Asthma

Asthma is a long-term condition where the airways become narrow, inflamed, and twitchy — causing cough, wheeze, chest tightness, and breathlessness. In India, asthma is extremely common, often poorly controlled, and frequently misdiagnosed as "recurrent bronchitis". With the right inhaler, most people with asthma can live completely normal lives.

Common triggers

• Air pollution — Delhi/NCR, winter stubble-burning, firecrackers, indoor smoke.
• House-dust mites, cockroach allergens, mould.
• Pollen — seasonal peaks.
• Viral infections (the commonest trigger in children).
• Exercise, cold air, laughter, stress, strong smells.
• Cigarette and biri smoke, wood and cow-dung smoke.
• Some medicines — aspirin, NSAIDs, beta-blockers (in sensitive patients).

The single biggest issue in India: under-use of inhalers

• Inhalers are the best treatment for asthma — far better than tablets or syrups.
• Many Indians delay or avoid inhalers because of myths: "inhalers are addictive" (false), "inhalers are only for severe cases" (false), "steroid inhalers are dangerous" (the inhaled dose is tiny and far safer than repeated oral steroid courses).
• Every asthma patient needs a daily preventer inhaler (inhaled corticosteroid, often combined with a long-acting bronchodilator) plus a reliever inhaler for breakthrough symptoms.
• A spacer device hugely improves delivery — use it, especially in children.

How asthma is controlled well

• Daily preventer inhaler even when you feel fine.
• Reliever inhaler (short-acting bronchodilator) — use only as needed; needing it more than 2×/week means control isn't good.
• Written asthma action plan — what to do on good days, flare days, and red-flag days.
• Identify and reduce triggers — dust-mite covers, no smoking at home, pollution masks on bad-AQI days, flu vaccine annually.
• Peak-flow meter at home for older children and adults to spot deterioration early.

Red flags — emergency (dial 112)

• Severe breathlessness, can't speak in full sentences, lips/fingers turning blue.
• Reliever inhaler not working after 6–10 puffs.
• Drowsy, confused, exhausted child or adult.
• Silent chest (wheezing stops but breathing is very laboured).
• While waiting: 6–10 puffs of reliever every 20 minutes, upright position, call 112.

Avoid

• Relying on oral steroid "Dexona" tablets or injections for routine control — this is a major driver of Cushing's syndrome, diabetes, and osteoporosis in Indian asthma patients.
• Unregulated Ayurvedic asthma "cures" — some contain hidden steroids.
• Stopping preventers because "I feel fine".