ASTHMA



Asthma is a chronic disease of the respiratory tract characterized by shortness of breath due to inflammation and narrowing of the airways. Asthma can be suffered by all age groups, both young and old.

Asthma sufferers have more sensitive respiratory tract than normal people. When the lungs are exposed to asthma triggers, the muscles in the airways stiffen, making the airways narrow. In addition, phlegm production also increases. The combination of these conditions makes sufferers experience asthma symptoms.

Based on the report of the Indonesian Ministry of Health in 2018, it is estimated that 2.4 percent of the entire Indonesian population suffers from asthma. Meanwhile, according to WHO data in 2019, asthma sufferers worldwide reached 262 million people, with the death rate from asthma reaching 461,000 people.

Asthma occurs when the muscles in the airways narrow and tighten. This condition makes the respiratory tract experience swelling or inflammation and produces excessively thick mucus or phlegm. As a result, people with asthma will find it difficult to breathe.

The cause of asthma is still not known with certainty. However, there are allegations that this condition is related to genetic and environmental factors. The asthma triggers themselves can vary for each sufferer, including:

Respiratory tract infections, such as the flu
Allergens (substances that trigger allergies), such as animal dander, mites, dust, and pollen Exposure to chemical fumes, cigarette smoke and air pollution Weather conditions, such as storms, cold or hot air, humid or windy weather, and drastic changes in temperature Room conditions that are damp, moldy, or dusty stress Excessive emotions, such as protracted sadness, uncontrollable anger, or laughing out loud Physical activity or exercise that is too strenuousMedications, such as non-steroidal anti-inflammatory pain relievers (such as aspirin or ibuprofen) and beta-blockers Food or drink containing additives, for example jam, shrimp, processed food, ready-to-eat food, packaged fruit juice, beer and wine,Food allergies, for example to shrimp or nuts Acid reflux disease (GERD) There are several factors that can increase a person's risk of developing asthma, namely:

Gender is male in children, and female in adolescents or adults Family history of asthma or atopic allergies, such as food allergies, allergic rhinitis, or eczema Overweight or obesity History of bronchiolitis or lung infection in childhood Born with a weight below normal Premature birth, especially if a ventilator is needed Smoking habits, including in pregnant women Exposure to secondhand smoke as a child Jobs that are at risk of exposure to chemicals, such as farmers, hairdressers, or factory workers Asthma can be characterized by various symptoms. These symptoms can last continuously, come and go, or only occur at certain times, for example when you are exercising. The severity of the symptoms also varies, from mild to severe.
 
The main symptom of asthma is difficulty breathing, which can include:

It's hard to breathe Cough The chest feels tight, painful, and feels like pressure
Wheezing or wheezing The above complaints can resemble the symptoms of other diseases. However, these complaints can be suspected of being caused by asthma if they have the following characteristics:

Worse in the morning or at night Disappear on the same day Arises or gets worse when the patient is infected with a virus, such as a cold Triggered by exercise, allergies, cold air, or excessive breathing when laughing or crying Besides that, there is also the term asthma attack, which is marked by a worsening of symptoms. Asthma attacks can occur suddenly or over several days. This condition is characterized by more serious symptoms, such as :

Symptoms of coughing, wheezing, and tightness in the chest that are getting more frequent and worse Trouble speaking, eating, or sleeping due to difficulty breathingLips and fingers that look blue Need to use the inhaler more often Heart rate increases Dizzy, tired, or sleepy Faint Immediately see a doctor if you or your family experience symptoms of an asthma attack, especially if accompanied by the following conditions:

Cannot be relieved by using an inhaler  Very fast breathing Shortness of breath and wheezing that gets worse very quickly
Cough that's hard to stop or wheezing that's loud enough to breathe Shortness of breath when doing light activities Anxiety and panic The color of the fingers, lips and gums becomes bluish or pale Chest pain or pressure
It's hard to talk Pale face and cold sweat
A severe asthma attack can be life-threatening. Immediately seek medical help to the emergency room to get further treatment.

Asthma treatment aims to relieve symptoms and prevent asthma attacks from occurring.The doctor will adjust the treatment method to the cause of asthma, as well as the patient's age, severity of the condition, and response to treatment.

Asthma treatment can be done in the short term or long term. The following is an explanation of each method and its treatment:

Short Term Treatment Short-term treatment methods aim to quickly relieve asthma attacks while they are occurring and prevent symptoms from recurring. There are three types of drugs that can be used in this method, namely:

1. Short-acting beta2-agonist inhalers

Inhalers can be used for quick relief of symptoms during an asthma attack. This medicine can open narrowed airways so that air can get back in. Although inhalers can easily relieve asthma symptoms, they should only be used as directed by a doctor. This is because its use should not be too frequent and needs to be recorded every week. In addition, sufferers should understand very well how to use this asthma drug properly, so that the results are maximized.

2. Oral or infusion corticosteroids
The doctor will prescribe corticosteroids to relieve inflammation in the respiratory tract.

3. Anticholinergic drugs
Anticholinergic drugs, such as ipratropium and tiotropoium, are used to relax the airways so that the patient can breathe more easily.

Long Term Treatment

Long-term treatment aims to relieve symptoms by reducing inflammation and preventing narrowing of the airways. This method is done by taking drugs regularly, such as:

Corticosteroids in inhaled or pill form, to reduce the body's response to inflammation Injectable biologic drugs, such as omalizumab, mepolizumab, reslizumab, and benralizumab, which function to relieve the body's response to allergens in people with severe asthma The antihistamine drug ketotifen, as an adjunctive therapy to reduce the frequency, duration, and severity of asthma.

Leukotriene-modifying drugs, such as montelukast, zafirlukast, and zileuton, to reduce inflammation and keep the airways open Mast cell stabilizers, such as cromolyn, to prevent inflammation of the airways when exposed to allergens or other causes of asthma by preventing immune cells from producing inflammation-promoting signals Immunotherapy, in the form of inhalation, tablets, or syrup, to reduce the body's response to allergens that cause asthma Long-acting beta agonist bronchodilator inhalers, such as salmeterol and procaterol, to prevent narrowing of the airways Asthma attack is a life-threatening emergency. In these conditions, the doctor will give medicines via a nebulizer or infusion. If needed, doctors can also provide oxygen therapy or breathing aids, such as ventilators or oxygen cylinders.

Bronchial Thermoplasty

thermoplasty is surgery to treat severe asthma and cannot be treated with other methods of treatment. Even so, not all people with asthma are suitable for this procedure.

This procedure is performed by inserting a thin, flexible tube into the lung, to warm up the muscles around the airways. The goal is to damage these muscles so that the narrowing of the airways and asthma attacks can be reduced.
Asthma is difficult to prevent,because the cause cannot be known with certainty. Even so, there are several efforts that can be done to avoid asthma attacks, namely:

Undergoing asthma treatment that has been prescribed by a doctor, including by taking medicines for asthma regularly and according to the doctor's instructions Get regular flu and pneumonia vaccinations Know the triggers for the appearance of asthma symptoms and avoid them Watch for asthma symptoms, such as coughing, wheezing, or shortness of breath Treat asthma symptoms as early as possible by taking medications or stopping activities that can trigger attackConsultation and examination with a doctor if treatment is not able to relieve symptoms Live a healthy lifestyle by consuming a balanced nutritious diet, exercising regularly at light intensity, and not smoking Lose weight if you are obese Manage stress well.