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Recent developments in the treatment of asthma have brought good news to the two to three million Britons who suffer from this chronic respiratory disease, causing attacks of breathlessness, coughing and wheezing. Although asthma is incurable, new drug therapies can actually prevent attacks. Research that shows the benefits of exercise is allowing asthmatics to enjoy active lives. In addition, those who suffer asthma attacks after exertion can learn to minimize their effects through using simple breathing techniques or even by avoiding certain foods.

What is Asthma ?

An asthma attack is an abnormal respiratory reaction to one or more irritants. It usually begins suddenly, and may be mild and transitory, or severe enough to require emergency treatment. In an attack, there is a constriction of the trachea and the connecting network of bronchial tubes. The smooth muscle surrounding the small bronchioles deep in the lungs goes into spasm, the membranes lining the bronchioles swell and secretions of mucus in the tubes increase. Air flow to and from the lungs is reduced, resulting in coughing, wheezing and a general shortness of breath.

An asthma attack makes it more difficult to exhale than inhale, which leads to a build-up of stale air in the air sacs or alveoli, causing them to overstretch. Repeated attacks can damage the alveoli, which diminishes lung capacity and may eventually lead to emphysema or other pulmonary disorders. About 2,000 people die annually from asthma in the U.K., and this number has actually increased in recent years.

Who Gets Asthma ?

Asthmatics are sensitive to a number of irritants that cause no respiratory distress in most people. In many cases, asthma is an allergic response. While a single, specific cause cannot always be found, common irritants are pollen, dust, animal dander, feathers, mould spores, cigarette smoke, chemicals, flour, drugs and certain foods. One tenth of all asthmatics are children; attacks may get less frequent as a child grows.

Asthma can also be precipitated at any age by respiratory infections, strenuous exercise or sudden exposure to cold air. In recent years, there has been a worldwide increase in hospital admissions for asthma attacks in children under 14, which may be the result of air pollution.

While it has been speculated that asthma is emotionally induced, current research does not support this theory. An upset, however, might bring on an attack in someone who already has asthma.

How to Minimize the Effects of Asthma

An accurate diagnosis is an important first step to effective management. Determining just what triggers asthma in an individual is not always easy or possible, since there might he a whole constellation of irritants. If the triggers are known, the obvious step is to avoid them. This is done easily enough with many contained allergens, such as foods, feathers and animal dander.

Controlling asthma is much more difficult if the triggers are environmentally produced, such as dust and pollen. In such cases, asthmatics must do their best to minimize exposure by getting rid of dust collectors such as scatter rugs and venetian blinds. Allergic reactions such as hay fever can sometimes be corrected by a series of desensitizing injections, but the practice is now rare in the United Kingdom because they occasionally cause death. If an allergen is in your work environment, you may have to change jobs or adjust your schedule to avoid the irritant. Moving to another climate is not recommended in most cases, since asthma can occur anywhere.

Exercise-induced asthma (EIA) can result in susceptible individuals after exertion. In the past, doctors told patients with EIA to avoid exercise altogether. Recent research has shown, however, that asthmatics can safely tolerate increased activity with medication, yet with a decrease in the severity of their attacks.

You can often minimize the effects of EIA by exercising in warm, humid environments, and warming up adequately. Many asthmatics can swim without symptoms; walking and cycling are less likely to cause attacks than running. If continuous exercise precipitates attacks, try stop-start sports such as tennis. Others can reduce the severity of their attacks by breathing slowly through their noses, thus preventing hyperventilation, which is often linked with the onset of EIA. In addition, researchers have noted that certain foods, especially shellfish, celery and peanuts, eaten before exercising, have been linked with the onset of asthma attacks. Aspirin, too, should be avoided.

Drugs are frequently required to prevent attacks as well as reduce their severity. Bronchodilators, which can be taken orally, inhaled or injected, are used to prevent or minimize attacks by increasing the diameter of air passages and easing the exchange of air in your lungs. Some may require an inhalant called cromolyn, which desensitizes you to allergens.

Asthmatics also report improvements from reducing stress and practising relaxation techniques. By lessening anxiety, these techniques help reduce the severity of attacks.


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