Dr Andrew Ives, Pediatric Pulmonology Consultant at Danat Al Emarat Hospital, sheds more light on this long-term condition
PARTNER CONTENT: Asthma is a chronic, long-term condition that causes inflammation. Common symptoms include coughing, shortness of breath and chest tightness, according to Dr Andrew Ives, Pediatric Pulmonology Consultant at Danat Al Emarat Hospital, with wheezing being the cardinal symptom of this chronic lung disease.
The causes of asthma, however, are complex. “Like most medical conditions, the causes are from a contribution of varying degrees from genetics and environment,” Dr Ives says. “We still don’t understand completely why some people get asthma while others don’t.
“But one of the commonly quoted statistics is that if both your parents have asthma, you’ve probably got about a 50 per cent chance of having asthma yourself. If one parent has asthma, you’ve probably got about a 25 per cent chance of being asthmatic. Although there’s a strong genetic basis to that, it is not absolute.”
Dr Ives goes on to explain how environmental influences can have an effect on breathing. “There are also clues and hints about other causes of asthma, which may well be influenced by some early life events, including into a mother’s pregnancy,” he says.
“Early exposure to tobacco smoke, pollution, and early life infection may have some influence on the development of asthma down the line. Other big triggers for asthmatics also include exercise, stress and strong emotions. “Allergies are a common trigger; pollution and environmental irritants, for example.”
Dr Ives looks after children with all lung diseases. From conditions like asthma, right through to rare lung disease. “Asthma is one of the common conditions that we look after as respiratory specialists at Danat Al Emarat Hospital.
“Asthma can be anything from a mild form of the condition through to extremely complex, difficult to control, much more problematic asthma, which needs much more expertise and input.”
Allergies are very common in asthmatics, with eczema and hay fever going hand-in-hand with asthma. “Allergic asthma, while extremely common in childhood, is not quite so common in adulthood,” Dr Ives says. “Most asthmatic patients I see will have some kind of allergy to something that may be just eczema, but pet allergies are quite common.”
To that end, when patients who have difficult or problematic asthma are seen by the doctor, they are tested for all manner of allergies.
Growing out of Asthma
While Dr Ives admits you can grow out of asthma, he points out that despite all the statistics available on the same, it is down to each individual case.
“A lot of young children wheeze and cough, which is extremely common, especially with viral infections. A good proportion of those children, however, will not go on to have asthma. Therefore, it’s very, very hard to predict who’s going to get asthma.”
Based on such, there are clues to help determine if a child is asthmatic.
“Does one or both parents have asthma? Most diagnosis of asthma is just based on a good history, as in what a parent tells me about their child, not actually much on examination,” he says.
Dr Ives goes on to explain an important point. “There is no diagnostic test to say for certainty whether someone has asthma or not. It is more based on the patient’s history mostly. A lot of that comes down to the experience of the doctor you are seeing. Are they asking the right questions? Are they getting the right information for the questions?”
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As already mentioned, children with infections often have asthma-like symptoms, such as wheezing, shortness of breath and chest tightness.
“What I am interested in just as much,” says Dr Ives, “is does the child have respiratory symptoms in between, or what I call interval symptoms? Also during other times, for example, such as at night or during exercise when the child is well, including any significant family history of asthma, allergies, or other kinds of similar problems.”
In terms of asthma treatment, Dr Ives shares how the last 10 years have seen “a sort of revolution in asthma with new treatments becoming available.
“But the treatment for most people continues to be controllers and relievers, in the form of inhalers. Relievers are taken when a person with asthma is feeling wheezy, and then the controller group of medicines hopefully keep the disease under good enough control,” he says, adding that controllers are extremely important in ensuring that asthmatics can continue to live life to the fullest.
“If you think about it, we know that very many top-class sports people have asthma. The key is not to not do sports, but to control your asthma well, and with good control of your asthma, you absolutely should be able to play sports.”
Dr Ives points out that the most important medicine is inhaled steroids. “Without question it is important to get the right diagnosis, and then to make sure you are on the right treatment, and not just that but also taking that treatment the right way.”
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