Underlying these phenomena is an inflammation of the airways, accompanied by a narrowing of the muscles of the bronchi and an increase in bronchial secretion, all of which impede the flow of air.
These processes are almost always triggered by exposure to triggering factors that, while in non-asthmatic subjects they are harmless, in asthmatic subjects they can cause various problems, such as pollen, food, a simple laugh, a deep breath or a short run.
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Doctors distinguish between two types of asthma: intrinsic (or non-allergic) and extrinsic (or allergic) asthma
The former is not sustained by an allergic process, while the latter is.
Generally, non-allergic asthma appears in adulthood, while allergic asthma can begin at any time in life, although it often appears as early as childhood.
Since sensitisation to allergy-inducing substances (called allergens) increases as the child’s exposure increases, the peak incidence of allergic asthma usually occurs at school age.
How to know if you have asthma
Symptoms of asthma vary from person to person: some people have attacks infrequently, some have manifestations only at certain times, for example when in a dusty environment or in the middle of a lawn or when exercising, and some have discomfort constantly.
In any case, the signs and symptoms of an attack may include:
- Shortness of breath;
- Sense of chest tightness
- chest pain
- coughing or wheezing attacks
- wheezing during exhalation
- sleep disturbances caused by shortness of breath, coughing or wheezing
These attacks can be greatly aggravated by the presence of viruses, such as those that cause the common cold or flu, which is a common sign of asthma especially in children.
Signs that asthma is probably worsening are an increase in breathing difficulty and the appearance of the symptoms described, manifesting poor control of the disease, which is measured at home with a device that checks the functioning of the lungs (peak flow meter), and the need to use a fast-acting inhaler more often.
For these reasons, people prone to asthma attacks should always carry a spray with bronchodilator substances, which are capable of rapidly reducing bronchial spasm (so-called ‘life-saving’).
When asthma attacks occur
For some people, the signs and symptoms of asthma occur in certain situations:
- when they do sport. In this case, we speak of exercise-induced asthma, which can worsen when the air is cold and dry;
- when carrying out one’s profession. We speak, in fact, of occupational asthma, a condition that is triggered by irritants breathed in at work, such as chemical fumes, gases or dust;
- in the case of exposure to allergenic substances. In this case we speak of allergic asthma, a type caused by airborne substances such as pollen, mould spores, dust mites or pet dander;
- during the night. This situation is referred to as nocturnal asthma;
- when taking acetylsalicylic acid drugs, antibiotics, anti-inflammatory drugs in general, anaesthetics. In this case, other symptoms such as runny nose, sneezing, sinus pressure and coughing are also present, and we speak of drug-induced asthma.
The different types of asthma
Based on symptoms, doctors classify asthma into:
-intermittent mild, in which symptoms are mild and appear less than twice a week. Nocturnal symptoms appear less than twice a month;
-persistent mild, with symptoms present three to six times a week and nocturnal symptoms present three to four times a month. Asthmatic attacks may affect normal activities;
-moderate persistent, with daily manifestations and nocturnal attacks five or more times a month. Symptoms may affect the person’s activities;
-severe persistent, with symptoms persisting both during the day and at night, such that the person is forced to limit their activities.
Severe asthma attacks can be life-threatening, which is why they must be addressed promptly.
Signs of an emergency include: rapid worsening of shortness of breath or wheezing; no improvement even after using a quick-relief inhaler; shortness of breath at rest.
Asthma, the risk factors
Certain risk factors are thought to increase the chances of developing asthma, including:
- having a relative with asthma, such as a parent or sibling;
- suffering from another allergic condition, such as atopic dermatitis (which is characterised by the presence of symptoms such as red, itchy skin) or hay fever (which causes runny nose, congestion and itchy eyes)
- being overweight;
- being exposed to second-hand smoke, exhaust fumes or other types of pollution;
- being exposed to occupational triggers, such as chemicals used in agriculture and by hairdressers.
Asthma, when to go to the doctor
People who have a frequent cough and/or wheeze lasting more than a few days or other signs or symptoms that can be attributed to asthma should consult their doctor as soon as possible, who may then decide to refer them to a pulmonary specialist.
It is important not to underestimate the situation and not to wait too long: if treatment of the disease is started early, the risk of long-term lung damage and worsening of the disease over time is significantly reduced.
Good long-term control of the disease helps you feel better day after day and can prevent a life-threatening asthma attack.
To monitor asthma after diagnosis, it is important to work with your doctor, also because the disease often changes over time and changes to the prescribed treatment may be necessary.
Do not take more medication than prescribed without first consulting your doctor, as overuse of asthma medication can cause side effects and worsen the situation.