World Asthma Day!

Dr. Praveen Valsalan K
Consultant Interventional Pulmonologist,
Aster Medcity, Kochi

Today is World Asthma Day! It is an extremely common chronic respiratory disease involving the airways in the lungs. A recent study states that India has 10% of the global asthma burden worldwide and its number is rising every year. In India, the soaring numbers have reached 15-20 million and the number will continue to grow until adequate emphasis is laid on the importance of identifying the right medication, which can help manage asthma effectively.

People with asthma has inflamed airways. They become even more swollen and the muscles around the airways can tighten when something triggers your symptoms – asthma flare ups. This makes it difficult for air to move in and out of the lungs, causing symptoms such as coughing, wheezing, shortness of breath and/or chest tightness. Dust, cold, pollen, furry pets, and viruses and air pollutants, and even emotional agitation act as triggers for an asthma attack. 

Current theme of world asthma day – better air, better breathing – stresses on the need to have a unpolluted air which can reduce the burden of asthma. The rapid pace of industrialisation has a definite role in the increasing epidemic of allergic diseases. 

When we think of Asthma, we picture a sneezing or a wheezing individual who seems to be perpetually ill. But is this the case every time? Often we try to run away from the harsh reality of the disease and ignore it, making the situation worst. But that is not always the case. With the current treatment modality – inhaler treatment – one can easily control asthma. Although asthma is not curable, it is possible to gain complete control over it and lead a normal active life. The best and safest way to take asthma medication is by inhalation as it reaches your lungs directly and starts acting immediately. Commencing the inhaler treatment at the earliest helps in controlling the disease, prevention from attacks, preserves the condition of the lungs and also improves the quality of life.

Symptom free is NOT asthma free. This remains one of the biggest challenge to the management of asthma, when there is discontinuation of the medication once the symptoms have subsided. This can be majorly to save the cost of the medication. Unfortunately, this may result into aggravation of the disease and chances are that symptoms may flare up anytime - this time with double impact. It is important to understand being symptom free does not mean one is free of the disease. Always, consult a doctor before taken such steps.

There are many reasons why patients stop inhalers. These include unnecessary concerns about the cost of medication, side effects, myths about inhaler devices and social stigmas. There are also several psychological barriers which lead to inhibitions such as dissatisfaction with healthcare professionals, inappropriate expectations, anger about one’s condition, underestimation of the severity of the condition and casual attitude towards health.

Need of an hour is to overcome barriers/ taboos and understand the importance of inhalation therapy and adhere to it. Myths associated with the treatment needs to be busted. Inhaled corticosteroids have been recognized and widely accepted as the mainstay of asthma management. However, due to lack of awareness many people remain reluctant to take the therapy.

Asthma is a public health problem not just for high-income countries; it occurs in all countries regardless of the level of development. In fact, asthma in countries like the UK, Australia and New Zealand is higher than the global average, which could perhaps be attributed to the factor of ‘Hygiene Hypothesis.’ This means that those living in cleaner environments have greater chances of developing asthma than those living in less clean surroundings. This is because children with no exposure to infections leads to their immune system getting more provoked by allergens in the environment while those who have repeated exposures to infections develop an immunity towards the infections and not to allergens. However, most asthma-related deaths occur in low- and lower-middle income countries. This is due to the fact that asthma is under-diagnosed and under-treated in these countries. It creates substantial burden to individuals and families and often restricts individuals’ activities for a lifetime.