Asthmatic triggers

Asthma is a chronic disease of the respiratory system in which the airway sometimes constricts and becomes inflamed. Also, the respiratory lining produces excessive amounts of thick mucus, often in response to one or more triggers. This mechanism is responsible for symptoms such as wheezing, shortness of breath, chest tightness, and coughing.

What triggers these asthma attacks?

Well, the answer to this question is not easy to give. Theoretically, there are many possible triggers, and yet every person reacts individually, so, there are simply no rules. Attacks may be triggered by such things as exposure to an environmental stimulant, cold air, warm air, moist air, exercise or exertion, or emotional stress. Fortunately, all these symptoms of asthma, which can range from mild to life-threatening, can usually be controlled with a combination of drugs and environmental changes. Of course, the most effective way of control is avoiding the triggers.

 

Asthma signs and symptoms

While in some individuals asthma is characterized by chronic respiratory impairment, in others it is an intermittent illness marked by episodic incidents. It is an extremely widely spread disease. Approximately 14 million adults and 6 million children in the U.S. have asthma. 

An acute exacerbation of asthma is medically known as asthma attack. These attacks can be mild, symptomatic, asymptomatic, or severe.

The clinical characteristics of a most common form of an attack are:

•         shortness of breath (dyspnea)
•         wheezing
•         stridor
•         cough

Signs of an asthmatic episode include:

•        wheezing
•        rapid breathing (tachypnea)
•        prolonged expiration
•        a rapid heart rate (tachycardia)
•        rhonchous lung sounds (audible through a stethoscope)
•        over-inflation of the chest

As we’ve said earlier, sometimes asthma attacks can be extremely serious. During these kinds of attacks the accessory muscles of respiration, especially sternocleidomastoid and scalene muscles of the neck may be cramped.

During very severe attacks, an asthma patient can:

•        turn blue from lack of oxygen
•        experience chest pain
•        experience even loss of consciousness
 
Asthmatic aura

A number of asthmatic claim to be able to predict when an attack will happen because they experience something they call the “asthmatic aura”. Just before loss of consciousness, sometimes a patient will feel numbness in the limbs, and palms may start to sweat. Feet may become icy cold. 

Triggers of asthma

What exactly triggers asthma? As previously mentioned, every person has their own triggers.

There are many possible asthma triggers and some of the most common are listed below:

•         Allergens
•         Irritants such as tobacco smoke, strong odors
•         Gastrointestinal reflux disease (GERD)
•         Emotional anxiety
•         Medications
•         Foods 
•         Weather changes
•         Viral or sinus infections
•         Exercise
 
Allergens: These are different types of substances that can be found all around us.

Some of the most common are: 

•         House dust mite
•         Pollens
•         Molds
•         Animal dander
•         Cockroach droppings
•         Food

If your asthma is triggered by allergens, simply avoiding them would be a much better plan then to use tons of medications to treat your symptoms.
 
Irritants: Asthmatic lungs aren’t as healthy as those of other people. This is why inflamed asthmatic airways are hyper-sensitive to environmental irritants.

Some of the most common environmental irritants are:

•         tobacco smoke, wood smoke, chemicals in the air and ozone
•         vapors, dust, gases or fumes
•         strong odors or sprays such as perfumes, household cleaners, hairspray, cooking fumes, paints or varnishes
•         coal dust, chalk dust or talcum powder

Also, in rare cases, even simple changing weather conditions, such as changes in temperature and humidity, barometric pressure or strong winds can cause severe asthma attacks. This is important because such irritants can hardly be avoided.
 
Infections: Some viral infections such as colds or viral pneumonia can trigger or aggravate asthma, especially in young children. Initially, experts were not sure about this claim, but after several studies done on this matter, it is now considered a proven fact.
 
Exercise: Sometimes strenuous physical exercise can also trigger attacks.

Some examples of activities which can trigger asthma are:

•         prolonged mouth breathing
•         diving for a long time
•         exercising in cold, dry air
•         medium- to long-distance running
 
Reflux disease: The gastro-esophageal reflux disease (GERD) is a condition in which stomach acid flows back up the esophagus. Via this act, asthma can also be activated. The most common symptoms of GERD are:

•         severe heartburn
•         belching
•         night asthma
•         increased asthma symptoms after meals or exercise
 
Medications and food: Certain types of medication can cause asthma attacks in some patients. Some of the most common asthma trigger medications include aspirin (or other NSAIDS such as ibuprofen®) and beta-blockers. Aslo, certain types of food or food additives can trigger asthma symptoms. Some of the most common asthma triggers are milk, eggs, peanuts, tree nuts, soy, wheat, fish, and shellfish. 
 
Emotional Anxiety: For a long time experts thought that asthma was in fact a psychological disorder, since it was known to happen to people under stress. Now, it has been proven not to be an emotional disorder, although emotions can trigger it. Anxiety and nervous stress probably cause fatigue, which may also increase asthma symptoms and aggravate an attack. 

Asthma management – medications

Asthma medications include those that prevent and control asthma symptoms, and those that reduce airway inflammation. We can divide these medications into two big groups- quick-relief and long-term control medications.

Quick-relief medications include:

•         Bronchodilators: These medications are also called the “rescue medications" because they are used during active asthma attacks. Their purpose is to open up the bronchial tubes so that more air can flow through. They come in several forms such as inhalation medications, tablets, liquids or injections.

•         Corticosteroids: Usually administered for short-term use orally or by injection to speed up the resolution of airway inflammation, corticosteroids have the same purpose as bronchodilators.
 

Long-term control medications

These medications should be taken daily to control the airway inflammation. Therefore, there is no point in using them during an asthma attack.

•         Inhaled corticosteroids are probably the most effective long-term therapy available for persistent asthma.
•         Cromolyn or Nedocromil stop the development of inflammation in the lungs, as well as help prevent it. Although they are not as effective as corticosteroids, they are generally considered much safer.
•         Leukotriene modifiers are also extremely effective medications which work to fight potent chemicals called leukotrienes. This, of course, reduces airway inflammation. 
•         Methylxanthines are drugs that provide mild to moderate dilation of the airways and may have a mild anti-inflammatory effect. The most commonly used is Theophylline.
•         Anti-IgE-medications are also useful. Omalizumab shows best results when used by patients with moderate to severe persistent allergic asthma. IgE is an antibody that we all have, responsible for causing allergic reactions in some people. Another drug from this class is Xolair, which is delivered by injection every two to four weeks. Like with any other medication, it can cause some side effects; risks include the possibility of a severe reaction within two hours of receiving the shot, blood-clotting problems, and a possible link to cancer.