Asthma

Medical experts have warned that non-communicable diseases (NCDs) such as hypertension, diabetes, cancer, cardiovascular diseases are responsible for the majority of Coronavirus disease (COVID-19) deaths in the country.

President, NCD Alliance Nigeria, Olorogun Dr. Sonny F. Kuku, in his opening remarks during a webinar on, “Non-communicable Diseases and COVID-19 in Nigeria – The response”, held Tuesday, July 21, 2020, said: “… We are only seeing the tip of the iceberg and unfortunately, people with NCDs are at greater risk. It is impacting the poorest people and most vulnerable. People with hypertension, diabetes and heart disease are the most vulnerable. We are now seeing stroke as symptom. This means COVID-19, which is an infectious disease is manifesting as an NCD in the form of stroke…”

Vice President, Scientific Affairs, NCDs Alliance Nigeria, Dr. Kingsley Akinroye, has said blamed the situation on the nation’s years of lack of commitment to the course of NCDs. The cardiologist said NCDs account for 29 per cent of deaths in Nigeria.

Akinroye, at the launch of the New Civil Society Solidarity Fund on NCDs in response to COVID-19, harped on the need to strengthen the healthcare system, intensify awareness, increase access to care and treatment, and vote more money for NCDs care and management.

However, the NCD Alliance Nigeria and 19 other global and national NCD Alliances have been awarded $300,000.

Akinroye added that regional and national NCD Alliance including NCD Alliance Nigeria would get $15,000 to address the critical needs of people living with NCDs during the pandemic through advocacy and communication activities that would support stronger organisational stability and resilience

According to the cardiologist, COVID-19 shows many connections between it and NCDs stating that people living with NCDs are more vulnerable to COVID-19 with a substantially higher risk o becoming severely ill or dying from the virus.

The expert said that actions taken to control NCDs in Nigeria include the launch o the First Multi-Sectoral Action Plan or Prevention and Control o NCDs by the Federal Ministry of Health (FMoH) and the NCD Alliance Nigeria Publication of the Handbook on Civil Society Organisation in NCDs.

“Activities in Nigeria will include the development of a database of people living with NCDs in Lagos, Osun, and Federal Capital Territory and by NCD area of focus. Also, establishment and support for people living with NCDs with skills and knowledge, and connect them to NCD Alliance Nigeria, federal Ministry o Health, World Health Organisation and State Ministry of Health in the four states,” he added.

Akinroye further stated that they would build capacity for people living with NCDs on advocacy for their rights to health, prevention, access to treatment and care; provision of support and empowerment

He explained that NCD Alliance Nigeria would develop a directory and a database in the states by area of focus cardiovascular disease, diabetes, cancer, sickle cell disease, respiratory diseases and mental health and also develop advocacy communication materials targeting Lawmakers, Policymakers and opinion leaders that are persuasive and effective to improve prevention, care and access to treatment for people living with NCDs.

The expert, however, tasked the Presidential Taskforce on COVID-19 to mobilise for more testing and awareness amongst the grassroots and also provide free hypertensive and diabetic drugs or the vulnerable population.

Executive Director, NCD Alliance Nigeria, Prof. Akin Osibogun, also presented a paper on “NCDs in Nigeria and COVID-19: The Nigerian experience.”

Osibogun is a consultant public health physician/epidemiologist, a member of Lagos State COVID-19 Response Team and former Chief Medical Director (CMD), Lagos University Teaching Hospital (LUTH) Idi Araba.

Member, Nutrition Committee, Nigerian Heart Foundation (NHF) and Food Scientist, Prof. Isaac Adebayo Adeyemi, spoke on “COVID-19 and Nutrition: Gathering evidence.”

Akinroye delivered a paper on “People Living with NCDs in Nigeria and COVID-19.”

Adeyemi, who is Vice chancellor of Bells University of Technology Ota, Ogun State, and the pioneer Deputy Vice-Chancellor, Ladoke Akintola University of Technology (LAUTECH), Ogbomoso, Oyo State, said functional foods are important to boost the immune system.

Adeyemi said that a well functioning immune system is key to providing robust defence against pathogenic organisms. Adeyemi noted that mortality in people living with NCDs is likely the result of immune decline or impaired immune response.

The expert said that energy is required to fight the virus likewise, protein to produce essential antibodies.

He encouraged intake of Phytochemicals like quercetin from onions, phloretin and also Epigallocatechin gallate (EGCG) as well as conventional foods containing bioactive food compounds like vegetables, fruits, grains, dairy, fish and meat.

“Eat fresh and unprocessed food every day like fruits and vegetables, legumes and whole grains and animal products. Eat a moderate amount o fats and oils. Eat at home to reduce your rate of contact with other people,” he added.

Adeyemi urged the consumption of plant food such as grains, legumes and oilseeds, fruits and vegetables containing vitamins, minerals, fibre and phytochemicals.

He, however, stressed on the need to avoid the intake of caffeine, trans fat while also limiting the intake of salt because they are predisposing factors that contribute to morbidity o patients with COVID-19.

According to a study published in Scholars Journal of Applied Medical Sciences and titled “COVID-19 and Nutrition: Review of Available Evidence”, nutritional support is indicated for depleted patients with respiratory diseases because it provides not only supportive care, but direct intervention through improvement in respiratory and peripheral skeletal muscle function and in exercise performance.

The researchers noted: “A combination of oral nutritional supplements and exercise or anabolic stimulus appears to be the best approach to obtaining significant functional improvement. Patients responding to this treatment even demonstrated a decreased mortality. Furthermore, weight loss and malnutrition opens the door of infection reoccurrence. Poor response was related to the effects of systemic inflammation on dietary intake and catabolism.

“Dietary management of pre-existing diseases has been suggested as a strategy to minimise the potential risk of COVID-19 infection in conditions such as irritable bowel syndrome, Crohn’s and Colitis. WHO, dietetic associations and dietitians have been calling for patients with pre-existing conditions to continue abiding by their dietary advice and nutritional therapy steps received from their dietician if tested positive for COVID-19.”

Meanwhile, according to a World Health Organisation (WHO) survey, prevention and treatment services for NCDs have been severely disrupted since the COVID-19 pandemic began. The survey, which was completed by 155 countries during a three-week period in May, confirmed that the impact is global, but that low-income countries are most affected.

This situation is of significant concern because people living with NCDs are at higher risk of severe COVID-19-related illness and death.

Director-General of the WHO, Dr. Tedros Adhanom Ghebreyesus, said: “The results of this survey confirm what we have been hearing from countries for a number of weeks now.

“Many people who need treatment for diseases like cancer, cardiovascular disease and diabetes have not been receiving the health services and medicines they need since the COVID-19 pandemic began. It’s vital that countries find innovative ways to ensure that essential services for NCDs continue, even as they fight COVID-19.”

The main finding is that health services have been partially or completely disrupted in many countries. More than half (53 per cent) of the countries surveyed have partially or completely disrupted services for hypertension treatment; 49 per cent for treatment for diabetes and diabetes-related complications; 42 per cent for cancer treatment, and 31 per cent for cardiovascular emergencies.

Rehabilitation services have been disrupted in almost two-thirds (63 per cent) of countries, even though rehabilitation is key to a healthy recovery following a severe illness from COVID-19.

In the majority (94 per cent) of countries responding, ministries of health staff working in the area of NCDs were partially or fully reassigned to support COVID-19.

The postponement of public screening programmes (for example for breast and cervical cancer) was also widespread, reported by more than 50 per cent of countries. This was consistent with initial WHO recommendations to minimize non-urgent facility-based care whilst tackling the pandemic.

But the most common reasons for discontinuing or reducing services were cancellations of planned treatments, a decrease in public transport available and a lack of staff because health workers had been reassigned to support COVID19 services. In one in five countries (20 per cent) reporting disruptions, one of the main reasons for discontinuing services was a shortage of medicines, diagnostics and other technologies.

Unsurprisingly, there appears to be a correlation between levels of disruption to services for treating NCDs and the evolution of the COVID-19 outbreak in a country. Services become increasingly disrupted as a country moves from sporadic cases to community transmission of the coronavirus.

Globally, two-thirds of countries reported that they had included NCD services in their national COVID-19 preparedness and response plans; 72 per cent of high-income countries reported inclusion compared to 42 per cent of low-income countries. Services to address cardiovascular disease, cancer, diabetes and chronic respiratory disease were the most frequently included. Dental services, rehabilitation and tobacco cessation activities were not as widely included in response plans according to country reports.

Seventeen percent of countries reporting have started to allocate additional funding from the government budget to include the provision of NCD services in their national COVID-19 plan.

Encouraging findings of the survey were that alternative strategies have been established in most countries to support the people at the highest risk to continue receiving treatment for NCDs. Among the countries reporting service disruptions, globally 58 per cent of countries are now using telemedicine (advice by telephone or online means) to replace in-person consultations; in low-income countries, this figure is 42 per cent. Triaging to determine priorities has also been widely used, in two-thirds of countries reporting.

Also encouraging is that more than 70 per cent of countries reported collecting data on the number of COVID-19 patients who also have an NCD.

Director of the Department of NCDs at WHO, Dr. Bente Mikkelsen, said: “It will be some time before we know the full extent of the impact of disruptions to health care during COVID-19 on people with NCDs.

“What we know now, however, is that not only are people with NCDs more vulnerable to becoming seriously ill with the virus, but many are unable to access the treatment they need to manage their illnesses. It is very important not only that care for people living with NCDs is included in national response and preparedness plans for COVID-19 – but that innovative ways are found to implement those plans. We must be ready to ‘build back better’- strengthening health services so that they are better equipped to prevent, diagnose and provide care for NCDs in the future, in any circumstances.”

According to the WHO, NCDs kill 41 million people each year, equivalent to 71 per cent of all deaths globally. Each year, 15 million people die from an NCD between the ages of 30 and 69 years; more than 85 per cent of these “premature” deaths occur in low- and middle-income countries.

A panic attack is a sudden, intense episode of overwhelming fear and anxiety. There are several ways to help a person who is having a panic attack. These include using grounding techniques and helping them get their breathing under control.

In this article, we discuss how to help someone during a panic attack. We cover grounding tips, early warning signs, and when to get help.

How to help someone during a panic attack

Due to the extreme nature of the symptoms, it is important to understand how to react when someone has a panic attack, as they may feel as though they are dying during an episode.

Certain strategies and methods can help alleviate panic, ease the situation, and even stop the symptoms from getting worse. The ways a person can help include:

Remaining calm

Panic attacks are unpredictable and happen for different reasons. Among those who experience panic attacks, some may only have a couple of attacks in their lifetime, while others have recurrent attacks. One 2016 report shows that most people who have one panic attack will likely have more.

As panic attacks come without warning, they can be very scary, and it is important for everyone else to stay calm. A panicked response can make the situation worse.

Symptoms of a panic attack typically reach peak intensity in 10 minutes. So it is important that people act quickly to help alleviate the symptoms where possible.

Making conversation and positive affirmations

What a person says in response to someone having a panic attack is just as important as what they do. Engaging in conversation can distract from the extreme symptoms and help the person regulate their breathing. It is important to ask whether a person requires help rather than just assuming that they do. Here are some guidelines on what to say and do:

  • Ask questions: Introduce yourself and ask if the person needs help. If so, ask them if they think that they are having a panic attack and whether they have had one before. This prompt may remind them about previous attacks and how they recovered.
  • Stay or go: Let the person know that they do not have to stay where they are. Leaving a certain situation can take the pressure off someone having a panic attack. Find out what makes them feel most comfortable.
  • Kind words: Staying positive and nonjudgmental is important. Help the person understand that you are there to assist them, they are safe, and they are going to get through this. Remind them that the panic attack is only temporary.
  • Have a friendly conversation: An engaging chat can help distract a person from their symptoms. If you are a friend, gently bring up a topic that they are interested in to help them think of something else.

Suggesting grounding techniques

When a person has lost control of themselves and their surroundings, grounding techniques can help them come back to the present moment. These techniques include:

  • Sitting down: Relaxing in a comfortable chair sounds simple, but it can be extremely effective. With the feet comfortably on the floor, a person should focus on breathing in and out slowly and how it feels sitting on the chair.
  • The 5-4-3-2-1 technique: Focusing on other things in the room and different senses can distract the person from the panic attack. They can focus on identifying five items to see, four objects to touch, three noises to hear, two different smells, and one taste.
  • Simple maths: Counting from one to 10 out of order or performing simple mathematical calculations, such as times tables, provides something else on which to concentrate.
  • Focus: Ask the person what day of the week it is, who they are with, and where they are.

Providing ongoing help

Some people may feel embarrassed about having a panic attack, as well as finding it stressful. Continuing support and engagement will help ease their anxiety. Reach out by checking in now and again. Finding out more about the condition may also help if the situation happens again.

How to help someone breathe during a panic attack

When a person is experiencing a panic attack, it is important that they get their breathing under control. Someone trying to help should not give them a paper bag to inhale and exhale from, as this could make them pass out.

Instead, it is better not to bring attention to their breathing and to keep calm and breath normally so that they can mirror this pattern. This method should hopefully get their breathing back under control.

What not to do when someone is having a panic attack

Helping someone who is having a panic attack can be very stressful, so it is important that a person is mindful of what actions could make a panic attack worse.

Actions that could make a panic attack worse include:

  • Saying “calm down”: While getting a person to talk is vital, phrases such as “calm down,” “don’t worry,” and “try to relax” could make the symptoms worse.
  • Becoming irritated: Remain patient to help a person deal with a panic attack and do not belittle their experience. The focus should be on them, for however long it takes the symptoms to pass.
  • Making assumptions: Always ask a person what help they need, rather than assuming or guessing the correct advice.

Warning signs and when to get help

While a panic attack can happen very suddenly, the person will often experience warning signs. These may include:

  • shortness of breath
  • feelings of terror or dread
  • shaking and dizziness
  • heart palpitations
  • feeling as though they are dying

Someone having a panic attack may not feel comfortable asking for help. However, the symptoms could last for hours with one panic attack rolling into another, so a person should get medical assistance if they feel that it is necessary.

Pain in the arms or shoulders is also a concern, as the symptoms of a heart attack and panic attack can be similar. If a person has not had a panic attack before, has chest pain, and is vomiting, dial 911 immediately.

Learn more about the differences between a heart attack and a panic attack here.

People who frequently have panic attacks may wish to consider joining a support group or, if possible, relying more on family members and friends to help prevent panic attacks from reoccurring.

Panic attack symptoms

Panic attacks can start without warning, and they can be frightening. An attack can happen when a person is relaxed or even asleep. While the symptoms vary, common ones include:

  • rapid heart rate
  • sweating, trembling, or shaking
  • shortness of breath
  • feeling sick or nauseated
  • a loss of control
  • sense of impending danger
  • chest pain and stomach cramps
  • lightheadedness or faintness

People who have panic attacks may receive a diagnosis of panic disorder. According to the Anxiety and Depression Association of America, statistics show that panic disorder affects about 6 million adults in the United States, or 2.7% of the population.

Summary

Panic attacks are scary for everyone involved, especially when they happen suddenly.

As the person’s stress levels rise, it is essential for others to stay calm and empathetic. How they respond to the person experiencing the attack can influence its severity.

If a person is experiencing other symptoms, such as nausea and vomiting, they may be having a heart attack. In this case, it is essential to dial 911 immediately.

A laboratory study has found that the asthma drug salbutamol prevents the formation of tangles of fibrous protein that are a hallmark of Alzheimer’s disease. The next step will be to test the drug in animal models of the disease.

About 50 million people worldwide have dementia, and every year, there are nearly 10 million new cases, according to the World Health Organization (WHO).

They note that the most common form of dementia is Alzheimer’s disease, which accounts for 60–70% of all cases.

In the United States, the National Institute on Aging estimate that more than 5.5 million people have Alzheimer’s disease. Most of them are over 65 years of age.

The disease is a neurological disorder in which the death of brain cells results in progressive memory loss and cognitive decline.

While existing drug treatments help reduce the symptoms of Alzheimer’s disease and improve people’s quality of life, they neither slow its progression nor cure it.

The brains of people with the condition contain distinctive plaques between nerve cells, as well as clumps of fibers known as neurofibrillary tangles inside the cells.

The plaques consist of a protein called beta-amyloid, while another protein called tau makes up the tangles.

Promising drug target

After clinical trials found that drugs that clear beta-amyloid from the brain failed to slow the disease’s progression, attempts to find a treatment have shifted to tau.

Researchers at Lancaster University in the United Kingdom believe that tau could be a more promising drug target for Alzheimer’s disease. They point to previous research, which found that in the absence of the tau neurofibrillary tangles, beta-amyloid does not seem to harm nerve cells.

Also, the number of tangles in the brain appears to be a much better indicator of the severity of the disease than the number of amyloid plaques.

In healthy brain cells, tau proteins help stabilize the internal network of microscopic tubes, or “microtubules,” that transports nutrients and other molecules around nerve cells.

In Alzheimer’s disease, these tau molecules break away from the microtubules and begin to stick together to form threads and, eventually, tangles. In turn, these disrupt the microtubule transport network.

The scientists from Lancaster University believe that compounds that prevent tau molecules from aggregating in this way could make promising treatments for Alzheimer’s disease.

Giant microscope

To screen more than 80 compounds for their ability to block the formation of tangles, the researchers used a powerful technique — synchrotron radiation circular dichroism — for imaging structural changes in proteins.

This technique involves illuminating samples with beams of light 10 billion times brighter than the sun. The U.K.’s Diamond Light Source (DLS) in Oxfordshire, which experts have likened to a giant microscope, generated this light for the study.

One of the compounds that the DLS identified was the hormone epinephrine, which stabilized tau proteins and prevented them from forming tangles.

The body rapidly metabolizes epinephrine, however, so the researchers went on to screen four existing drugs with very similar chemical structures.

Of these, two were effective: a drug called dobutamine, which doctors use to treat heart attacks and heart failure, and salbutamol (also known as albuterol), which is available under the brand name Ventolin for treating asthma.

The scientists ruled out dobutamine as a practical treatment for Alzheimer’s disease because it requires injection, and its effects are very short-lived.

Further tests on salbutamol suggested that it binds to individual tau molecules, preventing them from forming “nuclei” around which other protein molecules can aggregate.

The researchers published their findings in the journal ACS Chemical Neuroscience.

Early days

“This work is in the very early stages, and we are some way from knowing whether or not salbutamol will be effective at treating Alzheimer’s disease in human patients,” says Prof. David Middleton, one of the authors.

“However, our results justify further testing of salbutamol and similar drugs in animal models of the disease and, eventually, if successful, in clinical trials.”

Salbutamol is on the WHO’s Model Lists of Essential Medicines and is the 10th most commonly prescribed medication in the U.S.

Dr. David Townsend, who led the research, says that it demonstrated the potential benefits of finding new applications for existing drugs with proven safety records:

“Salbutamol has already undergone extensive human safety reviews, and if follow-up research reveals an ability to impede Alzheimer’s disease progression in cellular and animal models, this drug could offer a step forward, whilst drastically reducing the cost and time associated with typical drug development.”

The researchers note that only a small amount of salbutamol reaches the brain when people use asthma inhalers, which deliver the drug to the lungs.

If further research in animals proves successful, a new delivery method will be necessary.

Future research could also focus on other asthma drugs in the same class — beta-adrenergic agonists — that circulate in the bloodstream for longer.

Asthma is a chronic lung condition in which the airways narrow and become inflamed, which leads to wheezing, coughing, and chest tightness. Extrinsic asthma and intrinsic asthma are subtypes of asthma.

The symptoms of these subtypes are the same, but they have different triggers:

  • Extrinsic asthma symptoms occur in response to allergens, such as dust mites, pollen, and mold. It is also called allergic asthma and is the most common form of asthma.
  • Intrinsic asthma has a range of triggers, including weather conditions, exercise, infections, and stress. People may call it nonallergic asthma.

In this article, we discuss the causes, symptoms, and treatment of intrinsic and extrinsic asthma.

Intrinsic vs. extrinsic asthma

Intrinsic and extrinsic asthma are two subtypes of asthma, which people more commonly refer to as allergic and nonallergic asthma.

Both types cause the same symptoms. The difference between the two subtypes is what causes and triggers asthma symptoms. The treatments are similar for each type, although the prevention strategies differ.

Triggers

Woman taking inhaler for asthma whilst playing football. Intrinsic and extrinsic asthma have the same symptoms but different triggers
Intrinsic and extrinsic asthma have the same symptoms but different triggers.

In people with extrinsic asthma, allergens trigger the respiratory symptoms. Common triggers for extrinsic asthma include:

  • pollen
  • mold
  • dust mites
  • pet dander
  • cockroaches
  • rodents

In some cases, a person is allergic to more than one substance, and several allergens trigger asthma symptoms.

In people with intrinsic asthma, allergies are not responsible for the symptoms. Instead, the following triggers cause symptoms:

  • cold
  • humidity
  • stress
  • exercise
  • pollution
  • irritants in the air, such as smoke
  • respiratory infections, such as colds, the flu, and sinus infections

In some cases, intrinsic asthma can occur with no known cause.

Prevalence

Extrinsic or allergic asthma is the most common form of the disease. According to the Asthma and Allergy Foundation of America, about 60% of people with asthma have allergic asthma.

Less commonly, intrinsic or nonallergic asthma occurs. Research in The Journal of Allergy and Clinical Immunologyindicates that intrinsic asthma occurs in anywhere from 10% to 33% of people with asthma.

It occurs more often in females than males and typically develops later in life than extrinsic asthma.

Causes

In all types of asthma, a person has overly sensitive airways and airway inflammation, which produces asthma symptoms.

Inflammation causes swelling in the airways that narrows the tubes and makes breathing difficult. The body also produces excess mucus, which further impairs breathing. These factors decrease the amount of air that can get into the lungs.

The inflammatory processes are similar in extrinsic and intrinsic asthma. In both, the immune system releases cells called T-helper cells and mast cells.

Research has found that there may be more similarities between the two types of asthma than researchers previously thought. Both types of asthma involve the production of IgE locally at the airways in response to the relevant triggers:

  • Extrinsic asthma occurs when the immune system overreacts to a harmless substance, such as pollen or dust. The body releases an antibody called immunoglobin E (IgE). The release of this antibody leads to inflammation and asthma symptoms.
  • Intrinsic asthma occurs when something other than allergens triggers an immune system response. People are not always able to identify the trigger.

Symptoms

The symptoms of extrinsic and intrinsic asthma are the same and may include:

  • wheezing
  • chest tightness
  • shortness of breath
  • coughing
  • increased mucus production
  • trouble breathing

Symptoms can vary in severity and may develop suddenly. Ignoring the signs and symptoms of an asthma attack can lead to a life-threatening situation. Recognizing symptoms as soon as possible and following an asthma action plan can help decrease the severity of an attack and reduce complications.

Treatments

The treatment options for intrinsic and extrinsic asthma are similar and include medications, lifestyle changes, and the avoidance of triggers. Since the triggers are different, the prevention strategies may differ.

Reducing triggers

It may be easier to identify the triggers for extrinsic asthma because allergies are the culprit. With both types of asthma, the identification of triggers allows an individual to take steps to reduce exposure and decrease symptoms.

The following steps can help reduce asthma symptoms in people with extrinsic asthma:

  • fixing leaky pipes to prevent mold buildup
  • keeping doors and windows closed when the pollen count is high
  • vacuuming often to reduce dust
  • keeping pets out of the bedroom

Triggers of intrinsic asthma do not involve a specific allergen. Due to the variability of triggers, it can take a little longer to determine the cause of flare-ups. People may find that avoiding humid, dry, or cold weather can prevent symptoms.

Medications

People can use the following medications to treat flare-ups of both intrinsic and extrinsic asthma:

Short-acting bronchodilators

Short-acting bronchodilators, also called quick relief medications, reduce symptoms fast. They work by relaxing the muscles of the airways.

Long-acting medications

People take long-acting bronchodilators daily, and they also open up the airways. Long-acting bronchodilators do not treat sudden symptoms as they take longer to work than short-acting bronchodilators.

Corticosteroids

Corticosteroids decrease inflammation in the airways. People take steroids daily to prevent symptoms.

Omalizumab

Omalizumab is an anti-IgE antibody therapy that prevents the release of IgE. Reducing IgE decreases the allergic response and prevents asthma symptoms.

People usually use omalizumab to treat extrinsic asthma, but it may also help with intrinsic asthma.

Lifestyle changes

Lifestyle changes might also help decrease symptoms of both types of asthma.

People with asthma may wish to consider adopting the following lifestyle practices:

  • maintaining a healthy weight
  • quitting smoking
  • avoiding secondhand smoke
  • reducing stress
  • getting a flu vaccine each year
  • washing the hands frequently to decrease the risk of infection

Outlook

Although there is currently no cure for either extrinsic or intrinsic asthma, people can manage the symptoms with medications, prevention methods, and lifestyle changes.

Intrinsic asthma is often harder to control than extrinsic asthma, as identifying its triggers is sometimes difficult. People can work closely with a doctor to determine the causes of asthma symptoms and find an effective treatment.

Asthma makes people’s airways hyperreactive, causing them to get smaller and often resulting in difficulty breathing. While it is not always possible to prevent asthma, people can try to avoid risk factors such as smoking, being overweight, and having prolonged exposure to air pollution.

According to the Centers for Disease Control and Prevention (CDC)asthma is responsible for around 10 deaths per day in the United States.

Although asthma affects both children and adults, adults are four times as likely to die from asthma-related complications than young people.

So, preventing asthma symptoms whenever possible is vital. The following are some avoidable asthma risk factors.

1. Smoking

Exposure to firsthand cigarette smoke can irritate the airways and make it more likely that a person with asthma will have more frequent and severe symptoms.

This is also true for secondhand smoke. Even when people smoke outside the home or in a car, the lingering smoke and chemicals can expose others to secondhand smoke.

Children whose mothers smoke cigarettes during pregnancy are also at greater risk of asthma than children whose mothers do not, according to the American Lung Association.

2. Obesity

Doctors are not yet sure of the underlying cause, but obesity seems to be linked with asthma. Scientists have a theory that obesity can cause inflammation in the body, including in the airways, leading to asthma.

Obesity increases the amount of specific inflammatory factors that can increase the number of white blood cells in the body. This may cause inflammation and airway irritation.

3. Air pollution

People who live in urban areas, where there is more smoke and smog, are more likely to have asthma. Smog is darker air pollution that tends to be present in bigger cities with more vehicles and factories.

Ozone, which is a major component of smog, can trigger asthma symptoms such as wheezing and shortness of breath.

As well as ozone, smog contains sulfur dioxide, which can irritate the airways and trigger asthma attacks.

4. Occupational exposures

Scientists have linked exposure to irritants such as pesticides to a higher risk of asthma. This risk extends beyond those who work with pesticides, such as farmers.

In fact, other at-risk groups include:

  • children of pesticide workers who store equipment near the home or wear clothes that carry pesticide residue
  • people who live near pesticide-treated areas or factories
  • people who live in agricultural areas where it is likely that pesticide spraying occurs indoors or outdoors

Exposure to harsh chemicals such as cleaning products may also be a risk factor for asthma. This is especially true for spray cleaning products distributed into the air.

5. Allergies

Allergens such as pet dander and pollen can trigger asthma attacks. People who have allergy-related conditions such as eczema and allergic rhinitis are more likely to have asthma.

As a result, avoiding allergic triggers can help prevent asthma reactions.

Examples of allergens that may trigger asthma include:

  • pet dander
  • dust mites
  • mold
  • pollens

If certain allergens trigger asthma symptoms, avoiding these triggers whenever possible is vital.

6. Respiratory infections

Children with asthma who have upper respiratory infections are more likely to experience wheezing. During an upper respiratory infection, such as a cold, the airways may be more prone to the wheezing that can lead to asthma symptoms.

While it is not always possible to prevent upper respiratory infections, it is vital to take steps to prevent illness in children. A caregiver can achieve this by encouraging frequent handwashing and avoiding exposure to people with colds or other respiratory infections.

Family history

Scientists have found more than 100 genes potentially responsible for asthma, according to a study paper in the Italian Journal of Pediatrics. However, no single gene by itself causes asthma.

Some research suggests that 35–95 percent of people with a family history of asthma will get the condition, according to a study paper in the journal Pediatrics & Neonatology.

Although it is not possible to change family history, people can be aware that others in their family have asthma and seek treatment if they start to have asthma-like symptoms.

Such people can also avoid common asthma triggers if they know they have a genetic predisposition to the condition.

Treatment and prevention

Some strategies to help prevent asthma symptoms include:

  • stopping smoking and refraining from smoking around others, especially children
  • avoiding public places where cigarette smoking occurs
  • limiting outdoor exposure on days with heavy smog or smoke
  • encouraging a diet high in fruit, vegetables, whole grains, and lean protein
  • encouraging childhood vaccinations that can prevent common respiratory infections that could lead to worsening asthma symptoms
  • avoiding allergens that trigger asthma attacks, such as pet dander, dust mites, mold, and pollen

A person should consider talking with their doctor if they think that allergens are triggering their asthma.

Recognizing asthma symptoms, such as wheezing, coughing that is worse at night, and shortness of breath, is vital because it can help people seek suitable treatments for the condition.

An estimated 75 percent of severe asthma attacks are preventable, according to the American Academy of Allergy, Asthma, & Immunology.

Doctors can prescribe many different treatment types and combinations to help a person treat their asthma. This includes inhalers to open up the airways, steroid medications to reduce inflammation, and other oral medications that help reduce airway reactivity.

If a person takes them consistently, medications alongside preventive efforts can help prevent asthma attacks from occurring.

Summary

Asthma can affect a person’s quality of life and cause serious respiratory distress that can sometimes be life-threatening. Knowing risk factors and triggers for the condition can help a person engage in preventive efforts.

If a person has asthma or concerns about risk factors, it is important that they talk with their doctor about how to consistently and effectively manage their symptoms.

The majority of people can donate blood. However, those who use nicotine products, cannabis products, or both may wonder whether or not they can donate blood.

Hospitals and health clinics use donated blood to treat various medical conditions. According to the World Health Organization (WHO), the number of blood donations collected around the world per year exceeds 117.4 millionTrusted Source.

Blood donations can help with:

  • serious injuries
  • surgery
  • anemia
  • cancer
  • chronic illnesses

Read on to learn more about how different ways of using cigarettes, cannabis, and other drugs can affect a person’s ability to donate blood.

Nicotine

If a person smokes cigarettes or vapes, it does not disqualify them from donating blood.

However, both tobacco cigarettes and electronic cigarettes (e-cigarettes) contain harmful chemicals that may affect a person’s blood.

The American Lung Association claim that a burning cigarette produces more than 7,000 chemicals, including carbon monoxide, ammonia, and arsenic. Several of these chemicals are toxic, and 69 of them can cause cancer.

In addition to nicotine, e-cigarettes may contain the following harmful substances:

  • propylene glycol, which is present in paint solvents, antifreeze, and some foods (as an additive)
  • acetaldehyde, which is a toxic product of ethanol alcohol
  • formaldehyde, which is a chemical preservative present in disinfectants, glue, and plywood
  • diacetyl, which is a flavoring agent that tastes like butter
  • heavy metals, including nickel and lead
  • benzene, which is a chemical compound present in car exhaust

Currently, minimal information exists regarding the exact effects of vaping on blood donations. One thing to keep in mind is the fact that both vaping and smoking cigarettes can increase blood pressure.

According to American Red Cross guidelines, people can donate blood as long as their blood pressure is between 90/50 millimeters of mercury (mm Hg) and 80/100 mm Hg.

In one 2018 studyTrusted Source, researchers compared blood donations from people who smoke with donations from people who do not smoke. They concluded that smoking cigarettes does not affect the overall quality of the donated blood.

However, the researchers did note that the donations from the people who smoke had higher concentrations of carboxyhemoglobin (COHb) in the red blood cells. COHb forms when red blood cells come into contact with carbon monoxide, significantly reducing the amount of oxygen that red blood cells can carry.

Based on these findings, the researchers recommend that people avoid smoking for 12 hoursTrusted Source before donating blood.

Cannabis

Like smoking cigarettes and vaping, smoking cannabis does not disqualify a person from donating blood.

Current scientific researchTrusted Source suggests that cannabis use can negatively impact the cardiovascular system by:

  • increasing blood pressure and heart rate
  • narrowing the blood vessels
  • causing inflammation in the vessel walls
  • promoting blood clots

However, these potential adverse health effects should not impact the quality of any donated blood.

That being said, Vitalant — a nonprofit blood service provider — explain that people must not be under the influence of recreational drugs or alcohol at the time of donation.

Other drugs

According to the American Red Cross, people with a history of recreational intravenous drug use are not eligible to donate blood. This requirement helps prevent the spread of HIV and hepatitis.

It is important to note that this is not the case for people who have used drugs in other ways, such as by smoking them or taking them orally. The American Red Cross and other blood donation companies do not specify drug use as an excluding factor.

However, a person does need to make sure that substances such as nicotine and cannabis are not in their system when donating blood.

Excluding factors

To donate blood, the general requirement is that a person should be at least 17 years old. A person can be 16 years old, but they must have a legal guardian’s consent.

Other factors that may disqualify a person from giving blood include:

  • feeling sick or having cold or flu symptoms
  • using intravenous drugs not prescribed by a licensed doctor
  • having an active infection
  • having HIV or testing positive for hepatitis B or C
  • having uncontrolled diabetes
  • having a blood clotting disorder
  • having ever had the Ebola virus
  • having blood cancers, such as leukemia or lymphoma
  • having received a blood transfusion within the past 12 months
  • having a heart rate below 50 beats per minute (BPM) or above 100 BPM
  • having recently traveled to a foreign country
  • being pregnant, or having given birth within the past 6 weeks

Read more about the advantages and disadvantages of donating blood here.

Summary

Although smoking cigarettes, vaping, and using cannabis will not disqualify a person from donating blood, they should refrain from smoking for at least 2 hoursTrusted Source before and after donating blood.

A person may feel lightheaded or weak after giving blood, and smoking can exacerbate these symptoms. It is a good idea to avoid smoking until these symptoms go away.

Everyone, including people in excellent shape, can experience pain in their chest during exercise. The many potential causes range from benign to potentially life-threatening.

Everyone who exercises regularly should recognize the symptoms that can accompany chest pain when the underlying issue is serious.

Read on to learn more about the causes of chest pain during exercise and how to treat and prevent them.

Causes

Serious conditions, such as heart attacks, and less serious issues, such as muscle strains and asthma, can lead to chest pain during exercise.

Heart attack

Myocardial infarction is the medical term for a heart attack. A heart attack occurs when the coronary arteries become blocked. The blockage causes the heart to lose oxygen. If a person does not receive treatment, the heart muscle can die.

A heart attack can cause pain in the jaw, back, chest, and other parts of the upper body. The pain may go away and return, or it may last longer than a few minutes.

Other symptoms of a heart attack include:

  • pressure or pain in the chest
  • sweating
  • nausea
  • dizziness
  • anxiety
  • shortness of breath

Heart attack symptoms can vary. Both men and women are likely to report chest pain, but women are more likely to experience:

  • back pain
  • nausea
  • vomiting
  • jaw pain
  • shortness of breath

If a person experiences any symptoms of a heart attack, they should seek immediate medical attention.

According to the American Heart Association, the most common risk factors for a heart attack include:

  • Age. People ages 65 and older are most at risk.
  • Sex. Men have a much higher risk, even when they are younger, than women.
  • Genetics. African-Americans and people with a family history of heart disease are more vulnerable to heart attacks and heart disease.

Angina pectoris

Angina pectoris, or angina, is a pain that stems from the heart. The main cause of angina is a lack of blood flow to the area. When this occurs, a person may feel tightness, pain, or pressure in their chest.

Some additional symptoms of angina include:

  • tightness in the arms or jaw
  • shortness of breath
  • fatigue
  • nausea

Exercise and stress can cause angina, and people often mistake this pain for a heart attack. A person should seek immediate medical attention if they experience any symptoms of a heart attack.

According to the American College of Cardiology, women are three times more likely than men to experience throat discomfort and jaw tightness or pain because of angina.

Women may also experience sharper pain, while men are more likely to experience feelings of pressure associated with angina.

Hypertrophic cardiomyopathy (HCM)

According to the American Heart Association, HCM is a common condition that can affect nearly anyone.

HCM occurs when the cells of the heart muscle enlarge, causing the walls of the ventricles to thicken.

HCM can also result if the wall dividing the left and right sides of the heart grows and puts pressure on the ventricles.

In either case, the heart has to work harder to pump blood, and a person may experience:

  • dizziness
  • shortness of breath
  • chest pain
  • fainting

In some people, HCM presents no symptoms. In rare cases, a person may experience sudden cardiac arrest during physical activities.

Asthma

Asthma is a common condition that affects the airways in the lungs.

People with asthma have inflamed airways that tighten in response to triggers, including exercise. The medical term for this is exercise-induced bronchoconstriction.

A person with a family history of asthma is more likely to develop it. People with asthma may experience:

  • wheezing
  • coughing
  • chest tightness
  • shortness of breath

Muscle strain and injuries

According to a research paper published in 2013, nearly half of all reported cases of muscle strains in the chest involve the intercostal muscles. These help a person breathe and stabilize the chest.

Common symptoms of muscle strains in the chest include:

  • sharp pain
  • bruising
  • swelling
  • pain while breathing
  • difficulty moving the area

The most common cause of a muscle strain is overuse. As a result, people who regularly exercise the chest muscles are more likely to experience a strain or tear.

The risk of chest muscle strains varies by age group:

  • Older adults are more likely to get this type of strain from a fall.
  • Children are least likely to develop this strain.
  • Adults are most likely to sustain this strain from exercise, sports, or high-impact crashes.

When to see a doctor

Speak to a doctor about any new, unidentified, or worsening chest pain. A doctor can help determine the underlying cause and recommend a treatment plan, which may include lifestyle changes.

Seek emergency medical treatment for any symptoms of a heart attack. Chest pain is the most common symptom, and certain other symptoms, such as nausea, are more common in women than men.

A person with exercise-induced asthma should seek specific treatment. A doctor may be able to prescribe medication and suggest other ways to reduce symptoms. This may enable a person to continue exercising or participating in sports.

Prevention and precautions

Not all chest pain is preventable. However, there are some general tips for preventing some causes of chest pain, such as heart attacks, strains, and asthma.

A person may be able to prevent chest pain by:

  • eating a balanced diet
  • exercising regularly
  • avoiding tobacco smoke and alcohol
  • managing high blood pressure with medications
  • avoiding activities that increase the risk of physical injury
  • controlling asthma with medications

Outlook

A range of conditions, from muscle strains to heart attacks, can cause chest pain during exercise.

Anyone who experiences this pain should consult a healthcare provider about the best course of treatment. Some causes of chest pain can be serious.

Many people can prevent chest pain by making lifestyle changes and following a doctor’s treatment plan.

If any symptoms of a heart attack occur, seek immediate medical attention.

Allergy remedies
Allergy remedies
Allergies are a common cause of illness and can occur at any stage in someone’s life. Numerous different things cause allergies from pollen to food to medication, meaning it is not always easy to know the best treatments or home remedies.

According to the Centers for Disease Control (CDC), more than 50 million Americans experience an allergic reaction each year, and the best treatment will depend on the cause and severity of the reaction.

In this article, we take a close look at a range of treatments for allergic reactions, depending on a person’s symptoms and their severity, including anaphylaxis.

Fast facts on treating an allergic reaction:

  • Most minor allergy symptoms can be treated with antihistamines, corticosteroids, or decongestants.
  • Saline nasal rinses can be used for congestion-related allergy symptoms.
  • Corticosteroid creams can treat skin rashes related to allergies.
  • Immunotherapy is a long-term treatment option for chronic allergy symptoms.
  • Anaphylaxis is a medical emergency, and people should call 911 if they suspect someone is having an anaphylactic reaction.

What is an allergic reaction?

The immune system overreacts to these allergens and produces histamine, which is a chemical that causes allergy symptoms, such as inflammation, sneezing, and coughing.

Mild allergic reactions can usually be treated with home remedies and over-the-counter (OTC) medications.

However, chronic allergies need treatment from a medical professional. Severe allergic reactions always require emergency medical care.

Treating allergic reactions

Many mild to moderate allergic reactions can be treated at home or with OTC medications. The following treatments are commonly used to reduce the symptoms of an allergic reaction:

Antihistamines

Antihistamines can help to treat most minor allergic reactions regardless of the cause. These drugs reduce the body’s production of histamine, which reduces all symptoms, including sneezing, watering eyes, and skin reactions.

Second-generation antihistamines, including Claritin (loratadine) and Zyrtec (cetirizine), are less likely to cause drowsiness than first-generation antihistamines, such as Benadryl.

Antihistamines come in several forms, usually to help deliver the medication closer to the source of the reaction or make it easier to consume, such as:

  • oral pills
  • dissolvable tablets
  • nasal sprays
  • liquids
  • eye drops

Antihistamines in these forms are available from pharmacies, to buy online, or on prescription from a doctor.

Antihistamines can also be taken to prevent allergies. Many people with seasonal or pet allergies will begin taking antihistamines when they know they are going to be exposed to an allergen.

A person who is pregnant or has a liver disorder should consult their doctor before taking antihistamines.

Nasal decongestants

Nasal decongestant pills, liquids, and sprays can also help reduce stuffy, swollen sinuses and related symptoms, such as a sore throat or coughing.

However, decongestant medications should not be taken continuously for more than 72 hours.

Nasal decongestants are available over the counter and online.

Anti-inflammatory medication

Non-steroidal anti-inflammatory medications (NSAIDs) may also be used to help temporarily reduce pain, swelling, and cramping caused by allergies.

Avoid the allergen

The best way to treat and prevent allergic reactions is to know what triggers the reaction and stay away from it, especially food allergens.

When this is not possible or realistic, using antihistamines or decongestants when in contact with allergens can help to treat the symptoms.

Use a saline sinus rinse

The AAAAI recommend the following saline recipe:

  • mix 3 teaspoons of salt (without iodide) with 1 teaspoon of baking soda
  • add 1 teaspoon of this mixture to 8 ounces of boiled water
  • dissolve the mixture in the water then use as a saline rinse

Sinus rinsing devices can be purchased online or from a pharmacy.

Treating environmental allergies

For airborne allergens, such as pollen, dust, and mold spores, additional treatment options include:

  • throat lozenges with soothing ingredients, such as menthol, honey, or ginger
  • shower and wash all clothing after being exposed to an allergen
  • exercise for a few minutes to help reduce nasal congestion

Treating allergies on the skin

For allergic reactions that cause skin symptoms, including those associated with allergens found in animal saliva, poisonous plants, drugs, chemicals and metals, additional treatment options include:

  • Topical corticosteroid creams or tablets. Corticosteroids contain steroids that reduce inflammation and itching. Mild forms of these creams can be found online, and a doctor can prescribe stronger versions.
  • Moisturizing creams. Emollient creams with soothing ingredients, such as calamine can treat skin reactions.
  • Bite or sting medication. Medication targeted to reduce allergic reactions to insect bites or stings have a similar effect to other allergy medications.
  • Ice pack. Applying an ice pack wrapped in cloth to the area for 10- to 15-minute intervals can reduce inflammation.

Treating severe allergies

People should speak to a professional if they have or suspect that they have severe or chronic allergies.

A doctor or allergy specialist can prescribe medications that contain much stronger doses of the compounds found in OTC products.

Treatment options for chronic or severe allergies include:

  • Immunotherapy, or allergy shots. Immunotherapy can be between 90 and 98 percent effective at reducing allergic reactions to insect stings, for instance.
  • Prescription asthma medications, such as bronchodilators and inhaled corticosteroids.
  • Oral cromolyn can be taken for food allergies.
  • Drug desensitization therapy is used for specific allergens.

Natural remedies for allergic reactions

Many traditional medicine systems use herbal supplements and extracts to both treat and prevent allergic reactions, especially seasonal allergies.

Though there is little scientific evidence to support the use of most alternative or natural remedies, some people may find that some can provide relief from their symptoms.

The American Association of Naturopathic Physicians recommend the following natural treatments for allergies:

  • Dietary changes. A low-fat diet high in complex carbohydrates, such as beans, whole grains, and vegetables may reduce allergy reactions.
  • Bioflavonoids. These plant-based chemicals found in citrus fruits and blackcurrants may act as natural antihistamines. These can also be taken as supplements.
  • Supplements. Flaxseed oil, zinc, and vitamins A, C, and E are suggested to improve allergy symptoms.
  • Acupuncture. Acupuncture treatments may help some people to find relief from their symptoms.

Identifying and treating anaphylaxis

A very severe allergic reaction can lead to a condition called anaphylaxis, or anaphylactic shock.

Anaphylaxis occurs when the body’s immune response to an allergen is so severe and sudden that the body goes into a state of shock.

Anaphylaxis can impact multiple organs and if left untreated lead to coma, organ failure, and death.

The early symptoms of anaphylaxis can be fairly mild and similar to those of minor to moderate allergic reactions, but they often rapidly worsen.

Symptoms unique to anaphylaxis include:

  • unexplained anxiety
  • tingling in the palms of the hand, soles of the feet, and lips
  • swollen tongue, throat, mouth, and face
  • difficulty breathing
  • rapid but weak pulse
  • low blood pressure
  • sense of dread or doom
  • vomiting or diarrhea
  • confusion or disorientation
  • loss of consciousness
  • very pale or blue skin
  • a heart attack

Anyone who suspects anaphylaxis should call 911 and seek emergency medical care.

If the person carries an EpiPen, which is a self-injectable dose of epinephrine that is designed to treat anaphylaxis, inject this into their thigh, as soon as possible.

First aid for anaphylaxis includes:

  • try to keep the person calm
  • the person may vomit, so turn them on their side and keep their mouth clear
  • try to get the person to lay flat on their back with their feet raised about a foot above the ground
  • make sure the person’s clothing is loose or remove constricting clothing
  • do not give them anything to drink or eat, even if they ask for it
  • if they are not breathing, practice CPR with around 100 firm chest compressions every minute until emergency services arrive

If a person does not have an EpiPen, a doctor or paramedic will give an injection of the hormone epinephrine, or adrenaline. This will immediately increase the output of the heart and blood flow throughout the body.

A person should seek medical care each time anaphylaxis occurs. Even if they start to feel better or their symptoms go away, a second severe allergic reaction can occur up to 12 hours after the initial response.

Allergy symptoms

The symptoms associated with an allergic response depend on the specific allergen, how severe the allergy is, and whether a person has touched, swallowed, or inhaled the allergen.

Not everyone responds the same way to each allergen. But there are similar sets of symptoms most people experience when exposed to specific allergens.

Common symptoms associated with different type of allergens include:

Airborne allergens Animal saliva Insect stings/bites Food allergens Drug allergens Metal/ chemical allergens
Sneezing/ itchy nose Y Y
Runny/stuffy nose Y Y
Coughing Y Y
Skin rash/itchy skin Y Y Y Y Y
Wheezing/ shortness of breath Y Y
Hives/welts Y Y Y Y
Pain, redness and swelling at the exposure point Y Y Y Y
Peeling /blistering skin Y Y
Watery, itchy, red eyes Y Y
Sore throat
Vomiting, nausea, or diarrhea Y
Swelling of the throat, tongue, and mouth Y Y Y
Dizziness Y Y Y
Sun sensitivity Y
Itchy mouth/odd taste in the mouth Y Y
Pale skin Y Y
Swelling of the eyes, face, and genitals Y
Chronic joint or muscle pain Y Y

Outlook

Many people experience allergic reactions when they are exposed to specific allergens, ranging from pet dander and pollen to compounds in foods, drinks, and personal hygiene products.

The best way to treat an allergic reaction depends on the cause, though most minor cases can be treated with OTC antihistamine and anti-itch products.

A person should seek immediate medical attention for chronic or severe allergic reactions, especially those that involve swelling of the throat or changes in heart rate. Anaphylaxis should always be treated as a medical emergency.

Chocolate lovers, rejoice; the sweet treat is not only delicious, but studies show that it can also promote friendly bacteria and reduce inflammation in our guts.

First, some background: trillions of bacteria live in our guts. They contribute to our immune system, metabolism, and many other processes essential to human health.

When the delicate balance of microbes in our intestines is disturbed, it can have serious consequences.

Irritable bowel syndrome, chronic fatigue syndrome, autism spectrum disorders, allergies, asthma, and cancer have all been linked to abnormal gut microbiomes.

A healthful diet supports bacterial diversity and health, but could chocolate be an integral part of this?

Benefits of cocoa

Cocoa is the dry, non-fatty component prepared from the seeds of the Theobroma cacao tree and the ingredient that gives chocolate its characteristic taste.

Many health benefits have been attributed to cocoa and its potent antioxidant functions. These include lowering cholesterol, slowing down cognitive decline, and keeping the heart healthy.

Cocoa metabolism is partly dependent on the bacteria that live in our intestines.

Our bodies are only able to absorb some of the nutrients in chocolate. As such, we need our tiny microbial passengers to break complex molecules into smaller components, which we would not be able to take into our bodies otherwise.

This allows us to make full use of the many health-promoting molecules in cocoa. It doesn’t stop there, however. The gut microbes also benefit from this relationship, which, in turn, has an even greater effect on our health.

Gut health and inflammation

Several studies show that the consumption of cocoa increases the levels of so-called friendly bacteria in the gut.

Researchers from the Department of Food and Nutritional Sciences at the University of Reading in the United Kingdom measured higher levels of Lactobacillus and Bifidobacterium species in the intestines of human volunteers who drank high-cocoa chocolate milk for 4 weeks.

The same team previously showed that components in cocoa can reduce the growth of Clostridium histolyticum bacteria, which are present in the guts of individuals with inflammatory bowel disease.

In pigs, higher levels of Lactobacillus and Bifidobacterium species were also found in the colon in response to a high-cocoa diet. Interestingly, the expression of known inflammatory markers was reduced.

Friendly bacteria including Lactobacillus and Bifidobacterium have, in fact, been implicated in actively promoting anti-inflammatory processes in our intestines, keeping our gut healthy.

Chocolate as part of a healthful diet

Despite the fact that these scientific studies support the claim that cocoa can be beneficial for our gut microbiomes, cocoa does not equal chocolate.

The cocoa extracts used in research do not contain the high levels of sugar and fat found in our everyday chocolate bars.

Unsweetened cocoa powder or high-cocoa content dark chocolate are the closest alternatives to the cocoa used in these studies. Consumed in moderation, chocolate may therefore promote friendly bacteria, and, by extension, a healthy gut, keeping inflammation at bay.

Everyone has experienced a nagging cough after a cold or needed to cough while in a quiet room.

Despite these problems, coughing actually serves a very valuable and useful purpose. Coughing is a protective action, helping the lungs clear out potential germs or harmful objects.

Sometimes, however, that cough is not linked to a cold or infection and can linger for weeks to months at a time. This may lead people to wonder or worry that their cough is a sign of something more serious, such as lung cancer.

This article takes a look at the connection between coughing and lung cancer, including when someone should see a doctor.

Coughing and lung cancer

A cough associated with lung cancer may be either dry or wet.
A cough associated with lung cancer may be either dry or wet.

Not every cough signifies the presence of lung cancer. However, many people do complain of a chronic cough or a “cough that just won’t go away” at the time of their diagnosis.

If a cough is associated with other symptoms, such as those in the list below, it warrants a trip to the doctor to get checked out:

  • coughing up blood or rust-coloured phlegm
  • shortness of breath
  • chest pain

A cough that is associated with lung cancer can be either dry or wet. It can occur at any time, and even be so severe that it interferes with sleep at night.

Lung cancer symptoms

There are many symptoms other than persistent or worsening coughing that is associated with lung cancer. Some of these symptoms include:

  • ongoing chest pain
  • coughing up blood
  • shortness of breath
  • wheezing or hoarseness of the voice
  • problems swallowing
  • loss of appetite
  • losing weight
  • Fatigue and tiredness
  • frequent lung infections, such as pneumonia or bronchitis

Causes of coughing

Man in field of yellow flowers coughing and blowing his nose.
Allergies such as hay fever may cause short-term coughing. A long-term cough that does not clear up a few weeks, or that gets worse, may have a more serious cause.

There are many reasons why someone might be coughing. A short-term cough can be caused by:

  • an infection, such as a cold, pneumonia, or bronchitis
  • an allergy, such as hay fever
  • inhaled dust, smoke, or debris
  • a long-term respiratory condition, such as asthma or COPD

Sometimes, a short-term cough can develop into a chronic or a persistent cough. When this happens, it may be caused by one of the following factors:

  • Long-term respiratory infection, such as chronic bronchitis or pneumonia.
  • Asthma, which causes shortness of breath, tightening of the chest, and wheezing.
  • Allergies, such as hay fever.
  • Smoking. Chronic coughing in a smoker is also known as a “smoker’s cough” and is the result of smoke and other debris irritating the airways.
  • Bronchiectasis, which is a widening of the airways in the lungs.
  • Postnasal drip, which is mucus dripping down the throat and triggering a cough. This is usually associated with a cold or allergy.
  • Gastroesophageal reflux disease (GERD), where stomach acid flows back into the food pipe. The throat gets irritated by the acid and triggers a cough.
  • Medications, such as ACE inhibitors, which are used to treat high blood pressure and heart disease.

When to see a doctor

Most coughs clear up within a few days to a few weeks.

It is important to see the doctor if the cough is persistent or occurs along with other symptoms, such as coughing up blood or chest pain.

Seeing a doctor promptly can help to determine the cause of a cough and ensure that nothing more serious is going on.

Diagnosis

Firstly, the doctor will take a thorough medical history and perform a physical exam. In addition to asking about family and personal medical history, the doctor will ask about the history of coughing, shortness of breath, and other symptoms.

During the physical exam, the doctor will listen to the heart and lungs, and look for other potential causes of the coughing, such as signs of an infection or postnasal drip.

Depending on the findings from the history and physical, the doctor may order additional testing. This may include imaging tests, such as:

  • a chest X-ray
  • CAT scan
  • PET scan
  • MRI

If lung cancer is suspected based on these results, the doctor will likely want to take a biopsy of the suspicious cells. A doctor can do this by passing a needle into the lung tissue through the skin.

Another way is by bronchoscopy, where a small tube is inserted down the nose and into the lungs. A small sample is removed through the tube and analyzed.

A specialist called a pathologist will look at the cell samples under the microscope to determine if there is cancer. If cancer is present, they will also work out the type, and how far it has advanced.

If lung cancer is diagnosed, the doctor may want to order additional testing to see if it has spread beyond the lungs.

Researchers have also found some genetic markers that can impact how a cancer behaves. This includes whether it is aggressive or spreads quickly, or is responsive to certain hormones.

Some doctors will order genetic testing to look for these genetic markers. Positive results can sometimes help with making treatment decisions, as there are new medications that can be more effective than traditional therapies.

Treatment options

Senior mans hand in chair as he receives chemotherapy.
Chemotherapy is a common treatment option for lung cancer, although complete removal of the tumor is usually preferable.

The best treatment for lung cancer is complete removal of the tumor and unhealthy cells surrounding it.

Removal is usually only an option when the growth is small and contained, or has only spread to the nearby tissues.

Radiation or chemotherapy is sometimes also given to ensure that all of the cancerous cells have been removed or destroyed.

Once a tumour has spread significantly, it may no longer be removable or curable. The doctor may recommend radiation or palliative care to prevent further complications and treat symptoms.

New targeted therapies may be more successful in certain groups of people or with particular types of cancers. These include female non-smokers or carriers of certain genetic markers.

The doctor can help work out whether someone may benefit from these types of treatments.

Outlook

The outlook for someone diagnosed with lung cancer depends on the stage of cancer when it is diagnosed.

In general, someone with small cancer that has not spread to other parts of the body has a much better outlook than someone who has an aggressive form of cancer that has spread.

Early diagnosis and treatment are very important in increasing the odds of surviving lung cancer. There is no screening test, which can make early detection more difficult.

The best way to prevent lung cancer is to live a healthful lifestyle and avoid cigarette smoke whenever possible. In addition to not smoking, or quitting smoking, avoiding secondhand smoke is essential.

Someone with a high risk of developing lung cancer, based on either family history or history of smoking, should discuss any unusual symptoms with their doctor as soon as possible. These symptoms include a persistent cough that occurs with chest pain, shortness of breath, or blood.