Bronchial Asthma
Q) What is bronchial asthma?
A) Asthma is a disease of our airways. It is seen mainly in childhood and early adulthood, but can start at any age. The common symptoms of asthma are breathing difficulty, wheezing, chest tightness and cough that can vary over time and in intensity. Seasonal and diurnal changes mark the disease. Symptoms are mainly due to narrowing of our airways and increased airway secretions.
By United States-National Institute of Health: National Heart, Lung, Blood Institute -
http://www.nhlbi.nih.gov/health/health-topics/topics/asthma/, Public Domain, https://commons.wikimedia.org/w/index.php?curid=24760677
Q) Are there different types of asthma?
A) About 50-60% of asthmatics have an underlying allergic tendency (atopy) and it is known as an allergic asthma. These individuals frequently have associated eye, nasal and skin symptoms of allergy. A history of similar symptoms in the family members is seen. Non-allergic asthma is equally common. It is triggered by viral infections, pollutants (O3, NO2, particulate matter), occupational exposures etc. Obesity associated asthma is also known.
Q) What tests are done for diagnosis of asthma?
A) A chest x-ray, pulmonary function tests (PFT) and a complete blood count are usually done initially for supporting the diagnosis of asthma and for grading the disease. Specific tests for identifying the allergens in sensitized individuals are also done on a case-to-case basis. Tests like CT scan of chest, ECG and 2D Echo maybe required to rule out conditions mimicking asthma.
Q) What is the treatment for asthma?
A) The main therapy for asthma is the use of inhaler medicines. An inhaled cortico-steroid (ICS) is necessary for the control of asthma along with the use of an inhaled airway dilator medicine. The use of inhaler medications on a regular basis helps in control of symptoms and halting the progression of disease. A short course of oral steroids maybe required for treating asthma flare-ups. Antibiotics are not required unless there are definite signs of a bacterial infection.
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Q) What are the side effects of using inhaler medicines?
A) Inhaler medicines directly reach airways and lungs and only miniscule amounts reaches bloodstream. Few known side effects are dryness of mouth, fungal infections of mouth, tremors in hands and increased heart beat. These are often non-troubling and easily preventable by using inhalers the right way.
Q) What is meant by asthma flare-up, asthma attack, or exacerbation of asthma?
A) When the symptoms of breathing difficulty, chest tightness, wheezing and cough increase significantly and are not controlled by the regular prescribed medications that the patient is taking at home, it is known as a flare-up. Acute exacerbation of asthma and asthma attack are other terms used to describe this sudden worsening of symptoms.
An asthma flare-up is usually triggered by viral infections, bacterial infections, exposure to smoke and pollution, exposure to allergens to which person is sensitive (pollens, dust, new pets etc.), and changes in weather. It can also be triggered if the person becomes irregular with the prescribed medications or stops them completely.
Q) What is to be done when there is a flare-up of asthma?
A) It is always advisable to consult the treating doctor or the nearest hospital at the earliest for management of an asthma flare-up.
Q) Are there any newer therapies?
A) Several new modalities are now available for asthma patients whose symptoms and flare-ups are not controlled on the inhaled steroids and bronchodilator therapy. Some of them are desensitization with Allergen Immunotherapy (AIT), injectable Biological therapies/ Targeted therapy, and Bronchoscopic Bronchial Thermoplasty procedure. The decision to start on higher therapies varies from patient to patient, and is to be discussed with the treating doctor and experts in the field.
Q) Is there a cure for asthma?
A) Asthma is a genetically determined disease. There is no cure for asthma at present. But it is an easily manageable condition with the use of right medicines.
Q) Are there any treatments for asthma in traditional and alternative medicine?
A) Evidence for an effective treatment in traditional or alternative systems so far is not encouraging.
Q) Does doing yoga and breathing exercises help in controlling asthma?
A) Yoga and breathing exercises by itself can not control asthma. But they may help in dealing with asthma symptoms better, and can be done along with the use of regular medicines.
Q) How can we prevent asthma from getting worse, in addition to using medicines?
A) Avoidance of known allergens in sensitized individuals, smoking cessation, reducing exposure to outdoor and indoor air pollution, using inhalers as prescribed, taking vaccinations against flu and pneumococcal pneumonia as per schedule, regular physical exercises and leading a healthy lifestyle are all recommended for keeping asthma under control.
Sources and further reading:
1. GINA Patient Guide: You Can Control Your Asthma. https://ginasthma.org/gina-patient-guide-you-can-control-your-asthma/
2. https://www.who.int/news-room/fact-sheets/detail/asthma
4. https://www.mayoclinic.org/diseases-conditions/asthma/symptoms-causes/syc-20369653
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