Asthma burden is growing globally, especially in developing countries like India, due to urbanization and related factors. The list of asthma triggers runs longer each day. Though treatment for asthma has become more effective and safer, mainly through inhaled medication, many patients with asthma do not have access to these inhalers
. Compounding the problem is the fact that in Asian countries, indigenous medicine and concepts of health and disease still influence the attitude of patients and their acceptance of modern treatment.
Medindia heard Dr. Raj B Singh, MD, FRCP, FCCP Medical Director, Chest Foundation of India and Senior Respiratory Consultant, Apollo Hospitals
, speak on the challenges in treating asthma in India and the need to step up asthma treatment awareness among the general public. Q. What are some asthma myths that hinder asthma treatment in India? A. Myth 1:
Alternative medicine, particularly the 'swallowing-live-fish-treatment' can cure asthma. Fact:
The holistic and sometimes more sympathetic approach of many traditional practitioners of alternative medicine should be commended. However alternative systems of medicine have not been subjected to the stringent scientific scrutiny that forms the basis of allopathy. Though traditional systems of medicine are always claimed to be safe and without side-effects, this is not always true. Hence we have to adopt a healthy skepticism for claims of 'asthma cure'. Myth 2:
Self medication, such as popping antibiotic pills relieves the asthmatic condition. Fact:
Antibiotics are usually not indicated in the treatment of asthma unless there is evidence of bacterial infection. Asthma exacerbations are rarely due to bacterial infection. Self medication for any disease should be discouraged. Myth 3:
"Formation of phlegm" is the cause of asthma. Fact:
This concept is an influence of ayurveda which contends that most diseases are due to imbalances in Kapha (phlegm), Pitta (bile) and Vata (gas). However, phlegm is only a symptom of respiratory disease. Many diseases cause phlegm; TB asthma, COPD, lung cancer and pneumonia being common causes. Each disease has to be treated differently even though they all cause phlegm. Myth 4:
Inhalers have serious side effects, hence meant only for very severe asthma attacks. Fact:
Inhalers are safe and benefit the patient more in the early stages. Myth 5:
Asthma treatment is necessary only while there is an asthma attack. Fact:
Patients sometimes mistake their symptoms for the disease. Asthma is a disease which can be present even when symptoms are not obvious. It can be controlled only by continuing medication even when asymptomatic, just as in any other chronic disease.Myth 6:
Asthma can be kept in check by just avoiding asthma triggers such as dust, pollen, and certain food items. Fact:
Asthma triggers keep adding each day. It is indeed important to avoid obvious triggers. But it is important to continue the right medication too and not get too obsessed with avoiding all the potential triggers. In fact, the anxiety of avoiding various things, sometimes even imagined to be triggers, can worsen asthma!Q. How can asthma treatment be improved in India?A.
All the best medicines in the world for asthma treatment are available in India at affordable prices. However, asthma treatment awareness
has to percolate down to all levels of society for people to seek effective asthma treatment
. Most people believe it is enough to control the symptoms and not treat the disease. People have to understand that like most non-communicable diseases asthma has no cure
but the condition can be controlled with proper medication to an extent where the quality of life is not affected. To begin with, people who have difficulty in breathing should see a doctor who will measure the volume and rate at which the person breathes, using a spirometry test (a common pulmonary function test, PFT) to diagnose asthma and decide the course of treatment. Q. Some tips to control asthma?A.
Consult a doctor if you have prolonged cough for a week, tightness of chest or short breath. Do not stop the medicine once the symptoms go away.
Stay clear of allergens like dust, pollen, pets, cold air etc.
Consult your doctor and use preventive inhalers such as inhaled corticosteroids, every day even when there are no symptoms because it takes up to 3 months for inhaled steroids to reverse the changes which have taken place in the lungs, even though symptoms like cough and breathlessness may subside within a few months. Inhaled steroids repair the damage to the airways caused by asthma and will protect the airways from further damage.
Use Reliever Inhalers (eg. Salbutamol) only for symptom relief and not for asthma control. These will open airways and facilitate breathing. Q. How does the Chest Foundation of India help to improve asthma treatment in India?A.
Chest Foundation of India was launched as a registered non profit Trust in October 2006 with a view to raise awareness of respiratory diseases such as asthma, TB, COPD, lung cancer, and to improve their management in the community. We focus on continuing medical education programs (CME) to improve awareness among health professionals regarding chest and respiratory disorders and their management. The Trust works to make effective asthma therapy accessible to different sections of society. We work through hospitals to increase awareness of treatment options for patients with chest related disorders. We conduct awareness camps for asthma and we are now spreading awareness about managing the condition through schools and colleges. Asthma, the chronic lung disease characterized by recurring breathing problems and symptoms such as prolonged coughing, breathlessness wheezing and tightness in the chest can be fatal if it is not managed effectively. World Asthma Day 2011 offers us yet another opportunity to learn more about the condition and for asthmatics to live a normal healthy life with near-normal lungs and the asthma well under control. After all, famous people like Charles Dickens, Beethoven, John F. Kennedy, David Beckham and Indian tennis ace Vijay Amritraj, to name a few, have succeeded in leaving the world breathless with their achievements, despite asthma.