Asthma 

• Symptoms: Intense coughing, wheezing, pain in the chest, shortness of breath, tightness in the chest, breathing issues, trouble sleeping, whistling sound while breathing, fatigue, rapid breathing, frequent infections, anxiety, difficulty talking
• Causes: Genetics (a family history of asthma), respiratory infections, environmental factors (exposure to toxins, fumes, smoke, etc.), allergies
• Risk Factors: Dust mites, air pollution, strong chemical smells, occupational exposures to allergens, excessive exercising, exposure to moulds and fertilizers, pet fur, tobacco smoke
• Severity: Mild to moderate
• Which doctor to consult: Asthma Specialists, Immunologists, Allergists

Overview:

A long-term disease of your lungs, asthma, causes inflammation of the airways that lead to the lungs. Once the airways are narrowed and inflamed, a plethora of breathing issues and difficulties will arise. If not brought under control on time, an individual might even experience trouble being active or talking. The individual might even find it impossible to do the above activities past a certain point in the disease progression.

To understand how the disease affects, let's first understand how breathing works. When one breathes, air enters the body through the nose and mouth and travel down the throat. It passes through the airways and makes its way to the lungs. Now, this oxygen is passed into the bloodstream via multiple air passages.

When an individual gets diagnosed with asthma, the linings of these airways swell up, causing the surrounding muscles to tighten up. Furthermore, the mucus accumulates in these passages, allowing very little air to pass through. As a result, an individual experiences an asthma attack.

When to Consult a Doctor?

To be able to identify the presence of asthma, and individual needs to have a proper understanding of the symptoms that the disease entails. Here is a list of symptoms that announce the onset of asthma:

• Intense coughing
• Wheezing
• Pain in the chest
• Shortness of breath
• Tightness in the chest
• Breathing issues
• Trouble sleeping
• Whistling sound while breathing
• Fatigue
• Rapid breathing
• Frequent infections
• Anxiety
• Difficulty talking

If any individual experiences any of these symptoms and hasn't been diagnosed with the condition before, he/she should head to the doctor for a checkup. If left unchecked, asthma can cause significant damage to the air passages and overall health.

Furthermore, here is a collection of reasons that justify visiting the doctor for asthma:

• Diagnosed with asthma: An individual needs to head to the doctor if he/she starts experiencing any of the following symptoms. Once these symptoms have lingered for a few days, he/she must get checked.
• Monitor the condition post-diagnosis: If an individual has already been diagnosed with asthma, the next logical step is to monitor and keep it under control. This can reduce the chances of experiencing a severe attack down the line.
• Review treatment: The progression of asthma might change its course over time. So, an individual must make sure that he/she meets the doctor regularly to keep the disease under control.

Severe attacks can even prove to be life-threatening. In case an individual experiences signs of the condition worsening despite treatment, it might be an emergency. As a result, the individual will need emergency treatment if he/she experiences the following scenarios:

• No improvement in the condition after puffing the inhaler 
• Minimal physical activity causing shortness of breath
• Worsening of wheezing and shortness of breath

Diagnosis:

To obtain an accurate diagnosis of the condition, a doctor will examine the patient’s medical history. This will help the doctor understand what might be causing the symptoms. Is it asthma, or is it something else? To get a better insight into the situation, the doctor might ask the individual a couple of questions, including:

• What symptoms the individual is experiencing?
• What triggered those symptoms?
• Do the individual smoke, or has he/she been exposed to tobacco smoke in some way?
• Does an individual has allergies?
• Is the individual constantly exposed to any airborne irritants?
• Does the individual has pets?

Once this is done, they will proceed to a physical examination. The physical examination entails checking your throat, nose, and upper airways. Secondly, the doctor will then use a stethoscope to understand your breathing and gauge the airways for the presence of blockages.

If there are blockages, you might wheeze a lot, which can be easily caught with the stethoscope. 
Lastly, the doctor will also examine the skin for signs of allergies (hives, eczema, etc.) to rule them out completely.

To confirm the diagnosis, the doctor might ask the patient to get the following tests done:

Lab Tests: The primary lab test employed to detect the presence of asthma is spirometry. This test is used to detect and diagnose asthma in anyone over five years of age. First, an individual has to take a deep breath and exhale into a tube connected to the spirometer. The device studies the volume of the exhaled air, and if certain measurements are below the recommended level, it might hint at the presence of asthma.

Another lab test employed by doctors to diagnose asthma is the challenge test. If the spirometer readings are unclear, doctors might ask the individual to forcefully inhale a substance that might trigger asthma symptoms if he/she has the condition. This includes substances like methacholine.

This challenge can also be done in the form of intensive physical exercise, which might also trigger the symptoms. An individual has to retake the spirometer test post-challenge completion, and conclusive results will be obtained.

Another popular lab test for asthma detection is the nitric oxide test. This test will gauge the amount of nitric oxide in the breath. The presence of higher-than-normal nitric oxide levels in the bloodstream is a sign of asthma. This happens when the airways are inflamed.

Imaging Tests: Some imaging tests used to detect the presence of asthma are chest X-rays and CT scans. In a chest X-ray, the doctor will get a clearer view of the air passages.

On the other hand, a CT scan is essentially made up of a series of X-rays, giving the doctor a clear view of the lungs and the airways. A CT scan of sinuses and lungs can identify the cause of any breathing problems an individual is experiencing, allowing doctors to point out exactly where the issue stems from.

Advance Tests: Another test that can be used to diagnose the presence of asthma is the Sputum Eosinophils test. This test studies the saliva for high levels of white blood cells (eosinophils) and mucus in the sputum. This will also help doctors offer a clear diagnosis of the condition.

Treatment:

Here are some of the top treatment options for dealing with asthma the right way:

Home Care: In case an individual is constantly experiencing asthma symptoms and the medications aren't of much help, he/she can opt for some home remedies to ease the discomfort. They are as follows:

• Dietary changes
• Buteyko breathing technique (system of breathing exercises that can bring down asthma symptoms)
• Papworth method (breathing and relaxation technique to relieve asthma symptoms)
• Consumption of caffeine 
• Yoga 
• Consumption of omega-3 supplement 
• Consumption of ginger, garlic, and honey

Medication: The type of medication required to manage asthma will vary based on factors like symptoms, triggers and age. These factors help doctors decide what will help keep asthma under control. As a result, these asthma medications have been split into three groups. They are as follows:

1. Long-term asthma control medications: These medications are generally used to manage and alleviate symptoms on a daily basis. These reduce the chance of an individual succumbing to an asthma attack. Various types of long-term asthma medications include: inhaled corticosteroids (budesonide, ciclesonide, beclomethasone, fluticasone furoate, etc.), leukotriene modifiers (montelukast, zafirlukast, zileuton, etc.), combination inhalers (fluticasone-salmeterol, budesonide-formoterol, formoterol-mometasone, etc.), and theophylline. 
2. Short-term asthma control medications: These medications are used to curb the symptoms of a rapidly approaching asthma attack on short notice. This includes medicines like short-acting beta-agonists, anticholinergic agents, and oral and intravenous corticosteroids. 
3. Allergy medications: These medications help if asthma symptoms worsen due to allergies. These include allergy shots (immunotherapy) and biologics (omalizumab, mepolizumab, reslizumab, dupilumab, benralizumab etc.)   
4. Surgical Treatment: If the condition deteriorates too much, and individual needs to opt for surgery. This surgery is known as Bronchial Thermoplasty, and it aids in opening up the airways. The surgery will be done in three separate parts, with a gap of three weeks between each session. One session can last for about an hour each and focuses on different parts of the lungs each time.

To start, the doctor will gauge how much air an individual can really blow out. Then the individual will be given medication that might numb his/her mouth and throat. The doctor will then insert a small tube known as a bronchoscope down the throat, to the lungs. This tube will heat up to warm the airways and remove the swelling. Keep in mind that this heat is quite mild and won't cause considerable discomfort.

Risks & Complications if Left Untreated

If left untreated, asthma can cause several complications. These complications are as follows:

• Sleep: Most of the asthma symptoms trigger at night, disrupting quality sleep and leading to sleep deprivation. Sleep deprivation can impede daily function, making a person more lethargic and devoid of energy. 
• Physical activity: Severe asthma can prevent an individual from participating in sports, which might pave the way for other health complications like weight gain, depression, diabetes and high blood pressure. 
• Medical complications: Unchecked asthma can have long-term side effects on the body and might lead to medical side effects such as oral yeast infections, insomnia, rapid heartbeat and gastroesophageal reflux. 
• Attack and respiratory failure: If asthma gets too severe, an individual will become prone to more asthma attacks. As a result, he/she might even experience respiratory failure, a condition where enough oxygen isn't delivered to the bloodstream. This can result in death if not curbed on time.