ICD-10 · J45
Asthma
Asthma is a chronic condition in which the airways become inflamed and narrow, causing episodic wheeze and breathlessness. Air pollution in Indian cities is a major trigger, and asthma is frequently undertreated because of misplaced fear of inhalers.
Symptoms
Wheezing, shortness of breath, chest tightness, and a dry cough that worsens at night, in early morning, during exercise or on exposure to dust, smoke, cold air or pollen.
Causes & risk factors
Genetic predisposition combined with environmental exposure: dust mites, pollen, pet dander, cockroach allergen, tobacco smoke, vehicle exhaust, respiratory infections, cold weather, exercise, and certain drugs such as aspirin and beta blockers.
Diagnosis
Spirometry showing reversible airflow obstruction (improvement after a bronchodilator), peak flow variability, and allergy testing when a specific trigger is suspected. Chest X-ray is used mainly to exclude other causes.
Treatment options
Inhaled corticosteroids such as budesonide or fluticasone control the underlying inflammation and are taken daily. Reliever inhalers containing salbutamol (or formoterol combinations) treat acute symptoms. Montelukast is added in allergic asthma. Inhalers deliver medicine directly to the lungs at a fraction of the oral dose — they are not habit-forming and are not a last resort.
When to see a doctor
A reliever inhaler needed more than twice a week, night waking due to symptoms, an attack not relieved by the inhaler, difficulty completing a sentence, or bluish lips — the last two are emergencies.