Asthma

Asthma is a disease of the respiratory tract that makes it difficult and difficult to breathe. Coughing is also common. The treatment consists of, among other things, various drugs that you breathe in. With the right treatment, the hassles usually reduce or disappear.

Symptoms of asthma

These are common symptoms of asthma

  • You get bouts of shortness of breath, that is, it is heavy to breathe. 
  • You breathe with a beeping and whistling sound.
  • You have a prolonged cough every time you are cold.
  • You have a prolonged cough that you can’t find any explanation for. The cough often comes at night.
  • You get shortness of breath and cough when you exert yourself physically, for example when you exercise.

The problems with asthma come in periods, sometimes you can feel completely healthy and sometimes you can have major problems.

Asthma can be triggered by various things

Asthma is due to a chronic inflammation of the mucosa of the trachea. Inflammation, among other things, makes the trachea extra sensitive. Cold air, strong smells, and smoke are examples of things that can cause asthma problems. For example,  stress , physical exertion and respiratory tract infections can cause you to have more asthma problems.

Most often you get asthma as a child, but the disease can start at any age.

Allergic asthma and non-allergic asthma

Asthma can be divided into two types: non-allergic asthma and allergic asthma. In adults, non-allergic asthma is most common, while allergic asthma is most common in children with asthma .

You who have allergic asthma can have asthma problems if you come into contact with what you are allergic to. For example, it can be pollen,  fur animals or mites . But asthma can also be triggered by, for example, cold air, strong smells and smoke.

The symptoms and treatment are basically the same, no matter what type of asthma you have.

When and where should I seek care?

Contact a health care provider if you suspect you have asthma.

Seek medical care directly at a health center or emergency room if you have asthma and suddenly find it difficult to breathe and your medications do not help.

Investigations

You can tell your doctor about your problems. You will be told when they come and if there is something special that will cause you trouble.

The doctor does a body examination and examines how your lungs work. There are several different methods for examining the function of the lungs. The most common ones are spirometry and using a PEF meter. Both examine lung function, but in different ways.

Spirometry

Spirometry measures how much air you can blow out and how fast it goes. It is more difficult to blow out the air quickly if your trachea is narrow.

You are usually allowed to do the examination at a health center. You can then blow in different ways in a nozzle connected to an appliance, a so-called spirometer. The nozzle can also be connected directly to a computer with a spirometry program.

A spirometry is done, among other things, to check if it is asthma you have and not other respiratory problems or lung disease  COPD. Spirometry is also used to see how your drugs or your possible smoking affect lung function.

Spirometry examination provides more reliable results and more information, compared to a PEF measurement.

PEF Measurement   

A PEF measurement shows how much air you can blow out when exhaling.

To find out your so-called PEF value, you have to blow as hard as you can in a tube. The pipe leads to a meter that records the airflow. In the case of asthma, the trachea becomes narrow and the airflow decreases, thus reducing the PEF value.

You usually get to measure your PEF values ​​for two weeks. You can then borrow a PEF meter. You usually measure your lung function in the morning and evening. If you have been given bronchodilator medication, measured before and after taking the medication.

PEF measurement is usually not enough to diagnose asthma, but is used in conjunction with other screening methods to confirm the diagnosis.

PDF is an abbreviation for Peak Expiratory Flow. This means maximum airflow during exhalation.

Other investigations

You may do more examinations in an asthma study.

Reversibility

During a reversibility test, your doctor can see if your trachea is dilated by drugs. The test is usually done at the health center.

Here’s how:

  • First, your lung function is measured by spirometry.
  • Then you get to inhale a bronchodilator drug.
  • After about 15 minutes, your lung function is measured again.

It indicates that you have asthma if you get much better after taking the medicine.

Treatment Try

Depending on what the other tests have shown, you may be able to make a so-called treatment trial. In such a test, you get to try cortisone. You may either inhale cortisone every day for three to six months, or you may take cortisone tablets for two to three weeks.

If the treatment makes your lungs work better, it indicates that you have asthma.

Stress Test

You will have to do an effort test especially if you have trouble when you exert yourself, and the other examinations look good.

An effort test goes as follows:

  • First, your lung function is measured by spirometry.
  • Then you have to work intensively for at least six minutes. For example, you can run on a treadmill or ride a test bike.
  • Afterward, your lung function is measured again with spirometry.

Testing the sensitivity of the trachea

There are methods that measure how sensitive the mucous membranes in the trachea are. You then inhale a substance that irritates the trachea and causes them to contract. Then your lung function is measured and how it changes as you inhale even more of the irritating substance. Everyone responds to these topics, but if you have asthma you usually respond faster and more vigorously.

The examination can be a complement to other examinations and is only done in hospitals.

NO measurement

You have more of the substance nitric oxide in the air that you exhale if you have inflammation in the trachea, such as in asthma. The amount of nitric oxide in the exhaled air can be measured in an apparatus. Nitric oxide can be shortened NO and the study is called NO measurement.

Along with other studies, NO measurement can help the physician diagnose asthma. It can also be a way to follow up on treatment for asthma and assess how much medicine you need to take.

Allergy Test

An allergy test is also done when investigating suspected asthma. You then have to do an allergy test. The most common tests are a so-called dot test or a blood test.

In order for you to be considered allergic, you need to have both a rash on the test and symptoms when you come into contact with the rash. So it is not enough that only the test results, you have to have symptoms as well.

After the investigations

After the surveys, you should know when and how to find out the result. You should also find out who to contact if you get worse.

Treatment for asthma

The goals of the treatment for asthma include the following:

  • You should not have any asthma symptoms.
  • You should not be hindered by asthma in your life.
  • You should not need to take extra bronchodilator medication.
  • You should not have any troublesome side effects of your medicines.
  • Your lungs should function properly.

Drugs for asthma

In asthma, drugs from several drug groups are used. They work in different ways and the drugs are often combined to make the effect as good as possible. The drugs you use depend on how much trouble you have from your asthma.

The most common thing is that you can combine cortisone and bronchodilator drugs, both fast-acting and long-acting. 

You inhale most drugs by mouth, so-called inhalation. You inhale them with the help of inhalers.

Learn more about the treatment

An important part of the treatment for asthma is that you learn more about the disease and how your various drugs work. Then you can more easily take control of asthma.

At many health centers, there are so-called asthma clinics with asthma nurses. They are specially trained nurses who can teach you the right inhalation techniques, explain the disease and how your medicines work. You usually get to see an asthma nurse both when you get your diagnosis and when you visit again.

At many health centers, special asthma schools are held. There you will learn, among other things, how the lungs work, how the drugs work, how you inhale and what it is like to live with asthma.

You can get a treatment plan

A written treatment plan is good for being able to take control of asthma. It says how to change your medication when needed. 

The best thing is if you write your treatment plan together with your doctor. Then you will also learn which drugs to take in different situations.

desensitization

Hyposensitivity is also called allergy vaccination or allergen immunotherapy. You can sometimes get hyposensitivity if you have severe problems with, for example, pollen allergy or fur allergy. When treatment is complete, asthma symptoms tend to decrease, and thus your need for medication.

Alternative treatments have no proven effect

Alternative treatments such as acupuncture, homeopathy and herbal medicine have no proven effect in asthma.

Good with regular visits

Astman’s difficulty often varies with time. Therefore, it is good if you go on regular visits where you get help deciding whether your medication or your dosage needs to be changed. Then you can also discuss with your doctor or asthma nurse if there is anything you wonder about.

Here are some examples of things to think about before returning:

  • Do you get more asthma symptoms when you are cold?
  • During the past month, have you had a cough during the night with a cough, chest pain or shortness of breath?
  • Do you suffer from asthma when you rush or stress?
  • Do you experience cough or shortness of breath when exercising?
  • Have you had to take extra bronchodilator medication due to asthma symptoms in the past month?
  • Do you have to refrain from doing something you want to do because of asthma?

When you come back for the visit you will be asked to fill out a questionnaire with five questions that show how good you are based on your asthma. 

What can I do for myself?

There are several things you can do to reduce your inconvenience.

Avoid smoking

You should not smoke if you have asthma. Smoking causes lung damage which in the long run impairs the function of the lungs. It is also more difficult to control asthma and asthma drugs work worse if you smoke. Talk to your doctor if you smoke and want to quit, there is a lot of help to be had.

Also try to avoid smoky environments. You inhale the smoke even if you do not smoke yourself, so-called passive smoking. Passive smoking gives you increased trouble and damages your lungs.

Measure yourself with PEF meter

Get your own PEF meter to measure your lung function on a regular basis. Your doctor or asthma nurse can print a PEF meter as an aid. Then you can get it for free at a pharmacy. Some health centers also lend PEF meters.

With the meter, you can see if your lung function changes. Then you may need to increase or decrease the doses of your medication. You may need to contact a physician to review your medication if, for example, you have had lower PEF values ​​for a longer period of time.

It is important to frequently check how your lungs work if, for example, you get an airway infection. You may need to change your medication so that lung function does not get too bad.

Avoid what you are allergic to

You should avoid the substance (s) that you are allergic to if you have an allergy. For example, if you react to pollen, a tip may be to keep it in the evening and night, as the pollen content is lower then during the day.

Take medication before exercising

Exercise is good for everyone. You can exercise even if you have asthma, but you may have asthma problems while exercising. To reduce or avoid the inconvenience, you can take a bronchodilator drug just before you exercise.

Sometimes you need to apply for a permit

You can use most asthma drugs if you are racing at the competition level. Previously, several drugs for asthma were doping, but they are no longer. An exception is terbutaline, which is found in Bricanyl. High-level athletes still have to apply for a license if they use terbutaline. For other low-level athletes, you can apply for a permit afterward.

Avoid certain medicines

Some people with asthma can get severe asthma symptoms from the following drugs:

  • Medicines for pain that contain acetylsalicylic acid, for example Treo, Aspirin, and Bamyl.
  • Anti-inflammatory painkillers, so-called NSAIDs or cox inhibitors. For example, In, Diclofenac and Naproxen.

It is better to take medicines containing paracetamol if you have a fever or pain. Ask your doctor, asthma nurse or staff at a pharmacy if you are not sure which medicines to take.

Even heart drugs and blood pressure medicines from the beta-blocker group can trigger or worsen asthma in some people.

Avoid certain occupations

In some workplaces, there may be chemicals, strong odors, flour or smoke that can aggravate your asthma. Therefore, some professions may be less good if you have asthma. Discuss with a doctor if you have questions about your workplace or choice of profession.

Pregnancy and asthma

It is especially important that you be careful about the treatment if you are pregnant, because asthma attacks can affect the fetus. Many people find that asthma improves during pregnancy, but some may have increased symptoms.

You should continue with your asthma medication if you become pregnant. Always talk to your doctor if you are or planning to become pregnant.

What happens in the body?

Asthma is due to inflammation of the mucous membranes of the trachea. The inflammation causes the mucous membranes to swell and it becomes difficult for the air to get to and from the lungs. The mucosa of the trachea also becomes extra sensitive by the inflammation, and responds more easily to certain things such as pollen and fur animals.

In the case of an asthma attack, several things happen simultaneously in the trachea. The mucous membrane of the trachea swells, the musculature around the trachea is contracted and tough mucus is formed which can clog the small trachea that leads into the lungs. This makes it difficult to breathe. Many also cough.

The hassles vary

It is common for colds and other respiratory infections to worsen asthma. You can also get worse when you exercise physically. This happens especially if asthma is not sufficiently treated.

It varies from person to person how powerful asthma is and how it affects life. Some only suffer from occasional complaints, while others have constant problems despite being careful with their treatment. Some suffer from asthma when they come into contact with certain substances that others with asthma do not react to.

Allergic asthma can be triggered by what you are allergic to

In case of allergic asthma, you get respiratory problems if you come into contact with substances that you are hypersensitive to. In the case of asthma, pollen, fur animals or mites are often the cause of problems.

There are special substances in the blood that recognize what you cannot tolerate. The substances are called antibodies. The antibodies react and trigger an allergic reaction when you inhale what you are allergic to.

There is a quick type of allergic reaction that comes within 20 minutes. There is also a slower type of reaction that comes only five to six hours after you have been in contact with what you are allergic to.

Asthma may be associated with other disorders

It is more common to have asthma if you have allergic pruritus, ie pruritus due to allergy. The snout is then thin and transparent. You may need to be treated with cortisone in your nose to be completely free of asthma symptoms if you have allergic symptoms.

It is also more common to be hypersensitive to some medicines if you have both asthma and nasal polyps. The drugs are anti-inflammatory painkillers and medicines containing acetylsalicylic acid.

If you have acid reflux you can have more trouble with your asthma, especially at night. The buildup is because acidic stomach contents go up into the esophagus. The very acidic stomach juice teases the trachea, which contracts.

You may have more asthma problems if you have a respiratory break during sleep, called sleep apnea.

What is the cause of asthma?

Asthma is becoming more common in the western world, both among children and the elderly. The reason for the increase is not entirely clear. Heredity plays a certain role, but there are others that also matter. Allergies, air pollution, certain substances in the professional world and chemicals may contribute to the development of asthma.

In Europe, about 8 to 10 out of 100 people have some kind of asthma.

Influence and participate in your care

You can seek care at any medical center or open specialist clinic you want throughout the country. Sometimes a referral to the open specialized care is required.

You should understand the information

In order for you to be involved in your care and treatment, it is important that you understand the information you receive from the healthcare staff. Ask questions if you don’t understand. For example, you should get information about treatment options and how long you may have to wait for care and treatment.

You have the opportunity to get help from an interpreter. You also have the opportunity to get help from an interpreter if you have a hearing loss.

If you need tools, you should get information about what is available and how to get it.

You can get regular health care contact

If you have contact with many different people within the care, you can have permanent care contact. It is a person who among other things helps to coordinate your care.

Children should be able to participate 

There is no age limit for when a child can have influence over their care. The child’s ability to participate is related to the child’s maturity.

The older the child, the more important it is for them to be involved in their care. In order to be active in the care and to make decisions, it is important that you as an adult and the child understand the information you receive from the care staff.

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