One out of 10 Keralites is asthmatic

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It’s a little known, but alarming fact. Of the 300 million asthmatics around the world, 3.5 million are from Kerala, or to put it simply , one in every 86 asthmatic in the world is a Malayalee.

Although no recent studies have been conducted on asthmatic trends in the state, leading pulmonologists here agree that one in 10 people in Kerala is asthmatic, while the world average is one in 12. The trend is clearly worsening as only one in 20 was asthmatic in 2005, and by 2020 it could be one in six.

Not surprisingly, Kerala is ranked among places most prone to asthmatic conditions in the country.
Dust is the major culprit both in Kerala and elsewhere in India.

“Allergy to dust, certain food, insects, weather, genetic carryover or even emotions can cause asthma which is not a disease, but a state of hyper responsiveness,” says Dr Jacob Baby, consultant pulmonologist, Ernakulam cooperative medical college.

Studies show that children who study in schools near major roads are more prone to respiratory diseases, according to Dr S. Sachidananda Kamath, former president of Indian Medical Association (Kochi) and a consultant paediatrician at Welcare hospital in Kochi.

But opting for antibiotics or inhalers is not the way to deal with asthma, say doctors, explaining that the cause can vary from person to person.

“If one person is allergic to dust, another finds egg disagreeable. So, it is about finding the cause and getting rid of it. Also it is impossible to cure asthma, as it may come back any time in life. We can only control it,” adds Dr Kammath.

Fortunately only one out of three children carry asthma into adulthood as two third of asthmatics successfully control their condition while still growing, he explains.

But atmospheric pollution and genetic influences set Kerala apart and pulmonologists predict the next generation could produce a huge number of asthmatics in the state.

Asthma can be controlled with regular treatment

Asthma is disease which affects the airways which carry air in and out of your lungs. The airways become swollen or inflamed, thus narrowing the passage of air, making it difficult for you to breathe.

There are millions of people suffering from asthma in India and this number is increasing by the day. In spite of the best treatment available for asthma, people continue to suffer due to the lack of proper knowledge and the false beliefs which still prevail.

Myth: Asthma can be cured
Fact: Asthma is a controllable disease but there is still no cure available for asthma. No therapy can provide you with a total cure but yes with proper and regular medications your symptoms can be brought under excellent control.

The condition has to be taken seriously as uncontrolled symptoms can result in hospital admissions and even death.

Myth: I don't have regular symptoms of asthma. My asthma comes and goes.

Fact: No, you have asthma even when you don't have THE symptoms of asthma. Having symptoms like a cough, breathing difficulties or wheezing indicates a flaring up of your asthma or as in medical parlance, exacerbation of asthmatic symptoms.

This indicates the need to step up your medication for the control of these symptoms. It is important to know that asthma is a chronic disease and can be kept well under control with the regular use of treatment, which needs to be continued even in the absence of symptoms.

Myth: Inhalers are addictive. Once started, I will have to use them all my life.

Fact: Not at all. Using inhalation medication regularly doesn't mean that it is habit forming. Inhalers for asthma just have to be compared to medications for diseases like hypertension and diabetes.

For good control of hypertension and diabetes if a patient has to use the medications lifelong then why not for asthma? Once you have achieved good control of your symptoms, treatment can be stepped down.

Myth: My symptoms are not severe enough to require inhalers/puffs.
Can’t I be treated with oral medication?

Fact: The best treatments available for asthma at present are inhalation medications, and there is enough data to prove this fact.

It's just like applying an ointment on your burns. When you take a puff from your inhaler the medication is directly delivered to your lungs relieving you from your symptoms almost immediately.

Oral medications take time to act and the dosage is in milligrams compared to the micrograms dosage in inhalers. Therefore you have fewer side effects with inhalers.

Myth: Inhalers have steroids which have a number of side effects in long run.

Fact: Inhalers do have steroids in them but in a dosage of micrograms which are less likely to cause any serious side effects when used over a period of time.

The use of inhalers in a proper way and a simple mouth wash and gargling with plain water after the use of inhalers can prevent some of these.

(The author is Consultant Pulmonologist, West Fort Hospital, Trichur)