Info Sihat

 

Asthma

 

Asthma — Comprehensive overview covers symptoms, treatment of this condition that causes difficulty breathing.

Definition

Asthma occurs when the airways in your lungs (bronchial tubes) become inflamed and constricted. The muscles of the bronchial walls tighten, and your airways produce extra mucus that blocks your airways. Signs and symptoms of asthma range from minor wheezing to life-threatening asthma attacks.

Asthma can’t be cured, but its symptoms can be controlled. Management includes avoiding asthma triggers and tracking your symptoms. You may need to regularly take long-term control medications to prevent flare-ups and short-term “rescue” medications to control symptoms once they start. Asthma that isn’t under control can cause missed school and work or reduced productivity due to symptoms. Because in most people asthma changes over time, you’ll need to work closely with your doctor to track your signs and symptoms and adjust your treatment as needed.

Symptoms

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If you have asthma, the inside walls of the airways in your lungs are inflamed and swollen. This makes the muscles surrounding your airways very sensitive, so they tighten and constrict spontaneously. In addition, membranes in your airway linings secrete excess mucus. The result is narrowed airways and obstructed airflow that typically lead to coughing, wheezing and shortness of breath.

Mechanism of asthma

Asthma signs and symptoms range from minor to severe, and vary from person to person. You may have mild symptoms such as infrequent wheezing, with occasional asthma attacks. Between episodes you may feel normal and have no trouble breathing. Or, you may have signs and symptoms such as coughing and wheezing all the time or have symptoms primarily at night or only during exercise.

Asthma signs and symptoms include:

• Shortness of breath
• Chest tightness or pain
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• An audible whistling or wheezing sound when exhaling
• Bouts of coughing or wheezing that are worsened by a respiratory virus such as a cold or the flu

Signs that your asthma is probably getting worse include:

• An increase in the severity and frequency of asthma signs and symptoms
• A fall in peak flow rates as measured by a peak flow meter, a simple device used to check how well your lungs are working
• An increased need to use bronchodilators — medications that open up airways by relaxing the surrounding muscles

Work with your doctor to determine when you need to increase your medications or take other steps to treat symptoms of worsening asthma and get your asthma back under control. If your asthma keeps getting worse, you may need a trip to the emergency room. Your doctor can help you learn to recognize emergency signs and symptoms so you’ll know when to get help.

Causes

It isn’t clear why some people get asthma and others don’t, but it’s probably due to a combination of environmental and genetic (inherited) factors.

Asthma triggers are different from person to person. Exposure to various allergens and irritants can trigger signs and symptoms of asthma, including:

• Airborne allergens, such as pollen, animal dander, mold, cockroaches and dust mites
• Respiratory infections, such as the common cold
• Physical activity (exercise-induced asthma)
• Cold air
• Air pollutants and irritants such as smoke
• Certain medications, including beta blockers, aspirin and other nonsteroidal anti-inflammatory drugs
• Strong emotions and stress
• Sulfites, preservatives added to some perishable foods
• Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat
• Menstrual cycle in some women
• Allergic reactions to foods such as peanuts or shellfish

Risk factors

Asthma is common, affecting millions of adults and children. A growing number of people are diagnosed with the condition each year, but it isn’t clear why. A number of factors are thought to increase the chances of developing asthma. These include:

• A family history of asthma
• Frequent respiratory infections as a child
• Exposure to secondhand smoke
• Living in an urban area, especially if there’s a lot of air pollution
• Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing
• Low birth weight
• Being overweight

When to seek medical advice

Three key circumstances may lead you to talk to your doctor about asthma:

• If you think you have asthma. If you have frequent coughs that last more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early, especially in children, may prevent long-term lung damage and prevent worsening of the condition over time.
• To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good asthma control not only helps you feel better on a daily basis, but also can prevent a life-threatening asthma attack.
• If your asthma symptoms get worse. Contact your doctor right away if your medication doesn’t work for you. Asthma changes over time, and you’ll need periodic adjustments to your treatment to manage your symptoms. Don’t try to solve the problem by taking more medication without consulting your doctor. Overusing asthma medication can cause side effects and may even make your asthma worse.

Severe asthma attacks
Severe asthma attacks can be life-threatening and require emergency treatment. If your asthma isn’t getting better with quick-relief medications, seek emergency help right away. Work with your doctor ahead of time to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma attack that needs emergency treatment include:

• Rapid worsening of shortness of breath or wheezing
• No improvement even after using short-acting bronchodilators
• Shortness of breath with minimal activity

Tests and diagnosis

Diagnosing asthma can be difficult. Signs and symptoms can range from mild to severe and are often similar to those of other conditions, including emphysema, early congestive heart failure or vocal cord problems. In children, it can be hard to differentiate asthma from wheezy bronchitis, pneumonia or reactive airway disease.

In order to rule out other possible conditions, your doctor will do a physical exam and ask you questions about your signs and symptoms and about any other health problems. You may also be given lung (pulmonary) function tests to determine how much air moves in and out as you breathe.

Tests to measure lung function include:

• Spirometry. This test measures the narrowing of your bronchial tubes by checking how much air you can exhale after a deep breath, and how fast you can breathe out.
• Peak flow. A peak flow meter is a simple device that can be used at home to help detect subtle changes before you notice symptoms. If the readings are lower than usual, it’s a sign your asthma may be about to flare up. Your doctor will give you instructions on how to track and deal with low readings.

Lung function tests often are done before and after taking a bronchodilator to open your airways. If your lung function improves with use of a bronchodilator, it’s likely you have asthma.

Other diagnostic tests to diagnose asthma include:

• Methacholine bronchial challenge. If you have asthma, inhaling a known asthma trigger called methacholine will cause mild constriction of your airways. A positive methacholine test supports a diagnosis of asthma. This test may be used if your initial lung function test is normal.
• Nitric oxide test. This test is sometimes used to diagnose and monitor asthma. It measures the amount of a gas called nitric oxide you have in your breath. If your airways are inflamed — a sign of asthma — you may have higher than normal levels of nitric oxide. This test isn’t widely available.

How asthma is classified
To classify your asthma severity, your doctor will evaluate your answers to questions about symptoms (such as how often you have asthma attacks and how bad they are), along with the results of your physical exam and diagnostic tests. Determining the severity level of your asthma will help your doctor choose the best treatment for you. Asthma severity often changes over time, requiring an adjustment to treatment.

Asthma is classified into four general categories:

Asthma classification	Signs and symptoms
Mild intermittent	Mild symptoms up to two days a week and up to two nights a month
Mild persistent	Symptoms more than twice a week, but no more than once in a single day
Moderate persistent	Symptoms once a day and more than one night a week
Severe persistent	Symptoms throughout the day on most days and frequently at night

Complications

Asthma may cause a number of complications, including:

• Emergency room visits and hospitalizations for severe asthma attacks
• Permanent narrowing of the bronchial tubes (airway remodeling)
• Side effects from long-term use of some medications used to stabilize severe asthma

Treatments and drugs

Treating asthma involves both preventing symptoms and treating an asthma attack in progress. Preventive, long-term control medications reduce the inflammation in your airways that leads to symptoms. Quick-relief (rescue) medications quickly open swollen airways that are limiting breathing. Most people with persistent asthma use a combination of long-term control medications and quick-relief medications, taken with a hand-held inhaler.

In some cases, medications to treat allergies are needed.

The right medication for you depends on a number of things, including your age, your symptoms, your asthma triggers and what seems to work best to keep your asthma under control.

Long-term control medications
In most cases, these medications need to be taken every day. Types of long-term control medications include:

• Inhaled corticosteroids. These medications include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), triamcinolone (Azmacort), flunisolide (Aerobid), beclomethasone (Qvar) and others. These medications are the most commonly prescribed type of long-term asthma medication. You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, these corticosteroid medications have a relatively low risk of side effects and are generally safe for long-term use.
• Leukotriene modifiers. These oral medications include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo, Zyflo CR). They help prevent asthma symptoms for up to 24 hours. In rare cases, these medications have been linked to psychological reactions such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual reaction.
• Theophylline. This is a daily pill that helps keep the airways open (bronchodilator). Theophylline (Theo-24, Elixophyllin, others) relaxes the muscles around the airways to make breathing easier. It’s not used as often now as in past years.
• Long-acting beta agonists (LABAs). These inhaled medications include salmeterol (Serevent Diskus) and formoterol (Foradil Aerolizer). LABAs open the airways and reduce inflammation. However, they’ve been linked to severe asthma attacks. LABAs should be taken only in combination with an inhaled corticosteroid.
• Combination inhalers such as fluticasone and salmeterol (Advair Diskus) and budesonide and formoterol (Symbicort). These medications contain a LABA along with a corticosteroid. Like other LABA medications, these medications may increase your risk of a severe asthma attack and need to be used with caution.

Quick-relief medications
Also called rescue medications, quick-relief medications are used as needed for rapid, short-term symptom relief during an asthma attack — or before exercise if your doctor recommends it. Types of quick-relief medications include:

• Short-acting beta agonists. These inhaled bronchodilator (brong-koh-DIE-lay-tur) medications can rapidly ease symptoms during an asthma attack. They include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair Autohaler). These medications act within minutes, and effects last several hours.
• Ipratropium (Atrovent). Your doctor might prescribe this inhaled medication for immediate relief of your symptoms. Like other bronchodilators, ipratropium relaxes the airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis, but it’s sometimes used to treat asthma attacks.
• Oral and intravenous corticosteroids. These medications relieve airway inflammation caused by severe asthma. Examples include prednisone and methylprednisolone. They can cause serious side effects when used long term, so they’re only used to treat severe asthma symptoms on a short-term basis.

Treatment for allergy-induced asthma
If your asthma is triggered or worsened by allergies, you may benefit from allergy treatment as well. Allergy treatments include:

• Omalizumab (Xolair) . This medication is specifically for people who have allergies and asthma. It reduces the immune system’s reaction to allergy-causing substances, such as pollen, dust mites or pet dander. Xolair is delivered by injection every two to four weeks.
• Allergy medications. These include oral and nasal spray antihistamines and decongestants as well as corticosteroid, cromolyn and ipratropium nasal sprays.
• Allergy shots (immunotherapy). Immunotherapy injections are generally given once a week for a few months, then once a month for a period of three to five years. Over time, they gradually reduce your immune system reaction to specific allergens.

Don’t rely only on quick-relief medications
Long-term asthma control medications — such as inhaled corticosteroids — are the cornerstone of asthma treatment. These medications keep asthma under control on a day-to-day basis and make it less likely you’ll have an asthma attack.

If you do have an asthma flare-up, a quick-relief inhaler can ease your symptoms right away. But if your long-term control medications are working properly, you shouldn’t need to use your quick-relief inhaler very often. Keep a record of how many puffs you use each week. If you need to use your quick-relief inhaler more often than your doctor recommends, see your doctor. You probably need to adjust your long-term control medication.

Treatment by severity for better control: A stepwise approach
Treatment based on asthma control can help you manage your asthma. Asthma treatment should be flexible and based on changes in symptoms, which should be assessed thoroughly each time you see your doctor. Then, treatment can be adjusted accordingly.

For example, if your asthma is well controlled, your doctor may prescribe less medicine. If your asthma is not well controlled or getting worse, your doctor may increase your medication and recommend more frequent visits.

Prevention

Working together, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks.

• Develop a written asthma plan. With your doctor and health care team, write a detailed plan for taking maintenance medications and managing an acute attack. Then be sure to follow your plan. Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life in general.
• Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.
• Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath. But because your lung function may decrease before you notice any signs or symptoms, regularly measure your peak airflow with a home peak flow meter.
• Identify and treat attacks early. If you act quickly, you’re less likely to have a severe attack. You also won’t need as much medication to control your symptoms. When your peak flow measurements decrease and alert you to an impending attack, take your medication as instructed and immediately stop any activity that may have triggered the attack. If your symptoms don’t improve, get medical help as directed in your action plan.
• Don’t let up on your medication program. Just because your asthma seems to be improving, don’t change anything without first talking to your doctor. It’s a good idea to bring your medications with you to each doctor visit, so your doctor can double-check that you’re using your medications correctly and taking the right dose.

Lifestyle and home remedies

Although many people with asthma rely on medications to relieve symptoms and control inflammation, you can do several things on your own to maintain overall health and lessen the possibility of attacks.

Avoid your triggers
Taking steps to reduce your exposure to things that trigger asthma symptoms is a key part of asthma control. Here are some things that may help:

• Use your air conditioner. Air conditioning helps reduce the amount of airborne pollen from trees, grasses and weeds that finds its way indoors. Air conditioning also lowers indoor humidity and can reduce your exposure to dust mites. If you don’t have air conditioning, try to keep your windows closed during pollen season.
• Decontaminate your decor. Minimize dust that may aggravate nighttime symptoms by replacing certain items in your bedroom. For example, encase pillows, mattresses and box springs in dust-proof covers. Remove carpeting and install hardwood or linoleum flooring. Use washable curtains and blinds.
• Maintain optimal humidity. Keep humidity low in your home and office. If you live in a damp climate, talk to your doctor about using a dehumidifier.
• Keep indoor air clean. Have a utility company check your air conditioner and furnace once a year. Change the filters in your furnace and air conditioner according to the manufacturer’s instructions. Also consider installing a small-particle filter in your ventilation system. If you use a humidifier, change the water daily.
• Reduce pet dander. If you’re allergic to dander, avoid pets with fur or feathers. Having pets regularly bathed or groomed also may reduce the amount of dander in your surroundings.
• Clean regularly. Clean your home at least once a week. If you’re likely to stir up dust, wear a mask or have someone else do the cleaning.
• If it’s cold out, cover your face. If your asthma is worsened by cold, dry air, wearing a face mask can help.

Stay healthy
Taking care of yourself and treating other conditions linked to asthma will help keep your asthma under control. A few things you can do include:

• Exercise. Having asthma doesn’t mean you have to be less active. Treatment can prevent asthma attacks and control symptoms during activity. Regular exercise can strengthen your heart and lungs, which helps relieve asthma symptoms. Aim for 30 minutes of exercise on most days. If you’ve been inactive, start slowly and try to gradually increase your activity over time.
• Maintain a healthy weight. Being overweight can worsen asthma symptoms, and it puts you at higher risk of other health problems.
• Control heartburn and gastroesophageal reflux disease (GERD). It’s possible that the acid reflux that causes heartburn may damage lung airways and worsen asthma symptoms. If you have frequent or constant heartburn, talk to your doctor about treatment options. You may need treatment for GERD before your asthma symptoms improve.

Coping and support

Asthma can be challenging and stressful. You may sometimes become frustrated, angry or depressed because you need to cut back on your usual activities to avoid environmental triggers. You may also feel hampered or embarrassed by the symptoms of the disease and by complicated management routines. Children in particular may be reluctant to use an inhaler in front of their peers.

But asthma doesn’t have to be a limiting condition. The best way to overcome anxiety and a feeling of helplessness is to understand your condition and take control of your treatment. Here are some suggestions that may help:

• Identify the things that trigger your symptoms. This can be one of the most important ways to take control of your life. Also take peak flow measurements regularly and follow your action plan for using medications and managing attacks.
• Pace yourself. Take breaks between tasks and avoid activities that make your symptoms worse.
• Make a daily to-do list. This may help you avoid feeling overwhelmed. Reward yourself for accomplishing simple goals.
• Talk to others with your condition. Chat rooms and message boards on the Internet or support groups in your area can connect you with people facing similar challenges and let you know you’re not alone.
• If your child has asthma, be encouraging. Focus attention on the things your child can do, not on the things he or she can’t. Involve teachers, school nurses, coaches, friends and relatives in helping your child manage asthma.

 

BANANA NUTRIENT INFO

 

Never, put your banana in the refrigerator!!!Depression: According to a recent survey undertaken by MIND amongst people suffering from depression, many felt much better after eating a banana. This is because bananas contain tryptophan, a type of protein that the body converts into serotonin, known to make you relax, improve your mood and generally make you feel happier.PMS: Forget the pills – eat a banana. The vitamin B6 it contains regulates blood glucose levels, which can affect your mood.Anemia: High in iron, bananas can stimulate the production of hemoglobin in the blood and so helps in cases of anemia.Blood Pressure: This unique tropical fruit is extremely high in potassium yet low in salt, making it perfect to beat blood pressure. So much so, the US Food and Drug Administration has just allowed the banana industry to make official claims for the fruit’s ability to reduce the risk of blood pressure and stroke.

This is interesting. After reading this, you’ll never look at a banana in the same way again. Bananas contain three natural sugars – sucrose, fructose and glucose combined with fiber. A banana gives an instant, sustained and substantial boost of energy. Research has proven that just two bananas provide enough energy for a strenuous 90-minute workout. No wonder the banana is the number one fruit with the world’s leading athletes.

But energy isn’t the only way a banana can help us keep fit. It can also help overcome or prevent a substantial number of illnesses and conditions, making it a must to add to our daily diet :

Brain Power: 200 students at a Twickenham (Middlesex) school were helped through their exams this year by eating bananas at breakfast, break, and lunch in a bid to boost their brain power. Research has shown that the potassium-packed fruit can assist learning by making pupils more alert.Constipation: High in fiber, including bananas in the diet can help restore normal bowel action, helping to overcome the problem without resorting to laxatives.Hangovers: One of the quickest ways of curing a hangover is to make a banana milkshake, sweetened with honey. The banana calms the stomach and, with the help of the honey, builds up depleted blood sugar levels, while the milk soothes and re-hydrates your system.Heartburn: Bananas have a natural antacid effect in the body, so if you suffer from heartburn, try eating a banana for soothing relief.Morning Sickness: Snacking on bananas between meals helps to keep blood sugar levels up and avoid morning sickness.Mosquito bites: Before reaching for the insect bite cream, try rubbing the affected area with the inside of a banana skin. Many people find it amazingly successful at reducing swelling and irritation.Nerves: Bananas are high in B vitamins that help calm the nervous system.Overweight and at work?
Studies at the Institute of Psychology in Austria found pressure at work leads to gorging on comfort food like chocolate and crisps. Looking at 5,000 hospital patients, researchers found the most obese were more likely to be in high-pressure jobs. The report concluded that, to avoid panicinduced food cravings, we need to control our blood sugar levels by snacking on high carbohydrate foods every two hours to keep levels steady.Ulcers: The banana is used as the dietary food against intestinal disorders because of its soft texture and smoothness. It is the only raw fruit that can be eaten without distress in over-chronicler cases. It also neutralizes over-acidity and reduces irritation by coating the lining of the stomach.Temperature control: Many other cultures see bananas as a “cooling” fruit that can lower both the physical and emotional temperature of expectant mothers. In Thailand, for example, pregnant women eat bananas to ensure their baby is born with a cool temperature.Seasonal Affective Disorder (SAD): Bananas can help SAD sufferers because they contain the natural mood enhancer tryptophan.Smoking & Tobacco Use: Bananas can also help people trying to give up smoking. The B6, B12 they contain, as well as the potassiu! m and ma gnesium found in them, help the body recover from the effects of nicotine withdrawal.Stress: Potassium is a vital mineral, which helps normalize the heartbeat, sends oxygen to the brain and regulates your body’s water balance. When we are stressed, our metabolic rate rises, thereby reducing our potassium levels. These can be rebalanced with the help of a high-potassium banana snack.Strokes: According to research in “The New England Journal of Medicine, ‘eating bananas as part of a regular diet can cut the risk of death by strokes by as much as 40%!Warts: Those keen on natural alternatives swear that if you want to kill off a wart, take a piece of banana skin and place it on the wart, with the yellow side out. Carefully hold the skin in place with a plaster or surgical tape!PS:
Bananas must be the reason monkeys are so happy all the time! I will add one here; want a quick shine on our shoes?? Take the INSIDE of the banana skin, and rub directly on the shoe…polish with dry cloth. Amazing fruit!

 

So, a banana really is a natural remedy for many ills. When you compare it to an apple, it has four times the protein, twice the carbohydrate, three times the phosphorus, five times the vitamin A and iron, and twice the other vitamins and minerals. It is also rich in potassium and is one of the best value foods around So maybe its time to change that well-known phrase so that we say, “A banana a day keeps the doctor away!”