Bronchial Asthma: The Neglected Aspect - By Dr. Rahul Antony Simon

Blog by Dr. Rahul Antony Simon (Department of Pulmonology) on the topic "Bronchial Asthma" : The Neglected Aspect

Bronchial Asthma: The Neglected Aspect/ Can you completely control Bronchial Asthma – Yes

What is Asthma?          

Asthma causes symptoms such as wheezing, shortness of breath, chest tightness and cough that vary over time in their occurrence, frequency and intensity.

Are all breathlessness-Bronchial Asthma?

No, there are, many disease which present as breathlessness Eg: COPD interstitial lung disease, various heart disease and many more. So how do you know if you are suffering from Asthma? Well the definition says it all. The main differentiating feature of Asthma is the symptom free interval (unless it has progressed to a c/c persistent Asthma) and association of specific triggering factor. Identifying these triggering factors is of utmost importance otherwise the patient will progress to c/c persistent Asthma which is very difficult to treat. It is equally important to identify the different varieties/phenotypes of Bronchial Asthma. In the past Bronchial Asthma used to be associated with a strong family history however in modern times Bronchial Asthma is being diagnosed in children/adults, randomly without a family history. One of the attributable factor for this may be due to a history of antibiotic abuse in childhood which may predispose the individual to develop an allergic immune response.

So what’s new in Bronchial Asthma management? And can we completely control Bronchial Asthma is the big question? The answer is yes.

• Diagnosis and management of Bronchial Asthma has advanced a long way from merely diagnosing Asthma from clinical symptoms, spirometry and prescribing these patients with inhalers to identifying the specific phenotype triggering factors and offering targeted therapy to Asthma patients thereby reducing the medication (ESP oral corticosteroids) related side effects. Ideally diagnosis Bronchial Asthma would require at least 20-30 minutes with a patient who involves a very detailed history taking to identify all the possible triggering factors, ruling out other differential diagnosis as well as to confirm the diagnosis. Various blood test/skin prick test are availability to diagnosis the cause/specific allergen responsible for your Asthma there by helping us to offer you a targeted treatment.
• Even though inhalers as the mainstay of treatment, it is very challenging to achieve good Asthma control. Without identifying the Asthma phenotypes, specific allergen and treating the co-morbidities associated with Bronchial Asthma, it is impossible to achieve a good Asthma control and would ultimately result is patient progress to chronic persistent Asthma and patient developing medication related side effects.
• Off late one of the most life threatening cause for Asthma exacerbation is environmental pollution, environmental tobacco smoke and indoor pollution. 
• I request all readers to avoid, use protection measures and combat environmental pollution.

So to conclude, Asthma can be completely controlled if you identify the specific phenotype, avoid specific allergen and take optimized Asthma control medications.