Chronic Asthma – Advanced Medical Treatments to Control
Asthma is characterized by narrowing of airways followed by difficulty in breathing air out of the lungs, luminal wall thickening, and increased mucus production. In India there are 30 million asthmatics. India ranks first in the world in deaths due to asthma in India 30 million people are asthmatics. World asthma day is celebrated to raise awareness regarding asthma, control symptoms, and improve the quality of life of people living with asthma.
World asthma day is celebrated every year on the first Tuesday of May month. This year’s theme – is closing gaps in asthma care Symptoms include cough, wheezing, shortness of breath, and chest tightness. Risk factors for asthma include – genetic, environmental factors, babies born by caesarean section, preterm birth and low birth weight, maternal smoking, air pollution (indoor and outdoor)Triggers for asthma – smoke, bugs at home, chemical fumes, pollen grains, fungal spores, stress, anger, exercise. Earlier asthma was thought to be a single disease. With advances in research now it is known that asthma has multiple clinical phenotypes.
“Treatment for every phenotype is not the same. Grossly we have eosinophilic and no eosinophilic asthma. In eosinophilic asthma, we have allergic asthma, occupational asthma, cough variant asthma (in which only presentation is cough), aspirin-exacerbated asthma, and intrinsic anoneosinininophilic asthma we have infection-related asthma, cigarette smoke-induced asthma, air pollution-induced asthma, obese asthma”Dr Vinita Paritala, Senior Pulmonologist, Kamineni Hospitals, Vijayawada.
Asthma is diagnosed by symptoms, spirometry, and peak flow meter monitoring. The severity of asthma is classified into intermittent, mild, moderate, and severe persistent asthma based on symptoms, night time awakenings, frequency of inhaler usage for control of asthma, and lung function.
“Inhaled medications are better than oral medication as the dose given is less compared to oral dose and inhaled medication reaches the lungs directly so that the adverse effect of drugs is very minimal. Many people are in a false belief that there would be an addiction to inhaled medication which is actually false. There are athletes and sportspersons who have won gold medals with their asthma kept under well control by means of inhaled medicines” said, Dr S. Kiran Kumar , Senior Pulmonologist, Kamineni Hospitals, Vijayawada.
Do people with asthma need lifelong medication? This is a difficult question to answer. Some people can have their asthma well controlled without medications if they can avoid the triggering factors. Allergic asthma can be well controlled if the triggering allergens can be identified by skin prick tests and as such immunotherapy can be planned accordingly.
“For severe uncontrolled asthma, we have advanced therapies like biologics and bronchial thermoplasty. The aim of this asthma day is to see that people with asthma will lead normal life both qualitatively and quantitatively” Dr. Vinita added.