Dr. Jagruti Nadkarni

What are the triggers for asthma?
Asthma triggers are exposures that precipitate or worsen a person’s asthma. A person with asthma may have more than one trigger.
• Allergens
Common examples include pets (such as cats or dogs), foods (such as peanuts, tree nuts, shellfish), or aeroallergens (such as ragweed, grasses, or pollens).
• Cold
• Cigarette smoke
• Exercise
• Infections: viral or bacterial
• Bronchitis/chest colds
• Pneumonia
• Sinusitis
• Irritants
• Medications
• Stress
• Sulphites/food additives.
By correctly identifying asthma triggers and avoiding exposure to those triggers, one’s asthma will be better controlled.
Asthma is a lung condition characterised by symptoms of cough, wheezing and an abnormal sensation of breathing or heaviness in the chest. Wheezing occurs when air travels through narrowed airways. This presents as tightness and pressure in the chest and laborious breathing. The symptoms may range from mild to severe and even vary in the same person over a period of time. Waking up from sleep due to cough and wheezing may also signify poor control of asthma.
The reason for repeated wheezing in child can be because of asthma. This is accompanied by recurrent chest infections. However, other causes of wheezing such as heart problems, congenital problems, tumors and foreign bodies need to be ruled out before making a diagnosis of asthma.
Why are asthma cases increasing?
Asthma was initially thought to be present only in developed countries. However with the advent of industrialisation and westernisation, asthma is being recognised more in developing countries like India. The reasons include environmental factors, air pollutants and poor air quality in urban industrial areas. Smoking is another important risk factor. Infants whose parents/family members smoke have a higher chance of developing asthma. Due to earlier recognition and diagnosis, asthma is seen to be more common in our country.
What are the causes of asthma?
We don’t know what exactly causes asthma, but what we do know is that there are complex interactions occurring at the genetic and the environmental levels which increase susceptibility to develop asthma. The latter includes infections with certain viruses, cigarette smoke, pets, pesticides and certain chemicals, painkiller medicines, wood smoke, dust mites, etc. Similarly, those with family history of allergy and asthma are more prone to develop asthma in life.
When do we suspect asthma?
Asthma has to be ruled out in any person whose cough lasts for more than 8 weeks. If wheezing is accompanied with cough and if there is a family history of asthma and allergy, then asthma diagnosis is much more likely. In a healthy young adult who is a non-smoker, intermittent cough, wheeze and chest discomfort especially after a viral chest infection or after change in weather may be suggestive of asthma. Or if a child has a bout of cough every time after playing outdoor games and this is accompanied by chest tightness and breathing difficulty, asthma needs to be ruled out.
How a doctor will diagnose asthma?
A doctor will diagnose asthma based on one’s symptoms and by physical examination. He may recommend tests like chest x-ray and a lung function test to confirm the diagnosis of asthma.
What are the medicines available to treat asthma?
Asthma medicines are best prescribed in a stepwise fashion. Treatment is started with one or two types of medicines and then depending on the response and the lung functions, medicines may be added or reduced. There are inhalers or “pumps” and oral medicines for asthma. Inhaler medicines deposit the drug directly into the lungs as opposed to the oral ones. The action is quick and lasts for several hours. The quick relievers help to give instant relief while the controllers are used daily to maintain asthma control. Oral medicines can also control asthma and allergy especially in children and in those with exercise induced asthma. If good asthma control is achieved for at least 3 months, one may try to reduce the medicines.
Are the steroids used in asthma treatment harmful?
Asthma is characterised by ongoing lung inflammation. Steroids are good anti-inflammatory agents and when prescribed by your doctor especially as inhaled therapy, are safe and effective. They are not to be confused with anabolic steroids which are misused for weight gain. A poorly controlled asthma has a greater chance of affecting a child’s growth apart from causing school absenteeism.
Role of diet and exercise in asthma:
Apart from medicines, a well balanced diet is also recommended for asthma control. Supplements should not replace good eating habits. Good intake of Vitamin D, calcium and omega 3 fatty acids have shown to help in achieving good asthma control. Also obese adults who lose weight have a better asthma control than their overweight counterparts. As long as asthma is well controlled, participation in sports and other aerobic activities is encouraged. Swimming, for example, is a very good aerobic exercise recommended in children. Similarly, Yoga and Pranayam with deep breathing exercises also help in achieving a good lung function.
Can we do something to prevent development of asthma?
There is evidence that reducing exposure to environmental tobacco smoke, house dust mites and cockroaches decrease the chances of developing asthma. Exclusive breast feeding for 4-6 months after birth and avoiding early introduction to solid food in a child also delays development of allergies. Most of the food allergies in a child are secondary to ingestion of cow’s milk, eggs, nuts and fish including shell fish. Hence delay in introduction of these substances in a child’s diet may also help in delaying asthma. However, there is no known intervention at present that completely prevents development of asthma.
Will asthma disappear as the child grows?
As the child grows, symptoms of asthma may remain absent for months/years together giving the impression that asthma has disappeared. However, it is important to remember that asthma is a lifetime diagnosis. In general, a child may stop experiencing symptoms of asthma after the first decade if there is no family history of asthma or if the first trigger was a viral infection. However, since each person is different it is difficult to predict the course of asthma with certainty every time.
In managing asthma well, physicians and patients both play important roles. One should know the correct method of taking medicines and also adhere to the treatment plan. The main goal of asthma treatment is to allow a person to fully enjoy work, play and sports while adhering to his individualised treatment.

Dr. Jagruti Nadkarni,
Chest Physician.
MBBS, DNB (chest diseases)
Ph: 9423183317
“Arogya”, Opp. Borkar superstores, Vidyanagar, Margao