Minimize air hunger and lead a quality life

Dr Amitava Acharyya, CNS Correspondent, India
The recent decades have seen a sharp increase in the prevalence of allergic diseases, including asthma and allergic rhinitis. Both are common long term diseases that affect the quality of life of patients. It is estimated that 350 million people worldwide suffer from asthma and this figure is projected to add more 100 million of people by year 2025.

Asthma is the chronic respiratory disease that causes wheezing, breathlessness, chest tightness, and coughing at night or early morning. Patients have to live with ‘air hunger’. Breathlessness in asthma patients is common and it hampers their day today life. Adherence to medication and avoidance of trigger factors are the best procedure to avoid acute exacerbation of bronchial asthma. Proper medication and lung capacity test (peak flow meter test) can minimize the cost of severity and hospitalization. Patients are often seen to avoid inhalers due to the prevalent misconception that they are toxic. Some also think that there is no need of inhaler management in minimum exacerbation. This non or irregular adherence to medication often leads to worsening of bronchial asthma— from mild to moderate asthma condition and can also result in unnecessary hospitalization.

Findings of a prospective birth cohort study done in Australia reveal that: ‘A significant reduction in the risk of childhood asthma at age 6 years occurs if exclusive breast feeding is continued for at least the 4 months after birth. These findings are important for our understanding of the cause of childhood asthma and suggest that public health interventions to optimise breast feeding may help to reduce the community burden of childhood asthma and its associated traits. The introduction of any milk other than breast milk before 4 months of age was a significant risk factor for all asthma and atopy related outcomes in children aged 6 years’.

Due to its numerous other benefits, breastfeeding should be recommended for primary prevention of asthma. Sensitization to allergens is one of the strongest determinants of subsequent development of asthma. Studies demonstrate a relation between asthma and exposure to house dust mite allergens and flower pollen. Smoking also is a triggers acute exacerbation of bronchial asthma. Some doctors also recommend annual vaccination of pneumonia and influenza for aged bronchial asthma patients to prevent recurrent hospitalization.

In a webinar hosted by CNS and the International Union Against TB and Lung Disease (The Union), Dr Jeremiah Chakaya Muhwa of Forum of International Respiratory Societies (FIRS) and Member, Board of Directors of The Union pointed out that asthma is the public health problem and need a public health response. He called for creating mass public awareness about this disease. Proper training and retraining of health workers on basic management of bronchial asthma, availability of essential medicines and equipment at each tier of public healthcare sector can minimise the healthcare burden of bronchial asthma. Management of bronchial asthma is not very complex. The availability of medicines (bronchodilators, expectorants, steroid) and equipments (nebulisation machine) can easily give comfort to the patient in acute exacerbation condition.

A recently published Cochrane Review has found moderate-quality evidence that practicing yogic exercises probably leads to small improvements in quality of life and symptoms in people with asthma. However there is still uncertainty about its effect on lung function and medication usage. More studies with large sample sizes need to be done for future research in this field. For now, proper lifestyle, avoidance of risk factors, and  adherence to medication can help bronchial asthma patients to minimize their ‘air hunger’ and lead a quality life.   

Dr Amitava Acharyya, Citizen News Service - CNS
May 15, 2016

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