by Jean Erasmus

Created on: April 16, 2008

Asthma is a common, multi-factorial respiratory condition that is associated with episodes of coughing and various degrees of breathing difficulty. It affects about 1 in 4 urban children, and can lead to death in serious cases.

Asthma is characterized by chronic 'background' inflammation of the upper to mid airways (bronchi), resulting in congested, mucous filled airways with episodes of acute flare-up, causing severe coughing and airway restriction (wheezing). This inflammation [inflammation: response by cells to 'non-self' elements such as chemical compounds, micro-organisms and radiation] is caused by two main factors:

* GENETIC PREVALENCE

Some people are born with a genetic predisposition where their immune system will 'over react' to external factors, causing the inflammatory response in the upper and mid airways associated with asthma. Thus, it could be said that asthma 'runs in families', and is an important question by a medical practitioner when first examining a patient.

* EXTERNAL FACTORS (most common)

There are various external factors that could cause asthma, but the following are the most common found:

Chemicals such as sulfuric, nitrous and volatile organic airborne and ingested chemicals.
Pollutants, most notably Tobacco smoke & micro fibers of synthetic carpets in the average home. Allergens like pollen, dust mite excrement and dry airborne animal saliva.
Micro-organisms such as various respiratory viruses, fungal spores & bacteria are also causes.

As mentioned earlier, these external as well as internal factors cause the 'background' inflammation, which then could be changed into an acute 'attack' where the threshold between chronic life sustaining, and life threatening will be crossed. This could be due to a higher intake of the above-mentioned factors, or triggered by mainly exercise, laughter or cold air. It is also usually present in the early hours of the morning due to a drop in bodily steroid production.

CLASSIC SYMPTOMS & SIGNS

Asthma is usually a chronic condition with episodic acute episodes. These two factors have different presentations. In the chronic phase, common symptoms are dry to 'wet' coughing; breathlessness & failure to thrive in children. Signs often only include a 'pigeon chest' in young children as well as delayed milestones. In young adults, there could be prolonged expiration times and occasional wheezes with auscultation. Mostly, asthma is first diagnosed after an acute episode, with symptoms including severe coughing, difficulty

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