Asthma

The airways, or bronchial tubes, are the passages through which air moves in and out of the lungs. They undergo constant changes in response to various triggers such as inhaling airborne allergy triggers, engaging in vigorous exercise, or sudden changes in weather. For example, when allergens like dust mites, pollen, mold, or pet dander, or irritants like cigarette smoke, invade the airways, the bronchial surface produces mucus to expel them. This buildup of mucus leads to phlegm. At the same time, the smooth muscles surrounding the bronchial tubes contract, narrowing them and causing coughing. This helps our bodies expel allergens through phlegm and coughing, preventing their entry.

However, when this natural defense mechanism becomes excessively reactive, it results in constant breathlessness and persistent coughing. The contraction and relaxation of the bronchial muscles, which trigger coughing, are regulated by the autonomic nervous system (sympathetic nervous system + parasympathetic nervous system). During relaxation, the parasympathetic nervous system predominates, causing the bronchial muscles to contract and narrow the airways. Conversely, during excitement, the sympathetic nervous system becomes active, relaxing the bronchial muscles and widening the airways. If the airways remain widened for too long, it becomes easier for allergens and irritants to invade. Therefore, the parasympathetic nervous system is activated during calm periods to prevent excessive widening of the airways. Conversely, during excitement, the sympathetic nervous system predominates, widening the airways to quickly intake more oxygen into the lungs and efficiently expel carbon dioxide. This regulation of the airways by the autonomic nervous system is fundamental in organisms that breathe air. You know how your body relaxes after a meal and sleeps soundly at night? The parasympathetic nervous system predominates during those times, causing the airways to narrow. The reason why "asthma attacks" are more common at night is because of this.

Repeated excessive reactions of the airways to various triggers can progress from minor incidents to significant "asthma" that requires active treatment (this process is called “remodeling”). In asthma, one can inhale but struggles to exhale, experiencing severe breathlessness and persistent coughing. The phlegm becomes thick and difficult to expel. Additionally, when a stethoscope is placed on the chest, wheezing sounds can be heard during exhalation, indicating narrowing of the airways. In severe cases, these sounds may be audible even without a stethoscope.

Treatment for Asthma

The fundamental treatment for asthma is prevention of attacks. Inhaled steroids are used to calm the hypersensitive mucous membrane of the airways. While steroids may have a negative connotation, inhaled steroid medications are generally safe to use as they are not absorbed into the bloodstream. After using inhaled steroids, it's important to rinse the mouth thoroughly to remove any residual steroids.

If an attack does occur, the first line of treatment involves medications specifically targeted at relieving the attack. These medications come in inhalable or patch forms and work by stimulating the sympathetic nervous system to relax the muscles of the airways, thereby alleviating the attack. It's strongly recommended to use any available medication at home or on the go, and if there's no improvement, seek urgent medical attention.

Asthma in children often occurs as a result of inhaling allergens, leading to frequent attacks. However, as the airways gradually widen with physical growth, the severity of attacks typically diminishes over time. Conversely, asthma that develops in adulthood often lacks a clear identifiable allergen and may be triggered by changes in stress or overall health conditions. Therefore, it's crucial to reflect on what factors may trigger an attack.

Asthma attacks, which can occur due to minor triggers such as changes in health or weather, are more akin to a constitution than a disease. Understanding asthma and managing it effectively can lead to healthier days ahead.