Docyard | Breathe the easy way

As per World Health Organization, there are around 15-20 million asthmatics in India, out of which 10-15 per cent are children under five-11 years of age. It is although a largely avoidable disease, still it tends to occur in epidemics. These rates are increasing by 50 per cent every year. The economic costs associated worldwide with asthma exceed to that of tuberculosis and HIV/AIDS combined. For some, it can just be a minor problem, but sometimes asthma attacks greatly affect patient’s quality of life and can be life-threatening too.

Causes

The exact cause of asthma is still unclear, but it can be a combination of environmental and genetic factors. Normally, the airways carry air to the lungs. As the air passes through the lungs, airways become smaller and smaller anatomically just like tree branches. In asthma, the airways to the lungs become inflamed and narrow causing constriction of the passage and restricting the amount of air that can enter. less air gets in and out of the lungs. During asthmatic attack, airway constricts even more and throws more mucus in the passage, which further clogs up and reduces the amount of air going in and out of the lungs. This makes breathing difficult along with a cough, wheezing and breath grasping.

Triggers

Various factors can trigger the symptoms including pollen, perfume, pets, stress on lungs due to exercise or laughing, upper respiratory infection, cigarette smoke, dust, sulfites or acid reflux in food or drink preservatives, indoor allergens like bedding mites, carpets,  outdoor pollution, food items such as dairy products, peanuts, fish, soy, shellfish, wheat, etc, traffic on roads, pollution, chemical fumes, gases, dust, etc.

Other risk factors include low birth weight, asthmatic patient related with blood, allergic rhinitis or atopic dermatitis, being overweight, and being a smoker.

Symptoms

The symptoms include trigger cough, wheezing while exhaling, shortness of breath, and chest pain or tightness, or trouble sleeping or feeling of drowning.  Emergency symptoms include rapid worsening of breath, no relief with an inhaler, or shortness of breath with minimal physical activity.

Treatment

The disease can’t be cured but its symptoms can be managed or controlled.

• Medications can calm down the symptoms by relaxing the muscles of the airway. These medications should be hands-on for such patients. For llergen triggered asthma attacks, allergy medications also help manage the symptoms. Every patient does not take the same medicine.
• Inhaled corticosteroids are to be used for several days to weeks for maximum benefit.
• Oral medications like montelukast help relieve the symptoms for few hours. Rarely, these can be linked with psychological reactions.
• long acting beta agonists like salmeterol are inhaled medicines that open the airways, but these too increase the risk for severe future attacks. That s why these are to be taken in combination with inhaled corticosteroid.nCombination inhalers are used which have long-acting beta agonist along with a cortiocosteroid
• Short acting beta agonists can be a hand-held inhaler or a nebuliser and can be used for quick relief.
• Oral and intravenous corticosteroids, mainly prednisone and methylprednisolone relieve airway inflammation. In long-term use, these can have severe side effects.
• Allergy shots (immunotherapy) reduce the immune reaction gradually to specific allergens.
• Prevention and long-term control of asthma is the key in management. The treatment plan should be flexible and assessed thoroughly by the doctor.
• Patients must get vaccinated against influenza and pneumonia and learn to recognise the breathing pattern for any change.