Asthma is a respiratory disease that affects around 300 million people worldwide. It affects people of all ages and is a frequent and potentially serious cause of chronic disease. Like any chronic disease, it can cause limitations in the professional and physical activity of those affected, presenting periods of exacerbation that sometimes require urgent medical evaluation and can be fatal. It is, therefore, an important cause of death, including among young people, with 96% of cases occurring in poor/developing countries.
In terms of symptoms, patients complain of wheezing, shortness of breath, chest pain and/or coughing. These symptoms are a consequence of changes that occur in the airway where there is chronic inflammation responsible for the thickening of the bronchial wall, “tightening” them and increasing mucus production. These symptoms can vary in intensity and frequency throughout life, presenting periods of worsening (exacerbations).
The good news in this disease is that the disease can be properly controlled and treated. The basic treatment is based on inhaled corticosteroids, which reduce the severity and frequency of symptoms and exacerbations.
The objectives of good asthma control are: not having symptoms day or night, not needing SOS medication, having a productive and physically active life, avoiding serious exacerbations and having normal respiratory tests.
To achieve these objectives we must: avoid causes of exacerbation/worsening of symptoms. Viruses are causes of exacerbation (it is important to adhere to COVID and Influenza vaccines); allergens (dust, pollen, fungi); tobacco (avoid passive or active exposure); stress. Some medications trigger asthma attacks, such as aspirin or non-steroidal anti-inflammatory drugs, which should therefore be avoided.
Physical exercise should be encouraged, although it can worsen symptoms if there is not good prior asthma control. There are defined medical strategies for these patients who can, for example, use their inhaler before starting sporting activity.
Identify diseases that may be associated with asthma: rhinitis, chronic rhinosinusitis, gastroesophageal reflux disease, obesity, sleep apnea, depression and anxiety are the diseases most frequently associated with this disease and which must be treated.
On a daily basis, at home, we should:
- avoid carpets and curtains that accumulate dust;
- carpets must be washed frequently;
- avoid humidity in homes due to the accumulation of fungi;
- avoid the presence of animal hair indoors;
- do not smoke indoors;
- use vacuum cleaners with a HEPA filter to extract dust;
- Avoid keeping the house too cold, as the cold can cause airway hyperreactivity.
Last but not least, all patients must have an action plan agreed with their attending physician. It must include the daily medication, the medication to be taken in case of worsening and in which situations they should resort to the emergency service.
The final message I want to convey is that although it is a scary disease, it is possible to control it and have a perfectly normal life, and to do so, healthy lifestyles must be adopted. The measures described above can help achieve the goals of good asthma control, thereby reducing morbidity and mortality associated with the disease.
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