Bronchial Asthma

by Cesar Antonio Boza, MD. Hospital HIMA San pablo, Caguas, PR

Bronchial Asthma is a common reactive obstructive airway disease caused by inflammation and bronchoconstriction that result in increased resistance to airflow. This condition affects 26 million people in the United States. It is the most common chronic disease in childhood, affecting an estimated 7 million children in the United States.

Patients with asthma will commonly complain of cough at night or early in the mornings, wheezing and dyspnea (Shortness of breath), but they may also claim chest tightness during an acute attack. If you have asthma, you will have it all the time, but you will only have acute attacks when something bothers your lungs (asthma triggers).

We do not know all the things that cause asthma, but we know that genetic, environmental, and occupational factors play an essential role in the development of this condition.

It is commonly seen in patients with atopy, which is the genetic tendency to develop allergic disease, but it does not mean that all asthma is allergic.

How can you tell that you have asthma? It is hard to tell someone has asthma, especially in children younger than 5 years old, but if the symptoms mentioned above are present, it is important having a doctor to check how well your lungs work and check for allergies to find out if you have asthma.

If you are diagnosed with asthma, an asthma attack can happen, specially if you are exposed to some common asthma triggers like tobacco smoke, dust mites, outdoor air pollution, mold, pets, pollen and even some infections like the flu or common colds.

What is an asthma attack? It is the abrupt onset of cough, chest tightness, wheezing and trouble breathing. When an asthma attack occurs, your airway begins to swell and there is strong constriction of your bronchi. The constricted airway causes air trapping which means that air can get in during inhalation but can’t get out during exhalation which will potentially hyperinflated your lungs causing the symptoms of chest tightness and breathing difficulty.

How is asthma treated? The most important thing is that you take the medication the way the doctor told you and to also to stay away from the things that can trigger an asthma attack in order control your asthma.

The medications the doctor choose to treat you will depend on the frequency of your symptoms and the response you have to those treatments. The main purpose of the treatment is to reduce the inflammation of the airway and to also reduce the bronchial hyperreactivity to improve the airflow through the airway.

Based on the severity of your asthma the doctor may decide to order rescue inhalers (those you use as needed) to keep your bronchi open, inhaled anti-inflammatories (to reduce the inflammation), long-acting inhalers for chronic treatments and orals treatments in case of poor response to the inhalers. During an asthma attack that is not responding to treatments, patients can be treated in the emergency room with nebulization and intravenous medications to reduce the inflammation of the airway.

Be aware the asthma medications can have some side effects, but most side effects are mild and soon go away. If you present any side effect or have any questions about your medication do not hesitate to ask your doctor about it.

About Dr. Cesar Boza:  He isa 2012 graduate from the American University (UAM) in Managua, Nicaragua, as a Doctor in Medicine and Surgery as well as a 2018 graduate with an M.Sc. degree in Public Health from the Research and Study Center for Health at the National Autonomous University of Nicaragua (CIES-UNAN).

He has a year, and a half of collective experience in medical research, and six years of experience serving as a medical instructor and primary care provider for various Non-profit Organizations. He co-founded his own non-profit called Synaptic Communities and created his own medical program He recently started a year of transitory medical training at HIMA San Pablo Hospital, in Caguas, Puerto Rico.

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