Bronchial Asthma

BRONCHIAL ASTHMA

Introduction

Asthma is a chronic inflammatory disorder, characterized by sudden attacks of breathing difficulty. Normal breathing is slow, regular, nasal, diaphragmatic, invisible and inaudible (no panting, no wheezing, no deep inhalations or exhalations). They take small inhalations and then relax for the exhalation. The exhalation is followed by an automatic pause (or period of no breathing) of about 2 s. The breathing is an effortless action, where the person is normally not aware about the processes. During the asthmatic attack the patient has to make extra efforts to breath in air (inhalation) which is accompanied with a prolonged expiration. This is due obstruction or spasm of the airways, which is reversible and associated with excessive secretion of viscid mucus.

Asthma is clinically presented with recurrent paroxysmal cough, breathlessness, tightness of chest and wheezing which vary in severity and frequency from person to person.  When people talk about bronchial asthma, they are talking about Asthma, which is a chronic condition that usually requires continuous medical care. Patients with moderate to severe asthma have to take long-term medication daily to control the underlying inflammation and prevent symptoms and attacks that affect their routine life. If symptoms occur, short-term medications are used to relieve them

Most of the asthmatics are hypersensitive to a wide verity of allergens.  Avoidance of   the trigger factors such as exercise, cold air generally imposes undue restrictions. However, smoking and those known triggers which can be avoided without disturbing the routine life may be discouraged. Medication is not the only way to control asthma. It is also important to avoid asthma triggers.  Each person must learn what triggers he or she should avoid.

In about 50 % of children, asthma may resolve automatically when they reach teen age.  There are only about 6 % chances of getting asthma, if neither of the parents are asthmatics, if one parent is asthmatic, there are 30 % chances and if both the parents are asthmatics, the chances of children getting asthma is about 70 %. The good news is that asthma is not contagious.

The general management  during an acute attack is provide the patient bed rest preferably a propped up posture on back rest, physical and mental rest, humidified oxygen inhalation and avoidance of precipitating factors. At time a stream inhalation may also help to relive acute symptoms

References:

www.cdc.gov

www.nhlbi.nih.gov

www.nlm.nih.gov
www.nhs.uk

http://www.normalbreathing.com/patterns-normal.php

Causes

Asthma is caused from complex interactions between an individual's inherited genetic makeup and their interactions with the environment. The major risk factors for developing asthma are exposure, especially in infancy, to indoor allergens (such as domestic mites in bedding, carpets and stuffed furniture, cats and cockroaches) and a family history of asthma or allergy. Exposure to tobacco smoke and exposure to chemical irritants in the workplace are additional risk factors. Other risk factors include certain drugs (aspirin and other non-steroid anti-inflammatory drugs), low birth weight and respiratory infections. The weather (cold air), extreme emotional expression and physical exercise can exacerbate asthma.

Urbanization appears to be correlated with an increase in asthma.  Worldwide, there is an average, rising by 50% asthmatics every decade. Allergies are strongly linked to asthma.

Some of the risk group prone for asthma are family history of allergic conditions, personal history of hay fever (allergic rhinitis), viral respiratory illness during childhood, exposure to cigarette smoke, obesity and lower socioeconomic status.

Air pollution, second hand smoke and pollen are common triggers of asthma attack. While there are no asthma free cities, some place trigger more attacks. The triggers of asthma may include infections such as colds, flu or pneumonia, allergens such as food, pollen, mold, dust mites, and pet dander, weather, especially extreme changes in temperature, food additives such as Mono Sodium Glutamate (MSG), emotional stress and anxiety, singing, laughing, or crying, perfumes and fragrances. Therefore, for asthmatic patients, where they live make a lot of difference. 

Shifting the pace of residence may improve the symptoms of asthma temporarily. Swimming is an optional exercise for those who suffer from asthma, however exercising in dry, cold air may trigger asthma. Since stress can aggravate asthma, it makes sense to learn and practice effective stress-management techniques.  Exercise, establishing a regular sleep cycle, proper nutrition, and relaxation training are all important aspects of stress control.

India has an estimated 15-20 million asthmatics. Asthma attacks all age groups but often starts in childhood. This condition is due to inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways so they become easily irritated. In an attack, the lining of the passages swell causing the airways to narrow and reducing the flow of air in and out of the lungs.

Reference:

www.cdc.gov

Symptoms

The symptoms of asthma may be mild wheezing to severe life threatening situations, usually called “Status Asthmaticus”. Asthma attacks usually starts suddenly.  Typical attacks starts in late night or early morning with difficulty of breathing, restlessness, wheezing, and a paroxysmal cough with air hunger desire for fresh air.  The coughing may be associated with very less mucoid expectoration. The attack usually subsides within few hours. In between the attacks the patient feels normal.

The patients usually adopt an upright position fixing the shoulder griddle to support the respiratory muscles to make his breathing easy. There is often an unproductive cough which aggravates the breathing distress. This associated with increased heart rate, sweating and at times cyanosis.

Reference:

www.nlm.nih.gov

Diagnosis

The clinical features of asthma with the history of earlier attacks help to diagnosis. Routine blood investigations for total and differential counts give a fair idea about the infection. In asthma, normally the Eosinophil count may be raised.  The sputum examination may show eosinophils and charcot-leyden crystals. The Chest X ray may show increased inflammation   of lung during acute attack and emphysematous changes in later stage.

The assessment of the health of the lung is done through Lung Function Tests (Pulmonary Function Test) through Spirometry, which measures how much air can be breathed in and out. It also measures how fast one can blow the air out.  This gives a fair idea about how well your lung is working.

Reference:

www.nhlbi.nih.gov

Complications

Major distressing problem associated with asthma is that the distressing symptoms interfere with the sleep, work or recreational activities. Permanent narrowing of the bronchial tubes (airway remodelling) is another complication. This happens in Chronic Obstructive Pulmonary diseases (COPD) and seriously affects breathing. Side effects from long-term use of some medications used to stabilize severe asthma are another associated complication.

Management

Asthma is a chronic condition. It, therefore, usually requires continuous medical care. Patients with moderate to severe asthma have to take long-term medication daily to control the underlying inflammation and prevent symptoms and attacks. If symptoms occur, short-term medications are used to relieve them.

Most of the asthmatics are hypersensitive to a wide verity of allergens.  Avoidance of   the trigger factors such as exercise, cold air generally imposes undue restrictions. However, smoking and those known triggers which can be avoided without disturbing the routine life may be discouraged. Medication is not the only way to control asthma. It is also important to avoid asthma triggers.  Each person must learn what triggers he or she should avoid.

The general management during an acute attack is to provide bed rest preferably a propped up posture on back rest, physical and mental rest, humidified oxygen inhalation and avoidance of precipitating factors. At time a stream inhalation may also help to relive acute symptoms.

Normal asthma  attacks does not kill people, however,  if the patient do not take proper medication or  not comply with treatment,  it  may lead to unnecessary deaths, most of which occur outside hospital. Status Asthmatics is a serious life threatening condition. It needs to be managed under medical supervision.

Reference:

www.nhs.uk

Homeopathic Concepts

As per the concepts of homeopathy Asthma is a multi miasmatic disorder, predominantly falls under the category of Sycosis. The expression of the acute episode differs from patient to patient depending up on the constitutional make up of the individual.

The therapeutic approaches   adopted are  ( i) to control the acute attack, (ii) to prevent the recurrence and (iii) to prevent complications

Homeopathy give importance to the constitution of the patient, emotional factors, allergic traits, and suppressed skin disorders and discharges if any and Heredity factors of the patient to arrive at a holistic approach.

The selection of remedy is based upon the theory of individualization. The aim of homeopathy is not only to treat asthma symptoms but to address its underlying cause and individual susceptibility. As far as therapeutic medication is concerned, several medicines are available for asthma that is selected on the basis of cause, sensation, modalities of the complaints.

Some homeopathic remedies that are helpful in the treatment of asthma symptoms are Aralia Recemosa, Blatta Orientalis, Grindelia, Ipecac, Lobelia, Natrum Sulph, Nux Vom and so on. Bio combination No 2 is widely used by patients as a supplementary medicine.  For individualized remedy selection and treatment, the patient should consult a experienced homeopathic doctor in person.

Homeopathic medicines selected on the basis of constitution of the individual are found to prevent further attack  and reduce complications. It is always suggested that undue exposure to the trigger, extremes of climate, severe emotional distress and improper diet and regime should be avoided   for a sustained effect. Yoga practices as advised by experts along with the Homeopathic medicines may help better results.

Reference:  

Muzumdar, K.P, Homeopathy it’s Fundamentals and Treatment, B Jain Publishers, New Delhi

 

 

  • PUBLISHED DATE : Mar 14, 2016
  • PUBLISHED BY : Zahid
  • CREATED / VALIDATED BY : Dr. Eswara Das
  • LAST UPDATED ON : Mar 14, 2016

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