Asthma is a breathing disorder. It occurs when the passages carrying air in and out of the lungs become constricted because of long-term inflammation.
This may lead to different symptoms, e.g. shortness of breath, coarse whistling/rattling sound while breathing (wheeze), tightness in the chest, cough etc. These symptoms are recurrent and particularly worse at night or early morning or during exercise.
According to WHO asthma is the most common chronic condition in children. In 2019, 262 million people around the world were suffering from asthma. The same year there were almost half a million deaths attributed to it.
In Bangladesh, National Asthma Prevalence Study results published in 2002 showed that there were 7 million asthma patients, of which 4 million were children. This has definitely increased over the years.
What will happen if asthma is not properly treated? People with inadequately controlled asthma can suffer from tiredness in the daytime due to sleep disturbances at night.
Additionally, asthma may cause work or school absenteeism, financial loss along with deteriorating personal health. If asthma is severe, it can often result in frequent and life-threatening episodes or even death.
So it is imperative that we get proper treatment for asthma. It must be kept in mind that this treatment is not only a physician’s responsibility but also patients' and their families' as well. The physician can suggest the treatment but if the patient does not follow it properly it will not be successful.
The most important thing in asthma treatment is to remember that, like diabetes, it is a lifelong condition.
Most patients with mild to moderate disease will be able to attain an almost normal quality of life with adherence to the prescribed therapy. But in severe asthma, it has to be accepted that there will be several restrictions.
There are many treatment options available. However, the main treatment is usually inhalers. These are devices that asthma patients breathe in the medicine.
This medicine can relieve immediate breathlessness (reliever inhalers), or it can be used to prevent frequent attacks (preventer inhalers). Sometimes there is a combination of preventer and reliever medicines in inhalers. Many combinations and preventer inhalers contain steroids which are critical in asthma treatment.
In our country, there is often a reluctance to use inhalers. One reason may be that many patients find it difficult to use.
In some hospitals and private chambers in our country, there is a specialist nurse/personnel to demonstrate correct use to the patients. It is important to talk to the physician about the use of inhalers when prescribed.
Also sometimes the patients are afraid that inhalers containing steroids may cause some sort of big side effects. While it is true all medications have side effects, the risk-benefit in asthma is in favour of steroids.
Another common concern for patients is that they are not comfortable using inhalers lifelong. Again that depends on disease severity and frequency of attacks.
If asthma is controlled, treatment focus will be on managing episodes when they happen.
For instance, in the case of seasonal asthma, patients may need the inhaler only when that pollen is in the air. But we must remember that asthma is a lifelong disease, and whether we like it or not we may need to take some form of medicine most or all of the time. And for asthma control, an inhaler may be our best choice.
Imtiaz Ahmed completed his MBBS from Dhaka Medical College.