Condition: Asthma

Asthma is often categorized into different types based on the triggers identified by the doctor and the patient that cause breathing problems and make asthma symptoms worse. They include:

• Allergic asthma
• Aspirin-induced asthma
• Cough-variant asthma
• Exercise-induced asthma
• Nighttime asthma
• Steroid-resistant asthma
• Occupational asthma

The exact causes of asthma are unknown, although it can be associated with hereditary and environmental factors:

• Genetics: asthma tends to run genetically through families
• Environment:  exposure to viral infections, allergens, chemical or odors at a young age have been linked to developing asthma due to the undeveloped nature of the immune system. Smoking can also irritate the lungs.
• Allergies: if you have allergies, you may be more likely to develop asthma – certain conditions are closely linked with asthma.
• Respiratory infections in early development: when you are growing up, if your lungs incur tissue damage from something like a respiratory infection, you are more likely to get asthma.

Certain circumstances may trigger your asthma. Understanding these can be really important to limiting and managing your symptoms.

Flare-ups

The symptoms of your asthma can get worse within a short space of time, usually when triggered by something and this is known as a flare-up or a asthma attack. Some common triggers are listen below, although these will vary depending on the individual

• Respiratory infections such as: the flu, a cold, or a sinus infections.
• Acid reflux.
• Pregnancy hormones
• Emotions: strong emotions can increase rapid breathing and trigger an asthma attach. Stress can be a trigger.
• Exercise: walking/climbing stairs. Intense exercise.
• Allergens such as Mold and strong odors such as perfume, and deodorant.
• Food allergies and certain drugs (e.g. Aspirin, non-steroidal anti-inflammatory drugs)
• Smoke – from a fireplace or cigarette
• Weather and Pollen –  asthma flare-ups can be increased during the warmer moths due to increased pollen in the air. Extreme heat and extreme cold can also trigger asthma.
• Animal skin and saliva, fur and feathers from birds, can all contribute to asthma.
• Pests such as dust mites and cockroaches can also be triggers, as well as rodents.

When your asthma is not well controlled, symptoms can include the following:

• shortness of breath – feeling as though you cannot get enough breath in your lungs.
• coughing – this may be frequent and at night and you may cough up mucus.
• wheezing – whistling sounds when you cough
• a tight feeling in your chest – this may occur when you are in cold weather or when you exercise.

Your doctor at OneWelbeck will start by evaluating your symptoms and ask for your health history. They may also conduct a physical exam and carry out certain tests. Your doctor will identify which type of asthma you have (see About Asthma, above) and tailor your diagnosis according to this.

Testing for Asthma

There are a variety of tests that your doctor can perform – the most common of which is the lung function test is called spirometry. Using a device called a spirometer, your doctor will measure the amount and speed of the air you blow out. This will help your doctor to determine how well your lungs are working.

Other tests could include:

• Allergy testing
• Blood tests
• Exhaled nitric oxide or FeNo test
• Challenge tests, such as methacholine.

Other lung diseases may cause some of the same symptoms as asthma – if this is the case, your doctor may carry out other tests to help determine the cause of your symptoms.

Allergy plays an essential role in asthma as one of the significant factors associated with the cause and persistence of asthma. Around 80% of people with asthma have positive allergy test results, meaning that allergens–like dust mites, mould, animal dander and pollen - worsen asthma symptoms. There are three main ways in which allergy plays an essential role in asthma:

· Allergy itself can produce allergic inflammation in the airways.

· Exposure to one or more allergens can trigger an asthma attack.

· People with allergic asthma often also suffer from allergic rhinitis or allergic inflammation in the nose. If their nose is inflamed, their chest symptoms can also worsen.

However, there are other asthma triggers, including respiratory infections, exercise, cold air, smoke, and strong odours. And these triggers can affect people with both allergic and non-allergic asthma.

The only way to determine whether you have allergic asthma is through allergy skin prick tests and blood tests.

At OneWelbeck Lung Health, we offer:

·   The opportunity for all our patients with asthma to see an allergy specialist and to undergo allergy skin prick testing.

·   We also offer spirometry, which is a lung function test that requires the patient to breathe in and out of specialised equipment to measure rates of airflow through the airways, the volume of the lungs at total capacity, at rest and their most empty; and, finally, measure the ability of the lung to exchange gases with the bloodstream.

We also offer more specialised tests to assess the strength of the breathing muscles, the degree of inflammation (a FeNO test), and finally, the airways' response to “provoking” agents to try to diagnose asthma.