World Asthma Day is an event organized by Global Initiative for Asthma (GINA) in association with the World Health Organisation (WHO) and The National Heart, Lung and Blood Institute, USA. This year the focus is on children and youngsters under the theme ‘You can control your asthma’.

WHO reports that asthma is the most common chronic disease in children and over 80% of asthma deaths occur in low and lower-middle income countries. The Global Burden of Asthma Report reveals that asthma is likely to be particularly more prevalent in India. A 2% increase in the prevalence rate in India would add up to 20 million people suffering from the disease. 

According to Paramesh H, paediatric pulmonologist, Lakeside Medical Centre and Hospital, Bangalore, as reported in the Indian Journal of Paediatrics, allergic respiratory disorders, in particular, asthma are increasing in prevalence. Even though genetic predisposition is one of the factors in children for the increased prevalence – urbanisation, air pollution and environmental tobacco smoke contribute more significantly.

The trouble with asthma is that it is under-diagnosed and also under-treated thereby restricting activity and reducing the quality of life. The Global Alliance against Chronic Respiratory Diseases (GARD) work from varied countries contributing to WHO towards reducing the global burden of chronic respiratory ailments as asthma.

Disease control

Asthma sufferers experience from minor wheezing to life-threatening asthma attacks. The disease cannot be cured but the signs and symptoms can be controlled. And this can be done most importantly by tracing the disease triggers and avoiding them. Management is the next step. Quick relief or ‘rescue’ medications to take care of the symptoms at the time of asthma flare up help. Long-term medications help in preventing attacks.

‘Rescue’ medications include bronchodilators such as beta-agonists; medications that can be inhaled. These ease breathing temporarily by relaxing the airway muscles and act within minutes giving relief for about four to six hours. Inhaled anticholinergic medicines also give instant relief. For severe acute attacks of asthma, doctors prescribe oral and intravenous corticosteroids.

For long-term treatment, doctors’ advice inhaled corticosteroids. Other group of inhaled medications includes long-acting beta-2 agonists (LABA’s) that are long-acting bronchodilators. Ranbaxy Laboratories Ltd have launched inhalation capsules which contain a combination of LABA and corticosteroid, which need to be used with Rheohaler, the world’s first capsule-based multi-dose dry powder inhaler.

Leukotriene modifiers are inhaled medicines, which help open airways, reduce inflammation and decrease mucus production. Theophylline, a bronchodilator taken each day helps open your airways and relaxes muscles around.

Allergy-induced asthma requires immunotherapy – allergy desensitization shots. Anti-IgE monoclonal antibodies help in reducing the reaction of the immune system to allergens.

Design a plan

• Identify and avoid asthma triggers. Certain allergens as in food, irritants such as pollen, dust mites, climatic conditions – all can trigger asthma attacks
• Try and pinpoint the warning signs that come prior to an asthma attack such as cough, wheezing or shortness of breath
• Identify and treat attacks early and if the symptoms do not improve, seek treatment immediately
• Talk to your doctor before you stop taking or changing any medications
• Regular exercise can strengthen your lungs and heart and this improves the asthma symptoms. Exercise at least for 30 minutes every day
• Maintain a healthy weight. Being overweight may worsen asthma symptoms
• Get treated for heartburn or gastro esophageal reflux disease (GERD), as this may worsen asthma symptoms
• Visit your doctor regularly for monitoring of medications

Pic: Nick Winchester