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chronic inflammatory disorder
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Asthma: Understanding, Trigger Factors , Prevention And Treatment
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Asthma, is a chronic medical disorder which is potentially life threatening and afflicts millions of people throughout the world. In the United States it affects approximately five percent of the population.

It is a chronic inflammatory disorder of the airways characterised by periods or phases of exacerbations (when the symptoms of the disesase are present) and remissions, when the patient or affected individual does not experience any symptoms of the disease.

During exacerbations the patient there is reversible obstruction of the airways due to spasm of the smooth muscles of the bronchioles (bronchoconstriction), oedema or swelling of the lumen of the bronchioles due to inflammation and excess production and secretion of mucus.

These will result in coughing, tightness of chest, shotrness of breath or difficulty breathing and in the more severe cases an audible wheeze. The audible wheeze ( is so named because it is heard without of the stethescope) and is an easily recognised sign charcterised by a high pitched sound which is produced when air is being forced through the constricted airways. Those affected with asthma have hypersensitivity of the airways to allergens, which are factors in the environment which act as the provocative agents and are part of a broad and varied group that is referred to as the trigger factors for asthma attacks or exacerbations.

The trigger factors are a varied group and knowledge of these and avoidance or minimising exposure to them will significantly reduce the likelihood, frequency and severity of asthma attacks which is a crucial step in the management of patients. Common trigger factors range from:

Allegens: which include food products such as chocolate, eggs, orange juice, fish, milk. Pollens from flowers, and trees, moulds and spores. The furs and excreta of pets such as cats and dogs, feathers of chickens and other birds.

Dusts from cloth uholstered furniture, carpets, draperies that gather dusts, dirty filters and air conditioners, dusts on pillows. Comon household products like deodorising sprays, polish and paints and industrial chemicals like pesticides.

Other key environmental factors including sudden changes in the weather or extremes of heat or cold, cigarette smoking especially in confined spaces and also smokee from burning rubbish or industrial refuse and the exhaust from cars.

Asthmatics are not forbidden to participate in physical education or even competitive sports like football during periods of remission. However, it is important to point out that although exercising sustain, develop and strengthen the body, strenuous physical activities or the involvement in games in conditions like a dusty or smoky environment ,or in conditions of weather earlier listed can trigger asthma attacks.

Even with the best efforts aimed at prevention by avoiding the well known asthma triggers, attacks may still occur. Therapy can be divided into main objectives which are to prevent astma attacks and to abort attacks or exacerbations when they do occur.

As was earlier stated acute severe attacks are always potentialy life threatening. Medications which are refeered to as bronchodilators are contained in aerosol or inhalation form and are used to abort the acute exacerbations when they occur. However steriods form the cornerstone of therapy aimed at prevention and treatment during attacks or exacerbations because they act at all the mechanisms of the development of the disease and the medications are given in aerosols or inhalers, injections or tablets.

Therapy is always multifactorial and takes into consideration the trigger factors and mechanism of the exacerbation. Antihistamine and leukotrine receptor drugs are administered to counteract the allergic reactions which occur and also play an important role on preventetive therapy or prophylaxis and antibiotics are administered in the presence of infection and other drugs such as cough mixtures antipyretics to treat fever are prescribed as indicated on an individual basis.

Although asthma is poentially life threatening and unfortunately many people still die from asthma and it is a condition which does reult in loss of produtive time due to absence from work and children from school, when it is correctly managed and treated and there is the right compliance people diagnosed can achieve their full life expectancy of a normal productive and happy life.


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