Asthma is an inflammation and obstruction of the bronchial tubes, passages that allow air to enter and leave the lungs. During an asthma attack, muscles surrounding bronchial tubes constrict, narrowing the air passage making it difficult to breathe. The duration of the attack may vary depending upon the course. At Medicircle, on the occasion of World Asthma Day, we are speaking to eminent Pulmonologist, Respiratory Therapists, Paediatricians to build awareness regarding respiratory-related diseases and their available treatments.

Dr. Anil Kumar Singal is a renowned Pulmonologist, TB and Chest Specialist, and a Family Physician in Mumbai. He has 26 years of experience in the medical field. He has completed his MD in TB and Chest Medicine from Mumbai. Currently, he is a Chief Medical Officer at BEST, Mumbai, and a Consulting Physician to the State Bank of India. He runs his own clinic with the name Maniben Health Clinic in Mumbai. He has worked on TB, HIV, Tobacco, and COVID and has been acknowledged at various National and International platforms.

What is Asthma?

Dr. Anil describes, “Asthma is a chronic disease that involves airways in lungs. These bronchial tubes allow air to come in and out of the lungs. If anyone has asthma, these air tubes are narrowed and inflamed. Due to the narrowing of passage, there is an obstruction in passing air thus hindering the flow of air. When something triggers, this makes it more difficult for air to move in and out of the lungs. A person may feel tightness in the chest, coughing, shortness of breath, suffocation, may become a hunger for air.”

Dr. Anil speaks, “There are many variants of asthma- 

United airway disease – Patients have cold and this cold gets converted into asthma. It is a kind of sinus. Allergic / Seasonal response – some people are allergic to dust, pollens, or pets, exposing them to these things can worsen their condition. A change in weather could also trigger their condition. Occupational – It is caused due to exposure to substances in the workplace, causing narrowing of airways. For eg. – a mechanic working in the automobile sector. Acidity – There is a connection between GERD and asthma, acid regurgitation can worsen asthma symptoms.”

Dr. Anil adds, “These variants are the triggering factors. When an asthmatic person comes in contact with these, the person starts experiencing asthma symptoms. When the person breathes, he feels wheezing. So, during an asthma attack, this airway gets narrowed and blocked, the person is unable to breathe and its saturation level drops down. If it doesn’t get treated on time, the person may get severe or lethal or die also. When the patient is exposed to any triggering factors, he gets attack and between any two attacks, the person is all normal.”

The history of the patient plays a major role

Dr. Anil talks, “We track history of the patient, sometimes it runs in family. There can be a history of any allergic reactions not necessarily of asthma to anyone in the family, these kinds of patients are more prone to get bronchial asthma. The asthmatic patient often gets cold and takes a long time to get a cure during their childhood also. Geographical distribution of their stay also plays a major role.”

Ways to diagnose asthma

Dr. Anil expresses, “ECG is used to check heart rhythm of asthma patients. We can do a pulmonary function test to diagnose the asthma attack. Allergic tests can be performed through a blood or skin test. There is a rise in IgE levels while doing a blood test for allergic asthma. If the patient has the problem of sinus, we can do a chest X-ray to see if there is any inflammation.”

Peak flow meter

Dr. Anil states, “Peak flow meter is a portable, hand held device used to measure the amount of air that can be expelled from the lungs. The normal score is 400-700 liters per minute. To take the reading in peak flow meter, one has to blow hard in a single attempt and take the reading. By this method, we can anticipate asthma attack and can take necessary precautionary step to avoid the severity of attack.”

Inhalers are ideal for the treatment of asthma 

Dr. Anil emphasizes, “There are many treatments available in the market, the ideal is an inhaler. As it is a disease of the airway, inhalers act directly at the desired site. It helps to open the airway and lets more air move in and out of your lungs and helps to breathe more easily. Advantages of inhalers – lower quantity of drug is required, gives quick action, has lesser side effects.” 

Oral medications have some limitations

Dr. Anil voices, “Asthma is a chronic disease, it is going to be there for a long time. Inhalers are very effective in small doses with faster action, hence it is very safe. If we are using in small doses, there are fewer chances of side effects also. Inhalers are much safer than oral medication. Personally, I prefer the use of inhalers over oral medicines. We can take inhalers for regular use whereas oral medications have some limitations. Along with this, a doctor’s consultation is also important. If asthma is in control, one can stop using inhalers, but they always have to keep it with themselves for emergency use. Inhalers are useful as an emergency reliever as well as in long run as preventive measures. So, inhalers are a very good option for treating asthma.”

(Edited by Renu Gupta)