Asthma: a breathtaking disease

What is asthma?

Asthma is a chronic, recurrent disease that affects over four million people (children and adults) in France. It refers to a chronic inflammation of the bronchial tubes and generally manifests itself as sporadic attacks separated by periods of normal breathing. For some people, it can cause ongoing respiratory difficulties. It results in difficulty breathing, getting out of breath, wheezing or a feeling of constriction in the chest.

Asthma can be a serious disease when it is not correctly identified or treated. It represents a significant cost for society, since it is responsible for 600,000 days of hospitalisation, seven million days off work and almost 2,000 deaths a year. Moreover, it has a considerable negative impact on patients’ quality of life, resulting in insomnia, a reduction in activity and absence from school or work.

Causes

The exact causes are not well known but it would appear that asthma results from a combination of two sorts of factors:

  • Predisposing, congenital factors, which form the “backdrop”,
  • and immunoallergic, psychological or environmental factors that prompt the disease to appear.

Asthma is associated with respiratory allergies in around 80% of cases. Allergies are an increasing problem, with the WHO estimating that half the population will be allergic by 2050.

People with asthma have an excessive sensitivity (bronchial hyperresponsiveness) to one or more substances. Some kinds of asthma are triggered occasionally in very specific conditions, such as workplaces, contact with animals or walking in the countryside when the pollen count is high. This is known as intermittent asthma. In other cases, asthma is present all year round. It is then described as persistent, and may be more or less severe. Asthma often has multiple causes.

Predisposing factors for the disease include: family history or genetic predisposition, allergic rhinitis during childhood and allergic conjunctivitis, but also prematurity and frequent bouts of bronchiolitis during childhood.

An assessment based on questioning the patient and a clinical examination is carried out to evaluate the severity of the condition and identify its causes. Respiratory and skin tests are conducted to see if the asthma is linked to allergies.

bronchial tube during asthma attack

The asthma attack

The asthma attack (or episode of acute dyspnoea) manifests itself in a difficulty breathing, combined with coughing and wheezing. Numerous allergens can prompt an asthma attack, including dust mites, pet hair (cat, dog, rabbit, hamster, etc.), pollen, mould, atmospheric pollution (such as car fumes and tobacco) and even some foods. When these substances get into the respiratory system, they attack the cells that line the inside of the bronchial tubes:

  • the muscles around the tubes then contract, which reduces the size of the airway;
  • the tissue lining the inside of the bronchial tubes, called the “bronchial mucosa”, is irritated;
  • this then produces secretions called “mucus”, which further reduce the size of the airway.

Attacks can occur a few hours, a few days or even several months apart. Breathing between attacks is generally normal.

Treatments

Asthma cannot be cured: it persists throughout someone’s life but there are effective treatments available that allow people with asthma to live perfectly normally.

There are two kinds of medication:

  • Acute or emergency medications provide immediate relief, but do not deal with the inflammation of the bronchial tubes. Fast-acting bronchodilators have the effect of relieving occasional or immediate symptoms.
  • Control or underlying treatment, taken daily: anti-inflammatory medicines that help to reduce inflammation in the bronchial tubes and reduce the frequency of attacks. Corticosteroids reduce inflammation in the airways and therefore the production of mucus. Long-term bronchodilators are prescribed as a supplementary treatment when inhaled corticosteroids are not sufficient to control asthma symptoms on their own.

Nonetheless, although treatments are effective, six asthma patients in 10 are unsuccessful in controlling their symptoms. The main causes are poor understanding of the disease, fear of side effects and forgetting to take their medication. It is true that it can sometimes be difficult to follow a treatment when you do not have the impression of being ill and there are no real symptoms outside of an attack. Following your treatment correctly, however, is essential for feeling well on a daily basis and avoiding attacks. Pilbox offers a wide range of pill dispensers adapted to patients’ needs and treatments to help them take their medicines regularly and make their daily lives easier.

Using a spray is not always easy or effective. You have to be able to coordinate releasing the spray with your breathing. Using sprays may seem straightforward but many patients, both adults and children, do not use inhalers correctly. Using a spacer is highly recommended for taking medicines in an aerosol form, particularly among children. These help to administer the prescribed doses correctly in order to deliver the treatment directly to the bronchial tubes where it needs to act. Stiplastics offers the VisionAIR Plus, a compact, antistatic device with a second valve to check that the dose has been correctly inhaled.

VisionAIR Plus

VisionAIR Plus - Stiplastics' spacer device

Therapeutic education

Numerous health specialists agree that the best therapy is to involve individuals actively in their treatment.

Health professionals (doctors, nurses, pharmacists and physiotherapists) offer educational activities aimed at asthma patients and their families to help them understand and manage asthma on a daily basis, and know how to react to difficult situations.

Sources: inserm.fr, passeportsante.net, sciencesetavenir.fr, asthme-allergies.org