Tackle obesity to combat asthma

In order to combat the rising numbers of asthma cases in India, city doctors say it is important to address the problem of obesity. It is among the several medical conditions, like diabetes and sleep disorders, which play a critical role in aggravating an asthmatic attack.

A recent study published in the American Journal of Respiratory and Critical Care Medicine claims a direct link between obesity and development of a phenomenon known as dynamic hyperinflation when air breathed into the lungs cannot be exhaled. It is seen in many cases where obese patients face serious difficulty in breathing and those with asthma start gasping for breath. "Due to increase in fat deposition in the abdomen, the diaphragmatic boundary is pushed upwards, and because of this the lungs' space is compromised. This obstructs lung function," says Dr Anoop Misra, director and head of department, diabetes & metabolic diseases, Fortis Healthcare.

With obesity becoming a common problem in children, there is all the more reason to worry. Doctors say it might trigger wheezing or an asthma attack. "It is often seen that obese children run short of breath if they do even a small physical exercise. These kids have lower lung reserve and are not able to exhale properly," says Dr Sanjeev Bagai, head of the department, paediatrics, and director, Rockland Hospital.

Along with obesity, it's co-morbidities like type2 diabetes, hypertension, gastroesophageal reflux etc can also result in worsening of asthma. "Diabetes and hypertension can affect any part of the body. It can also have a damaging effect on lungs because of which respiratory system can get affected," says Dr Vivek Jaggi, senior consultant, pulmonologist, Artemis Health Institute.

Asthmatic patients with sleep disorders are more prone to getting an attack. "The lower airway is as it is compromised in asthmatic patients. But due to sleep disorders, the situation becomes worse, as the upper airway also gets affected.

A lot of patients on medication for asthma complain of problem in sleeping as the medicine has stimulants. And in sleep apnea or snoring, a person's upper airway space gets narrow and this further reduces the supply of oxygen to the lungs. Decrease in oxygen level in blood can affect the sympathetic nervous control like heat rate, pulse etc.

Such patients are at a higher risk of getting a heart attack, increase in heart rate, stroke etc, as compared to other asthma patients," warns Dr Manvir Bhatia, chairperson, sleep medicine, Sir Ganga Ram Hospital.

With the change in season, there are pollens and other allergens in the air. So asthma patients need to look out. But better management and precautions can certainly help.

There are a host of patient-friendly devices in asthma care that are now available in the metros. There are newer drug delivery devices, better medicines and pocket-sized oxygen cylinders that assure asthmatics of a better quality of life. Medicines for asthma used in the West now make their way to Indian shores almost simultaneously.

At the hospital end too technology promises better treatment.