All you need to know about adult-onset asthma

Asthma is a condition that affects the airways — the thin tubes that carry air in and out of the lungs. From time to time, the airways are constricted (narrowed) and this manifests as asthma, thereby setting off a series of alarms or symptoms. The extent of the narrowing, and how long each episode lasts, can vary greatly from person to person.

Many develop asthma in childhood. However, asthma symptoms can appear at any stage in life. It is possible to develop asthma at the age of 30 or 50 or even later.  Some individuals who have had allergies as children or young adults with no asthma symptoms could develop asthma as adults.

What is adult asthma?

Several factors may act as catalysts in causing the onset of adult asthma. Women are more likely to develop asthma after the age of 20.

At least 30 per cent of adult asthma cases are triggered by allergies. People allergic to cats may have an increased risk of developing adult-onset asthma. Exposure to cigarette smoke, mold, dust, feathered bedding, perfume or other substances commonly found in the environment can trigger the first symptoms of asthma. Prolonged exposure to certain workplace materials too can set off asthma symptoms in adults.

Hormonal fluctuations and changes in women play a role in bringing on adult-onset asthma. Some women may notice the symptoms for the first time during or after pregnancy. Similar effects can be noted in women going through menopause.

Different illnesses, viral infections can be a factor in adult-onset asthma. Many individuals develop asthma after an episode of bad cold or flu.

Adult-onset asthma is not caused by smoking. However, if you smoke or are exposed to cigarette smoke (passive smoking), it can provoke the sensitive airways.

What are the signs?

- Dry cough, especially at night or in response to specific “triggers”
- Tightness or pressure in the chest
- Difficulty breathing
- Wheezing — a whistling sound when exhaling
- Shortness of breath after exercise
- Colds that go to the chest or stay for 10 days or more

How does adult-onset asthma compare with childhood asthma?

Unlike children, who often experience intermittent asthma in response to allergy triggers or a respiratory infection, adults with newly-diagnosed asthma will typically show persistent symptoms. Daily medications may be required to keep asthma under control.

How is it diagnosed?

As the symptoms start to show at a later stage of life, patients tend to ignore the aforementioned symptoms as there are other diseases that can mimic asthma. Clinical assessment along with some special tests like the Peak Flow Meter and Spirometry are ways to diagnose asthma.

A Peak Flow Meter is a small device that you blow into. It measures the speed of air that you can blow out of your lungs. If you have untreated asthma, then you will  have low and variable peak flow readings. Similarly, the Spirometry test measures how much air you can blow out into a machine called a Spirometer.

What are the treatments available?

Patient education is key in managing asthma. It is one of the important aspects for effective management of asthma. For most adults, the symptoms can be prevented with treatment. It shouldn’t be an impediment if treated with the right medication. If your asthma symptoms are caused by allergens, take steps to control and avoid contact with them.

There are certain medications like Ibuprofen and Aspirin, etc., which can trigger asthma. Always consult a doctor before taking pain killers.

Most people with asthma are prescribed inhalers. Inhalers deliver a small dose of drug directly through the airways. The dose is enough to treat the pain or discomfort. There are two types of inhalers, Reliever inhalers help to ease symptoms immediately and are used only as per requirement. Preventer inhalers are used daily to prevent symptoms from developing.

Occasionally, some patients may require medicines (tablets), especially those suffering from recurrent, severe symptoms.

Effective control of asthma will need an effective management plan and regular consultation with an asthma specialist.

(The author is head of Medical Quality and Centre Head, NationWide Primary Healthcare Services.)