Asthma is a chronic lung disease that inflames and narrows the bronchial tubes, the passageways that allow air to enter and leave the lungs. This disease is Incurable, but it can be managed and treated to live a normal, healthy life.

• Allergic Asthma: The most common form of asthma. A response starting in the immune system that often triggered by inhaling allergens, which are typically harmless substance such as dust mites, pet dander, pollen or mold.
• Non-allergic asthma: Asthma symptoms may be triggered by exercise -exercise-induced bronchoconstriction-, viral or bacterial infections, cold air or under the effect of gastroesophageal reflux disease.

The definite cause of asthma isn't known. Experts think it is a combination of environmental and genetic factors most often early in life. From these factors: An inherited tendency to develop allergies and certain respiratory infections during childhood.

Causes of Asthma Symptoms (Triggers):

• Allergens: house dust mites, animal dander, molds, cockroach droppings, pollen, strong odors or fumes.
• Tobacco smoke: It is an irritant that often aggravates asthma. This involves as well second-hand smoking.
• Heavy exercising: some physical activities -especially prolonged, vigorous exercises and physical exertion- may trigger asthma symptoms in many patients.
• Some medications: certain drugs can cause or worsen asthma symptoms. These include: aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs). Beta-blockers that used to treat heart disease and high blood pressure is another example.
• Strong Emotions: stress and anxiety may also increase asthma symptoms and trigger an attack.
• Viral and bacterial respiratory infections such as the influenza and sinusitis.
• Exposure to cold, dry air or sharp weather changes.
• Acid reflux: the backward flow of acidic stomach content into the esophagus and over possibility may irritates the airways and lungs.
• Sulfites in foods and drinks: these compounds are still commonly used to preserve dried fruits and meats or in wine making.

Note: Asthma is different from one person to another. Some of the triggers listed above may not affect everyone.

• Family history of asthma.
• Children often experience wheezing and respiratory infections.
• Having another allergic condition, such as atopic dermatitis or allergic rhinitis.
• Obesity or overweight.
• Smoking, even secondhand smoke.
• Exposure to pollutants and occupational hazards, like chemicals used in farming and hairdressing.

The airways consist of tubes that carry air into and out of the lungs. People who have asthma have airways that tend to react strongly to certain inhaled substances. IgE antibody is produced in response to allergen exposure, which results in the release of chemicals called mediators that cause inflammation. The inflammation makes the airways swollen and very sensitive.

When the airways react, the muscles around them tighten. This further narrows the airways, decreasing air flow into the lungs. Cells in the airways might make more mucus than usual that can further narrow the airways. This chain reaction can result in asthma symptoms.

Sometimes asthma symptoms are mild, last few minutes and go away spontaneously or after minimal treatment with asthma medicine. Other times, symptoms continue to get worse and can last from hours to days.

The usual signs & symptoms of asthma are:

• Coughing, especially at night or during exercise.
• Chest tightness
• Shortness of breath
• Wheezing (a high-pitched whistling sound made while breathing, mainly when breathing out).

exam and test results. The severity of the disease is further determined. The doctor listens to breathing and look for signs of asthma or allergies. Diagnostic tests that may be done:

• Lung Function Test: assessing how lungs are working through “spirometry” that measures the amount of air can inhaled or exhaled and the speed of blowing air out. In case of expected asthma, the starting results are below normal and improve with prescribed medications or it is supported by signs & symptoms of the disease.
• Bronchoprovocation test: A technique to measure the sensitivity of the airways by repeated checkups of lung function during physical activity or after receiving increasing doses of cold air or a special chemical to breathe in.
• Allergy testing: This diagnostic tool involves having a skin or blood test to disclose the possible trigger of the symptoms.
• A test to check another condition with the same symptoms as asthma, such as reflux disease, vocal cord dysfunction, or sleep apnea.
• A chest x-ray: The conventional imaging procedure will help reveal whether a foreign object or other disease may sit behind asthma symptoms.

The goal of asthma treatment is to control the disease. It is important to treat symptoms when first noticed to prevent worsening of the symptoms and prohibit asthma attack. Treatment also includes interventions to protect from recurrent symptoms. The Comprehensive dealing with asthma encompass:

• Determining the type: Knowing if your asthma is allergic is integral for taking control of your condition by identifying what you are allergic to and recommend ways to avoid exposure to that trigger.
• Setting the General frame works: work with your healthcare provider to create an asthma action plan with instructions for early treatment of asthma symptoms and adherence to regular healthcare.
• Long-Term Control Medicines: A preventive way of treatment that need taking some medications daily by most asthma patients. It works by reducing airway inflammation, but don’t give you quick relief from symptoms. The main medicine for that group is Inhaled corticosteroids, also the list includes: Cromolyn, Omalizumab, Leukotriene modifiers and Inhaled long-acting beta2-agonists.
• Quick-Relief Medicines: Needed by all people who are affected by active asthma attack to help relieve symptoms by relaxing the bronchial muscles and open the airway. Inhaled short-acting beta2-agonists are the first choice. It should be taken when first notice asthma symptoms and carried all the time. Examples of these medications are levalbuterol, pirbuterol and albuterol (Ventolin) which can be used alone or with combination with ipratropium.
• Immunotherapy: this includes injecting allergen in small but gradually increasing amounts over time -usually along several years- to build up tolerance toward the allergen thus it no more trigger symptoms.
• Tracking the disease and have checkups: keep records of your symptoms, check your peak flow number by a peak flow meter, and get regular asthma checkups. See the doctor every 2 to 6 weeks in the beginning of treatment, then from once a month to twice a year after controlling the disease.
• Working with your doctor to treat other conditions that can interfere with asthma management. This may require certain types of medications or therapies depending on the underlying case. For example: proper and suitable antibiotics could be prescribed to treat bacterial lung infections “bacterial pneumonia”.

• Poor quality of life: asthma may cause work and school absences thus affect a person’s livelihood, education and emotional well-being, which can lead to Depression.
• Side effects from prolonged use of some medications of severe asthma, like mouth infection called thrush and osteoporosis due to using inhaled corticosteroids for long period.
• Serious asthma attacks could need seeking help and hospitalization, which can be stressful and costly. Also, it can progress to respiratory arrest and could be life-threatening.

There are many things can be done to decrease the risk of having asthma or asthma symptoms and attacks:

• Adherence to preventive practices that reduce the risk of Viral and bacterial infections, like frequent, good hand washing, available vaccination, and obviating crowded areas.
• Asking doctor about medications that can cause or worsen asthma symptoms. These include aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs) and beta-blockers which are used to treat heart disease and hypertension.
• Staying calm and relaxed to avoid the effect of strong emotion on breathing patterns that cause bronchial tubes to constrict — such as shouting, crying or laughing.
• Regular, precise exercising. Even for asthma people, Physical activity is an important part of a healthy lifestyle. Talk with your doctor about choices that can help you stay active without causing harm or aggravate the symptoms.
• Controlling diseases and conditions that worsen the problem. This Requires Maintaining a healthy weight and managing gastroesophageal reflux if present.
• Avoiding asthma triggers. That may impose:
  • Using air conditioner which reduces the amount of outdoor, airborne pollen that reach inside.
  • Encasing pillows, mattresses in dustproof covers to minimize dust that may worsen nighttime symptoms.
  • Remove carpeting and install hardwood or linoleum flooring then wiping it up regularly.
  • Adjusting humidity. Dust mites and molds proliferate in wet conditions. Talk to your doctor about using a dehumidifier and clean rotten areas when noticed.
  • Reducing pet dander. This can be achieved by avoiding pets with fur or feathers and bathing pets regularly.
  • Frequent Cleaning. Clean your home at least one time per week. Wearing a mask or have someone else do the job could is better.
  • Covering nose and mouth in cold weather and keep warmness as could as possible.
  • Watching food labels to chick out Sulfites in foods and drinks in order to abstain from that possible aggravator.

There is no cure for Asthma. Despite feeling good, the disease still existed and it can flare up at any time. However, with available, updated knowledge and treatments, most affected people are able to control the disease by taking an active role in managing it. Symptoms and episodes are limited. They can have normal, active lives without interruption from asthma.

Many young children who wheeze when they get colds or respiratory infections don't go on to have asthma after they are 6 years old. A child may wheeze because he or she has small airways that become narrower during colds or respiratory infections. The airways grow as the child grows older, so wheezing no longer occurs when the child gets colds.

Asthma affects people of all ages, but it begins mostly during childhood. Among children, more boys have asthma than girls, while more women have the disease than men between adults. Most children who have asthma develop their first symptoms before 5 years of age even it is hard to be diagnosed at this age.

The most recent revised global estimate of asthma by Global Burden of Disease (GBD) Study suggests that 334 million people have asthma. Most people affected are in low- and middle-income countries, and its prevalence is estimated to be increasing fastest in those countries. WHO considers asthma as the most common noncommunicable disease among children.