Asthma: A respiratory disorder

 

Asthma: A respiratory disorder

Prof Yamini Bhusan Tripathi, PhD Biochemistry

Former Dean, Ayurved Faculty, Institute of Medical Sciences, Banaras Hindu University,

CEO, Yamini Innovations (LLP), Varanasi-221005, yamini30@gmail.com, www.yaminiinnovations.com

Asthma is considerably increasing due to rapid industrialization, excessive crowding, Increasing pollution. It belongs to NCDs, affecting both children and adults. As per WHO, about 300 million people are affected with this disease, and bringing to death of about 500,000 deaths world-wide. About 15% of Indian population suffers from Asthma. The WHO has included it under its “Global Action Plan for the Prevention and Control of NCDs and the United Nations 2030 Agenda for Sustainable Development”. The WHO has introduced a Package of Essential Noncommunicable Disease Interventions (PEN) which includes protocols for the assessment, diagnosis and management and modules on healthy lifestyle counselling, and self-care. The Global Alliance against Chronic Respiratory Diseases (GARD) is also working closely with The Framework Convention on Tobacco Control like MPOWER and mTobacco Cessation.

In Allopathy, Asthma is defined as a chronic lung disease affecting people of all ages. In Ayurveda, it has been defined as Shwas Roga, initiated due to imbalance of 'Pranvayu' and 'Kapha dosha' in the lungs. It’s primary causes include inflammation, excess mucus accumulation on the inner epithelial layer and muscle tightening around the airways, that is bronchus and bronchioles, causing- airway constriction, resulting to difficulty in breathing. It results to other factors like sleep disturbance, tiredness during the day, and poor concentration, resulting to overall bad quality of life. In Ayurveda, asthma has been defined as of 5 types and 1^st three types are not curable, but last 2 are manageable. 1]Maha-shwas (problem with dep breathing), 2]Urdhva-shwas (problem with inhalation), 3] Chinna-shwas (problem with sudden stopping of breathing), 4]Tamak-shwas (sudden attack), and 5]Kshudra-shwas(shortness of breathing)

Symptoms: Shortness of breath at night or during exercise the persistent cough, wheezing when exhaling, chest tightness, making it difficult to breathe deeply are its earliest symptom. These symptoms become more worse with the change in climate like cold, humidity and exposure to triggers, like dust, smoke, fumes, grass and tree pollen, animal fur and feathers, strong soaps and perfume. These symptoms get manifested in those people who have family background of this problem, (genetic predisposition), but get exposed to other secondary comorbid conditions like, like eczema, rhinitis (hay fever), tuberculosis, anemia, Heart disease, Epilepsy (Vataja Apasmara) 2. tremors (Apatantraka), 3. In piles or haemorrhoids (Kaphaja and Vataja Arshas) 4. GIT problems like flatulence/constipation (Pureeshaja anaha) or 5. Indigestion (Amashaya), Hypersensitivity to different types of allergens, house-dust, mites, Moulds, occupational hazards, exposure to excess-cold/warm or moist air, exposure to tobacco-smoke, excess-exercise or exertion, emotional stress, foods allergens. Low birth weight, premature delivery, viral respiratory infections etc at early age of life, and overweight or obesity at later stage, are the predisposing factors. The diet related issues to trigger asthma: Excess use of difficult-digesting diet classified in Ayurveda as dry (Ruksha') and heavy (Guru) diet, like lablab beans, black grams, raw milk, soar curd, excess salt, flesh of aquatic and wet-land animals, cold water and cold drinks, 'Abhishandi (Kapha producing) diet, irritant-diet, are responsible for escalating the symptoms of asthma. Work related triggers of asthma: Excessive exposure to dust, smoke, wind, cold, cold bath, excessive heat, sun bath, Exhaustive exercise, walking, excessive sexual activities, Suppression of natural urges and psychological factors.

Symptoms: (1) Dyspnoea (compromised breath), Hikka (Hiccough) etc, (2) Wheezing (means high-pitched whistling sound during exhalation), (3) Chest Tightness (feeling of pressure in the chest, (4) Persisting Cough (Kash), (expulsion of mucus or cough from mouth and nose). In patients of asthma, these symptoms are more pronounced at night. In this disease early diagnosis, awareness about aggravating factors and changed lifestyle are the main factors to treat the disease and to improve the quality of life.

Common tests: (1) Lung function tests by Peak flow measurement, Spirometry, allergy tests, Methacholine challenge test, (it is done when spirometry results are normal) and count of eosinophils in the sputum (mixture of mucus and saliva) (2) Association with inhalative allergies via IgE cross reactivity, (3) Direct GIT sensitization test by using different diets, which enhances allergic respiratory disorders.

Preventive steps: To improve the quality of life changed lifestyle and diet choices, are important as to Avoid (1) cold and damp places, (2) over exercise, do light exercise but regularly like morning or evening walk, yoga, 'Pranayama, (3) over eating, dinner 2 hour before going to bed, (4) Tobacco, wine and smoking, (5)  air conditioners, coolers and direct air of fan, (6) perfumes, Agarbatti. Mosquito repellents or any type of smoke near your place etc. Drink boiled water in plenty, keeping the rooms well ventilated, dining 2 hrs before sleep, prevention of triggers, changed lifestyle and food habits are recommended.

Treatment: Asthma is difficult to cure, but its symptoms can be minimized, and quality of life can be improved by adopting a protocol of identifying the early symptoms before its full attack and selfcare practices. Public awareness about its protocol and action plan is essential. The inhalation of medication by traditional methods (Nasya), use of inhalers or spacers with mask and inhalers are primary steps to control its acute condition. They include bronchodilators to reduce muscle spasm (such as salbutamol), or steroids to reduce inflammation (beclomethasone) in the air passages. Due to versatile approach of treatment, the Ayurveda is being more popular these days.  Drinking decoction of dry ginger (sunthi), black pepper (Kali mirch), black salt (Kala namak), Basel leaves and local application by fomentation, use of warm medicated oils over chest and back are effective. Through nasya, steam vapor oil, powder, paste made up of several medicinal plants are in practice. Some of them have been described below in this blog.

Oral medication includes use of several Ethno-medicinal plants and non-pharmacological Ayurvedic approaches for the management and treatment of Asthma. Different preparations and food supplements made up of, Asystasia gangetica leaf, Lafoensia pacari and ellagic acid, Moringa oleifera Lam Tinospora cordifolia, andrographolide, Phyllanthus fraternus Webster, ginger (Zingiber officinale), fenugreek (Trigonella foenumgraecum L., Pimpinella anisum, curcumin/ turmeric (Curcuma longa), Saussuria lappa, Piper longum, Adhatoda vasica, Picrorhiza kurroa, onions, Nigellia sativa, Solanum xanthocarpum and Solanum trilobatum, Boswellia serrata gum resin, Oscimum tenuifolium Linn. (O. Sanctum), Benincasa hispida, stem bark of Ailanthus excelsa Roxb, Solanum melongena leaf, Tea-leaf saponin (TLS), rhizome of Curculigo orchioides gaertn, Myrica sapida, stem bark of Myrica esculenta Buch-Ham (Myricaceae), Ursolic acid and Plantago major, Devadaru Compound (Dc), Alstonia scholaris leaves, Calotropis procera, Elaeocarpus sphaericus, Ocimum sanctum, Cannabinoids, etc.

(https://orcid.org/0000-0002-8093-1109)