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at 2021.03.17
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Asthma also may be caused by hypersensitive bronchi or chronic
lung disease resulting from smoking. Attacks in this type of asthma
also may be triggered by environmental factors or other causes such as
bacterial infections. Asthma also may occur in people with congestive
heart failure or pulmonary edema (fluid in the lungs).

Attacks vary widely in duration, intensity and frequency. While milder
cases are often more of a nuisance than a threat to health, prompt
investigation and treatment are advisable if future complications are
to be avoided. In typical cases, an attack comes on suddenly and is
characterized by distressful efforts to exhale, and as air is taken in,
there are spells of coughing and wheezing.

These attacks occur because of the abnormal reaction of the
windpipe (trachea) and the bronchial tree to a precipitating stimulus,
which constricts the airway passages in the following way: The smooth
muscles go into spasmodic contractions; there is a swelling of the
membranes that line the bronchioles, and the secretion of mucus
increases. Because this bronchial mucus is abnormally sticky, coughing
does not expel it, and it therefore plugs up the smaller air passages.

Since greater difficulty is experienced in breathing out than in
breathing in, increasing amounts of stale air are retained as new
breaths are taken. In a severe attack, this leads to a feeling of near
suffocation. An attack may be brief or it may last long enough to
demand emergency measures.

Causes of Asthma

Well over half a million people suffer from allergic asthma, and in a
majority of cases, the specific and immediate cause cannot be
identified. Where the disorder runs in the family, and especially when
onset occurs in childhood, a particular allergen may be identified as
the cause, thus simplifying and hastening treatment. Among the more
common offenders are house dust, mold spores, dander from the hair or
feathers of house pets, and dairy products, especially eggs and milk.

At any age, a first attack may occur as a result of a
respiratory infection, strenuous exercise or other non-allergic factors
such as sensitivity to cold air. For a significant number of adults,
onset may occur because of exposure to occupational hazards, such as
chemical fumes or other industrial air pollutants. Sensitivity to
tobacco smoke is another major precipitating factor.

Much has been made of the role of emotional stress as a prime
cause of the disorder, but most specialists now agree that in both
children and adults, emotional complications are likelier to be a
result of the condition rather than the cause.

Treatment of Asthma

While there is not yet a cure for asthma, more effective medications
have recently become available that help control symptoms. When a
particular substance has been identified as the cause of the disorder,
treatment may involve desensitization by injection. Avoidance of the
offending allergen is also recommended, but is often difficult,
especially when a beloved pet, on-the-job pollution or very common
substances, such as house dust, are involved. In these instances, drug
therapy may be recommended as an alternative to life-style change. For
all asthma patients, smoking should be avoided.

Drugs to treat Asthma

The most widely used preparations contain ingredients that act as
bronchodilators, meaning they relax and widen the airways which link
the windpipe and lugs. To treat severe attacks known to originate in an
allergic response, an inhalant may be prescribed.

When these medications, separately or in combination, fail to
produce the desired results of relaxing bronchiolar muscles, reducing
inflammation and swelling of mucous membranes and loosening the
obstructive plugs of viscous mucus a corticosteroid may be prescribed
in aerosol form, so that it can be inhaled directly to the airways
instead of being absorbed into the body, as would be the case with
cortisone preparations taken by mouth or by injection. Steroid drugs
should be used under close medical supervision and are usually reserved
to treat the more severe asthmatics.

Breathing exercises and biofeedback techniques are among the
more unconventional methods now being used to forestall attacks,
minimize their unpleasantness and shorten their duration. However, to
avoid falling victim to quackery, make sure these approaches are taught
by recognized medical authorities.

Complications and Precautions

Untreated asthma can lead to emphysema, because the continued
stretching of the bronchial sacs during attacks by accumulations of
stale air can eventually enlarge the delicate tissues to the point
where they lose their elasticity and cease to function. However,
self-treatment is inadvisable and especially dangerous for older people
who attribute their chronic shortness of breath to asthma when, in
fact, they may be suffering from progressive heart failure. Anyone who
experiences breathing difficulty should consult a doctor.

Summing Up

Asthma, especially if untreated, can be a disabling disease that
afflicts both children and adults. Efforts should be made to identify
precipitating causes, especially in children, because effective
treatment is then easier to prescribe.

A variety of therapeutic approaches may be tried to control
asthma; effective therapy usually involves combinations of treatments
that may include drugs, avoidance of precipitating causes and
desensitization shots. Although many people have the mistaken notion
that asthma is an emotional disorder, this does not seem to be the
case. However, asthma–like any chronic disease–can produce emotional
problems that involve not only the victim but other family members as
well. Emotional support, for both the patient and family membersFree Web Content, is an
important element in the overall treatment of asthma.


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