( What is asthma and how to control it .)
“When you cannot breathe easy, nothing else matters “.According to WHO may 2020, 339 millions of people are suffering from asthma world wide . 80 % asthmatic deaths occurred in low and lower-middle income countries. India accounts for around 1.31 billion asthmatics of which 6 % are children and 2 % are adults. One in every 10 asthma patients in the world is in India.
WHE
N I HAVE AN ASTHMA ATTACK, I FEEL LIKE A FISH WITH NO WATER.
-5 YEAR OLD GIRL , JESSE
Asthma is a chronic inflammatory airway hyper responsiveness disorder. Lungs show an exaggerated response to inciting agents like dust, pollen, grass, cat fur, dog hair, cockroaches, house mites, perfumes, chemicals , pollution and smoking. 50 % of asthmatics have their own parents suffering from asthma.
Symptoms of asthma are difficulty in breathing ,tightness in chest ,cough or wheeze (some musical sounds). Difficulty in breathing is more severe at night or early mornings. Most of the patients are normal in some days and symptomatic in some days (seasonal variation).
40-50 % of asthmatics have associated allergic rhinosinusitis .It has features like running nose, sneezing, head ache ,watering from eyes. Some of them may have gastric problems like acid regurgitation . Obesity is commonly associated with asthma.
Asthma is mainly diagnosed clinically by the physician. Patients need to assessed by investigations such as allergy blood tests and spirometry .
Asthma is mainly managed by inhalers. Patients need to be trained properly on the use of inhalers. Oral medications are supportive to inhalers. Few of the asthmatics taking self medications inadvertently and consuming steroids usually have undesirable side effects.
Recent treatment modalities for asthma has developed enormously and includes immunotherapy, allergen desensitisation and bronchial thermoplasty surgery.
Patients have to do follow up visits atleast once in 3 months.
CONTROL STRATEGIES :
1.Breast feeding till 2 years of age (at least 6 months)
2. Proper hygiene and sanitisation
3. Avoid allergens like cockroaches, dust mite. Clean the room properly and avoid cotton pillows.
4.Avoid pet animals like cats and dogs in house of asthmatics.
5.Take proper childhood vaccinations recommended by IAP.
6.Active and passive smoking should be avoided.
7. Avoid air pollution and can use mask while going out.
8. Avoid cooking using cowdung cakes , firewood stoves. It can be replaced by gas stoves.
9.Consume more vegetables and fruits.
10. Avoid exercising in cold and moist air.
11. Yoga and meditation can improve symptoms and gives us mental well being too
12.Reduce excessive body weight.
13. Occupations having increased risk for asthma like wood saw mills, chemicals, varnishing, cotton, jute mill have to be avoided.
14. Make written action plans for asthma and make own “asthma diary” and record your symptoms.
15.Avoid stress ,depression and anxiety. Sound mental health is mandatory.
Adhere to inhaler and we will win against asthma …….
DR. D. SURESH KUMAR MBBS,DTCD
FINAL YEAR MD PGT
PULMONOLOGIST
IPGMER & SSKM HOSPITAL..