Pulmonary Function Tests or PFTs are a set of tests that are used to determine, measure or observe the functioning of the lungs. The most common pulmonary function tests used are spirometry, gas diffusion, and lung plethysmography. 

Highlights of pulmonary function tests

A spirometry test is used to measure the amount of air inhaled and exhaled. It also measures the amount of time taken to complete a respiration cycle.
A lung plethysmography measures the amount of air in the lungs after the patient has taken a deep breath. It also measures the amount of air that remains in the lungs after the patient has exhaled as much air as possible.
What does a Pulmonary Function Test measure?
Pulmonary function tests would not only check how well the person is breathing but also how effectively the lungs are able to conduct oxygen to the rest of the body. In addition to air flow, these tests would measure the size and volume of the lung and lung diffusion.

These tests can also be used to measure

Total Lung Capacity   the amount of air present in the lungs after breathing in deeply
Forced Vital Capacity   the amount of air that can be exhaled after breathing in deeply
Minute Volume   the amount of air exhaled per minute
Vital Capacity   the total volume of air that can be breathed out after inhaling as much as possible
Tidal Volume   the amount of air inhaled or exhaled when breathing normally
Maximum voluntary ventilation   the amount of air that can be inhaled and exhaled in one minute
Functional Residual Capacity   the amount of air that remains in the lungs when breathing normally
Forced Expiratory Flow   the flow or volume of air during an exhalation
Peak Expiratory Flow Rate   the rate at which a person can exhale
When are Pulmonary Function Tests recommended?
A physician might recommend a patient undergo a PFT as part of a routine physical check-up. This test would be advised if the patient is experiencing any symptoms associated with lung problems or disorders such as asthma, respiratory infections, chronic obstructive pulmonary disease, COPD. A doctor would also use these tests to monitor and check whether a certain treatment prescribed for a lung disease or condition is working effectively.

Pulmonary function tests are safe as they are non-invasive but it is important to follow the instructions of the doctor or technician before, after and during the test. It is important to make your doctor aware of any surgeries, respiratory infections, chest pains or heart attacks that you might have experienced before the test. If you are taking any medications you might need to follow the advice of the doctor as to whether you can take them before the test.

Your doctor would also advice you on how to prepare for the test such as not eating a large meal, avoiding caffeine and wearing loose-fitting clothes. If you have any doubts, concerns or queries discuss them with your doctor.

Pulmonary Function Tests - Why Is It Required?

If you have been diagnosed with asthma, it is important for you to know about the most common triggers of asthma. Asthma is a medical condition, which is characterised by paroxysmal wheezing respiration dyspnoea. It causes breathing difficulties, tightened chest and coughing. By identifying and reducing your exposure to several asthma triggers, you will be able to manage or control your asthma symptoms and the frequency of your asthma attacks. Here are the most common triggers of asthma you should know about:

Allergies that trigger asthma
Allergies, are common problems and over 80% of people are suffering from asthma and are allergic towards substances like weed pollens, animal dander, dust mites, mould and cockroach particles. Children having large amounts of cockroach droppings in their homes are more likely to develop childhood asthma. Dust exposure may lead to dust mite allergy in asthmatic patients.

Food which triggers asthma
Certain food allergies may lead to isolated asthma, where other symptoms are absent. Patients with food allergies can exhibit asthma as a part of anaphylaxis, which are food induced. The common food items which are associated with allergies include eggs, peanuts, cow milk, soy, fish, wheat, shrimps, salads and fresh fruits. Several food preservatives also trigger asthma. They may include sulfite additives such as potassium bisulfite, potassium metabisulfite, sodium sulfite, sodium bisulfate and many others. These are commonly used in food processing and trigger asthma in sensitive people.

Asthma induced by exercise
Strenuous exercise may lead to the narrowing of the airways in maximum people having asthma. Exercise acts as a primary trigger for asthma symptoms in many people. Patients having exercise induced asthma are likely to feel chest tightness accompanied by coughing and breathing difficulties after completing an aerobic workout session. Although the symptoms subside, they may reoccur within some hours. You should warm up properly and slowly before a rigorous workout session to prevent an asthma attack.

Smoking
People who smoke are more likely to have asthma. If you have asthma and still smoke, the symptoms of wheezing and coughing worsen. Pregnant women who smoke increase the chance of wheezing in their to-be-born babies. You should absolutely quit smoking if you have asthma.

Infections which trigger asthma
Several infections such as cold, bronchitis, flu and sinus may cause asthma attacks. The respiratory infections, which are viral or bacterial, are a common cause and trigger asthma, especially in children. Asthma is also associated with severe heartburn. According to studies, more than 85% people with asthma also suffer from heartburn. This is a condition known as gastroesophageal reflux disease or GERD.

Asthma - Common Triggers Behind it?

Symptoms of Acute Bronchitis

Most of India’s urban populace is highly prone to respiratory infections and problems due to the dangerously high air pollution levels in all major cities across the country. Air we breathe in travels through the bronchial tube to reach our lungs. Problem begins when these tubes get inflamed and mucus builds up. It leads to coughing and shortness of breath which is known as bronchitis. It is very important to identify the symptoms in the beginning and get yourself treated by a doctor immediately. 

Look out for these symptoms of acute bronchitis.

1. Prolonged Cough - If your coughing goes beyond ten days, it could be bronchitis. If you have been coughing so long, check if the mucus is coloured too.

2. Shortness Of Breath - If you are facing shortness of breath despite not being asthmatic, you should see a doctor.

3. Chest Pain - Chest pain and chest tightness could be a symptom of acute bronchitis as breathing troubles might cause problems in such areas.

4. Sore Throat - Sore throat with persistent coughing is also a symptom for acute bronchitis.

5. Flu Like Symptoms - Most children show very different symptoms of bronchitis. They might show flu like signs of runny nose, sore throat, back or muscle pain and chills.

6. Weight Loss - You might also experience unexplained weight loss.

7. Barking Cough - Deep, barking cough is a sure shot symptom of something serious and you need a consult a specialist immediately.

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Did You Know: Every 7th Urban Indian Is Prone To  Bronchitis

Asthma is the most common chronic condition for women in pregnancy. While Asthma control can affect pregnancy, pregnancy too can affect Asthma. Yet while pregnancy does not beget Asthma, neither does it abate.

Nevertheless, Asthma management during pregnancy is very important. Improper Asthma management, especially in difficult Asthma, during pregnancy may imperil both the mother and the child.

Along with taking the right medications, Asthma patients also need to avoid exposure to Asthma triggers.

Avoiding Asthma Triggers

Asthma triggers may be different for different people. In general, one or a few of the following act as Asthma triggers:

Allergens like pollen, dust mite etc.

Smoking

Certain exercises

Certain occupational exposure

Pollution

Certain drugs like  blockers, aspirin etc.

Alcohol, dairy products, orange juice, peanuts etc.

Additives like tartrazine, monosodium glutamate etc.

Certain medical conditions like gastric reflux, rhinitis etc.

Apart from avoiding these Asthma triggers, she would also need to follow the instructions of her gynecologists. She should always be concerned that if the treatment is not working or if she is experiencing any trouble, she must consult with the gynecologists. She can also do some exercises to stay active and healthy.

However, she should always consult a doctor before doing any exercise, especially for those who have experienced Asthma attacks in the past.

Effects of Asthma on Pregnancy

Poor Asthma management and difficult Asthma before pregnancy are associated with increased risk of hypertension during pregnancy, which can beget Preeclampsia. Studies have also shown that women with Asthma tend to undergo Caesarean sections more than others. It has also been observed that Asthma may restrict the growth of the fetus leading to low birth weight.

However, this is more due to poor Asthma control such as persistent breathing difficulty or poor lung function etc., than Asthma per se.

Effects of Pregnancy on Asthma

Certain physiological factors during pregnancy do affect Asthma. In difficult Asthma, control usually deteriorates between 24 and 36 weeks of pregnancy, mainly due to poor adherence to corticosteroids. This is why pregnant women with Asthma should be monitored closely irrespective of the severity of Asthma.

Breathlessness in Pregnancy

Breathlessness during pregnancy is common. In fact, even pregnant women with no Asthma symptoms may feel breathless at times. It reflects some normal physiological and anatomical changes during pregnancy. Even anxiety may precipitate breathlessness. This indicates that pregnant women with difficult Asthma may feel breathless, not just because of Asthma, but also because of normal changes during this period. However, new incidents of Asthma can also be a cause of breathlessness.

Respiratory Distress in Pregnant Women

Respiratory distress in pregnant women may not always be due to asthma. There may be a whole host of reasons that include Anxiety, Hyperventilation, chest infection, dysfunctional breathing, pneumonia, interstitial lung disease, thromboembolic disease, amniotic fluid embolism, pneumothorax, ischemic heart disease, arrhythmias, cardiomyopathy and a variety of endocrine, hematological and renal disorders.

Preventing Respiratory Distress During Pregnancy

Apart from avoiding Asthma triggers, pregnant women with Asthma or difficult Asthma need to strictly adhere to Asthma control. This indicates that they need to adhere to their corticosteroids religiously. However, before that, they also need to make sure that the corticosteroid is safe to be taken during pregnancy.

Asthma may or may not affect pregnancy. However, it is always a great idea to go for Asthma management. This will help women deal with complications related to Asthma during pregnancy.

Apart from that, always consult a doctor before going for any medication related to Asthma control, or actual treatment of Asthma.

Difficult Asthma - All You Should Know!

Asthma is an inflammatory disease, which affects the airways of your lungs (respiratory tract that pumps oxygen into the lungs). It is long term in nature. It is characterized by shortness of breath, coughing and wheezing. It occurs a few times a day or a few times a week depending on the person it affects. Sometimes it worsens during the night.

What triggers Asthma?

Airborne particles such as dust mites, mould spores, pollen and cockroach waste.
Infections in the respiratory system such as a common cold.
Cold air can also trigger asthma.
Physical or outdoor activities which make you pant such as running, skipping, jogging and jumping can cause shortness of breath, thus triggering asthma.
Pollutants and irritants in air such as smoke.
Some medications can also trigger asthma.
Stress and nervous attacks (panic attacks) also trigger asthma.
How to manage asthma better by changing your lifestyle:

Try to avoid keeping animals in your houses such as dogs, cats and rabbits. Many times animal fur, waste, urine and saliva contains particles which can cause allergic reactions and make you cough uncontrollably. This, in turn, triggers asthma attacks. If you have pets try keeping them away from your bedroom.
Dust mites also cause allergies which trigger asthma. So wash your carpets, rugs, bed-linen and pillowcases in hot water.
Bugs and insects such as cockroaches are not only unhygienic but can also trigger asthma. Cockroach droppings near your bed, kitchen and food are dangerous and you should call an exterminator to get rid of these bugs.
Sometimes, the heavy fragrance also aggravates your respiratory tract and triggers shortness of breath. Avoid using heavy perfumes, deodorants and room fresheners.
Pollution also triggers asthma. Dust particles come out from the vehicles and mix with the air. If this air is inhaled, it might trigger uncontrollable asthma. So try to cover your mouth with a cloth when you step out of your house.
Asthma can be very severe and can bring many hurdles in your day to day activities. Changing your lifestyle and certain habits can reduce asthma to a great extent.

Lifestyle Changes to Manage Asthma Better

The term asthma and bronchial asthma are often used interchangeably. Bronchial asthma refers to the chronic inflamation of the airways either due to some internal or environmental allergen. This leads to the narrowing of airways, which makes breathing difficult and blocks air from entering the lungs. Children are most affected by this condition as the immune system is still in the process of maturity and often grows out of it as they age. However, if not treated, this can lead to many complications like respiratory failure and can prove to be fatal. Asthma cases often spike in winter months and in the flowering season. It can also be triggered by second hand or passive smoke, stress, sudden unaccustomed physical exercise, food additives, dust, house mites, perfumes, certain drugs and many other allergens. A family history of asthma, allergic rhinitis, atopic dermatitis and other allergic conditions can also increase a child s risk of suffering from this condition.

Some of the most noticeable symptoms of bronchial asthma include:

1. Wheezing 
2. Shortness of breath 
3. Excessive coughing that worsens at night 
4. Tightness of the chest 
5. Lowered energy levels 
6. Rapid breathing 
7. Tiredness 
8. Indrawing of chest and lower neck

These symptoms often worsen after exercising. Lung function test and Chest X-ray are often used to confirm a diagnosis of bronchial asthma. Once diagnosis is being confirmed, it should be categorized as per severity. Your doctor may prescribe medication in the form of pills and inhalants as per the category of disease. It is important to note that these cannot cure asthma, but can help manage it. Inhalers deliver low doses of steroids directly to the lungs to reduce inflammation and other inhaled medication like Beta 2 agonist will open the airway by relaxing the muscles of airway. Children suffering from asthma must be taught how to use the inhalers and should always have it with them. In the case of school going children, their teachers should also be informed about the condition. Parents should also know how to keep it, use it and clean the device in a proper and hygienic way.

In very small kids those inhalational medication can be given by face mask and spacer, but as the age grows or in case of elder children above 6 years of age, they can directly take the medication from spacer. Those children who are already on inhalers, but still face asthma attack , for them nebuliser is the better choice to manage the emergency. It will make the liquid medicine into mist and enters into the air passage easily and work promptly.

In addition, certain lifestyle changes can also help reduce the frequency of asthmatic attacks. Avoid going outdoors on windy days or days when air pollutant level is high. Reduce the child s exposure to allergens like pet hair, dander and dust by dusting and vacuuming on a weekly basis. Avoid the use of humidifiers inside your house as moist air can promote the infestation of dust mites. Try to keep the child in a room with adequate air and sunlight. Take plenty of green leafy vegetables and fruits, which contain lots of vitamins and minerals. If possible get your child to wear cover his or her nose and mouth while in outdoors.

Childhood Asthma - 8 Signs To Look For!

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