Doctor in Sakhala Lung Care
Treatment of Bronchiectasis
Treatment of Asthma
Treatment of Tuberculosis
Treatment of Shortness of Breath
Treatment of Pneumonia
Treatment of Bronchitis
Treatment of COPD
Treatment of Sleep Apnea
Treatment of Persistent Cough
Treatment of Occupational Lung Disease
Treatment of Sleep Disturbance
Treatment of Breathing Problems
Treatment of Lung DIseases
Treatment of Interstitial Lung Disease
Treatment of Asthma in Children
Treatment of Lung Fibrosis
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Cough that is dry and with white phloem that does not come out easily. I have been having this in cold season every year and once this cough catches, I land up with the struggle or a month or more. It appears as though I eel allergic to cold/dust. Also once the cough starts gets severe, there is non stop urination in droplets. Uncontrollable and stinks. This time that same condition has just started and I plan to take azax 500. Along with that cheston. Will that help?
Nasal polyps are soft and painless benign growths on the lining of the sinuses and nasal passages. Nasal polyps hang down as grapes or teardrops. Polyps can occur in one or both nostrils at a time. They can occur due to allergies, chronic infection, drug sensitivity, some immune disorders, or chronic inflammation because of asthma. You may not experience symptoms if you have small nasal polyps. People with many nasal polyps or larger growths may experience blockage in the nasal passages, breathing problems, frequent infections and loss of sense of smell. Nasal polyps are more prone to adults and males but they can affect any person. Your doctor may prescribe you certain medicines in order to eliminate or shrink nasal polyps. In some cases, surgery is required in order to remove nasal polyps. There is a possibility that nasal polyps can return even after proper treatment.
It is not necessary that you will experience symptoms if you have nasal polyps. Due to polyps, there can be a blockage in the nasal passages leading to chronic congestion. Check out various signs or symptoms of nasal polyps:
- People with nasal polyps may have a sensation that their nose is blocked.
- Due to nasal polyps, people may not sense the smell properly.
- People with nasal polyps may feel a pressure in the face or forehead.
- Nasal polyps can make you breathe through the mouth.
- Running nose, nasal stuffiness, and nasal congestion are all the possible signs of nasal polyps.
- You may suffer from sleep apnea due to nasal polyps. Postnasal drip is a situation in which excess mucus collects in the back of the nose or throat.
- Snoring can be a symptom of nasal polyps.
The causes of polyps are still not known. There is no clarification on the part that why people get chronic inflammation or why inflammation leads to the formation of nasal polyps in some people and not in other people. The chronic inflammation happens in the mucous membrane of the sinuses and nose. As per some evidence, it is clear that people who get nasal polyps have different chemical makers in the fluid-producing lining and a different response of immune system than people who do not get nasal polyps. Nasal polyps can occur to any person at any age. But it has been noticed that they are more prone to middle-aged and young adults. There is a possibility that people can get nasal polyps with no nasal problems in the past. As per scientists, there can be some possible triggers including:
- Churg-Strauss syndrome
- Cystic fibrosis
- Allergic rhinitis or hay fever
- Recurring or chronic sinus infections
- Non-steroidal anti-inflammatory drug sensitivity including aspirin or ibuprofen
How is it diagnosed?
As soon as you discover that you have nasal polyps, you should see a doctor as polyps can lead to various complications. Your doctor conducts a general physical examination and also an exam of your nose. Your doctor will check the polyps with the help of a lighted instrument. Your doctor will do a diagnosis depending on your various answers to queries about the symptoms that you are experiencing. Your doctor may ask you to get various diagnostic tests done in order to confirm the diagnosis:
- Nasal endoscopy: Your doctor conducts a detailed examination of the sinuses and nose with the help of a narrow tube with an illuminated magnifying lens or small camera, known as a nasal endoscope. The doctor inserts the nasal endoscope into your nostril and then guides it into your nasal passage or nasal cavity.
- Imaging studies: Your doctor obtains the images with the help of computerized tomography which helps your doctor to point to the location and size of polyps in deeper regions of the sinuses. It also helps the doctor to find out the range of the inflammation. Other obstructions in the nasal cavity including abnormalities in the structure or different type of noncancerous or cancerous growth can be found out by the doctors with the help of these studies.
- Allergy tests: Your doctor may ask you to get the epidermis test done in order to find out if allergies are developing due to chronic inflammation. A skin prick test can be conducted in which a few drops of allergens, substances that might be causing an allergy are pricked into the epidermis of your upper back or forearm. The drops of allergens are left on your epidermis for some minutes. Then your doctor observes your epidermis to check the signs or symptoms of allergic reactions. If it not possible to conduct a skin test then your doctor may ask you to get a blood test done that find out specific antibodies to allergens.
- Test for cystic fibrosis: If it is diagnosed that your child has nasal polyps then your doctor may order you to get the tests done for cystic fibrosis. Cystic fibrosis is an inherited disorder in which the lungs and digestive system damage and it can threaten the life of the affected person. The diagnostic test for cystic fibrosis is a sweat test which is noninvasive that determines if the perspiration of your child is saltier as compared to the sweat of most people.
Check out various ways that will help you to get prevention from nasal polyps:
- If you feel the dry air in your home then you should use a humidifier.
- You should wash your hands frequently especially after coming from outside or before starting a meal. This helps to reduce the chances of catching a viral or bacterial infection which can lead to a case of inflammation of the nasal passages and sinuses.
- You should avoid those substances that can create an irritation including chemicals, airborne pollutants, and some allergens. This may help you to reduce the chances of developing nasal polyps.
- You should manage your allergies and asthma properly. It is important to follow whatever is recommended by your doctor related to allergy and asthma treatment as it will reduce the risk of developing polyps.
- You should rinse the nasal passages with a saline spray or nasal lavage as it will help you to remove allergens and irritants and make better the flow of mucus.
It is a challenge to clear polyps completely. Your doctor will suggest you the best treatment option as per your condition in order to manage your symptoms and treat the factors that can lead to chronic inflammation. The treatment is given so that the size of polyps can be reduced or polyps can be eliminated. Initially, medicines are given to treat the affected person. In certain situations, the doctor may prescribe to go for a surgery. There is a possibility that polyps can recur that is why surgery is not a permanent treatment option.
In the treatment of nasal polyps, the doctor generally prescribes medicines in the starting. The medicines help to shrink and remove the polyps even the larger ones. Check out various medicines for the treatment of polyps:
- Nasal corticosteroids: Your doctor may prescribe nasal corticosteroid spray that will help you to minimize inflammation. By this treatment, polyps can eliminate or shrink. Budesonide (Rhinocort), fluticasone (Veramyst, Flonase), mometasone (Nasonex), flunisolide, ciclesonide (Omnaris), beclomethasone (Beconase AQ), and triamcinolone (Nasacort Allergy 24HR) are some of the nasal corticosteroids.
- Oral and injectable corticosteroids: Your doctor may recommend you an oral corticosteroid including prednisone if a nasal corticosteroid does not work for you. You can take it alone or in combination with a spray related to the nose. There are some side effects of oral corticosteroids that is why they are taken for a short period. If you have severe nasal polyps then your doctor may recommend injectable corticosteroids.
- Other medications: To treat the conditions which may contribute to inflammation (chronic) in the sinuses and nasal passages, a doctor may prescribe medication to curb the same. In order to treat allergies, antihistamines are used and to treat a recurring chronic infection, antibiotics are used. Patients with aspirin sensitivity and nasal polyps may get benefit from the treatment of aspirin desensitization.
If medications are not effective in eliminating or shrinking polyps then the doctor may ask you to go for endoscopic surgery. This will help in solving the problems related to sinuses and removing nasal polyps. In the surgery, the surgeon inserts a tiny tube with a camera or magnifying lens into the nostrils and guides the tube into the sinus cavities. Some instruments are used to eliminate nasal polyps and other obstacles that block the fluids from the sinuses. The affected person can be discharged on the same day of the surgery. Your doctor may recommend the patient to use the nasal spray after the surgery in order to prevent polyps from recurring. Saltwater (saline) rinse may also be prescribed by the doctor to catalyze the process of healing after the surgery.
Complications occur due to nasal polyps because it restricts the normal airflow, fluid drainage and also because of the degenerative inflammation that underlies their development. The major complications of nasal polyps generally include the following:
- Obstructive sleep apnea: In this chronic condition you usually stop and begin to breathe frequently during the time you sleep.
- Asthma flare-ups: The serious and chronic rhinosinusitis can cause and even worsen the condition of asthma.
- Sinus infections: It has been observed that you are more likely to get sinus infections if you suffer from the disease nasal polyps. These sinus infections occur very frequently and sometimes, they can also become serious or chronic.
- Disfigured structure of the face: Nasal polyps can alter the shape or structure of the face which consequently causes the condition of double vision. Often if the patient has cystic fibrosis, he or she can have eyes which are set wider apart than they are normally.
- Complications due to surgery: When nasal polyps are treated, especially by surgery, they can cause severe nosebleeds. Along with that, surgery in case of nasal polyps can also cause infections. If the treatment with nasal steroids sprays or oral corticosteroids is continued, it can reduce your ability to fight off and counteract sinus infections.
Noncancerous, soft, painless growths which may form on one’s sinuses or nasal passages are known as nasal polyps. They may look like teardrops or hanging grapes. Due to allergies, asthma, drug sensitivity, recurring infection or some immune disorders may result from chronic inflammation.
People generally do not experience symptoms when they have small nasal polyps. Nasal polyps may lead to breathing problems, frequent infections blockage in the nasal passages, and loss of sense of smell. Men are more prone to nasal polyps than women. Polyps can happen to a person of any age.
The word "asthma" originates from the Greek word, ásthma that means, "panting.” Asthma is a medical condition in which the airways swells and produces extra mucus that can make breathing difficult. Because of the inflammation and the extra mucus, it can trigger shortness of breath and wheeze or coughing.
Documented as early as Ancient Egypt, Asthma can be either a minor nuisance or life-threatening. In asthma, the inside walls of the airways get inflamed so that lesser air can pass through them from and to the lungs making breathing a difficult exercise. This swelling can also make the airways really sensitive and increase a person’s susceptibility to allergic reactions.
Asthma has been on the rise significantly since the 1960s and now according to WHO estimate, around 300 million people suffer from asthma worldwide. In fact Asthma is one of the most common chronic childhood illness.
Symptoms of Asthma-
The symptoms of asthma vary. But what most people with asthma have in common is the extreme airway sensitivity because of triggered airway inflammation. Some people have frequent asthma attacks, some people experience asthma only during certain times, some people have it all the time and some people only experience it infrequently.
Common asthma signs and symptoms include:
- Wheezing or coughing
- Shallow breathing
- Throat infection
- Faster heart rate
- Trouble in sleeping
- Difficulty in speaking
Types of Asthma-
Normally people suffering from an asthma attack tend to have a whistling or wheezing sound when exhaling. There are different types of asthma. Some of the most common types of asthma are:
1. Exercise-induced asthma
Also called exercise-induced bronchoconstriction, this type of asthma is induced by strenuous exercises and can cause symptoms like coughing, wheezing, shortness or breath and other symptoms. These symptoms may worsen when the air is dry and cold and usually get triggered during or after an exercise.
2. Occupational asthma
As the name suggests, occupational asthma is triggered by breathing in certain chemical fumes, dust, gases, or other kinds of exposure to allergens at the workplace.
3. Allergy-induced asthma
Allergy-induced asthma is the most common type of asthma, which is triggered by common airborne allergens like pollen, mold spores, dust mites, or particles of skin.
What Are Causes of Asthma?
Although the causes are not particularly clear and anyone can get asthma at any age, it is more common childhood ailment. The studies are still underway to prove a clear asthma cause but according to the researches this disease is believed to be caused by a blend of genetic and environmental factors. Genomics, which is the study of how a person’s genes interrelate with environmental factors, may be the key to understanding why certain people are more prone to asthma than others.
Asthma triggers can differ from person to person and the key is to know what irritants trigger your asthma to ensure minimized exposure to it. Some generic asthma signs and symptoms can include:
- Cold air
- Exercise and other physical activities
- Common cold and other respiratory infections
- Airborne substances like pollen, mold spores, pet dander, cockroach waste, dust mites, etc.
- Airborne substances, such as pollen, dust mites, mold spores, pet dander
- Certain chemicals and air pollutants (smoke)
- Certain preservatives (added to food and beverages)
- Gastroesophageal reflux disease (GERD)
- Certain medicines like aspirin, ibuprofen, etc.
There are several risk factors that can increase your chances of developing asthma including:
- Genetics. Having a family especially a blood relative suffering from asthma
- Having other allergic condition (hay fever)
- Exposure to secondary smoking
- Obesity (people who are overweight are at a greater risk of developing asthma)
- Exposure to increasing amount of smoke or other pollutants
- Occupational triggers
- Stress and anxiety
Diagnosis of Asthma-
Even though it is a common childhood disease, it doesn’t mean, as an adult one cannot develop it. If a person is feeling any of the symptoms whether a child or an adult, it is always a good idea to get checked to know for sure if you have asthma. Asthma symptoms can come and go since it is a ‘variable’ disease.
It is also important to not do self-diagnosis, as some symptoms, which may look like asthma triggers, may not be actually asthma-like persistent cough caused by other diseases like certain heart diseases and chronic obstructive pulmonary disease (COPD).
Effective diagnosis of Asthma depends upon its classification. There are four different classifications of Asthma:
Classification of Asthma
- Mild intermittent – It is a mild case of asthma if the symptoms last only for up to two days a week, symptoms flaring up mainly at night and asthma lasting not more than two nights in a month.
- Mild persistent – Mild persistent asthma is when the symptoms can occur twice in a week but not more than one episode per day.
- Moderate persistent – This happens when a person experiences symptoms once a day and in excess of one night a week.
- Severe persistent - Symptoms can last throughout the day and frequently at night on most days.
Diagnosis of Asthma
1. Physical test
The doctor would want to rule out other possible condition through a physical exam to get to know the signs and symptoms.
Some lung function tests can help in determining how the lung in functioning in a person.
One of the most common pulmonary function tests, spirometry measures lung function by checking the amount of air a person can inhale and exhale after deep breaths.
3. Peak flow
The peak expiratory flow is a pulmonary device that can measure the maximum speed one can breathe out. If the readings are low, it may be a sign that the person’s lungs are not working properly and could be a potential sign of asthma.
These tests can be done with a medicine called as bronchodilator (albuterol) to check if the lung functions better with the medication. If the test gets better after the use of bronchodilator, then it is highly likely for a person to suffer from asthma
Additional tests and Diagnosis For Asthma
Other tests that may be required to diagnose asthma include:
1. Methacholine challenge-
Methacholine is considered an asthma trigger and so when it is inhaled it can cause mild constriction of the airways. Most people who have asthma are likely to react to methacholine. Doctor could use this test to determine whether you have asthma.
2. Imaging tests-
Certain imaging tests like x-rays and CT scan can help in identifying certain abnormalities that might be causing breathing issues.
3. Allergy testing-
Most allergy tests can help in identifying allergy to triggers like pollen, dust, etc.
4. Sputum eosinophils-
This test can help in identifying the while blood cells in the mucus to see if asthma is present or not.
5. Nitric oxide test-
For people whose airways are inflamed, they may have higher nitric oxide level than normal which may be able to help in identifying whether the person is suffering from asthma or not.
7. Provocative testing for exercise and cold-induced asthma-
As the name suggests, in this a person is made to perform vigorous physical activities in a controlled environment to check for the triggers.
Treatment of Asthma-
Although there is no known cure available for asthma and it is generally a life-long condition, treatment can control asthma symptoms so a person can lead a normal life. Also when it comes to asthma, there is no one-size fit all treatment methodology. The idea is to understand the triggers that worsen your symptoms, taking steps to avoid them and taking the medication on time to keep asthma in check.
Inhalers are medical devices, which are used for supplying medication into the body through the lungs. There are three types of inhalers. These are:
- Reliever Inhalers: These inhalers are used for the purpose of relieving symptoms at the time of asthma attack. Normally reliever inhalers don’t have many side effects, in some people they may increase heart beat and induce shaking.
- Preventive Inhalers: True to their name, this types of inhalers are used to stop the symptoms from developing.
- Combination Inhalers: If either of these kinds of inhalers doesn’t work for a person, they would need an inhaler that would both relieve the attack and prevent it from happening again.
2. Tablets -
If inhalers don’t work to control the symptoms, one may also use tablets.
Leukotriene receptor antagonists (LTRAs)
LTRAs are the oral tablets prescribed for asthma and are also available in syrup and powder forms. It can be taken every day without many side effects. However, some people may experience some side effects including headaches and stomach pain.
If LTRAs tablets cannot be prescribed for some reasons or is not working, doctors may also prescribe Theophylline. It should be taken every day.
- Steroid tablets-
Steroid tablets are given to give relief from an asthma attack. Long-term usage of steroid tablets for is not recommended unless a person is suffering from severe asthma and if inhalers aren’t handy controlling the symptoms. Some possible side effects of using steroid tablets for long-term are mood swings, fragile bones, high blood pressure, etc.
Other treatments for Asthma
Other treatments like surgery or injections may be required in case other treatments don’t work for a person.
For certain people with severe asthma, some injections like omalizumab, mepolizumab, or reslizumab may be able control the symptoms. For some severe asthma patients, injections are prescribed every few weeks in order to control the symptoms. However, these injections should be taken only under the prescription from an asthma specialist, as these injections may are not advisable for every asthma patient.
For some people for whom treatments like inhalers, tablets, and injections don’t work or in certain cases cannot be administered, a surgical procedure called bronchial thermoplasty can be used. In this treatment, a flexible thin tube is passed down the throat into the lungs and heat is used to warm up muscles surrounding the air controlling nerves to stop causing asthma-like symptoms.
However, this process is fairly new and so much research has not been done on its long-term relief.
There are many complementary therapies that can help ease the symptoms, prevent asthma from happening, and help strengthen the lungs and the airway muscles. However, before incorporating any of these therapies in your lifestyle, it is always best to check with your asthma specialist first. These therapies include
Certain breathing exercises including yoga
- Alternative medicines like homeopathy, chiropractic, and Ayurveda
- Dietary supplements
- Certain traditional Chinese medicine
Common Myths About Asthma
Myth #1: Asthma is a psychological disease
One of the biggest beliefs that many people have is that asthma is psychological and thus they don’t believe in getting medical help. Since asthma affects the airways it is to be noted that is not psychological as it causes the immune system and the lungs to behave erratically when it comes to certain triggers.
Myth #2: Asthma medications lose their effectiveness over time
Asthma meds don’t lose their effectiveness over time and can be used for long-term if the right doses are taken as directed.
Myth #3: People with asthma should avoid physical activity
Although strenuous exercises can sometimes induce asthma, simple exercises can keep a person fit and healthy and help them lead a normal life.
Myth #4: You can outgrow asthma
Some asthma symptoms may improve over time. People also learn how to deal with asthma better as they age since they know what triggers it and what doesn’t. However, there is no outgrowing asthma because it is a lifelong condition.
Myth #5: Asthma Is Easy to Control
Asthma can be easy or difficult to control depends on the kind of asthma a person is suffering from and the triggers. Although even in mild form of asthma, the treatment is required to give the necessary relief to a person to reduce flares and maintain proper lung functions.
I have been detected TB and I am on Before Breakfast: Rcinex 600, Rcin 300, Veloz D After Breakfast: combutol 1200, Ondem 8 mg At Noon: Macrozide 2000, Ondem 8 mg At Night: Omnacortil 30 mg for 5 days and 20 mg for 5 days and then 10 mg for days, Ondem 8 mg I have started taking meds from last 2 days and it's my third day. I have realized I am getting better but I seem to require 4-5 times more nutrition than normal otherwise I feel weakness. Please advice about my routine as I am working person, who can not take a break. My weight was 94 kg at time of medication start. Also if anything let me know, which I can take as precaution. Thank you.
I am on homeopathic medicine, for allergy cough, asthma but now I have bad cough dry, n wheezing for more than a month, allopathy Dr. gave steroid tablet for 5 days and allergic cough syrup, can I take these with a gap of 2 hrs, will it have any side effects, or homeopathy effect will go Please help.
Hello Doctor, I wanted to know that if someone in my workplace is having TB, but that person is still coming to office, how can I protect my self from getting TB. Is there any vaccination available for prevention of TB?
Hi, I have Issue with Breathing (Temporarily). A cough/burp where I become unable to breath and cock. By relaxing myself, I try to breath in through my nose and I can slowly start breathing properly, but sit with a cough and unable to burp for a while (1-3 minutes)
Asthma is a condition marked by the swelling and narrowing of the airways thus, producing excess mucus. This triggers coughing, breathing difficulties and wheezing. Asthma can be a minor inconvenience for some, while for others, it can often result in a deadly asthma attack.
It isn’t definite as to what causes asthma in some and not in others, but a combination of genetic and environmental factors is a probable reason. Factors that trigger asthma is varied, and is subjective. Some common causes of asthma include:
- Airborne matters, such as cockroach waste particles, pet dander, mould spores, dust mites or pollen
- Respiratory infections
- Physical activity
- Cold air
- Irritants (such as smoking) and air pollutants
- Some medications, such as naproxen, ibuprofen, beta blockers and aspirin
- Stress and strong emotions
- Preservatives and sulphites added to some beverages and food, such as wine, beer, processed potatoes, dried fruit and shrimp
- Gastroesophageal reflux disease (Stomach acids retreat into the throat)
- Breathing difficulties
- Chest pain or tightness
- Trouble sleeping due to breathing problems, wheezing or coughing
- A wheezing or whistling sound at exhaling
- Wheezing or coughing attacks that are aggravated by respiratory virus, such as flu or cold
Complications associated with asthma include:
- Symptoms and signs that interfere with recreational activities or school work
- Sick days from work or school when asthma flares up
- Persistent contractions of the bronchial tube that can lead to problems in breathing
- Hospitalisation and visits to the emergency room during critical asthma attacks
- Long-term consumption of certain medications to fix severe asthma can cause side effects
Long-term control and prevention are the main goals of asthma treatment. Treatment generally applies learning about the things that trigger your asthma, taking necessary steps to dodge them and checking your breathing to ascertain that your regular medications are effectively controlling your asthma. Inhaled corticosteroids, long-acting beta agonists, theophylline are some common long-term treatments to control asthma.
Medicines are prescribed based on your symptoms, age, triggers and what best keeps your asthma regulated. Also, you and your doctor need to work together to come up with a plan to counter your asthma. For example, if you think your symptoms are getting better, consult with your doctor to reduce your medication doses.
Allergic bronchopulmonary aspergillosis (ABPA) is a allergic manifestation to the fungus Aspergillus sp. Patient with underlying Bronchial Asthma or Cystic Fibrosis are more susceptible to this. The patient may be having severe symptoms of asthma which respond poorly to inhaled medications.
This fungus is very commonly found in the surroundings and is referred to as mold. It is found at various places like soil, water, air and even on decaying matter. This fungus has the characteristic feature of spore formation and these spores are inhaled commonly from the air, without causing any disease or discomfort.
The fungus enters the body and produces colonies by inhabiting the airways. But the presence of Aspergillosis in the lungs does not always indicate an infection. In people with weakened immunity, this fungus enters the lungs and produces an acute infection that spreads along the respiratory tract. An allergic response given by the immune system to the Aspergillus fungi causes the allergic bronchopulmonary aspergillosis.
Symptoms of this disease are as follows:
1. Frequent cough
2. Brown colored mucus while coughing
3. Hemoptysis (blood in cough)
4. Difficulty in breathing
5. Wheezing sounds from the chest
6. Lethargy and weakness
7. Tightness of the chest In case of an asthmatic patient, if asthma is in a poorly controlled state, this condition is most likely to develop.
People suffering from asthma can contract ABPA when the medications are unable to control asthma. ABPA can also occur with cystic fibrosis which is a condition that has a genetic basis.
Diagnosis of this condition is difficult. It is usually diagnosed on the basis of the symptoms experienced by the patient. Certain specific tests like lung function tests (spirometry) can be carried out to evaluate the breathing capacity of the lungs.
An evaluation of the levels of the immunoglobulin IgE is also required. In conditions that are related to allergic responses from the immune system, it is observed that the levels of IgE are raised than above normal.
However, in ABPA the levels of the immunoglobulin IgE rise to a very high count. Monitoring of the IgE levels is done regularly during the management of ABPA. Chest x- rays do not help in the diagnosis of this disease. While treating ABPA, the evaluation of the immunoglobulin levels is done regularly. To relieve inflammation corticosteroids can be given.
Treatment of ABPA is Oral corticosteroids and in case of steroid dependence or persistent symptoms consider adding antifungal. Also, to treat the fungal infection, anti-fungal medications are prescribed. Repeated episodes of ABPA require more targeted treatment. Itraconazole is the anti-fungal drug which is effective in treating the fungal infection.