as you are well prepared.

Asthma patients using spray treatment | Image source: Flickr- NIAID

Do you know what asthma is?

According to the definition of WHO, asthma is a common non-communicable chronic disease. As the airways of asthma patients become inflamed, the entire airway cavity becomes narrow, hindering the normal circulation and exchange of gas, which in turn leads to symptoms such as coughing, wheezing, shortness of breath and chest tightness. These symptoms are intermittent and often worsen at night or during exercise.

The causes of asthma are complex, and multiple factors can increase the risk of asthma. It is difficult to find the direct cause. Common factors such as air pollution, respiratory infections, allergies, strenuous exercise and even mental stimulation can induce asthma. Therefore, with the worsening of environmental pollution, the prevalence of asthma has also shown a continuous upward trend in recent years.

Schematic diagram of the human respiratory tract | Image source: Wikipedia

According to the results of the 2015 Global Burden of Disease Study, asthma is one of the most common chronic respiratory diseases, with 358 million patients worldwide, and the prevalence has increased by 12.6% since 1990.

The "China Lung Health Study" survey conducted in 10 provinces and cities in China from 2012 to 2015 showed that the asthma prevalence rate among people aged 20 and above in my country was 4.2%, of which 26.2% of asthma patients already had symptoms of airflow limitation. According to the national census data of that year, there should be 45.7 million asthma patients in my country over the age of 20.

Asthma has little effect on the human body when it is not in an attack, but it is very harmful when it occurs. Persistent asthma can cause irreversible heart and lung damage, induce serious diseases such as emphysema, and even cause death. At the same time, persistent asthma can also make it difficult for patients to get a good rest, leading to sleep disorders, fatigue, difficulty concentrating, and other problems, which have an all-round impact on patients' lives.

Do we have a cure for asthma?

Although asthma cannot be cured, the current treatment options for asthma are quite mature. With proper treatment and medication, asthma patients can live a normal life.

The most common asthma medications are inhaled medications, which are the small bottle sprays we see in movies and TV shows. These drugs are divided into two categories: one is bronchodilators represented by salbutamol, which are used to open the airways and relieve symptoms; the other is steroid hormone drugs represented by belometadone, which are used to reduce airway inflammation.

This two-pronged approach can effectively improve asthma symptoms and reduce the risk of death from asthma attacks. In addition, for some patients with severe asthma symptoms, doctors often recommend short-term oral glucocorticoid treatment during the onset period.

A common glucocorticoid treatment drug | Image source: wikipedia- Jack.A.Black

When it comes to hormone therapy, many people may worry about the side effects. In fact, there is no need to be afraid of hormones. We may have heard of serious side effects such as femoral head necrosis, but this is caused by taking large doses of intravenous hormone therapy in critical moments. The dosage and method of administration are completely different from the inhaled hormones used by asthma patients.

The inhaled hormones used to treat asthma basically only act on the respiratory mucosa and rarely act on the whole body. Their safety has been effectively verified over many years of treatment. Even pregnant women and children can safely use this type of drug to treat asthma.

How can I minimize my asthma risks?

In life, we may also encounter asthma patients who are afraid of food, pets or specific smells. In fact, allergies are indeed an important triggering factor for many asthma patients. People with other allergic symptoms such as eczema and rhinitis are also more likely to suffer from asthma.

Among them, the most common and harmful allergens that cause widespread asthma worldwide are dust mites and fungi. In addition, animal dander, pollen, sulfur dioxide and other pungent odor gases, seafood and other foods are also common allergens in life.

Dust mites, their feces and chitin are the most common allergens in the home | Image source: wikipedia

Patients with allergic asthma often have precursor symptoms such as sneezing, runny nose, itchy nose, and coughing. Because the symptoms are similar to respiratory tract infections or inflammations, patients may misdiagnose them as colds in the early stages and neglect treatment.

If you find yourself suffering from similar symptoms and there is obvious seasonality (meaning that the disease only occurs in a specific season or the symptoms are more severe in a specific season) or time of day (usually the symptoms are milder during the day and more severe at night or early morning), you should seriously consider the possibility of respiratory allergy and go to the hospital in time to identify the allergens and take corresponding protective measures to avoid progression of the disease.

In addition to traditional drug treatments, there is also a desensitization treatment method for allergic asthma. This method uses allergens that the patient has an allergic reaction to, makes extracts of different concentrations, and repeatedly injects them subcutaneously to the patient, with the dosage increasing from small to large and the concentration increasing from low to high, gradually inducing the patient to tolerate the antigen and not have an allergic reaction.

It should be emphasized that during desensitization treatment, if the dosage of allergens is inappropriate, the patient may easily have local or systemic allergic reactions, or even serious symptoms such as anaphylactic shock. Therefore, this method must be carried out under the guidance of a professional doctor in a formal medical setting. Do not blindly follow others or even take allergens at home for "desensitization".

Like allergies, asthma is also a highly genetic disease. If other family members (especially close relatives such as parents or siblings) also have asthma problems or other allergic diseases, the possibility of asthma will be greatly increased. Therefore, readers with such a family history should also pay more attention.

What should we do if asthma strikes suddenly?

As mentioned above, acute asthma attacks are very dangerous. If we find that someone around us has symptoms such as extremely fast or slow breathing, difficulty breathing, noisy breathing, and inability to speak a complete sentence between two breaths, we need to be alert to the possibility of an asthma attack. Once an asthma attack occurs, you should call 120 emergency number in time or go to the hospital by yourself and let a professional doctor treat it.

During this period, keep the patient's environment fresh and warm. If it is allergic asthma, take the patient away from the allergen immediately. Let the patient sit or lie down, or let him kneel on the bed with a pillow, keep the patient's waist leaning forward to facilitate breathing, and let the patient inhale the asthma spray at hand immediately.

Image source: Veer Gallery

If the patient experiences severe breathing difficulties, blue lips and nails, or other symptoms of hypoxia, oxygen inhalation facilities should be found for the patient in time to supplement oxygen and avoid other damage to the body due to hypoxia.

Due to the complexity of influencing factors, the pathogenesis of asthma has not yet been clarified, and no cure can be given. However, if early intervention is carried out on asthma patients, such as allergen testing and timely medical treatment, it will effectively prevent the aggravation of their condition and greatly reduce the risk of disease and death. With the continuous efforts of Chinese medical staff, the control rate of asthma in my country has also increased significantly in recent years.

In 2008, a survey on the control status of asthma patients in respiratory specialist clinics of tertiary hospitals in 10 first-tier cities in mainland China showed that 28.7% of patients achieved asthma control; when the survey was repeated in 2017, it was found that this proportion had risen to 39.2%, a significant improvement. Although there is still a certain gap with developed countries, I believe that with the joint efforts of our health departments and medical staff, we can achieve overall control of asthma in the near future. Not only to control current symptoms, but also to reduce the risk of future attacks.

Finally, as an old patient suffering from asthma for 15 years, I sincerely wish all readers good health and not to be troubled by asthma.

Main references

[1]. Guidelines for the prevention and treatment of bronchial asthma (2020 edition)[J]. Chinese Journal of Tuberculosis and Respiratory Diseases, 2020, 43(12): 1023-1048.

[2]. World Health Organization/Media Center/Fact Sheet/Detail/Asthma
https://www.who.int/en/news-room/fact-sheets/detail/asthma

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