Asthma, COPD, Cough
Asthma is a chronic disease characterized by airway inflammation and increased responsiveness of the tracheobronchial tree to diverse stimuli that result in varying degrees of airway obstruction. Recurrent attack of wheezing, coughing, chest tightness, and dyspnoea (shortness of breath) are the symptoms.
Severity ranges from intermittent and mild complaints to continuous and disabling respiratory symptoms, despite intensive therapy.Bronchial asthma is usually intrinsic (no cause can be demonstrated), but is occasionally caused by specific allergies (such as allergies to mould, dust, pollen). Symptoms can occur spontaneously, or be triggered by respiratory infections, exercise, cold air, tobacco smoke or other pollutants. Pathological features of this inflammatory, allergic reaction within the bronchial wall include the presence of spasm, exudation (mucus production) and oedema.
Patients with bronchial asthma suffer attacks of wheezing and difficulty in breathing, due to bronchial spasm and sticky secretions. The cause of the disease is complex, and in most patients several factors contribute to development.
When asthma starts in childhood or adolescence there is more likely to be a family history of an allergic disorder, such as hay fever, asthma or urticaria. Migraine in a parent is common.
The bronchi are supplied by the vagus nerve, and various stimuli may induce attacks by reflex mechanism. Common examples are sudden exposure to cold air, laughing, severe exertion, and heavy meals.
It plays some part in every asthmatic and quite often they appear to be mainly responsible. Anxieties of various kinds, a sense of frustration or discord, tension in the home are often the causes of maintaining it. Treatment is not likely to be satisfactory unless these influences are also taken care during medication.
There are a large number of substances to which the asthmatic may become allergic. They may be inhaled from the atmosphere or absorbed from the gut. Common examples are pollen and spores from plants, moulds, animal hair, face powder, and dandruff. Food-stuffs are less often to blame, but eggs, milk, curd, fish, certain fruits i.e. banana, and chocolate may induce attacks. As far as possible these items should be avoided during medication.
When asthma starts later in the life it often appears to be complicated by chronic bronchitis. Respiratory tract infections, however, often precipitate asthma in asthmatic patients in whom allergy is also much in evidence.
Smoking adversely affects both mind and body. In fact every organ in the body is affected by smoking in one or the other from. Initial adverse symptoms include headache, disturbed appetite affecting weight, drowsiness or sleeping disturbances. Over a period, symptoms such as anxiety, tension, restlessness, frustration, impatience, difficulty in concentration, irritability and depression are felt. As per reports, approximately half of all cancers in men in India are tobacco related, while over 60% of those suffering from heart disease below the age of 40 years are smokers. India has one of the highest rates of oral cancer in the world, with 90% of the patients being tobacco chewers. Cigarettes contain cancer causing toxic agents such as tar, etc. The combination of an addictive substance (nicotine) with mutagens has made tobacco the foremost human poison.
A cough is a sudden noisy expulsion of air from the lungs as part of defense mechanism to remove unwanted materials. It may occur as result of reflex action caused by irritation of any part of respiratory mucous membranes. The cough may be dry.
A dry cough occurs when the mucous membranes of throat, larynx, or bronchi are affected by viral respiratory infections or irritation by tobacco smoke or pollution. In cases of bacterial complications, chronic diseases of the respiratory tract of after prolonged immobilization, the cough may develop a productive character. The sputum is of different quantity, consistency, odour and colour. In some patients, a cough may be entirely of nervous origin. The spasmodic cough is a typical symptom of croup, whooping cough and allergic asthma.
The lungs are exposed to approximately 7000 liters of air per day with all its suspended particulate and microbial contents. Most of the large particles are removed by nasal filters, mucociliary mechanisms and antimicrobial action of the lung fluids (macrophages). In spite of this, a cough is a very common symptom associated with respiratory infections
Lungs are directly exposed to the environment through the inhaled air. The air passage and respiratory bronchioles are lined by membranes, which enable the inhaled air to become warm and moist. Under normal conditions, the infective organisms or allergens get moved up by the sweeping action of cilia to remove the particulate matter before it reaches the lungs. The local defence consists of secretory IgA, microphages etc.. Diseased state occurs when the defence mechanisms are deficient.
Cough reflex is stimulated by irritation, and removes foreign matter with secretions. In the early stages, cough is dry and unproductive. With the development of inflammatory exudates. It becomes productive. In whooping cough the exudates is tenacious and the child gives a series of quick, repeated cough. It needs specific medical treatment.
Common cold, flu if not taken care of develops complications of acute bronchitis. Cold, damp and foggy climate helps the development of the disease. Wheezing, difficulty in breathing, mucoid sputum associated with fever and general malaise are common symptoms of the suffering children. If it is repeated season after season, it may be termed as chronic bronchitis. However, allergic asthma is different and many children suffer because of this. Wheezing is present but there may not be fever. Whooping cough has definite etiology, the bacteria called Bordetella perussies. The latter may require special treatment.
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