Bronchial Asthma: Diagnosis, Management and Treatment
New Delhi , May 16 : Bronchial asthma is a chronic disease of the airways, characterized by intermittent airway narrowing which is completely reversible either spontaneously or with medications.Asthma is one of the commonest respiratory problems worldwide. The incidence is on a steady rise courtesy urbanization and industrialization. The prevalence of asthma varies from 1-18 percent in different countries across the world and it is estimated to prevail in around two percent of Indians.
The true incidence of asthma among Indians is highly underestimated. Asthma adds to significant morbidity and the estimated cost of asthma treatment per year for the year 2015 has been calculated at about 139.45 billion Indian rupees.
Allergic Asthma is the most common type and it usually starts in childhood, however no age is immune. This form is usually associated with allergic rhinitis, skin allergy and eye allergy. Increasing epidemic of obesity is associated with poorly controlled asthma and is one of non allergic varieties. Occupational asthma which is related to work place is a well known entity since ages.
Asthma is usually a hereditary disease and runs in a family, that doesn't preclude the possibility of developing it de novo. Some occupations like teachers, drivers etc. are prone to develop asthma. Children who are fed with formula feeds rather than breast-milk are prone to develop wheezy illness early in childhood.
Asthma triggers include infections (viral and bacterial), pet dander, strong fumes, acid reflux, drugs like aspirin and few pain killers, dust mite (indoor allergen), fungal molds, tobacco smoke including second hand smoke, perfumes/deodorants, outdoor air pollution, cold air, exercise and even emotions.
The usual symptoms of asthma are cough, sputum production, wheezing, chest tightness and difficulty in breathing.
The symptoms are usually intermittent and sometimes get resolved spontaneously.
There might be seasonal variation also. These symptoms usually start immediately or few hours after getting exposure to the triggers. The severity of symptoms varies in each attack and sometimes it can be life threatening.
Dr Sandeep H S, consultant pulmonologist at BGS Gleneagles Global Hospitals, Bengaluru has listed the symptoms, diagnosis and treatment of the same.
When to suspect asthma?
-Repeated attacks of cough and cold.
-Cough that doesn't go away easily.
-Symptoms on performing / exposure to triggers.
The most important thing to be noted in all cases of bronchial asthma is although the symptoms are intermittent, the underlying disease process will be continuing and the frequency of symptoms as well as the severity of attacks will increase if it is not controlled with appropriate treatment.
Treatment of asthma has been revolutionized since the introduction of inhaled steroids. The inhaled steroids form the cornerstone of therapy for asthma. Temporary relief from symptoms can be achieved with short acting airway dilators which are also in inhaler form. Inhalational treatment has many advantages over systemic therapy, the most important one being the dosage of drugs. The drugs can be delivered to the site of action and this helps to reduce systemic side effects. Various studies have shown that the systemic side effects of inhaled steroids are very minimal and in fact the complications of not taking the treatment are much more than that of inhaled steroids.
-Asthma spreads from one person to other.
-Asthma is completely curable.
-Asthma cannot be controlled.
-Inhalers are addictive.
-Steroids are harmful and should be avoided.
-Asthma can be completely controlled.
-Asthmatics can perform all the activities just like any non asthmatic individual.
-Inhalers are the best mode of drug delivery.
-Inhaled Steroids are the most important disease modifying drugs.
-One needs to continue the treatment irrespective of symptoms.
-Put pillows, mattresses, and box springs inside allergen-proof, zippered covers
- Wash all bedding in hot water about once a week.
- Non-carpeted flooring is best.
- If you have to do your own sweeping, wear a mask while you work.
- Regularly change filters on heaters and air conditioners
- Replace heavy, lined curtains or drapes with washable window coverings
- Dust often and everywhere, including lampshades and windowsills, with a damp cloth
- Store toys and books in closed bookshelves, drawers, or closets
- Clean bathrooms regularly with products that kill and prevent mold
- Keep indoor plants out of bedrooms.
- Visit your doctor periodically and follow his advice.