Even if you don’t know the numbers, you simply need to walk into the medical room of a school to know that a nebuliser is standard equipment. With rising outdoor and indoor pollution, high stress, and poor eating habits, asthma is one more ‘lifestyle disease’ so many people struggle with today. Here Dr Sundeep Salvi, Director, Chest Research Foundation, Pune, tells us what we should know about this “panic disorder of the airways”. There’s no damage to the airways.
It is hereditary
Asthma is hereditary, though the exact gene hasn’t been identified. “It is one of the strongest genetic disorders after schizophrenia,” says Dr Salvi. Atopy is a collection of genetically transmitted diseases: asthma, allergic rhinitis, eczema, migraine. A family history of any of these ups the risk of developing asthma by five to seven times. “The grandmother may have had allergic rhinitis, the mother eczema, while the child may develop asthma.”
It can be triggered by stress
Stress may bring on an attack, even if you’ve never had it before, but have a predilection. Whether it’s the excitement of a birthday party or the anxiety of an exam, a sports performance, or even stage fright. “The smooth muscles of the airways are controlled by the autonomic nervous system (that also controls heartbeat, digestion and other functions that happen ‘automatically’). The hormones released by this system are responsible for causing smooth muscle broncho-constriction. The airways become hypersensitive to even innocuous substances. The main underlying reason is always inflammation,” says Dr Salvi. In adults, the stress of a death or separation may trigger it, or even a consistently stressful life.
It’s an indoor problem too
A positive change in indoor environment can help. Avoid using mosquito repellents of all types that are vaporised; scented chemicals that evaporate quickly (deodorants, perfumes, sprays, cleaning agents); thick curtains and carpets that release volatile organic compounds. Stick to wet mopping rather than vacuum cleaning (the dust leaks on the other end). Avoid too much barbecuing, roasting or frying, especially in enclosed spaces, as all these release fine aerosols. Of course, stop smoking yourself and avoid it in or near the home.
Food helps
Antioxidants from fruits and vegetables help fortify the body and the airways. “They protect the airways from being hypersensitive,” says Dr Salvi. In a study, it was found that the airways of healthy individuals were coated with antioxidants, but in asthmatics, antioxidants were significantly depleted. “There is evidence that probiotics may be good, but it is such a generic term; a lot of research has to be done on which of those can help the airways.” And the artificial chemicals in junk food increase asthma risk.
Drugs have a role
Chronic, poorly diagnosed and treated asthma is a risk factor for Chronic Obstructive Pulmonary Disease (COPD), the second leading cause of death in India. Those who are asthmatic are more vulnerable to both bacterial and viral infections, and may receive more antibiotics than those who aren’t. Certain antibiotics are known to make asthma worse: penicillin, cephalosporin, and sulfas, for instance. About 5-8% of those with asthma may be sensitive to these. Aspirin too may trigger asthma — in about 10-15% of asthmatics. There’s also an association between paracetamol and asthma. Children born to pregnant mothers, who take it in relatively higher doses or more frequently, are found to be at greater risk for getting asthma. Babies unnecessarily given the drug (and antibiotics) in the first two years of life are also at greater risk than those not given it frequently. This may be because of the depletion of antioxidants in the airways. Check with your physician before you administer any drug.
