Asthma

Asthma is a heterogeneous disease, usually characterized by chronic airway inflammation. It is defined by a history of respiratory symptoms such as wheeze, shortness of breath, chest tightness and cough that vary over time and intensity, together with variable expiratory airflow limitation.

Why Asthma is Unique ?
VARIABLE TRIGGERS: First, it can have different triggers that can vary from person to person, including allergens such as pollen, dust mites, and animal dander, as well as irritants such as air pollution, smoke, and strong odors.

VARIABLE SYMPTOMS: Second, asthma symptoms can range from mild to severe, and can vary over time. Some people with asthma may have symptoms only during certain times of the year or in response to certain triggers, while others may have symptoms all the time.

NO CURE:  Third, asthma can be managed with a variety of medications and lifestyle changes, but there is currently no cure for asthma.

PERSONALIZED TREATMENT: Finally, while asthma is a common condition that affects millions of people worldwide, it is also unique in how it affects each individual. Each person with asthma may experience different symptoms and triggers, and may require a personalized treatment plan to manage their condition effectively.

Epidemiology
In the Gulf countries like UAE, the prevalence of asthma is relatively high, and it is estimated that approximately 10-15% of the population has asthma.
The prevalence of asthma is higher among children, and it is estimated to be around 20-25% among school-aged children.
Several factors contribute to the high prevalence of asthma in UAE, including air pollution, dust, sandstorms, and high levels of humidity.
Additionally, the Westernization of lifestyle and the adoption of a sedentary lifestyle have also been associated with an increased prevalence of asthma.

Non Allergic Asthma Triggers

  • Cold air
  • Respiratory infections like cold and flu, tobacco smoke, strong smells, and environmental pollution.
  • Physical activity, strong emotions, and stress can also trigger bouts of asthma in some.
  • Certain medications like aspirin, beta-blockers, and nonsteroidal painkillers like Ibuprofen and Advil can induce asthmatic reactions.
  • Preservatives and sulfites added to food and beverages like shrimp, processed foods, potatoes, and wine might trigger asthma in some people.
  • Diseases like GERD (gastroesophageal reflux disease) can cause asthma symptoms.

Approach

  • Detailed History including occupation
  • Family history of atopy
  • The doctor will perform a physical exam, listening to your lungs and checking for signs of asthma such as wheezing or a prolonged expiration phase
  • Pulmonary function Test : Process of having the patient perform specific inspiratory and expiratory maneuvers

Patient Instructions Prior to Testing

  • Should not drink alcohol for four hours prior to test
  • Should not smoke at least one hour before test
  • Do not eat a large meal two hours prior to test
  • No vigorous exercise 30 minutes before test
  • Do not wear tight form fitting clothes
  • May need to remove loose dentures for test
  • Should wait at least one month post MI, consider impact of problems that may affect results (chest/abdominal pain, oral or facial pain, stress incontinence, dementia, physical deformities or medical conditions)
  • Bring a list of all medications – potentially withhold bronchodilators, corticosteroids