Asthma

Author: Dr. Veena Deo

Asthma is a condition often of allergic origin that is marked by continuous or paroxysmal labored breathing accompanied by wheezing, a sense of constriction in the chest, and often by attacks of coughing or gasping. Descriptions of asthma focus on the clinical, physiological, and pathological characteristics, stressing the central role of both chronic airway inflammation and increased airway hyper-responsiveness.

Current Scenario:

Asthma affects 300 million people worldwide, and an additional 100 million people are expected to be diagnosed by 2025.

Causes:

Classical precipitants include exercise, particularly in cold weather, exposure to pollutants, and upper respiratory tract infections due to viruses.

Clinical Features:

Typical symptoms include wheezing, cough, chest tightness, and dyspnea, along with the presence of airflow obstruction that is variable over short periods or is reversible with treatment.
Recurrent episodes of wheezing, chest tightness, breathlessness, and cough. Sometimes asthma is mistaken for a cold or chest infection that fails to resolve.
Frequent coughs and colds, uneasiness while sleeping, and a whistling sound while breathing.
Patients with mild intermittent asthma are usually asymptomatic between exacerbations.
Persistent asthma involves ongoing breathlessness and wheezing, but variability is usually present, with symptoms fluctuating over a day, from day to day, or from month to month.
Exacerbation of asthma might occur due to air pollution, leading to shortness of breath.
Lung function becomes worse in the early morning. Poorly controlled symptoms such as cough and wheezing, which disturb sleep, have led to the term "nocturnal asthma."

Cough Variant Asthma:

In some people, cough may be the main symptom, leading to a delay in diagnosis.

Medication-Induced Asthma:

In some situations, asthma is triggered by medications.

Severe Asthma:

Some asthmatic patients have a similar inflammatory response in the upper airways.
An important minority of patients develop a particularly severe form of asthma, which is more common in women.

Required Investigations:

Measurement of allergic status.
Radiological examination.
Assessment of eosinophilic airway inflammation.

Exacerbations of Asthma:

Characterized by increased symptoms such as deterioration in lung function and increased airway inflammation.
Severe asthma generally occurs due to viral infections. Molds, pollens, and air pollution may also be caused.
Most asthma attacks involve gradual deterioration over several hours to days.
Some attacks involve sudden deterioration with little or no warning. This type is known as brittle asthma.

Occupational Asthma:

The most common form of occupational respiratory disorder.
Frequently reported causative agents include animals, flour and grain dust, and wood dust.
Workers most commonly reported to have occupational asthma include paint sprayers, nurses, food processing workers, chemical workers, welders, animal handlers, bakers, and pastry makers.

References:

Sourced from Davidson’s Principles & Practice of Medicine, 21st Edition.

Herbs to Treat Asthma

Ephedra: Acts as a bronchodilator to open constricted airways.

Clerodendrum serratum (Bharangi): In Eastern India, especially in Bengal, the root is used in the form of a decoction as a remedy for asthma. It has significant pharmacological properties such as direct inhibition of the constrictor response, antihistaminic, hypotensive, and antiasthmatic effects.

Ocimum sanctum: Exhibits potent antiasthmatic effects in experimental models.

Solanum surattense (Kantakari): Extensively used in the treatment of bronchitis and asthma.

Glycyrrhiza glabra (Yashtimadhu): Useful for treating asthma as it helps to soothe the respiratory passages. However, it is contraindicated in individuals with high blood pressure.

Coleus forskohlii: Contains forskolin, which acts as a bronchodilator.

Saiboku-to: A Japanese herbal tonic used for asthma.

Piper longum (Pippali): Clinical studies show this herb is very effective in treating bronchial asthma in children and other respiratory disorders. Compounds isolated from P. longum have antitubercular activity and coronary vasodilating activity.

Lobelia: Should be taken in small quantities. Consult a doctor, herbalist, or Ayurvedic physician before use.

Parsley Leaf: Can be used in the form of herbal tea. Patients taking diuretics should consult a doctor first.

Turmeric: Useful for treating inflammation related to asthma, which causes swelling in the lungs and breathing trouble.

Butterbur: Especially useful for treating allergic asthma.

Garlic: Has efficacy in relieving inflammation, which can be beneficial for asthma. However, more research is required.

Boswellia serrata: Helps reduce the recurrence of acute asthmatic attacks but is contraindicated in individuals taking anti cholesterol drugs.

Mullein: Helps relieve shortness of breath.

Ginkgo biloba: Useful for treating asthma but may cause side effects such as nausea, diarrhea, and headache.

Natural Home Remedies

Fish oil and flaxseed oil are advisable as they contain Omega-3 fatty acids.
Reishi mushroom has anti-inflammatory activity and helps boost immunity. It can also be used as food.
Clove: Boil one cup of water with 7-8 cloves until it reduces by half. Add one teaspoon of honey and take this twice daily.
Mustard oil with camphor: Gently massage warm oil on the chest of the patient.
Black tea is advisable.
Steam inhalation with eucalyptus oil.
Soak figs in water overnight and eat them in the morning before breakfast.
Make a powder of dried Indian gooseberry fruit and take it with honey.
Strawberries, blueberries, oranges, and onions are advisable.
Eat foods rich in magnesium.
Honey: Take equal quantities of honey and olive oil and add them to warm milk.
Evening primrose oil is advisable as it contains GLA.
Eat more frequent meals but in smaller quantities.
Maintain a healthy weight.
Fish such as tuna, salmon, and sardines are advisable.
Clean the home once a week, but take precautions—use a mask or ask someone else to help with cleaning.
Wrap a scarf around your nose and mouth in cold weather.

Avoid

Decrease refined carbohydrates like sugar and heavily processed foods.
Do not eat before going to bed.
Avoid foods that cause acidity, heartburn, or acid reflux.

Avoidance of specific triggers plays an important role in managing occupational asthma. Patients with allergies should reduce exposure to relevant antigens. Pet animals may need to be removed, and house dust mite exposure may be minimized by replacing carpets with floorboards, although improvements in asthma control following such measures have been difficult to demonstrate. Many patients are sensitized to several ubiquitous aeroallergens, making avoidance impractical. Measures to kill cockroaches or remove fungal exposures may aggravate asthma and should be avoided.

Smoking cessation is particularly important as smoking not only encourages sensitization but also induces a relative corticosteroid resistance in the airways. Avoid medications like NSAIDs.

Asthma is a chronic condition, but treatment is available for the majority of patients. Although I have mentioned the quantity of ingredients in some natural home remedies, consult an Ayurvedic physician for the correct quantities and further guidance.