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June 2010
Dr Saroj Kumar Patnaik
No one really knows what causes asthma, a chronic inflammatory disease of the airways in the lungs. The consensus is that a mix of hereditary and environmental factors cause it, but the scientific community is still to crack the ‘how exactly’.

What every asthma patient knows too well though, is that it causes recurring attacks of wheezing, breathlessness, chest tightness and coughing.

Tightening Airways
Asthma makes the airways become extra-sensitive, when the inflammation lasts a while. Various triggers like allergens, viruses, dust, smoke, stress, etc. can then cause faster and impacting damage, by:
  • Swelling up the airways, making them narrower, limiting the airflow.
  • Tightening the muscles that surround the airways, making them even narrower
  • Producing too much mucus, which blocks the airways
  • Making the airways extra-sensitive to irritants
Sitting Ducks
  • Blame it on the genes, but you are more likely to get asthma if it’s been already running in your family.
  • Children with eczema or food allergy are more likely than other children to develop asthma.
  • If you have an existing allergy to pollen, house dust mites or pets, your chances for developing this illness go up.
  • Exposure to tobacco smoke, air pollution or other inhaled irritants can also cause asthma symptoms.
Age Old Problem
Although asthma can start at any age, it often gets more severe if it starts at an older age. An older person with heart disease or other medical problems may have more difficulty in dealing with an asthma attack than a younger person. Poorly treated asthma gets worse with age, and the lungs of people with untreated asthma function less well than those of non-asthmatic individuals.

For the record, nearly fifty percent people with asthma have had their first symptoms by the age of 10, and many children with asthma have had their first asthma attack before the age of six. Your asthma does not stay the same, but changes over time, and every person with asthma has good and bad days of asthma, depending on its length and severity.

What is called asthma in elderly people is sometimes actually Chronic Obstructive Pulmonary Disease (COPD). This is a collective name for chronic bronchitis and emphysema, two diseases that are almost always caused by smoking.

Many of the symptoms of COPD are similar to those of asthma (breathlessness, wheezing, production of too much mucus, coughing). COPD is generally a more serious disease than asthma, because the changes in the airways are much more difficult to treat, and it usually has a worse outcome. Unfortunately, COPD can cause greater long-term disability and have a greater effect on the heart and other organ systems than asthma.
Dr.Saroj Kumar Patnaik is Consultant - Critical Care Unit at Apollo Hospitals, Bhubaneswar

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