Asthma: Symptoms, Triggers and Management of Asthma at Home - Dr Vasunethra Kasargod

Asthma is a very common respiratory illness affecting all age groups. The prevalence of the disease is ever-increasing in recent years. WHO estimated that almost 262 million people were affected by Asthma in a study done in 2019. It is the most common chronic illness among children. India leads the world in mortality due to asthma.

Asthma is a disease of the respiratory airways which gets inflamed due to exposure to certain triggers that could be inhaled or oral allergens, food, emotional stress, exercise or infection. Inhaled allergens could be in the form of pollen, dust mites, inhaled fumes like cigarette smoke, incense sticks, mosquito repellents, air fresheners, perfumes etc.

Dust mites are the most common allergen or triggers for asthma. These are microscopic organisms that infest wherever there’s indoor dust. They are most commonly found in the linen like bedspread, mattresses, carpet, curtains, sweaters, old books etc. So, most patients complain they have symptoms when exposed to them, especially when in bed or early morning. Symptoms occurs when they clean their indoors, wear their old clothes, dusty unkept rooms etc.

Pollen is a fine, powdery substance produced by flowering plants and seed plants for reproduction. The tiny pollen grains, which contain the male genetic material, are so small that they require magnification to observe in detail. Generally, pollens that cause allergies are those of plants where pollen is dispersed by air currents.

Such plants produce large quantities of lightweight pollen which can be carried for great distances and are easily inhaled, bringing it into contact with the sensitive air passages and causing symptoms. In India, the most common pollen allergens include parthenium, Bermuda grass and Cassia flower. Pollination season in India is mainly spring post monsoon and winters and accordingly the patient symptoms worsening during this time.

Air pollution is contamination of the indoor or outdoor environment by any chemical, physical or biological agent that modifies the natural characteristics of the atmosphere.

Household combustion devices, motor vehicles, industrial facilities and forest fires are common sources of air pollution. Pollutants of major public health concern include particulate matter, carbon monoxide, ozone, nitrogen dioxide and sulfur dioxide. Exposure to outdoor and indoor air pollution cause asthma attacks.

Food allergies are also important triggers for asthma. They are relatively rare when compared to inhaled allergens. Food allergens cannot be generalized and needs to be identified for each individual. Avoidance of these foods can prevent occurrence of symptoms.

Few other triggers are household pets like cats, dogs and birds. Allergens here include their fur, dander and drippings.

The narrowing of the respiratory tree lumen and excessive mucous production leads to increased resistance while breathing leading to common symptoms like cough with whitish sputum, wheezing, breathlessness, tiredness, disturbed sleep, chest tightness and headache.

These symptoms can occur anytime of the day, depending on exposure. But most commonly in nights and early mornings. If patients are not treated, then these symptoms can turn persistent and permanent, leading to poor quality of life and mortality also.

Management of asthma includes a proper evaluation by a pulmonologist or an allergist. Assessment of symptoms and disease by undergoing spirometry or lung function tests, blood allergy related tests, chest X-ray and if required a skin allergy test. Skin allergy tests identify the triggers effectively. As per the assessment, patients might be started on appropriate treatment in the form of inhalers, tablets or nasal sprays. Patient needs regular follow up for understanding the disease better and treatment titration.

Apart from following doctor’s advice, few strategies towards allergen prevention helps in reducing asthma severity. Dust mites’ exposure can be reduced by regular vacuuming of the mattress, washing pillows, bed sheets and carpets. Wet mopping should be encouraged.

Pollen exposure can be significantly reduced by using indoor air purifiers and using masks while venturing outsides. Prevent indoor air pollution by not using mosquito repellents, agarbattis, air fresheners etc. Avoid consumption of food to which the patient is allergic to. All these strategies help to reduce the progression of the disease and its complications.