By Dr. Amila Rathnapala

World Asthma Day falls on May 3


Asthma is a major non-infectious breathing disease affecting both children and adults. Inflammation and narrowing of the small airways in the lungs cause asthma symptoms which can be any combination of cough, wheeze, shortness of breath and chest tightness.

Asthma affected an estimated 262 million people in 2019 and caused 461,000 deaths  according to the WHO. International Asthma Day on May 3 aims to improve awareness of asthma among the public and this year’s theme is “closing gaps in asthma care”.

The Global Initiative for Asthma chose the theme as there are several gaps in asthma care that include inequal access to diagnosis and treatment facilities to communities with poor socio-economic backgrounds and the significant gap in the general public’s awareness and understanding of the nature of asthma.

: What is asthma?

 A:  Asthma is a condition           that affects the airways – the tubes that carry air in and out of the lungs.

If you have asthma, you have ‘sensitive’ airways that are inflamed and react to things that can irritate them such as pollen, cold weather, stress and hormones. When the airways react, they become narrower and more irritated. This causes you to have asthma symptoms, where you find it harder to breathe.

: What are the symptoms?

 A: The usual symptoms  include wheezing, cough, breathlessness and chest tightness.

Asthma symptoms can come and go. Even when you’re well, the asthma is there in the background.  Asthma is a long-term condition for which there is no cure.

If not treated properly, asthma can be serious and lead to a potentially life-threatening asthma attacks. The good news though, is that most people who get the right medicines and support can manage their asthma well and live a symptom-free life.

: What are the causes
of asthma?

A: It’s hard to say, but someone’s more likely to develop it if they have a family history of asthma, eczema, catarrh or allergies. In addition, modern housing, diet and a more hygienic environment may play a role. Occupational asthma is a common cause of asthma in adults (both new asthma symptoms and childhood asthma symptoms returning). Research shows that obesity can increase the risk of developing asthma.

: How can you deal with        asthma triggers?

A: Anything that can set off your asthma is known as a trigger. Everyone with asthma has their personal mix of triggers – you can have one or more.

The best way to help your body cope well with any asthma triggers is to take your preventer medicines every day as prescribed so your airways are less inflamed and sensitive. These medicines soothe your airways so they’re less likely to react to common triggers you can’t avoid like pollen, pollution, dust mites or cold weather. Using your medicines exactly as prescribed means you’ll be more likely to stay symptom-free and be able to go to work, exercise, have fun with your family, and enjoy your social life.

There are some triggers that are easier to avoid – for example, a food allergy, alcohol, cigarette smoking or smoke from open fires, incense sticks, mosquito coils. It can be useful to work out your triggers because then you can avoid the ones in your control. Bear in mind you might have more than one trigger, and you might not react straight away. You may need to do a bit of extra detective work – try keeping a diary of activities and symptoms to help spot any patterns.

If you’re taking your inhalers as prescribed but still have asthma symptoms, speak to your doctor so you can come up with a plan to improve things. It might be as simple as a change of inhaler technique.

: Is there a cure ?

A:Asthma cannot be cured  but it is possible to manage asthma to reduce and prevent asthma attacks, also called episodes or exacerbations.

: What are the aims of
asthma treatment?

A: The aim of treatment is to manage your asthma so that:

•    you get no daytime symptoms

•    you get no night-time waking due to asthma

•    you don’t need to use reliever inhalers (usually blue)

: What are the common
asthma treatments?

A: Asthma is commonly treated with inhalers that deliver medicines directly into the lungs without going to the bloodstream.

Reliever inhalers – everyone with asthma needs a reliever inhaler. They’re usually blue. They give you on-the-spot relief from asthma symptoms and asthma attacks, relaxing your airways very quickly.

However, if you use your reliever inhaler three or more times a week this can be a sign that your asthma isn’t well managed. Book an appointment with your doctor to review your treatment as soon as possible.

Preventer inhalers – most people with asthma are prescribed a preventer inhaler that helps prevent asthma symptoms and makes it less likely that your airways will react to triggers, by reducing swelling and inflammation in the airways.  There are several kinds of preventers.  You need to take your preventer inhaler every day (usually twice a day) even if you’re feeling well because the protective effect builds up over time and needs to be topped up regularly.

:What can you do to
control your symptoms?

A: The inhalers your doctor prescribes can’t deal with your asthma unless you take them in the right dose, in the right way, at the right time(s). Ask yourself these questions to see if you’re doing everything to stay on track.

Do you:

• Go for an asthma review at least once a year?

• Take your asthma medicines regularly as prescribed – even when you’re feeling well?

• Keep your reliever inhaler with you wherever you go?

• Recognize your asthma triggers so you can avoid or manage them?

• See your doctor if you need to use your reliever inhaler  three or more times a week?

: Asthma medications are          habit-forming, danger            ous and lose their effectiveness over time- true or false?

A. All these are false. The first three years of symptom onset is the crucial period as beyond this period, there are permanent changes within the airways.

These permanent changes are prevented by asthma medications. With early treatment, you can go ahead with a very low dose of medication without any danger, and it reduces health care associated cost too.  Asthma medications do not lose their effectiveness over time, it is vice versa in real life, where doctors reduce the dose of drugs over time if asthma is well controlled.

(The writer is a Consultant Respiratory Physician, National Hospital Kandy and the article is written on behalf of the Sri Lanka College of Pulmonologists)


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