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Bronchospasm: Treatment, Procedure, Cost and Side Effects

What is the treatment? How is the treatment done? Who is eligible for the treatment? (When is the treatment done?) Who is not eligible for the treatment? Are there any side effects? What are the post-treatment guidelines? How long does it take to recover? What is the price of the treatment in India? Are the results of the treatment permanent? What are the alternatives to the treatment?

What is the treatment?

Bronchospasm is a respiratory condition where the muscles that line the airways of the lungs get tightened. This results in the airways becoming narrow and this does not allow as much air to come in or leave the lungs as would happen normally. This further affects the amount of oxygen that enters our blood and the amount of carbon di-oxide that leaves our blood. As a result of low oxygen levels in their blood, a person may suffer from alveolar hypocapnia which can affect the lungs badly or cause arterial hypocapnia.

There can be a number of factors that may cause bronchospasm. These are allergens like dust and pet dander, chemical fumes, general anesthesia during surgery, exercise, chemical fumes, cold weather, exercises, smoking and smoke inhalation from fire. Some of the symptoms of bronchospasm are rapidly increasing peak inspiratory pressure, decreasing exhaled tidal volumes, slowly increasing wave on the capnograph and wheezing.

Doctors usually prescribe Beta-2 agonists that work to relax the smooth muscles of a person’s bronchi or airways to treat bronchospasm. Some of the medications that can treat bronchospasm are albuterol, terbutaline and isoetharine and metaproterenol. Doctors may also prescribe inhaled corticosteroids in the form of sprays and inhalers to prevent the narrowing of airways during asthma attacks.

How is the treatment done?

There can be two types of treatment for bronchospasms: pre-operative and intra-operative. Pre-operative treatment involves supplemental oxygen, inhaled B2 agonists and intravenous steroids. The Beta-2 agonists, that help to relax the smooth muscles of a person’s airways or bronchi, control the release of basophils and mast cells. These granulocytes can cause bronchospasms in people suffering from asthma.

The different medicines that are used to treat bronchospasms in the pre-operative phase are short-acting bronchodilators, long-acting bronchodilators, inhaled steroids and oral or intravenous steroids. The short-acting bronchodilators are medicines used to quickly get relief from bronchospasm symptoms. Their effect starts within a few minutes and can last for a few hours. Long-acting bronchodilators start to show their effects late but help to keep the airways open for up to 12 hours. Inhaled steroids can be used to control bronchiospasm for a longer period of time and they help to reduce the swelling in the airways. In case of severe bronchiospasms, oral or intravenous steroids are used.

The intra-operative treatment of bronchospasm involves the use of volatile anesthetic concentration, inhaled B2 agonists, intravenous steroids and consideration of alternate causes of high airway pressures like kinked tube or endobronchial intubation.

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

A person suffering from bronchospasm will feel that his/her chest feels tight and that he/she is also having problems breathing. Some of the other symptoms include making a sound while breathing, pain in the chest, fatique and coughing. A person generally experiences hypoxia, which is when the body and the tissues are deprived of oxygen. Sticky mucus is secreted by the bronchial glands and this is often difficult to remove. The mucus blocks the bronchus and impede the normal flow of air. This causes the patient to cough uncontrollably. People suffering from these symptoms and who have been diagnosed by a doctor as suffering from bronchospasm are eligible for treatment.

Who is not eligible for the treatment?

A person is said to be suffering from bronchospasm if he suffers from wheezing and coughing, which occurs due to poor flow of air to the lungs. A person is only eligible for treatment if he/she has been diagnosed by a doctor. A doctor will look for increased mucus secretion, a swollen nasal passage or polyps in the nasal canal to determine whether a person is eligible for treatment or not. Two other methods of detecting whether a person is suffering from bronchospasm or not are spirometry an challenge test. People suffering from other respiratory illnesses like chronic obstructive pulmonary disease, pulmonary embolism, lung infections and congestive heart failure are not eligible for this treatment.

Are there any side effects?

Some of the common side effects of Beta-2 agonists are headache, nausea, anxiety, nervousness, muscle tremors and increased or irregular heartbeat. Inhaled steroids, when used for a long period of time, can have a number of side-effects including sore mouth and throat, fungus infection inside mouth, cataracts, high blood pressure or fluid build-up in the eye and reduction of bone thickness in adults. Furthermore, a person can suffer from stomach irritation, rapid heartbeat, flushing of the chest, neck and face, feeling of warmth or coldness and increase in energy.

What are the post-treatment guidelines?

There are some guidelines that a person who has been cured from bronchospasm needs to follow so that they can prevent this illness from afflicting them again. If a person exercises, he/she should warm up for 5-10 minutes before exercising and also cool down for a similar period after exercise. A person can loosen any mucus in his/her chest by drinking lots of water. It will also be important for a smoker to quit smoking and also to stay away from anyone who smokes. People above 65 should get pneumococcal vaccines.

How long does it take to recover?

Bronchospasm can be caused due to the swelling or irritation of the airways. An episode of bronchospasm generally subsides within 7-14 days. A doctor generally prescribes medicines to clear the airways and to prevent wheezing. Medicines help to widen the airways and provides temporary relief.

What is the price of the treatment in India?

Beta 2 agonists can be purchased within a price range of Rs 40 to Rs 84. A person on inhaled steroids to treat bronchospasm will have to shell out close to Rs 10000 per month. Oral steroids are available for around Rs 330 in our country. Long-acting bronchodilators, if used over a long period of time, are sure to leave you poorer as they cost a lot.

Are the results of the treatment permanent?

The steroids and other medicines used to treat bronchospasm basically work to suppress its effects. They do not address the underlying causes. Bronchospasm may occur due to smoking, from chemical fumes, infection of the lungs or airways, from allergens like dust and a lot of other reasons. Thus, a person may suffer from bronchospasm even if he/she has undergone treatment for the same.

What are the alternatives to the treatment?

There is the Butyeko Breathing Technique, that has been developed by a Russian researcher, which consists of shallow breathing exercises that help the person to breathe easy. Omega-3 fatty acids reduce the levels of arachidonic acid in the system and so its intake will prove beneficial for people suffering from bronchospasms. Intake of sufficient quantities of tomatoes, carrots and leafy vegetables also help to avoid acute bronchospasms. Reducing weight also helps to deal with this disorder.

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MD - Pulmonary,MD PULMONARY,DTCD
Pulmonology
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