What is asthma, and how is it diagnosed?
Asthma is a chronic inflammatory disease of the bronchi characterized by bronchial hyperreactivity—the bronchi overreact to stimuli that do not affect healthy individuals. This hyperreactivity leads to recurrent episodes of bronchospasm, shortness of breath, dry cough, and wheezing. Asthma affects 4 million people in France—6% of adults and 10% of children. Natural products for respiratory comfort are available in the Respiratory Care line.
- Spirometry—a key test: measures FEV₁ (Forced Expiratory Volume in One Second) and FVC (Forced Vital Capacity)—an FEV₁/FVC < 0.70 indicates obstruction—reversibility (an improvement in FEV1 of ≥ 12% after a bronchodilator) is the diagnostic criterion for asthma—symptom variability (better in the morning, worse at night) is also characteristic
- Allergic vs. non-allergic asthma: allergic (extrinsic—IgE-mediated—triggers: dust mites, pollen, animal dander, mold — often associated with allergic rhinitis and eczema — onset in childhood) — non-allergic (intrinsic — non-allergenic triggers: respiratory infections, exercise, cold, stress, NSAIDs/aspirin, reflux) — mixed (both types coexist)
- Climate change and asthma: global warming is lengthening pollen seasons (starting earlier and lasting longer), increases pollen concentrations, promotes mold growth, and exacerbates air pollution—studies predict a 40–50% increase in the prevalence of allergic asthma by 2050 — monitoring pollen indices (RNSA) and air quality indices (Atmo France) is becoming essential
- Asthma and sleep: symptoms often worsen at night—decreased endogenous cortisol (a natural anti-inflammatory), increased parasympathetic tone (bronchoconstriction), exposure to dust mites in bedding, gastroesophageal reflux when lying down—use dust-mite-proof covers on mattresses and pillows, sleep with your head elevated, and use inhaled corticosteroids in the evening
Asthma Treatments and Attack Management
Asthma management is based on a tiered classification system (GINA—Global Initiative for Asthma) according to the level of control achieved. The goal is full control: no daytime symptoms, no nighttime awakenings, no limitation of activities, and no need for rescue bronchodilators. Maintenance therapy is adjusted quarterly based on the level of control.
- Acute attack treatment: short-acting beta-2-agonist bronchodilators (salbutamol—relief in 5 to 15 minutes) — use > 2 times/week = poorly controlled asthma = review of maintenance therapy — oral corticosteroids (prednisolone) for severe exacerbations
- Stepwise maintenance therapy (GINA): Step 1 (SABA as needed only) → Step 2 (low-dose ICS) → Step 3 (moderate-dose ICS OR low-dose ICS + LABA) → Step 4 (high-dose ICS + LABA) → step 5 (anti-IgE, anti-IL-5, anti-IL-4/IL-13 biologics for severe, refractory asthma)
- Complementary natural remedies: vitamin C (antioxidant for the bronchial mucosa) — zinc (supports the immune system and mucosal integrity) — magnesium (bronchial muscle relaxant — deficiency is common in people with asthma) — turmeric and ginger (natural anti-inflammatories for the respiratory tract) — vitamin D (immunomodulator — deficiency associated with more severe asthma) — these supplements are never a substitute for medical treatment
- Environment and prevention of asthma attacks: treat associated allergic rhinitis (an untreated runny nose worsens asthma—shared airways) — dust-mite-proof covers + 60°C bedding + HEPA vacuuming — smoking cessation — HEPA air purifier — annual flu vaccination
Asthma in Children, Sports, and Quality of Life
Asthma in children has specific characteristics: spirometric diagnosis is difficult before age 5 to 6, viral forms are common (infant asthma—3 episodes of wheezing with fever before age 3), and the course of the disease is unpredictable (50% of childhood asthma cases improve by adolescence). Pediatric management systematically includes therapeutic education for the child and their parents, and the implementation of an Individualized Care Plan (ICP) at school.
- Pediatric inhalation chamber: essential for children under 6 years of age (who are unable to coordinate inhalation with the activation of the metered-dose inhaler)—face mask up to age 3, mouthpiece thereafter — clean weekly — nebulizers are reserved for severe attacks in a hospital setting
- Sports and asthma: Swimming is the best-tolerated sport (warm, humid air in the pool; continuous, low-impact exercise—less likely to cause bronchospasm than running in cold air) — gradual warm-up for 10 to 15 minutes — always carry a rescue bronchodilator — avoid running in cold, dry weather without a scarf — regular physical activity improves lung capacity and reduces bronchial hyperreactivity in the long term
- Asthma and Quality of Life: Uncontrolled asthma limits activities, disrupts sleep, and leads to absences from school and work—therapeutic education (recognizing signs of worsening symptoms, correct use of inhalers, written action plan) is as effective as medication in improving control—mobile apps for symptom monitoring facilitate self-management
- Bronchial congestion and associated secretions: managed through hydration, mucolytics if necessary, and respiratory physical therapy in severe cases
