Learn the signs and symptoms of uncontrolled asthma. Find out how it develops and what can be done to prevent it

What is asthma?

A medical condition of the respiratory system that results in blocking and constriction of bronchial airways resulting in inflammation and swelling of airways causing mucus production and clogging of the bronchial tubes. This results in difficulty breathing, triggers coughing and causes a whistling sound and wheezing.

Asthma is a chronic condition that can never go away but it is possible to get temporary cure and prevent severe attacks. It can range from mild attacks to severe ones requiring emergency treatment. It is possible to come up with an action plan and discuss your goals with the primary care physician. This would mean sticking to medication schedules, diet, doctor visit scheduling, climate monitoring, staying away from environmental triggers and also keeping oneself in a positive place emotionally. It is possible to reduce stress with temporary exercise. As obesity abets asthma it is important to keep the weight in check. It is thought that long term effects of asthma attack on a long term results in blocking sleep and sleep deprivation.

This could lead to weight gain, diabetes, depression and exacerbates existing asthma symptoms making it more severe and resistant to medications. The associated cost of curing asthma is also quite high and sometimes Asthma is associated with death as well. It is a major non

communicable disease and affects both children and adults. WHO estimated that there were 262 million people in 2019 and caused 461000 deaths1.

It primarily affects people in low income countries where it’s often misdiagnosed and treated incorrectly. Since the main types of medications with Asthma are bronchodilators and steroids. Bronchodilators help in opening airways like salbutamol. Steroids help reduce inflammation in airways like beclometasone.

Symptoms of asthma

Symptoms include many of the following. It is not a one size fits all group of symptoms and is highly variable in the patient. It can range from mild to severe and can happen during triggers or even while exercising. Some of them remain on an everyday basis.

· Shortness of breath

· Difficulty breathing while lying down

· Heavy coughing and wheezing

· Frequently standing up or sitting to breathe

· Hunched shoulders, strained neck and stomach muscles · Wheezing while breathing out is predominantly seen in children patients

Some symptoms that Asthma attack is growing severe would include:

· Frequent and bothersome coughing, wheezing and laborious breathing · A incessant desire to use the inhaler more often

Some symptoms require immediate emergency care:

· Inhaler use does not reduce symptoms and it worsens with time.

· Asthma symptoms like inability to breathe, coughing increase in frequency and is present even with minimal physical activity

Causes and triggers of asthma:

There are many factors that trigger Asthma and they belong to either environmental or genetic components that irritate the respiratory system. According to mayoclinic.org

· Air pollutants like pet dander, pollen, dust mites, smoke particles. · Daily stress and rigorous physical activity.

· Cold air, common respiratory infections like common cold · Processed foods containing sulfites, preservatives like beer, wine. · Gastro esophageal reflux disease.

· Medications like ibuprofen, non-steroidal anti inflammatory disease and aspirin.

Risk factors:

There are many factors associated with asthma and those are.

Gender: Males are more susceptible to getting Asthma. Females are more susceptible to asthma after age 40.

Age: Younger people like children are more susceptible to get it while it’s possible to get age onset asthma after age 40.

Genetics: it is easier to get asthma if it runs in the family.

Obesity: Being overweight and obese is a high risk factor for getting asthma.

Uncontrolled Asthma vs. Severe Asthma

Patients with uncontrolled asthma respond to treatments even with comorbidities and are in a different class than severe asthma. Uncontrolled asthma is easier to cure and has more

perturbation of symptoms. Severe asthma is usually diagnosed if there is a poor inhaler techniques being followed, medication not taken properly, asthma misdiagnosis, obesity and other comorbid conditions 2

How Does Uncontrolled Asthma Develop?

Severe Asthma exacerbation and persistent asthma can occur with comorbid conditions like obesity, obstructive sleep disorder. An asthma flare up can happen with strong emotions or stress. Airway inflammation causing severe allergic asthma can occur due to pet dander. One can get uncontrolled asthma, asthma severity due to changes in weather and changes in hormones.

Uncontrolled asthma symptoms can also occur when hormones change in the body like puberty in girl children. Asthma medicines like systemic corticosteroids, inhaled corticosteroids can interact with other medications and cause asthma exacerbation. Foods one eat can also cause persistent asthma by creating hives, vomiting and diarrhea.

Sometimes the asthma could be another class like eosinophilic asthma and asthma medicines don’t help out so conditions might be different and proper diagnosis is key for treating the disease. Some asthma flare-ups are misdiagnosed symptoms for some other condition like allergic rhinitis.

Possible long-term effects of uncontrolled asthma

Airway remodeling and airway inflammation and severely damaged lung function in an asthma patient will further cause lung damage and airway scarring of tissues in controlled asthma, uncontrolled asthma, severe asthma and in chronic asthma conditions. In children it can cause

developmental delays and slow down puberty. The narrowing of airways and scarring of tissue further exacerbates asthma and causes lung infections like Pneumonia. It will result in difficulty in going to school, work and will need you to take time off work and school. This would also make you sleep deprived and put you at a risk for developing anxiety and depression. Since a multiple set of comorbidities develop with this condition it’s important to monitor and take control of uncontrolled asthma before it can control you. For example, simple conditions like common cold must be kept in check so that it does not cause a flare up.

What Happens When Asthma Isn’t Controlled According to health line.org when asthma is not controlled with asthma medicines, inhaled corticosteroids and pharmacological treatments it can cause sleep deprivation and sleep disturbances. Incessant coughing and inability to breathe can prevent a person from sleeping or having a quality sleep. This will further cause other problems like anxiety and depression. It also results in other problems like putting you at risk for developing diabetes, high blood pressure and obesity. In children and in adults the effects are severe;

with children it can cause growth delays, puberty being later than the normal average and can also create a higher risk of learning disabilities. This will test taking time off from school and maybe even frequent hospital visits. In adults it causes permanent narrowing of bronchial tubes and increased emergency treatment. This can increase costs associated with frequent hospital visits and medications. It is not only a chronic disease condition but also an expensive disease.

Taking Control of Your Asthma

Steps to follow while taking care of asthma are:

1. Being aware of triggers and keeping them at bay. One must always know from their action plan the type of triggers that had been associated with previous attacks. Being aware of them also means avoiding them like

keeping oneself informed on pollen attacks and staying away from pet dander and dust mites.

2. Taking medications and sticking to it at any cost. It is very convenient not to be regular but it might save the extra trip to the doctor if medication plans are strictly followed. It is not sufficient to use medications only on days of symptoms but regularly even when asthma symptoms are not there.

3. Knowing how to use the inhaler like an expert. The inhaler releases quick acting asthma medications like Advair. Improper use can result in asthma being left untreated and exacerbates symptoms. Omalizumab reduces airway inflammation but inhalers are the best and cheapest way to get treated for Asthma. Perform usage of inhalers in front of the physician and he will advise on how to get the medications to the airways.

4. Doing exercise to improve the immune system and also to strengthen respiratory breathing apparatus. Breathing exercises to clear congestion like pranayama, stress relieving exercises like Tai-chi, Yoga have a positive effect on preventing strong emotions that are triggers for severe Asthma.

5. Quitting smoking. One must also try and reduce secondhand smoke as they are a very common allergen and environmental trigger for severe asthma, uncontrolled asthma. Smoking can also reduce effectiveness of medications and interfere with severity and frequency of attacks making them more intense.

6. Make an asthma action plan. This would mean sticking with medication plans, doctor plans for monitoring environmental triggers like air pollutants and also for keeping stress at low.

7. Keeping the bad bugs and viruses away from you and following good hygiene. This would mean frequent hand washing, eating healthy immune boosting foods, keeping the house tidy and clean and regularly exercising. One must be regular with flu shots, pneumonia shots, and get enough

sleep. Rest and a good diet can be effective in killing viruses. It is also important to keep symptoms under check like cold, flu and other conditions that can exacerbate asthma.

Conclusion

Asthma is defined as a chronic condition in which the airways get inflamed and swollen causing the inability to breathe, coughing and wheezing. This is caused by environmental pollutants and other triggers. Asthma attacks are characterized by pharmacological interventions, frequent emergency visits, costs for treatment and hospital visits. It is treatable with medications like corticosteroids and quick relief medications.