For some people, asthma is a minor nuisance but for many, it’s a problem that greatly impacts their daily activities. If asthma is left untreated, it can be a life-threatening attack. WHO is taking several measures to increase the diagnosis and treatment of asthma. Asthma is part of the WHO Global Action Plan for Prevention and Control of Noncommunicable Diseases. It is also part of the United Nations 2030 Agenda for Sustainable Development. Medicircle is conducting an exclusive series for awareness of asthma in which you can gain direct and more reliable information from Pulmonologists and Respiratory Therapists.

Dr. Pratibha Gogia is the Head of Department, Respiratory Medicine, Venkateshwara Hospital, New Delhi. Her practice areas are bronchoscopy, biopsy, FNAC, and all interventional bronchoscopy procedures and bronchial thermoplasty. She has received an Interventional Pulmonology Fellowship from Royal Brompton, London. She has several presentations in national and international journals to her credit. 

Understand asthma

Dr. Pratibha mentions, “Asthma is a common ailment these days. An asthma attack is accompanied by breathlessness and wheezing which is the result of viral infection, high pollution levels, change in atmosphere, exposure to the strong smell, overexposure to dust, pet fur, bird feather, or certain exercises like running. Asthma is a clinical diagnosis where we examine patients by listening to their breathing through stethoscope and talk to them to identify the problem. We try to find if there is any involvement of family history of asthma, skin allergy, proximity to pets, occupational hazards, etc. for eg; one of my patients is a baker and is prone to getting attack when he comes in contact with certain smells or fumes inside the bakery, another patient of mine is a mechanic and prone to attack when he works in an air-conditioned environment in his workshop. So, every individual has his / her distinct case of getting asthma attacks.” 

Supportive tests for asthma diagnosis

Dr. Pratibha informs, “Apart from clinical diagnosis, we do supportive tests which are lung function tests and pulmonary function tests. Through these, we observe the capacity of the lung in order to ascertain the disease and its severity. In more than 30% of cases, the reports of these tests can be normal. In such cases, we have to base the diagnosis on the symptoms only.

Other than these tests, there are some less common tests like exhaled nitric oxide test, also known as the fractional exhaled nitric oxide (FeNO) test, through which we measure the level of nitric oxide in the exhaled sample of the breath. However, these tests are not readily available. There is another test called sputum eosinophil count, which is another sophisticated test. There is an IgE level test which is a marker of allergy. It has been found that 50% of allergic people have chances of developing asthma,” says Dr. Pratibha.

Can allopathy treat asthma from its roots?

Dr. Pratibha emphasizes, “Allopathy can not cure asthma from its routes. A doctor who claims that is misleading. Asthma is a tendency of the body that causes airways to over-react in certain situations. Whether it is an asthmatic or non-asthmatic person, the airways are bound to constrict in certain conditions like overexposure to dust. It’s just that the airways constrict more in people prone to asthma and breathing problems start getting evident in them.”

Come out of the stigma of inhalers

Dr. Pratibha says, “An inhaler is the best option to manage asthma but people do not use it due to stigma. Parents of young girls do not want them to use it. They do not want to project that their daughters are dependent on inhalers especially if they are in marriageable age. Others also tend to avoid it. However, people should understand that inhalers are the safest method. Inhalers are like friends of asthmatics that help to lead a normal life.”

Covid and asthma

Dr. Pratibha points out, “Covid and asthma both affect lungs so there is a kind of insecurity in asthmatic patients during these covid times. There is no strong proof of it but a few research studies are hinting and even I have observed in my practice that Asthmatics are having lesser covid attacks or even if they are having it, the severity is less. This is because one of the inhalers that we prescribe to asthmatics helps in controlling the viral load. Some doctors are routinely prescribing inhalers to Covid patients,” says Dr. Pratibha.

(Edited by Amrita Priya)