Astmas

Asthma, commonly misspelled as astmas, is a chronic inflammatory disease of the airways characterized by episodes of airflow obstruction and bronchial hyperresponsiveness. Symptoms typically include wheezing, coughing, shortness of breath, and chest tightness, often varying by time and with exposure to triggers.

Causes and risk factors: The exact causes are multifactorial, involving genetic susceptibility and environmental factors. Atopy, a family history of asthma, allergic rhinitis, eczema, urban or inner-city residence, exposure to tobacco smoke, air pollution, and obesity can increase risk.

Pathophysiology: Inflammation of the airway walls leads to swelling and increased mucus production, narrowing the airways. Bronchial smooth muscle constriction during attacks worsens obstruction.

Diagnosis: Based on patient history, physical exam, and tests. Spirometry showing reversible airflow limitation after bronchodilator use is characteristic. Peak expiratory flow monitoring can reveal variability. In uncertain cases, methacholine challenge or bronchodilator responsiveness testing may be used.

Management: Core treatment includes trigger avoidance and pharmacotherapy. Inhaled corticosteroids are the main controller therapy; short-acting beta-agonists provide rapid relief. For those not adequately controlled, combination inhaled corticosteroid and long-acting beta-agonist therapy or oral leukotriene receptor antagonists may be employed. Severe asthma may require biologic therapies targeting IgE or interleukins. An individualized asthma action plan helps patients adjust therapy during symptoms.

Prevention and prognosis: Regular vaccination, asthma education, and action plans improve outcomes. With proper control, most people experience good symptom control and minimal risk of future attacks; uncontrolled asthma increases the risk of exacerbations and hospital visits.