Month: October 2024

Bedfont® Scientific Limited hosted an informative webinar Children with Asthma, with seasoned respiratory nurse Carol Stonham MBE leading the discussion along with Kirsty at Medway Asthma Self-Help (MASH). The webinar was a private screening for local Medway football coaches and gave valuable insights on managing, treating and recognising an asthma emergency.

Children spend a lot of time away from home, whether it is at school, nursery or clubs, therefore, it is important that when they are away from home, they are safe. If a child has asthma, the responsible adults around them need to know what to do in the case of an asthma emergency.

The webinar covers some important topics:

• What asthma is,
• When and how to use an inhaler,
• What to do in an asthma emergency.

How common is asthma?

Asthma is a common respiratory condition that affects around 5.4 million people in the UK¹, with 1.1 million of them being children². Asthma is the most common long-term condition among children and young people and the UK has among the highest mortality rates in Europe. It is thought that emergency admissions and deaths related to asthma are largely preventable, with these statistics being linked with deprivation².

It is encouraging to see a small reduction in deaths among children and young people as a result of asthma between 2008-2018³, however, even though the figures are low, they are still too elevated for a condition that should be manageable, making the deaths preventable.

Unfortunately, the trend seems to be rising among 15 – 24 year olds³. A report in 2019 found that out of 19 countries, young people are more likely to die from asthma in the UK, compared to those in other wealthy countries⁴. This is not good enough and we should be doing better than that.

What is asthma?

According to the British Thoracic Society (BTS) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines, asthma is the presence of more than 1 of the following symptoms:

• Wheeze,
• Breathlessness,
• Chest tightness,
• Cough.

It is a combination of variable symptoms, and you may find that over weeks or months, you experience a difference in symptoms. The underlying problem is the airways, the airways can either have hyperresponsiveness, which is an increased sensitivity of the airways or inflammation.

What symptoms do asthma sufferers typically suffer from?

The most common symptoms of asthma are:

• Cough,
• Wheeze,
• Shortness of breath,
• Exercise limitation,
• Duration of symptoms,
• Triggers.

Hopefully, no one suffers from all of the above, but symptoms are variable and can come and go over a period of time. Quite often the person knows what sets their symptoms off.

How does asthma affect the lungs?

Asthma causes an inflammation of the mucous membrane, which can lead to swelling into the airspace, increase in mucous production, twitch airways and bronchospasms.

How do we measure asthma?

There are a few ways asthma can be measured/monitored. First would be a peak expiratory flow meter, this is a simple test where you have a device with a scale. First, you would make sure the slide on the scale is on 0, you would then take a deep breath in and provide a short, sharp blow into the meter.

Another way is spirometry, which is a more advanced look at how the air moves in and out of the chest. It measures how much air you can move out of your chest and how quickly you can do that, as well as the pattern the air follows as it leaves the chest. This test would be carried out in a clinic.

Finally, there is a Fractional exhaled Nitric Oxide (FeNO) test. As standard, we produce small amounts of Nitric Oxide in our breath, but when a patient has inflammation in the chest, the type typically seen in asthma, more Nitric Oxide is produced. A FeNO test, carried out by the NObreath® is suitable for both adults and children, it requires you to take a deep breath in and blow into the device at a steady pace.

Asthma is a serious, long-term condition, and poorly controlled asthma can present physical symptoms. Symptoms in children can include:

• Shortness of breath,
• Tight chest,
• Wheeze.

These symptoms can create further issues in children, as if they feel unwell, they are less likely to take part in physical activity, this then leads them to become deconditioned and at risk of obesity, which can make asthma worse. Poorly controlled asthma can also disturb sleep, which affects concentration, emotions and behaviour.

There are also psychological effects that poorly controlled asthma can have on children. Children, typically like to be like other children and having asthma can make them feel different. They might be embarrassed by their inhaler, meaning they may not use it when needed. They may have experienced an asthma attack in the past and it might make them frightened to do things that could trigger another attack, limiting them to what they can do.

Poorly controlled asthma can also affect education outcomes, as children with asthma may be absent from school for medical appointments or asthma attacks. They might also have reduced concentration due to disturbed sleep or feeling unwell.

How do we treat asthma?

There are around 119 different inhalers available, so there are lots of treatments and options. Our aim is for anyone with asthma to have:

• No daytime symptoms,
• No night symptoms,
• No activity limitations,
• No need for using a rescue inhaler,
• No side effects from treatment,
• Normal lung function.

The main part of treating asthma is treating the underlying inflammation, and if we get that treatment right, the swelling will settle down, the airways will open back up and the patient will find it easier to breathe. However, not all treatment is instant, if a brown-coloured preventer inhaler is used, it must be used for a few days. This allows the medication to settle down the inflammation slowly and once settled it is likely to be needed long-term.

Inhalers are broken down into 2 categories:

If anyone is using a blue rescue inhaler more than 3 times a week, their treatment is not quite right and this would need to be assessed. It is important to know the difference between the treatment inhaler, usually orange and brown in colour and the rescue inhaler which is always blue.

Maintenance and reliever therapy (MART) is also used, this is a combination inhaler. The inhaler contains treatment and rescue medication and is used regularly twice a day if there are symptoms. Extra doses of this inhaler should only be needed occasionally.

It is important to get the inhaler technique right, sadly, many people do not know how to use their inhaler properly and this is partly due to insufficient advice from their healthcare provider. This proves that education is key to enabling patients to take their medication correctly.

Types of inhalers:

• Pressurised metered dose inhaler,
• Spacer devices,
• Breath-actuated meter dose inhaler,
• Dry powder inhaler.

Knowing the different types and the correct way to use them is important. If you have a metered dose inhaler, the breathing technique should be slow and gentle, if you have a dry powder inhaler, you should breathe in fast and hard. If you use the fast and hard technique with a metered dose inhaler, the medication will hit your throat rather than go into your lungs, likewise with the dry powder inhalers, if you do not breathe in fast and hard, you will not move the powder into the lungs.

Spacers are available, usually for children. They are chambers for metered dose inhalers, to slow the speed of the medication and hold it for a few seconds, allowing more time for the user to breathe in. There are many different sizes of spacers available, depending on the age and capability of the users.

What if my asthma is not that good?

If you have all of the previous steps in place and your treatment is correct, asthma can still flair up. If this happens, there are steps you can take to tackle this.

• Use treatment inhalers regularly,
• Make sure you know how to best use your inhaler,
• Be aware of triggers,
• Book a review with the asthma nurse,
• If you need your blue rescue inhaler more than 3 times a week, book an appointment,
• If you are short of breath and your inhaler is not helping, make an urgent GP appointment for the same day.

What should you do in an asthma attack?

Knowing what to do during an asthma attack can be the difference between life and death, the below graphic from Asthma + Lung UK shows the steps you should take during an attack.

https://www.asthmaandlung.org.uk/conditions/asthma/asthma-attacks#:~:text=an%20AIR%20inhaler-,Sit%20up%20%2D%20try%20to%20keep%20calm.,not%20improving%2C%20repeat%20step%202

To ensure the care is right, everyone should have a personalised asthma action plan. Various formats are available, an example from Asthma + Lung UK below is:

Action plan available from https://www.asthmaandlung.org.uk/conditions/asthma/manage/your-asthma-action-plan

The green area represents when your asthma is good, this is how it feels when my asthma is good and this is the medication I take to maintain good asthma control.

Amber is when things are starting to get worse, how can I recognise when it is beginning to deteriorate? It gives you steps to follow to improve symptoms and move back into the green.

Red represents an asthma emergency and what to do in this situation.

It is important to recognise when you are in the red and what to do in case this happens, but it is also good to realise when you are in the amber so you can get yourself back on track to green.

How can we manage the effect of our triggers?

Sometimes, there is not much that can be done to avoid our triggers, but where possible, you can eliminate or avoid them. You can treat other conditions that trigger your asthma and make sure your asthma is well managed. You can predict the triggers. For example, if hay fever is a trigger, start treating your hay fever early. Lastly, always have your rescue medication to hand.

Parents and carers must understand asthma to understand how the medication works and why it is important. They need to have an asthma action plan, know how to maintain control and know what to do in an emergency. They also need to know what to do if an inhaler has been forgotten.

With asthma still an ongoing serious respiratory condition that kills children every year, this webinar has helped people understand the following:

• Asthma and the treatment,
• The goals of the treatment,
• How and when to use inhalers,
• Why asthma worsens,
• What to do in an emergency.

To watch the full webinar and gain in-depth insights, click here.

References

1. Asthma + Lung UK. [cited on 8/10/24] Available from https://www.asthmaandlung.org.uk/conditions/asthma/what-asthma
2. RCPCH State of Child Health. [cited on 8/10/24] Available from https://stateofchildhealth.rcpch.ac.uk/evidence/long-term-conditions/asthma/
3. PMC PubMed Central. Wei-Yu Chen, Ching-Wei Lin, Ju Lee, Po-Sung Chen, Hui-Ju Tsai and Jiu-Yao Wang. [cited on 8/10/24] Available from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102795/
4. BBC News. [cited on 8/10/24] Available from https://www.bbc.co.uk/news/health-47292157#:~:text=Young%20people%20in%20the%20UK%20are%20more%20likely%20to%20die,of%2019%20high%2Dincome%20countries.

Bedfont® receives recognition for creating a supportive and inclusive workplace and commitment to mental wellbeing.

 The Kent Mental Wellbeing Awards, an event delivered by Mind in Bexley, are held annually to showcase the people, organisations and initiatives that help us cope with life. Bedfont® was nominated for one of these awards last Summer.

Bedfont® is a local MedTech company, based in Harrietsham, with over 47 years of expertise and knowledge in designing and manufacturing medical breath analysis devices. With mental wellbeing at the heart of Bedfont®, there is a dedicated team of Wellbeing Warriors in force, ensuring a healthy work/life balance for all staff members.

Jason Smith, CEO at Bedfont® comments “At Bedfont®, mental wellbeing is at the core of everything we do. We understand that when our employees feel supported and empowered, they thrive, not just professionally, but personally as well.”

The Bedfont® Wellbeing Warriors continue to bring employees together, encouraging them to take a break from their desks and join in activities designed to help them switch off from work temporarily, giving their minds a break.

To keep up to date with all the activities and news at Bedfont®, follow their social channels. @bedfontLtd

Bedfont® champions Heart of Kent Hospice auction by winning sponsored sculpture and contributing to the memorial garden.

Bedfont® Scientific Ltd. a local med-tech company with over 47 years of expertise in the design and manufacture of medical breath analysis devices, proudly sponsored a Shaun the Sheep sculpture in this year’s Shaun in the Heart of Kent Art Trail. Organised by Heart of Kent Hospice, the event took place in the summer and saw many Shaun the Sheep sculptures lovingly decorated by local artists and community initiatives. The sculptures were then placed in various locations in and around Maidstone, aiming to raise vital funds for the hospice. The Bedfont® sponsored sculpture ‘Shorn the Return’ was located by the Old Boat Café in Maidstone.

Over 250 people attended the auction event and every sculpture was sold, raising a staggering £267,250.00 on the night. The event proved to be a massive success and the vital funds raised will allow Heart of Kent Hospice to continue the much-needed care and support to those at the end of their lives, along with their families and friends.

To find out more about the Bedfont® efforts in supporting Heart of Kent Hospice, follow the social channels @bedfontltd.

Bedfont® Scientific Limited hosted an insightful webinar Mastering Gut Health: Understanding SIBO, Carbohydrate Malabsorption, and Accurate Gastrointestinal Investigation. Gastrointestinal Physiologist and Bedfont® Medical Advisory Board member Melissa Dooley, led the discussion and shared valuable information on various gastrointestinal disorders and the importance of not self-diagnosing.

The webinar covers some important topics:

• SIBO & dietary malabsorption
• Finger-prick food intolerance testing. Does it play a supporting role in clinical testing, or is it a costly test without scientific evidence?
• Food allergies vs food intolerances
• Home breath testing devices & regulations

Small Intestinal Bacterial Overgrowth (SIBO) What is it?

SIBO occurs when there are higher numbers of bacteria in the small intestine. Too much bacteria here can interfere with the digestion and the absorption process. Bacteria, however, can also provide some benefits, such as:

What causes SIBO?

One of the most common causes is a dysfunction of the normal intestinal motility. Slow movement through the intestines allows bacteria to grow, causes of this can be:

• History of food poisoning
• Diabetes
• Certain medications
• Nerve damage

However, in some cases, the cause can be unknown. Melissa continues to discuss the consequences of SIBO, which include the dampening of villi, protein and carbohydrate malabsorption and B12 deficiency to name a few.

How can we test for SIBO?

The ‘Gold standard’ of SIBO diagnosis, culturing jejunal aspirate, is limited because many bacteria species do not grow in routine culture media, not to mention how invasive and costly this procedure is. The hydrogen breath test was developed due to difficulty accessing the small intestine and is used to detect SIBO and dietary malabsorption.

How can breath samples tell me what is happening in my intestines?

During metabolism, all cells produce carbon dioxide, however, only bacteria produce hydrogen and methane as metabolic by-products. These gases pass through the walls of the intestine into the blood. Once the blood reaches the lungs, a gas exchange occurs, allowing these gases to be detected in exhaled breath.

How to take a SIBO or malabsorption test

Before drinking the relevant substrate, a baseline breath sample is taken. The substrate ingested is mixed with 250ml of water and the type of substrate depends on the test being taken. The substrates can be either:

• Glucose
• Lactulose
• Sucrose
• Sorbitol

Breath samples are then taken at 15-30-minute intervals, depending on the test and can take up to 4 hours depending on the type of test. Treatment can involve antibiotics or dietary changes, depending on the test type and results.

Fructose malabsorption

• Inherited or acquired abnormality of the fructose-transporting protein
• Overuse of high fructose corn syrup or fruit juices in children
• SIBO
• Celiac disease
• Chemotherapy or radiation
• Dumping syndrome

Symptoms of fructose intolerance can include:

• Bloating
• Diarrhoea
• Constipation
• Flatulence

Unfortunately, there is no known cure, but an appropriate diet would help. Foods that have a high content of glucose will help absorb fructose.

To test for fructose intolerance, the patient would need to ingest 25g of fructose in 250ml of water. Breath samples would then be taken at 30-minute intervals over 3 hours.

Lactose malabsorption

Lactose is normally hydrolysed into glucose and galactose, which is readily absorbed in the jejunum. Lactose needs to be hydrolysed in the small intestine by lactase. If the lactase enzyme is lacking, the lactose will not be completely hydrolysed and result in lactose malabsorption. Symptoms of lactose malabsorption can include:

• Distension
• Cramps
• Flatulence

Lactose malabsorption is the most common intolerance, affecting almost half the world’s population.

Food allergies vs food intolerances

Often people confuse a food intolerance and a food allergy. A food intolerance can be caused by a change of routine, hormones, and eating out. Symptoms can be quite disruptive to someone’s life and lead them to avoid social activities due to the unpredictability of the symptoms. Because of this, many sufferers will turn to the internet for a quick and easy solution.

An intolerance is where the enzymes in the gut responsible for breaking foods down are deficient, defective, or there is an issue with the mechanism that transports the molecules through the small intestine. Symptoms are:

• Abdominal pain
• Discomfort
• Diarrhoea

Common food intolerances are:

• Lactose
• Fructose
• Sucrose
• Sorbitol

It’s important not to self-diagnose as many conditions can cause similar symptoms to irritable bowel syndrome (IBS) & SIBO, but they will have different treatments and management. It’s always important to visit your GP or healthcare professional. A food intolerance can be diagnosed by an elimination diet or a breath test.

If you have a food intolerance you may be able to consume a small amount of the food, however, with an allergy you must avoid these foods as food allergies can be fatal. Food allergies can be tested through skin prick allergy testing or an elimination diet.

Tests currently not recommended by healthcare professionals for food intolerances are finger prick tests and hair analysis tests, as these do not have any supportive scientific evidence.

Breath testing is the recommended method for detecting lactose malabsorption for several reasons. If you proceed with an elimination diet and remove milk, you may still ingest lactose which can be found in many unsuspecting foods such as:

• Hot dogs
• Breaded chicken
• Sweets

So even if the patient attempts to remove lactose from their diet, they can un-intentionally ingest lactose.

Other test methods can include:

• Endoscopic biopsies (invasive & costly)
• Blood test (repeated every 30 minutes)
• Stool acidity test (infants, young children)

Home breath testing devices

Home breath testing devices were more widely optimised due to the COVID-19 pandemic, to prevent waiting list delays and people felt safer taking the tests at home. There are several benefits of home testing kits, such as:

• Living far from the clinic and difficulty getting there
• Difficulty getting time off work
• Childcare issues
• Difficulties leaving the house with symptoms

However, the limitation of a home test could be that the patient doesn’t collect their samples correctly, resulting in the test having to be retaken. Therefore, patients must be provided with very clear and precise instructions to follow.

There are many home testing devices available now, but using one of these devices without the advice or guidance of a healthcare professional could result in self-interpretation, misdiagnosis, and incorrect preparation, leading to unnecessary avoidance of important food groups.

Home testing devices must be sourced from a reputable healthcare professional, who can discuss the results or provide a report for the treating medical professional. This will ensure an appropriate follow-up is conducted to make sure the patient doesn’t end up with a nutritional deficiency due to self-diagnosis.

There are many factors involved in diagnosing and treating gastrointestinal conditions. Melissa has highlighted these conditions and discussed the importance of not self-diagnosing, watch the full webinar now:

Bedfont® named regional winner of the prestigious British Chamber of Commerce Digital Revolution Award.

The British Chamber of Commerce is a network of accredited Chambers of Commerce across the UK and overseas. Representing businesses of all sizes and sectors, the Chamber Business Awards is an annual event that celebrates and recognises the success and contributions of businesses throughout the UK. Bedfont® was nominated for the 2024 Chamber Business Awards by the Kent Invicta Chamber of Commerce.

Jason Smith, CEO of Bedfont® said “We are truly honoured to be recognised as Business of the Year by the British Chambers of Commerce. This achievement is a testament to the hard work, dedication, and passion of our entire team. It reflects our commitment to innovation, excellence, and customer service. I am incredibly proud of what we have achieved together, and this award motivates us to continue pushing boundaries, growing, and contributing positively to our industry. Thank you to the Chamber and everyone who has supported us on our journey.”

Winning Business of the Year is a significant milestone for Bedfont®. This award not only highlights the commitment to excellence and innovation but also fuels our drive to continue delivering outstanding service to our customers and providing cutting-edge technology to the breath analysis market.

To find out more about Bedfont® and how their breath analysis devices are improving patient care, click here.