HealthyCanada.com

Overview

Asthma is a chronic inflammatory lung disease caused by increased reaction of the airways to various stimuli. Over the past 20 years more and more people have been coming down with asthma - with children appearing particularly vulnerable. Currently some 3-million Canadians suffer from this potentially life-threatening condition. Asthma is the leading cause of school absenteeism and the third leading cause of lost work time. It cannot be cured but it can be controlled.

Is your asthma under control? Try the Asthma Society's 30 second test.

Symptoms

Symptoms vary. You may find that you start to cough or wheeze get short of breath or have a tight feeling in your chest. Every one suffers asthma in their own unique way. Some react to only a few irritants while others have to deal with a myriad of triggers. Some symptoms appear only when the person is exposed to more than one trigger at a time. Some asthma attacks occur right away others are delayed. Some people get symptoms during childhood which then disappear in later life. Others develop 'late-onset' asthma in adulthood without ever having had symptoms as a child.

Causes

Nobody knows yet why certain people get asthma. However we do know that:

• asthma can be inherited
• changes in housing and diet and a more hygienic environment - may have contributed to the increase in asthma over the last few decades
• smoking when pregnant increases the chance of a child developing asthma
• environmental pollution can make asthma symptoms worse but has not been proven to actually cause asthma
• late-onset asthma may develop after a viral infection
• irritants found in the home or workplace may contribute to a person developing asthma

While there is more to be learned about the cause of asthma much is known about what triggers an attack. This can vary from one person to another but common asthma triggers include:

Colds and viral infections

Colds and other viral infections are very common triggers which are almost impossible to avoid.

Flu and pneumonia injections are recommended for everyone over the age of 65 and those who have severe asthma attacks or troublesome asthma symptoms. Get a flu shot every year.

Smoking

• If you smoke (or breathe in other people's smoke) you increase the risk of an asthma attack and may permanently damage your airways

• You are increasing the risk of your asthma persisting if you smoke as a teenager

• You are putting your children at risk of asthma if you smoke around them or during pregnancy

House-dust mites

Many people with asthma are sensitive to the droppings of house-dust mites. These are tiny insects that live in the dust that builds up around the house in carpets bedding soft furnishings and soft toys. If you know house-dust mites trigger your asthma you may be able to reduce some symptoms by following all the recommendations below.

• Use complete barrier covering systems on your mattress duvet and pillow

• Remove all carpets and replace with hard flooring

• Vacuum all areas frequently. Use a vacuum cleaner that has good suction and a filtered exhaust that does not scatter dust. Damp dust all surfaces or use an attachment on your vacuum cleaner

• Remove all soft toys from beds. Put them into a bag in the freezer for a minimum of six hours every one to two weeks to kill house-dust mites

• Hot wash (at 60 degrees C) sheets duvet covers and pillowcases once a week. Although some people are allergic to feathers there is no conclusive evidence to show that synthetic 'hypo-allergenic' pillows are any better

• Clean your soft furnishings with anti-house-dust mite chemicals

• Use a dehumidifier to dry the air as this makes it more difficult for the house-dust mites to survive

• Ask someone else to vacuum while you stay out of the room

Pets

• Allergens are found in their saliva flakes of skin (pet dander) fur and urine.

• If you cannot find a new home for your pet ensure that they don't go in your living room or bedroom

• Bathing cats and dogs twice weekly can help. Ask your vet for advice on how to do this properly

Exercise

Some people with asthma find that exercise triggers symptoms. However exercise is good for everyone including people with asthma. If your asthma is well controlled you should be able to join in have fun and keep fit. If your asthma symptoms worsen during or after exercise it could be a sign that your asthma is poorly controlled.

• Warming up before exercise may help to reduce your symptoms

• Take your usual dose of reliever inhaler (usually blue) about five to ten minutes before you start exercising and keep it close at hand at all times

• If you need to use your reliever inhaler wait for it to take effect before exercising again

Treatment

There are some very safe and effective asthma treatments available that can help to control your symptoms. Most people with asthma take two kinds of medication controllers and relievers:

• Controllers also called "preventers" reduce inflammation in the airways. Controllers should be taken every day. You will know that the controller medication is working because you will over time have fewer and fewer symptoms. When your asthma is totally controlled and you have no symptoms do not stop taking them. If you do the airway inflammation may return.

• Relievers are very good at helping to alleviate symptoms immediately. If you are coughing or wheezing use a reliever medication to reduce symptoms. However reliever medications do nothing for the underlying problem of inflammation. Relievers are only a short-term solution to breathing problems and indicate that there is underlying inflammation present that requires a controller medication. Monitor how often you use your reliever. Increased use over time is telling you the asthma is worsening.

In addition to inhalers there are drugs that can help relieve asthma symptoms. These include corticosteroids. Doctors generally prescribe inhaled steroids rather than pills because the drug goes directly into the lungs where it's needed and is less likely to cause unwanted side effects.

If your asthma cannot easily be controlled using a reliever and a preventer treatment your doctor may also prescribe a long-acting reliever. Unlike your short-acting reliever inhaler which is taken to immediately relieve asthma symptoms this can last for up to 12 hours. It will help reduce asthma symptoms by keeping the airways of the lungs open and relaxed.

What to do when asthma attacks

Sometimes no matter how careful you are about taking your asthma treatment and avoiding your triggers you may find that you have an asthma attack. If your asthma symptoms slowly get worse - don't ignore them! Quite often using your reliever is all that is needed to get your asthma under control again. At other times symptoms are more severe and more urgent action is needed.

1. Take your usual dose of reliever straight away preferably using a spacer device
2. Keep calm and try to slow down your breathing. Do not lie down. Sit and rest your hands on your knees to help support yourself.
3. Wait 5-10 minutes
4. If the symptoms disappear you should be able to go back to whatever you were doing
5. If the reliever has no effect call your doctor or 911.
6. Continue to take your reliever inhaler preferably using a spacer every few minutes until help arrives. It is safe to keep taking your reliever inhaler until help arrives. It is not possible to overdose on reliever.

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