ASTHMA FAQs 3

Can you achieve asthma homeostasis?

Homeostasis is the ability or capacity of the body to steadily maintain the balance of internal variables, such as carbon dioxide levels within the body. Asthma can impair the gas exchange in the lungs which causes an imbalance in carbon dioxide levels in our blood. Homeostasis can be achieved or maintained by asthma patients, however, this may require the use of a rescue inhaler. Rescue inhalers assist in reverting back to the normal breathing rhythm. Thus, maintaining normal levels of carbon dioxide and achieving homeostasis.¹

How to find out if you have asthma, COPD, or asthma-COPD overlap syndrome?

Asthma and Chronic Obstructive Pulmonary Lung Disease (COPD) are medical conditions that exhibit similar symptoms, these symptoms include:

• Breathlessness
• Wheezing (a whistling sound when breathing)
• A tight chest
• Coughing

COPD patients can experience frequent chest infections and a persistent chesty cough with phlegm that does not go away. Less common symptoms of COPD include weight loss, tiredness, coughing up blood, swollen ankles from fluid build-up (oedema) and chest pain. 

It is recommended that you consult a doctor if you are experiencing  any of the symptoms mentioned above so that you are properly diagnosed. The following diagnostic tests are carried out to find out if patients are asthmatic:

• FeNO test – you breathe into a machine that measures nitric oxide levels in your breath, this will allow the doctor to assess any indication of inflammation in your lungs
• Spirometry – you exhale or blow into a machine that measures how much you can inhale, exhale and how fast you exhale.
• Peak flow test – similar to a spirometer, you will need to blow into a handheld device that measures how fast you can breathe out

To help diagnose COPD, a doctor will require information about your symptoms, smoking history and any family history of lung problems. It is also likely that your chest will be examined using a stethoscope and your body mass index (BMI) will be calculated by measuring your height and weight. As the symptoms of asthma and COPD can be similar, comorbidities associated with the diseases will also be assessed to determine whether it is COPD or asthma.

Diagnostic tests for COPD: 

• Spirometry 
• Chest X-ray
• Blood tests

Sometimes more tests, such as Electrocardiogram (ECG) and CT scans may be needed to confirm the diagnosis or determine the severity of your COPD. This will help you and your doctor plan your treatment.

Diagnosing asthma-COPD overlap syndrome (ACOS) can be very difficult due to the nature of these two diseases. Doctors are still trying to understand ACOS and currently define the disease as a “Persistent airflow obstruction with features of asthma”.

According to a paper by Rogliani et al (2016), bronchodilator responsiveness and the degree of emphysema can be used to define ACOS in patients.

Doctors will gather a detailed medical history, perform physical examinations and may request a chest X-ray or CT scan to help them determine if its asthma, COPD or ACOS.^2-5

Could acid reflux be triggering your asthma?

Asthma and gastroesophageal diseases (GERD) are two conditions that interplay with one another. Acid reflux, also known as gastroesophageal reflux is shown to increase inflammatory responses in the airways of the lungs.  This, in turn, can trigger asthmatic symptoms. Similarly, asthma and asthma medication can be responsible for triggering an acid-reflux reaction.⁶

How can you prevent an asthma attack?

The NHS recommends carrying out the following steps that can be useful in preventing the occurrence of an asthma attack:

• Following  your personal asthma action plan and taking your medication as prescribed
• Having  regular asthma reviews with a GP or asthma nurse – at least once a year
• Checking with a GP or asthma nurse that you're using your inhaler correctly
• Avoiding the triggers that cause your symptoms whenever possible

You should not ignore your symptoms if they're getting worse and you will need to use your reliever inhaler more often than usual (up to a maximum of 4 times in 24 hours). ^7,8

What are the best exercises to do if you have asthma?

Asthma UK recommends regular exercise and physical activity for people with asthma, as this boosts immunity and lung power. They also mention safety measures, such as taking a preventer inhaler, informing people (you exercise with) about your asthma and what they should do if you were to have an asthma attack.

Different types of exercise are recommended depending on the severity of your asthma. It is always best to consult your doctor regarding this to see what suits you.

In the book Exercise for Human Health, the author recommends people with asthma to take up walking and swimming. The book also suggests that excessive exercise should be avoided.^9,10