Asthma is a chronic airway inflammation associated with respiratory symptoms like wheezing, shortness of breath, cough and chest tightness, that vary in intensity and time. Once a person has been diagnosed with asthma, he/she will have the symptoms on and off where the disease can unfold in various ways – acute flare-ups, chronic intermittent or stable asthma.

According to World Health Organisation (WHO), asthma is a chronic lung disease affecting people of all ages. It is caused by inflammation, collection of mucous and tightening of muscles around the airways, thus making it harder for individuals to breathe.

In an interview with HT Lifestyle, Dr Anusha CM, Consultant – Respiratory Medicine at Manipal Hospital in Malleshwaram, shared, “Flare-up/Acute asthma can be precipitated by a recent viral illness, sudden change in temperature, exposure to fumes, strenuous exercises, emotional states like anxiety or stress, and stoppage of using inhalers. These episodes of severe symptoms usually start out abruptly and need to be treated urgently.”

WHAT IS ACUTE ASTHMA?

Dr Anusha CM answered, “Acute flare-up of asthma mainly involves inflammation and obstruction of your medium and small size airways. There is an increase in the muscle thickness of your airways, causing narrowing and restricted airflow and hence patients experience chest tightness. A mild attack can last for a few minutes, however, a severe one can last for a few hours to a few days. Symptoms of acute flare-ups include chest tightness, coughing, wheezing, and coughing. Acute asthma needs immediate medical management at the hospital.”

Bringing his expertise to the same, Dr Vivek Nangia, Principal Director and Head - Pulmonology at Max Super Speciality Hospital in New Delhi's Saket, said, “Acute asthma also called an asthma exacerbation or flare is characterised by a progressive increase in symptoms of shortness of breath, cough, wheezing or chest tightness and progressive decrease in lung function. Such flares may require emergency visit, hospitalisation and can even be fatal. Symptoms can include coughing, wheezing, shortness of breath and chest tightness. These symptoms can be mild or severe and can come and go over time. Although asthma can be a serious condition, it can be managed with the right treatment.”

WHAT IS CHRONIC ASTHMA?

Dr Anusha CM revealed, “It’s a condition where acute asthma gets worse with time and becomes resistant to the usual line of management. The causes of chronic asthma include respiratory viral infections, house dust mites, pollens, air pollution, stress, anxiety, fumes, sudden exertional activities, etc.”

Dr Vivek Nangia explained, “Chronic is a term which is used to refer to anything that is long standing but is no longer used when referring to Bronhcial asthma. The terminologies currently used for describing the various states of asthma symptomatic control are uncontrolled asthma, difficult to treat and severe asthma. Uncontrolled Asthma refers to poor symptoms control and frequent exacerbations or worsening of symptoms.”

He elaborated, “Difficult to treat asthma is a state where the patient continues to have symptoms despite being on medium to high doses of medicines. It does not mean a ‘difficult patient’. In many patients, asthma may appear to be difficult to treat because of modifiable factors such as incorrect inhaler technique, poor adherence, smoking or comorbidities, or because the diagnosis is incorrect. Severe Asthma is a subset of patients who remain uncontrolled despite being on high dose medication after confirming the diagnosis, ensuring adherence to therapy and correcting inhalational technique, correcting the comorbidities. Such patients should be evaluated for the newly launched medications called the biologic therapies.”

HOW TO MANAGE CHRONIC ASTHMA?

Dr Anusha CM advised, “Medications mainly include Inhaled bronchodilators, leukotriene antagonists, immunotherapy, biologicals, etc. It is tailored based on patients' condition and severity. They aim at reducing inflammation and symptom control except for Immunotherapy which aims at modifying the disease response to allergens. Asthma is complex medical disorder although it is often seen as a manageable illness, untreated asthma can nonetheless have catastrophic consequences.”

She concluded, “It's critical to understand the hazards connected to having asthma if you have the condition. Ultimately, consulting a medical practitioner is the only method to distinguish between acute and chronic asthma symptoms. They can diagnose any underlying issues and assist you in choosing the best course of action. Don’t let asthma stop you from enjoying life. With the right course of treatment as advised by your pulmonologist, you can lead a healthy, fulfilling life with asthma.”

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