| Breathe easy
Asthma is on the increase in adults and children, and we still don't know why. Meanwhile, researchers are battling to find better treatments. Janet Wright and Dr Chris Brown investigate Thirty years ago asthma was a rare and frightening condition. Today some 5.1 million people have been diagnosed as suffering from the condition: that's one in 13 adults and one in eight children. Yet this chronic disorder - in which inflammation of the airways, often triggered by an allergic reaction, leads to coughing, breathlessness and a characteristic wheeze - can still be life-threatening. 'It has increased a lot in the past three decades, especially among children,' says Caroline Moye of the UK's National Asthma Campaign. 'But people don't always realise that it can also strike adults, even in their 40s or 50s, who have never had an asthma attack before.'
The cost of comfort? Other researchers blame fitted carpets and central heating for nourishing huge populations of chest-irritating dust mites. Certainly asthma has increased most sharply in the comfortable homes of Western Europe and North America. 'We don't know what causes asthma,' admits Ms Moye, whose organisation puts £2 million a year into trying to find out why people get asthma, and stop it happening. 'Some people inherit it, we know. And there's research going on into lifestyle, environment and diet. Studies are coming out all the time stating that "genes are very important" or "diet is very important."' One of the latest developments is the identification of a gene linked to asthma which may lead to it being detected in babies. The hope is that a new generation of drugs would aim to strengthen weak airways , as opposed to conventional drugs which treat the symptoms of wheezing and breathlessness.
Asthma and children Wheezing isn't necessarily a sign of asthma: it can also be caused by conditions such as heart failure, and it affects some people as a dangerous side effect of certain drugs including cold remedies, painkillers and blood-pressure medicine. Conversely, some asthmatics never wheeze: their main symptom may be breathlessness or a persistent cough. Many children fall into that category, warns asthma nurse-specialist Sue Mercer: 'one symptom is a tightness in the chest, but children describe things differently and may complain of a tummy ache, for example.' Be aware if your child doesn't want to play, or asks to be carried more than usual, which could be a clue that they feel breathless when they're active.
Family history If the diagnosis is asthma, you should be put on a 'step' programme to find what level of treatment you need, with regular reviews. To start with, you'll probably be given a blue inhaler (salbutamol or terbutaline) to relieve symptoms when you have an attack, and if necessary a brown 'preventer' inhaler containing a low dose of steroids. Further levels include stronger inhalers and steroid tablets. Both the ordinary inhalers are safe to use during pregnancy. But you should consult your doctor if you're using a long-acting 'reliever' inhaler (salmeterol or eformoterol). The medication you're prescribed should start to help within four weeks. If not, it could be because you're taking the wrong drugs, or too low a dosage - or it could mean you don't have asthma after all. If this happens, ask for further tests or a referral to a specialist.
Alternative treatments There's further hope in sight, too. Researchers at the University of Southampton are working on a vaccine using a bacterium called Mycobacterium vaccae, and it's hoped that this could get the immune system working properly again. Meanwhile Sue Mercer says, 'A lot of people live with a degree of coughing or wheezing because they think they have to - but they don't. For the vast majority of people, the right level of treatment should keep them symptom-free.' Further help can be found at:
|