Bronchial Asthma




Bronchial asthma is a chronic inflammatory disease of the airways. This includes narrowing of airway passage (bronchi) causing difficulty in breathing and a feeling of not getting enough air into the lungs. Common symptoms include shortness of breath, wheezing, chest tightness, cough and excess mucus production.Proper preventive measures, regular medication and life style changes can lead a healthy life.
Bronchial asthma is commonly divided into two types: allergic (extrinsic) asthma and non-allergic (intrinsic) asthma.


Allergic (extrinsic) asthma
It is characterized by airway obstruction and inflammation that occurs on allergen exposure. It is reversible with medications and removal of allergen. It is the most common form of asthma.
Allergic asthma is triggered by inhaling allergens such as dust mites, mold, pollens, pet dander, etc. An immune reaction sets in body in response to allergic/ trigger factors & the airways become inflamed and swollen. This causes coughing, wheezing and other asthma symptoms.

Non-Allergic (intrinsic) asthma
This type includes airway obstruction and inflammation like allergic type but the symptoms are not associated with an allergic reaction. Non-allergic asthma is triggered by other factors like anxiety, stress, exercise, cold air, etc.


Bronchial asthma is caused by thickening of airway due to inflammation, and bronchoconstriction - the narrowing of the airways in the lungs due to the tightening of surrounding smooth muscle.
Excessive mucus is produced by mucus glands due to immune response to allergens. This further blocks the airway resulting in cough and wheezing. The sensitive and inflamed bronchi get narrow due to edema from inflammation.
Common trigger factors of asthma include:
  • Animals - pet hair, dander, feathers, etc.
  • Dust and dust mites that live in pillows, mattresses, carpets, beddings, etc
  • Changes in weather (most often cold weather)
  • Respiratory infections, such as the common cold
  • Tobacco smoke.
  • Certain foods- beer, wine, shrimp, dry fruits, etc.
  • Cockroaches - their dried droppings and remains.
  • Strong odors, sprays and perfumes
  • Exercise
  • Mold
  • Pollens - tree and flower pollen in early spring, grass pollen in late spring and weed pollen in late summer are highest
  • Stress


The presentation of symptoms of asthma varies from person to person. Many patients have asthma attacks for specific duration, esp. on exposure to allergen and rest of the time the patient may remain symptom free.

Some patients may have prolonged shortness of breath with episodes of worsening it. Wheezing or a cough can be the predominant symptom.
Symptoms include:
  • Cough with or without sputum
  • Dyspnea( difficulty in breathing) worsened by exercise or activity
  • Wheezing
  • Use of accessory muscles for respiration
  • Anxiety from shortness of breath
  • Tightness in the chest
  • Chest pain
In case of severe asthma following symptoms are also seen:
  • Bluish color to the lips and face
  • Drowsiness or confusion
  • Sweating
  • Increased pulse rate


Thorough medical examination of patient will reveal wheezing and other asthma related symptoms.
Tests may include:
  • Chest x-ray
  • CBC to measure eosinophil count (a kind of white blood cell)
  • Lung function tests
  • Peak flow measurements
  • Arterial blood gas
Allergy testing may be helpful to identify allergens in chronic asthmatic patients.


Two main aims of treatment are
  • Maintain clear and normal airway
  • Avoidance from trigger factors that cause asthma
 Initial treatment will depend on the severity of asthma. Follow-up asthma treatment will depend on how well the symptoms are in control and frequency of asthma attacks.
There are types of medication for treating asthma:
  • Long term control drugs to prevent attacks
  • Quick-relief drugs for use during attacks
Long-term control drugs for asthma are used to prevent symptoms in people with moderate to severe asthma. They help to reduce airway inflammation and prevent asthma symptoms.
  1. Inhaled steroids: these prevent symptoms by preventing airway swelling and are almost always the first choice.
  2. Long-acting beta-agonist inhalers: these also help prevent asthma symptoms & can be used together with an inhaled steroid drug.
Quick-relief drugs are fast acting medicines which control asthma attack and relieve symptoms. They include:
  • Short-acting beta-2 agonist bronchodilators (inhalers) act quickly to relax smooth muscles around airways & help to open up the narrow air passage.
A severe asthma attack requires hospital admission along with emergency medical care.


The complications of bronchial asthma can be mild to severe depending upon type and prognosis of asthma. These include:
  • Reduced  capacity to exercise and do other activities
  • Permanent changes in the function of the lungs
  • Persistent cough
  • Disturbed or lack of sleep from attacks occurring at night.
  • Death in case of severe unresolved asthma attack


As such bronchial asthma symptoms can improve over time. With proper self care, avoidance of trigger factors and regular medical treatment, asthma can be controlled.


  • Avoiding the known allergens or trigger substances; is the best way to prevent occurrence of asthma symptoms.
  • Keep pet animals out of home or at least bedroom. Avoid keeping fabric covered furniture and carpets at home. If so, do clean them regularly with vacuum cleaner.
  • Clean the house regularly. Bedding should be covered with "allergy-proof" casings to reduce dust mites. Clean pillow covers, beddings regularly with warm water.
  • Remove carpets from bedrooms and vacuum regularly.
  • Remove stuffed toys from bed and wash them either warm water or with cold water along with detergent.
  • Cover nose and mouth during exposure to cold air.
  • Avoid tobacco smoking actively or passively at home or at work. Those who smoke outside carry smoke residue inside on their clothes and hair which this can trigger asthma symptoms.
  • Avoid eating/ drinking foodstuffs like beer, wine, shrimp, dry fruits, etc.
  • Keep food in containers and out of bedrooms which helps reduce the possibility of cockroaches. Do not keep food material left open in kitchen or unclean utensils in sink. Use pesticide tabs, pills or perfumes to kill cockroaches regularly but avoid direct exposure.
  • Avoid strong odors, sprays and perfumes. Use mild or unscented detergents or cleaning material at home.
  • Humidity levels in home should be kept low and any leaks should be fixed to reduce molds.
  • Stay indoors with windows closed from late morning to afternoon, as pollen and some mold spore counts are highest at that time.
  • Stress at work or home can be reduced or prevented by using various recreational activities or de stressing measures.
  • Avoid polluted areas, industrial dusts and irritating fumes, etc.
  • Keep taking medications regularly as prescribed by physician and get regular follow up visits.
  • Eat healthy diet which includes well balanced healthy meals, fruits and drink plenty of water.
  • Do regular moderate exercise daily as advised by physician for at least 30 min.
  • Keep track of asthma symptoms and level of control.
  • Follow an asthma action plan as discussed with physician to control asthma attacks and means to monitor it.

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