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So what is asthma and what are the symptoms? The condition consists of inflammation, tightening and swelling of the airways in the respiratory  system, resulting  in obstruction  of the flow of air to and from the lungs. The symptoms of asthma include  breathlessness,  wheezing,  coughing  and chest tightness. Sufferers may also have a blocked nose, frequent  colds and hay fever, or rhinitis. The symptoms and their severity are peculiar to the individual, and they vary from season to season and according to the individual’s susceptibility to a wide range of triggers.

An  ‘asthma  attack’ is  the  term   used  to  describe  an episode of breathing  difficulty. In some cases, this may follow exposure to a specific trigger, such as dust, pollen, or certain foods. In other cases there appears to be no particular trigger. Some people have a cough and no wheeze, while others may have  a  wheeze  and  very little  coughing,  but  each  case  is accompanied by some level of breathing difficulty. Symptoms may occur periodically, on a day-to-day or season-to-season basis, or they may be more or less continuous.

A ‘trigger’ is something that makes asthma  worse. The most common  triggers include (in alphabetical order): allergies;  cigarette   smoking   (and  cigarette   smoke   for  non- smokers); colds and flu; cold air; dust mites; exercise under certain   circumstances;   moulds;   noxious   fumes;   pollens; stress, and  weather  types such  as fog and  damp.  In some instances  an asthma  attack may be triggered  by a combina- tion of catalysts. Anxiety can be caused by the variations on the  asthma  theme,  particularly  where  a child  is involved. Sometimes,  there  may  be  confusion  between  doctor  and patient when a diagnosis is being made.

There is also a wide variety in the symptoms of asthma. The following is a list of those most commonly experienced by sufferers.

✦   Wheeze

This is a high pitched whistling sound produced when air is forced through  narrowed airways. If you blow through a Biro pen when  the ink refill is removed, the sound  is similar.

✦   Breathlessness

This is the feeling of not being able to take in enough air. There is a need to breathe  out while, at the same time, a compulsion to breathe in. If this symptom develops to an extreme  level it can be frightening for the  sufferer  and very distressing  for those close to him or her.

✦   Coughing

This may be either a repetitive dry cough or a cough with phlegm,   often   occurring   during   the   night   or   early morning.   Repetitive  coughing  can  put  a strain  on  the heart  and drives sputum  deeper  into the lungs. Patients with this symptom  may feel like they are on a conveyor belt: the more they cough, the more they feel the need to cough again.

✦   Chest tightness

Trapped air in the lungs generates  a feeling that the chest is over inflated. This is often described as someone squeezing or sitting on one’s chest.

✦  Frequent yawning

When asthma symptoms are at their worst, sleep is inter- rupted by difficult periods of breathing  which contributes to tiredness.

Non-asthmatics can, of course, observe these symptoms, but they will not appreciate the feelings of tension, panic, uncertainty and helplessness  which accompany them, particularly when  the asthmatic  struggles  to breathe.  If you are not an asthmatic, imagine  trying to breathe  while a pillow is being pressed firmly over your face. That feeling you imagine is the feeling someone  with asthma  has during  an attack. In your case, the imaginary pillow can be easily removed to allow you to breathe effortlessly; for an asthmatic, the remedy is not so simple.

Given the variety of symptoms  and their severity, diagnosing  a condition  that has no commonly  accepted  definition is not an exact science. Many asthma symptoms are also the symptoms of other conditions, such as chronic bronchitis or  bronchiectasis,  for example. Diagnosis  has  to  take  into account the chronic nature of asthma and the constriction of the airways due to inflammation by various cells and chemicals. Generally, diagnosis of asthma is based on the following factors.

✦  History  of the patient

This includes establishing  if the patient  has experienced asthma  symptoms  while at rest, during  exercise or after exposure to a known trigger.

✦   Lung function tests

The  peak flow meter  measures  the  maximum  speed  at which the patient can exhale air in one second. A person with asthma usually produces a lower reading, and, generally speaking, a more  inconsistent range  of results than  a  person  who  doesn’t suffer  from  the  condition. Spirometry  measures  both  the  speed and  volume  of air which is exhaled with each breath, thereby providing additional airway obstruction  information.

✦  Effect of reliever or steroidal medication

In part, diagnosis  of asthma  is based  on  the  effects of medication,  and whether  or not  it leads to a temporary reversal of symptoms.  Other  conditions  which  demonstrate  common  asthma-type  symptoms,  such as emphysema, include irreversible airway obstruction.

✦  Provocation  test

The patient inhales a broncho-constricting agent, such as histamine  or methacholine. The airways of people  with asthma  are  far more  responsive  to  inhalation  of these substances; agents like these will provoke more extensive narrowing of air passages in people with asthma.

✦  Skin tests to determine allergies

A number  of common  allergens are selected, such as dust mites, pollen or animal dander.  One at a time, the allergens  are  placed  on  the  forearm,  and  the  skin  is then gently pierced to allow the substances  to penetrate.  After fifteen   minutes,   the  skin  surrounding  this  spot  may develop a small rash. While this test is not always conclusive, the presence of a rash and the size of the weal indicate an allergy to a specific substance.

✦   Chest x-ray

X-ray is used  to rule out other  respiratory  diseases  in a person who has the symptoms of severe chronic asthma. X-ray charts show irreversible damage to the airways, and this aids the diagnoses of other respiratory disorders.