It's common but treatable: busting myths around asthma and its treatment

The Hindu

01-05-2025

Breathing is essential for our lives. But for some of us who have asthma, taking a breath becomes a difficult task, and affects quality of life. Asthma has many names in India – Vaayu roga, Dama, Asthma, Saans ki bimari or Eazhai Noi. Though difficulty in breathing can occur due to multiple causes, for example heart failure, Chronic Obstructive Pulmonary Disease (COPD) or interstitial lung disease, Asthma remains one of the most common causes of difficulty in breathing.
Scope of the burden in India
About 6 to 11 people in every 100 persons in India experience breathing difficulties due to asthma, making it a very common problem. Asthma is an inflammatory condition of the airways or breathing tubes inside the lungs, which are called bronchi. These air-tubes are a sensitive structure. When we get exposed to cold air or dust, these air-tubes may decrease a little bit in size, and one may feel a cough or suffocation for a few seconds. But in patients with asthma, there air-tubes are very sensitive due to inflammation, and they shrink in size significantly causing difficulties in breathing, with a wheeze and cough for many hours, days or sometimes weeks.
An asthma diagnosis should be suspected when such wheezing or breathlessness has been occurring in episodes of few hours or weeks for few months or years. In between these episodes, a person could be completely fine. An asthma diagnosis can be confirmed with pulmonary function tests such as spirometry, oscillometry and FENO (Fraction of exhaled nitric oxide). A patient can also easily learn performing peak expiratory flow rate (PEFR) measurements from his or her healthcare provider, and the changes in PEFR readings also help in confirming an asthma diagnosis.
Treatment for asthma
After confirming the diagnosis of asthma, treatment of asthma can be started in the form of corticosteroid inhalers. The dose of the corticosteroid in inhalers is very low (in micrograms) and usually very safe for use over many months and years. Inhaled bronchodilators like Salbutamol can be used as reliever medications for in-between symptoms relief. In a few selected patients with uncontrolled symptoms, newer therapies such as monoclonal antibody treatment or biologicals can help gain control over asthma symptoms.
There are many common queries or myths about asthma in the society. Here, we will try to address these question one by one.
I often develop a cold and cough and sometimes wheeze, which then improves on its own over a few days or weeks. Do I have asthma?
Yes, it can be asthma. But it can be treated easily, and one can live a normal life.
I had a fever and cold. I took antibiotics. The fever subsided, but the cough and wheeze are still persisting. Could it be asthma?
Asthma symptoms cannot be treated with antibiotics. Inhaled corticosteroids are the main treatment for asthma.
If I have asthma, can I eat cold things? Can I eat citrus fruits and curd?
With proper treatment of asthma with inhaled corticosteroids – you can eat all food items. Curd, milk, paneer, citrus fruits, and fruit juices are good for health and they do not cause asthma symptoms.
Can my asthma be cured or do I have to use inhalers for life?
Asthma is chronic disease like diabetes or hypertension. It persists, but with proper treatment with inhaler corticosteroids and PEFR monitoring, one can live a fully normal life.
Does the inhaler have steroids? Will It harm me if I use it for long durations?
Inhalers contain medicines in micrograms and these drugs stay in lung and do not reach blood in high doses. Thus, inhalers are very very safe for use over many years, even in children, pregnant women, and elderly population.
Can you give me tablets? I do not want to get habituated to the inhaler.
The use of inhalers is not habit-forming. Tablets contains medicines in milligrams or grams which is about a thousand times of a higher dose than the inhaler. Inhalers deliver medicines in very low doses and directly into the airways, making them safe and accurate treatment options for asthma.
I do not have any asthma symptoms anymore. Why do I need to use my inhaler if I am doing well?
In asthma, lung function decreases. The aim of treating asthma with inhalers is to bring back the lung function to normal, in order tokeep the person symptom-free. So please do not stop your inhaler just because symptoms have stopped. APFT is needed to check if lung function has also improved to normal. Your asthma physician will help you achieve normal lung function
Can you tell me what am I allergic to? Can I avoid those food or exposure to that substance, and get cured?
Withasthma, our airways become verysensitive to variety of trigger factors such asdust, smoke,strong smells from cooking in the kitchen,paint or perfume and cold air. Some patients may be allergic to a particular antigen like pollen or aspirin. A complete assessment by a physician can help. But all patients of asthma should avoid common triggers factors as mentioned above.
Can I use the air-conditioner?
Yes, you can set the AC temperature to 24 degree or above and can use it.
Asthma is a treatable disease, and with proper monitoring of lung function with spirometry and with regular treatment with inhaled corticosteroids, one can live a fully productive life.
(Dr. Prince James is with the Department of Interventional Pulmonology and Respiratory Medicine, Naruvi Hospitals, Vellore. [e-mail])