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Bronchial Asthma Treatment: Procedure, Cost and Side Effects

Last Updated: Jul 05, 2024

What is the treatment?

Asthma is a long-term ailment that causes the airways in the lungs to get irritated and inflamed. As a result, a person afflicted with this condition has hard time breathing. This condition causes periodic attacks of coughing, wheezing, chest tightness and shortness of breath. Asthma is associated with mast cells, eosinophils and T-lymphocytes. These cells, together with other inflammatory cells, cause the airway to get inflamed in asthma and thus cause respiratory problems, airflow limitation and eventually chronic diseases.

Some of the causes or triggers of asthma are: pollens or moulds, strong perfumes, certain types of food, cigarette smoke, medicines like aspirin and NSAIDs, respiratory infections like colds and influenza, psychological influences and other irritants like paint and varnish fumes, wood dust and flour and also changes in temperature. However, the exact cause of asthma is not fully understood and it is believed that it is caused by a combination of genetic and environmental factors.

Asthma is generally treated by avoiding triggers and through the use of medications. The main types of medications used to treat asthma are preventers, relievers, symptom controllers and combination inhalers. The long-term asthma control medications include inhaled corticosteroids, leukotriene modifiers, long-acting beta agonists, combination inhalers, theophylline. The quick-relief medications are short-acting beta agonists, ipratropium and oral and intravenous corticosteroids.

How is the treatment done?

There are a number of tests that can help to diagnose bronchial asthma. The tests are spirometry, peak expiratory flow and chest x-ray. After proper diagnosis, a doctor is likely to recommend some medications and also will ask the person to make some changes in his/her lifestyle. It has to be kept in mind that asthma cannot be cured. So what a person can do at the most is to take medications and avoid triggers.

Preventers are inhaled corticosteroid medications that help to reduce swelling and also reduce the body’s reaction to triggers. They should be taken regularly to ease the symptoms as these medicines generally take a lot of time to start working. Another medication is the reliever, which is generally inhaled. They reduce constriction and deal with the symptoms of asthma by causing the airways to relax. They are often referred to as bronchodilators and they provide quick results.

Symptom controllers are used together with preventers and they are actually long-acting inhaled relievers. Doctors will generally advice you to take this medication twice a day and they help to relax the airway muscles. A person will not have to use short acting relievers if he is on symptom controllers. Furthermore, a person suffering from bronchial asthma can also take combination inhalers which contain the properties of both the preventer and symptom controller medications in one device.

The medications that are used for long-term control of asthma are inhaled corticosteroids, leukotrine modifiers, long-acting beta-agonists, combination inhalers and theophylline. The medications to get quick relief from asthma are short-acting beta agonists, ipratropium and oral and intravenous corticosteroids.

Bronchial thermoplasty is done to patients when they do not respond to any other medication.

Who is eligible for the treatment? (When is the treatment done?)

There are a number of signs and symptoms that a person suffering from asthma will experience. They are shortness of breath, tightness of chest, excessive coughing or cough that impedes sleep and wheezing. A person becomes eligible for treatment if he/she experiences some or all of these symptoms. Furthermore, there are a number of tests that can detect asthma. They include: peak expiratory flow, chest X-ray and spirometry. A person who has tested positive for bronchial asthma after undergoing any of these tests is eligible for treatment.

Who is not eligible for the treatment?

When asthma tests like spirometry, chest X-ray and peak expiratory flow have not diagnosed a person to be suffering from asthma, he/she is not eligible for treatment. Coricosteroid medications have a few side-effects and are not suitable for people with certain complication. A person only becomes eligible to use such medication only after consulting with a doctor.

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Are there any side effects?

The side-effects of fluticasone, a preventer, include severe bleeding of nose, redness, sores or white patches in mouth and throat, fever, chills, weakness, nausea, vomiting, flu symptoms, noisy breathing and runny nose. Side-effects associated with terbutaline, a reliever, include drowsiness, dizziness, headache, rapid heartbeat, shortness of breath, palpitations and nervousness. Combination inhalers can cause infections in the mouth, cavities, pneumonia, throat pain, cough, headache and may even cause your voice to change. Formoterol, which is a symptom controller, can cause to worsen the symptoms of asthma, can cause chest pain, fast heartbeats, nervousness as well as throat infection, wheezing, chocking and other breathing problems. The side effects of bronchial thermoplasty include skeletal muscle tremor, potassium deficiency, headache, increased lactic acid and hyperglycemia.

What are the post-treatment guidelines?

Asthma cannot be permanently cured. So, what we can do is to follow some guidelines so as to ensure that nothing triggers the condition again. A person should have a self-management or action plan about how to deal with asthmatic triggers. A person can reduce the risk of serious asthma by taking a seasonal influenza vaccination as it helps to reduce the risk of influenza. One of the most important precautions that a person can take to avoid asthmatic attacks is to quit smoking. A healthy lifestyle will also go a long way in keeping asthma at bay. Avoiding allergen and desensitization will help to reduce the symptoms of asthma as well.

How long does it take to recover?

Asthma is a condition that cannot be permanently cured. All a person can do is to take medications to prevent the condition getting triggered. Long-term medications like inhaled corticosteroids and beta-agonists do not show their effects immediately. They need time to work. The time that they will require to offset the symptoms of asthma depends on the severity of the condition and also on the constitution of the person taking treatment. Sometimes, recovery may take years and sometimes it may also take an entire lifetime.

What is the price of the treatment in India?

The cost of fluticasone, which is an inhaled corticosteroid, is approximately Rs 1100 for 16 grams. Short-acting beta agonists may cost anything between Rs 650 – Rs 4000. Symptom controllers like foradil may cost something around Rs 4500 for 12-15 capsules. Check-ups at a doctor’s clinic will cost according to the doctor. Bronchial thermoplasty is an expensive procedure and can cost close Rs 10 lakhs.

Are the results of the treatment permanent?

Asthma is a condition that can never be cured. However, what we can do is control the factors that may cause the asthma to get more severe. The medicines that we take help to control the symptoms rather than addressing the underlying causes. Even the long-term medications only help to control and not to treat the condition as such. Thus there are no permanent treatments for bronchial asthma.

What are the alternatives to the treatment?

A person can take warm steam baths to deal with nasal congestion and irritation of the airways associated with asthma. Garlic helps to deal with asthma due to its anti-inflammatory properties. Asthma is an inflammatory problem and hence, garlic is a good remedy for it. Furthermore, ginger, Echinacea and Licorice root, turmeric, honey and omega-3 fatty acids, when incorporated in the diet, help to deal with the symptoms of asthma.

References

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Written ByDr. Pankaj Verma ACLS,POST GRADUATE COURSE IN RHEUMATOLOGY,Fellowship in Diabetes,MBBS,Post Graduate Course In Rheumatology,MD - Medicine,Masters in Psychotherapy and CounsellingInternal Medicine
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