Asthma is clearly a major health problem. Let’s see what causes asthma attacks.
The Physiology, Causes and Effects of Asthma
Asthma episodes typically begin when the immune system is activated to react in an allergic manner, producing antibodies that cause the bronchial tubes and other affected body tissues to release a chemical called histamine. This chemical causes irritation to those tissues. In an asthma attack, these events cause the bronchial tubes to become obstructed as their smooth muscles become inflamed, develop spasms, and produce mucus. These events last, perhaps, an hour or two and can lead to tissue damage, thereby increasing the likelihood of more frequent and severe future attacks. For some asthmatics airway inflammation becomes constant.
What Causes Asthma Attacks to Happen?
We do not have a full answer to this question, but we do know that attacks usually occur in the presence of certain conditions, called triggers. Asthma triggers can include personal factors, such as having a respiratory infection or feelings of anger or anxiety; environmental conditions, such as air pollution, pollen, or cold temperature; and physical activities, such as strenuous exercise. The triggers that lead to attacks are different for different asthmatics, and some individuals have attacks only when two or more triggers occur at the same time. The main triggers for many asthmatics are allergens substances, such as pollens or molds, that are known to cause allergic reactions. But other asthmatics do not have any known allergies, and other factors, such as physical exercise or cold air, are the main triggers for them. Tests for allergic reactions usually involve injecting a small amount of the allergen under the skin and checking to see if the skin in that area becomes inflamed.
Medical Regimens for Asthma
Medical approaches provide the cornerstone of treatment for asthma. Asthma regimens consist of three components, the first being to avoid known triggers of attacks. The second component involves medication. To treat an acute attack, patients mainly use bronchodilators, which open up constricted airways. To prevent attacks patients can use anti-inflammatories, such as inhaled or oral corticosteroids and cromolyn, which reduce bronchial inflammation or block the release of histamine and other chemicals that cause inflammation.
The third component of asthma regimens involves exercise. In the past, physicians advised many asthmatics to avoid exercise because it could induce an attack. But it now appears that the less these people exercise, the worse their conditions get. Many physicians today recommend treatment regimens that carefully combine fitness training and the use of medication.
Asthma’s potential for producing disability and, sometimes, death makes it important that patients adhere to their regimens. Although adhering to asthma regimens reduces attacks and incidents of wheezing, many asthmatics fail to take medication to prevent attacks and use medication during an attack incorrectly.
Psychosocial Factors in Asthma
Many people with asthma report that the triggers of their attacks often involve their emotional states, such as being worried, angry, or excited. Experimental research has shown that emotional arousal; such as when watching an exciting movie, can trigger attacks in some children. Studies have also found that suggestion can induce symptoms in some asthmatics.
In one study, researchers had asthmatics inhale several doses or a placebo solution, with each succeeding dose labeled as containing an increasingly strong level of an allergen. Nearly half of the subjects developed symptoms, either as full asthmatic attacks or as spasms of the bronchial muscles. Another study confirmed the effect of suggestion, but also showed that the asthmatic reaction could be negated if the subjects were first given another placebo that was described as a new asthma drug. In other words, the first suggestion blocked the second one.
For example, studies have shown that false feedback indicating that the airways are becoming obstructed increases breathlessness in people with asthma.
Although there is little question that psychosocial factors can influence asthma attacks, we do not know how these factors work and which asthmatics are more affected by them. It is possible that psychosocial factors make asthmatics more sensitive to allergens or other conditions that trigger their attacks.
Asthma attacks are frightening for the patient and family alike; and frequent episodes are costly to the family and disrupt these people’s lives and functioning. Living with this disorder adds to the stress that asthmatics and their families’ experience, and studies have found that asthma is sometimes related to maladjustment in patients and their families.