What is asthma?

What is asthma?
There is more than 3,5 million asthmatic in France (6% of the adult population and 10% of the children). It is about the first chronic disease of the child. Asthma causes 1.000 more deaths per annum at less than 65 years. The cost of this disease for the company is important because it is responsible 600.000 days of hospitalization and 7 million days of sick leave per annum. An allergic cause is found at 70 to 80% of the asthmatic adults and at 95% of the children reached.

What feels the patient?
The word more used is “oppression”.

The asthmatic one in crisis has difficulties in inspire and especially to expire the air contained in its lungs, as if it breathed through a small straw. A whistle accompanies this embarrassment and testifies to the contracting to its bronchi. The air is imprisoned in the chest, the thorax is blocked. This feeling is accompanied by an irritating cough and sometimes by a feeling of anxiety. It cannot be compared with the breathlessness due to the effort, although the exercise can cause a crisis at certain asthmatic.

Asthma is often unforeseeable.
Oppression, the whistle and the cough of asthmatic are of frequency and intensity variables.

The crises can be of short duration or persist several days. In this case it is then about a “attack of asthma”. These demonstrations can be related to starting factors precise, or appear without obvious reason.

Between the crises, breathlessness can persist and at certain asthmatic, often oldest, it can become permanent and more or less intense. One speaks then about persistent asthma. It is then about a “asthma with continuous dyspnea”.

Asthma is sensitive to several factors.
Asthma is due to an exaggerated sensitivity of the bronchi to several factors. One speaks “about not-specific bronchial hyperreactivity”. That explains why a crisis can occur in various situations:

Contact with an allergen: acarina, pollens, animals…
Inhalation of polluting substances: smoke, fumes exhaust, bombs aerosols, paintings…
Virus diseases: a simple cold can cause at the end of a few days of evolution the appearance of a crisis.
Catch of certain drugs: aspirine or anti-inflammatory drugs not stéroïdiens, drugs against hypertension, certain eye lotions…
Ingestion of a food: a food allergy can cause a true asthma attack.
Stress.
These various factors intervene in variable proportion from one subject to another. At the same person, they can also intervene in variable proportion according to the evolution of asthma.

“Is the stress responsible for my asthma?” is a question often raised by the asthmatic ones. It is real that the anxiety, the stress and the concern can worsen an existing asthma, but is not asthmatic which wants and asthma does not exist exclusively in the head!

There exists a natural variation of the asthma which coincides with our rate/rhythm of the sleep. It is more important at the first hours of the day (between 3 and 5 hours of the morning). The asthmatic one is then awaked by coughing fits or a whistling breathing. It can also be oppressed with the rising, even if the sleep were not disturbed. It is in middle of afternoon that the asthmatic one feels best.

The physical-activity is one of the starting factors of asthma, particularly at the child and the teenager. Indeed, a crisis can appear following an intense effort and can last fifteen minutes or more. This asthma due to the exercise is more intense when the fresh air is cold and dry, and that it is breathed by the mouth.

What does it occur in the lungs at the time of an asthma attack?
At the time of certain circumstances of which we spoke, the asthmatic one feels an oppression of the thorax, a whistling breathing, a cough and breathlessness sometimes distressing. What does it occur then in its lungs?

Normally, at the time of the inspiration, the air is brought in the air cells to bring to blood and the cells the oxygen which we need. It is led there by a system of pipes (the trachea and bronchi) surrounded by muscles (like laces).

The largest conduit which goes from the larynx to the bronchi is the trachea. The trachea is divided into two stumble-stocks right-hand side and left and each one of those still divide several times and become increasingly narrow.

At a person in good health, the bronchi remain sufficiently open to allow a free and easy inspiration and an expiry, not requiring any particular strain.

When a crisis is started by the various factors about which we spoke (allergy, irritations, viral infection), it occurs a contraction of the muscles and a more or less important ignition on the surface of the bronchi, which generates a contracting of the respiratory tracts. The air does not pass any more but with difficulty.

Asthma can be occasional or persistent
Certain asthmas are started occasionally under quite precise conditions: work places, contact with an animal, walk in the countryside at the time when pollens are in the air. It is about an intermittent asthma.

In other cases asthma is present throughout the year. It is then persistent and more or less severe. The causes are often multiple.

Whatever the trip, asthma is recognized today like an inflammatory disease: from where importance of the drugs anti-inflammatory drugs in the daily treatment of asthma and to cure acute crises.

In the actual position of our knowledge on the disease, one cannot speak about final cure. But the life of asthmatic has been transformed thanks to very important progress of its treatment for 30 years. There exist currently effective drugs which allow a total control of the signs of asthma. Asthmatic must be able to live normally if it is followed and treated well well.