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Asthma is a chronic airway inflammation associated with respiratory symptoms such as shortness of breath, shortness of breath, cough and chest tightness, which vary in intensity and duration. Once a person is diagnosed with asthma, he or she will have symptoms and the disease can manifest in different ways – acute flare-ups, chronic intermittent or stable asthma.
According to the World Health Organisation (WHO), asthma is a chronic lung disease that affects people of all ages. It is caused by inflammation, mucus accumulation, and tightening of the muscles around the airways, making it difficult for people to breathe.
In an interview with HT Lifestyle, Dr Anusha CM, consultant respiratory medicine at Manipal Hospitals in Malleswaram, explained, “A recent viral illness, sudden change in temperature, exposure to smoke, strenuous exercise, emotional situations such as anxiety or stress, and discontinuation of inhaler use can trigger a flare-up/acute asthma. These episodes of severe symptoms usually start suddenly and need to be treated immediately.”
What is acute asthma?
Dr. Anusha CM replied, “An acute asthma exacerbation mainly involves inflammation and obstruction of your medium and small-sized airways. There is an increase in the thickness of your airway muscles, leading to narrowing and restricted airflow and hence patients experience chest tightness. A mild attack may last for a few minutes, however, a severe attack may last from a few hours to a few days. Symptoms of an acute exacerbation include chest tightness, coughing, wheezing, and coughing. Acute asthma requires immediate medical management in a hospital.”
Sharing his expertise on this, Dr Vivek Nangia, Principal Director and Head of Pulmonology at Max Super Speciality Hospital, Saket, New Delhi said, “Acute asthma, also known as an asthma exacerbation or flare-up, manifests as a gradual increase in symptoms of shortness of breath, coughing, wheezing or chest tightness and a gradual decrease in lung function. Such an outbreak may require emergency visit, hospitalization and can also be life-threatening. Its symptoms may include coughing, wheezing, shortness of breath and chest tightness. These symptoms can be mild or severe and may come and go over time. Although asthma can be a serious condition, it can be controlled with the right treatment.”
What is chronic asthma?
Dr. Anusha CM explains, “It is a condition in which acute asthma gets worse over time and becomes resistant to the usual treatments. Causes of chronic asthma include Respiratory viral infections, house dust mites, pollen, air pollution, stress, anxiety, smoke, strenuous activities, etc.”
Dr Vivek Nangia explains, “Chronic is a term used to describe any disease that has been going on for a long time, but is no longer used in the case of bronchial asthma. The terminology currently used to describe the different states of control of asthma symptoms includes uncontrolled asthma, difficult-to-treat and severe asthma. Uncontrolled asthma means poor control of symptoms and frequent flare-ups or worsening of symptoms.”
He elaborated, “Asthma is difficult to treat when the patient continues to have symptoms despite taking moderate to high dose medication. This does not mean a ‘difficult patient’. In many patients, asthma may seem difficult to treat because of incorrect inhaler technique, poor adherence, modifiable factors such as smoking or comorbidities, or misdiagnosis. Severe asthma is a group of patients who remain uncontrolled despite taking high dose medication after confirming the diagnosis, ensuring adherence to treatment and correcting breathing technique, correcting comorbidities. Such patients should be evaluated for newly launched drugs called biologic therapy.”
How to manage chronic asthma?
Dr. Anusha CM advised, “The medications mainly include inhaled bronchodilators, leukotriene antagonists, immunotherapy, biologicals, etc. It is tailored based on the patients condition and severity. These aim to reduce inflammation and control symptoms, except immunotherapy which aims to modify the disease’s response to allergens. Asthma is a complex medical disorder, although it is often seen as a manageable disease, untreated asthma can have catastrophic consequences.”
He concludes, “If you have asthma, it is important to understand the risks involved. After all, consulting a medical practitioner is the only way to differentiate between acute and chronic asthma symptoms. They can diagnose any underlying problem and help you choose the best remedy. Don’t let asthma stop you from enjoying your life. With the right course of treatment prescribed by your pulmonologist, you can live a healthy, fulfilling life with asthma.”
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