Waiting to exhale

HEALTH

Sometimes even the expanding knowledge of medical science can fail to provide the answers. One such questionable disease is asthma whose origins still largely remain mysterious.

And though we might not be able to tell you just why or even how one succumbs to those exhaustive bouts of breathlessness, doctors and scientists have developed new techniques of addressing the disease to keep it under control.

Asthma is an innate predisposition that is caused not by infection but through increased sensitivity of airways to stimuli such as dust, smoke, seasonal changes, pollen, pets, industrial gases or any other unknown external trigger. Food, however, plays little role in causing or aggravating the condition.

The constriction of the body's airways, that don't allow enough oxygen to reach the lungs, cause the characteristic breathlessness associated with asthma. This can be reversed once the trigger passes on often aided by steroids.

Since the root cause of the disease is unknown, only a very small proportion of asthmatics, those with specific identifiable allergies, can actually prevent an attack. In most other cases there is still no prevention method.

Steroids are the most powerful and effective in treating asthma. Over the last 20 years, they have become mainstays in asthma treatment. These steroids are available in both tablet and inhaler forms. The tablets are meant only for short-term relief, while steroid inhalers provide long-term relief.

Today the market is flooded with different kinds of inhalers ranging from the meter dose inhaler, dry powder inhaler "" known to be the most reliable and easy to use "" and aerosol meter dose inhaler. Dr R K Mani, director for pulmonology at Fortis hospital, explains, "Though there are no new breakthroughs, we have developed a very specific line of treatment."

The first therapy that comes in the line of treatment is corticosteroid combined with long acting bronchodilator agents that make the efficacy of the steroid much better so that just by using one inhaler twice a day, the patient gets immense relief.

A fairly new agent that has come out is the leukotriene receptor antagonist, known as montelukast, that considerably reduces the overwhelming immune response to the stimuli and is made in tablet form.

However, cautions Mani, the agent is not a substitute for steroids and should be used in combination. With 15-20 million asthmatic patients in the country, including a large population of children under 11 years of age, doctors suggest keeping rescue medicine, either an inhaler or tablets, close at hand in case of a sudden attack.