Asthma is a chronic condition that intermittently inflames and narrows the airways in the lungs. The inflammation makes the airways swell. Asthma causes periods of wheezing, chest tightness, shortness of breath, and coughing. People who have asthma may experience symptoms that range from mild to severe and that may happen rarely or every day. When symptoms get worse, it is called an asthma attack. Asthma affects people of all ages and often starts during childhood.
Adults and children share the same triggers for symptoms that set off an allergic response in the airways, including airborne pollutants, mold, mildew, and cigarette smoke.


Causes
Many different aspects of a person’s environment and genetic makeup can contribute to the development of asthma.
Asthma is the most common chronic disease among children. The first symptoms become clear at around 5 years of age in the form of wheezing and regular infections in the respiratory tracts.

The following are the primary causes of asthma.
Allergies
A strong link exists between allergies and asthma.
Common sources of indoor allergens include animal proteins, mostly from cat and dog dander, dust mites, cockroaches, and fungi.

Smoking tobacco
Research has linked tobacco smoke to an increased risk of asthma, wheezing, respiratory infections, and death from asthma. In addition, the children of parents who smoke have a higher risk of developing asthma.
Smoking makes the effects of asthma on the airways worse by adding coughing and breathlessness to its symptoms, as well as increasing the risk of infections from the overproduction of mucus.

Environmental factors
Air pollution both in and out of the home can impact the development and triggers of asthma.
Allergic reactions and asthma symptoms often occur because of indoor air pollution from mold or noxious fumes from household cleaners and paints.

pollen
Anything from pollen to pollution can trigger an asthma attack and inflame the airways.
Other asthma triggers in the home and environment include:
pollution
sulphur dioxide
nitrogen oxide
ozone
cold temperatures
high humidity
Heavy air pollution tends to cause a higher recurrence of asthma symptoms and hospital admissions.

Changes in the weather might also stimulate attacks. Cold air can lead to airway congestion, constricted airway, extra secretions of mucus, and a reduced ability to clear that mucus.
Humidity might also lead to breathing difficulties for populations in some areas.

Obesity
Some studies, such as this report from 2014, suggest a link between obesity and asthma, although the American Academy of Asthma, Allergies, and Immunology does not recognize obesity as a formal risk factor for asthma.

Pregnancy
If a woman smokes tobacco or illicit substanes while pregnant, an unborn child might grow less in the womb, experience complications during labor and delivery, and have a low birth weight.
These newborns might be more prone to medical problems, including asthma.

Stress
People who undergo stress have higher asthma rates. Increases in asthma-related behaviors during stressful times, such as smoking, might explain these increased rates.
Emotional responses, including laughter and grief, might trigger asthma attacks.

Genetics
A parent can pass asthma on to their child. If one parent has asthma, there is a 25 percent chance that a child will develop asthma. Having two parents with asthma increase the risk to 50 percent.

Atopy
Atopy is a general class of allergic hypersensitivity that leads to allergic reactions in different parts of the body that do not come in contact with an allergen. Examples include eczema, hay fever, and allergic conjunctivitis.During atopy, the body produces more immunoglobin (IgE) antibodies than usual in response to common allergens.

The menstrual cycle
One type of asthma, known as perimenstrual asthma (PMA), leads to acute symptoms during the menstrual cycle .
The sex hormones that circulate during menstruation, such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH), impact immune activity. This increased immune action can cause hypersensitivity in the airways.

Be sure to identify any health conditions that can interfere with asthma management, such as:
· sinus infections
· acid reflux
· psychological stress
· sleep apnea
The single most important aspect of controlling asthma is the careful and planned use of drug treatments. However there are several things you can do to reduce the risk of an attack and decrease the severity of symptoms.

Do not smoke and try to avoid polluted or smoky atmospheres.
Take regular exercise to improve your stamina. Swimming is beneficial. Avoid exercise outside when it is cold. Avoid substances that are likely to provoke an attack. Do not keep furry animals as pets.
Make sure you use the steroid inhaler regularly on time and follow correct inhaler techniques Always carry an steroid and salbutamol inhaler (or puffer) and be sure to take your medication on holidays.

In spite of this encouraging outlook, thousands of people die from severe asthma attacks each year. In most cases the cause of death is a delay in recognizing the severity of the attack, and consequently a delay in getting to hospital. There fore if symptoms not better seek appropriate medical help early rather than late.

Pubudu Jayaweera

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