Asthma prevention may start before birth: Dr Sarthak Rastogi

Last Updated on September 5, 2023 by Shabnam Sengupta

In the realm of respiratory health, few conditions cast as wide a net of influence as asthma. This condition can affect individuals of all ages, backgrounds, and geographic locations. Its impacts are beyond mere physiological discomfort. This has prompted extensive research and medical attention into asthma. Dr Sarthak Rastogi, Pulmonologist at Jaslok Hospital and Research Center, discussed in detail about Asthma in this interview and explained various aspects of the disease.

What is asthma?

Dr Sarthak Rastogi: Asthma is a respiratory condition. There is a complex interaction of genetic factors and environmental factors, which leads to a chronic condition. In this condition, people experience breathlessness and wheezing and cough. Asthma can happen to anyone and to both sexes equally. The incidence is rising as of now in the last few decades.

What are the signs and symptoms of asthma?

Dr Sarthak Rastogi: The most common symptoms of asthma are prolonged cough, episodes of breathlessness, wheezing or chest congestion or tightness. Some patients have a history of allergies that trigger these symptoms. Some patients tend to have a type of asthma in which there’s just a cough and nothing else. It is called cough variant asthma.

What are the causes of asthma?

Dr Sarthak Rastogi: One of the causes of asthma can be prenatal. There are complex genes which can lead to asthma, and the patient tends to have a history of allergies or asthma in the family. Another big factor is the health of a woman during pregnancy. Malnourishment, lack of adequate diet, or lack of adequate weight during pregnancy, can result in an increased risk of asthma in the child. Similarly, a higher intake of sugar or lack of vitamin D, polyunsaturated fatty acids and micronutrients can also increase the risk of this condition in the child. Also, If the mother is asthmatic or has poorly controlled asthma, then again the child may have a higher risk of developing asthma. Complications of eclampsia can also result in a higher risk of a child developing asthma in the future.

Among the post-birth factors are premature birth, a history of chronic or recurrent infections, and exposure to smoke during childhood. Another such factor is indoor fungal growth like moulds. These moulds release airborne spores that can cause allergies and lead to asthma.

Cockroach allergens, indoor animals, like pets, especially cats and birds, can put you at risk of having asthma. One very common thing is childhood respiratory infections. Bacterial infections called mycoplasma put a person more at risk of asthma. Air pollution is another such causal factor, which is now emerging as one of the leading causes of childhood asthma.

Obesity, especially among children and teenagers, can increase the risk of asthma. Another lifestyle habit that can cause asthma is smoking. There are other factors as well that can cause asthma, like baking, living near main roads or highways, etc.

How is asthma treated?

Dr Sarthak Rastogi: The treatment of Asthma is based on the level of severity and control. Depending on your symptoms, their severity and frequency, the doctor will decide the course of your treatment. Usually, it mainly consists of inhalers. A lot of people have reservations about inhalers that they are addictive, but they are not.

A lot of people think that inhalers will make you weak or dependent, so they prefer alternative lines of therapy and medicine. But the fact is that if a child or a teenager takes an inhaler properly and regularly, their lung growth is optimal. They tend to grow up better than a person who did not get an inhaler for asthma.

It’s very important that we understand that inhalers are the backbone of asthma treatment. Apart from inhalers, there are certain therapies or oral tablets like leukotriene receptor antagonists. Doctors prescribe it in conjunction with the inhalers, and in some cases, without them.

If a person comes with seasonal allergies or seasonal asthma exacerbations, then we start the patient on treatment just before the season is going to begin and continue for a month or two after the problematic season is over. Similarly, there are people who present with exercise-induced asthma, mainly in colder countries. We ask them to take regular treatment and inhalers before they start their therapy.

Basically, we can tailor the therapy according to the patient’s needs. Apart from the patient’s symptoms, another thing that determines the line of treatment of a patient is their comorbidities. A lot of older adults tend to have asthma along with heart disease. The treatment for asthma can interact with heart conditions because it pushes up the heart rate. Therefore, in cases of arrhythmia, people have a little bit of trouble with asthma medications.

However, we have a lot of safe inhalers now, which tend to cause fewer cardiac side effects. In the treatment process, we have to factor in the patient’s condition. We can tailor the therapy according to different aspects of a patient’s overall health and symptoms.

Can asthma be treated using home remedies?

Dr Sarthak Rastogi: We have to understand here that asthma is an incurable disease. You can control it but there is no cure yet. Proper treatment can help a person manage the condition well and lead a perfectly normal life for decades. Therefore, if a person has asthma, I would not recommend home remedies only.

If you are trying to eliminate the trigger factors in the house as a part of your home remedy, that’s good. Changing a house or changing your moulded home furniture is good. But I would not recommend just the home remedies for an asthma patient. There is no amount of Ayurvedic Kaadas or homeopathic medicines that have been shown to reduce asthma.

We have to understand the fact that asthma tends to go into remission for decades also in some cases. A person who’s having severe asthma episodes now or for a few years goes on treatment, and after their puberty, their symptoms may go into remission for decades. But sooner or later, the asthma symptoms will come back.

Therefore, a lot of these alternative lines of medicine, tend to either claim that their treatment can cure asthma and the person takes it and goes into remission and thinks that whatever he has taken has worked. But it may not. For example, a lot of asthma patients started Ayurvedic home remedies that they got to know from various social media platforms during COVID time. Simultaneously they stopped meeting other people. The incidence of normal respiratory viral infections went down, air pollution went down, and they started a little bit of exercising or some other factors improved. As a result, a lot of my patients were convinced that they improved because of ayurvedic or homeopathic medicines. But it is more often than not a coincidence. During the COVID, improved air quality and lack of interaction resulted in lower respiratory viruses, which is one of the major reasons for asthma exacerbations.

You must know that home remedies may help with asthma to a very limited extent. They cannot control your asthma symptoms or treat your asthma exacerbation episodes, and they definitely cannot cure it.

They will be adjunctive to the therapy, but can never be the main modality of treatment. It should always be a steroid-based inhaler or a steroid-based nebulizer followed by other treatments which have to be the main pillar of asthma treatment.

So basically correlation of home remedies with the improvement of certain other factors tends to help the patient and make them feel as if their asthma is improved. I want to ask everyone to understand that inhalers are designed to directly deliver the drug into your lungs with minimal side effects on the rest of your body. They are not addictive, they will not make you dependent on them, and they will not make your body weak in any form.

In fact, on the contrary, during the growing phase, if a person with asthma takes inhalers, it results in an improvement in lung function or growth. If a pregnant mother takes inhalers, it leads to better lung development and growth of the foetus.

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