Should my brother get a second opinion for severe asthma?

Question

Hi doctor,

My brother is 27 years old and has been dealing with severe asthma since childhood. Over the past year, he has needed multiple emergency visits because of wheezing, chest tightness, and shortness of breath despite using inhalers regularly.

His current pulmonologist recently added stronger medications, but he still experiences flare-ups triggered by weather changes and respiratory infections.

We are wondering whether another specialist might offer additional treatment options.

Should someone with severe asthma that remains poorly controlled push for a second pulmonologist's opinion, especially if symptoms continue despite treatment?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern and will definitely help you with it

In your brother’s situation, taking a second pulmonology opinion is sensible. Repeated emergency visits at your brother's age suggest that the disease may need more detailed reassessment rather than only stronger asthma inhalers.

Sometimes patients are very sincere with medications but still continue having attacks because another contributing factor has not yet been identified.

Over the last few years, treatment options for severe asthma have improved significantly. Certain patients benefit from biologic injections that target specific inflammatory pathways involved in asthma.

These are usually considered in patients who continue having flare-ups despite appropriate inhalers and who show markers such as elevated eosinophils, allergic tendencies, frequent steroid use, or repeated hospital or emergency visits. A specialist with experience in severe asthma can evaluate whether your brother fits into that category.

The main goal at his age is not only temporary relief during attacks but also preventing repeated inflammation over the long term so that lung function remains preserved as much as possible.

I have seen young patients who were visiting emergency departments repeatedly for years and later became much more stable after a complete reevaluation and adjustment of therapy. In some cases the diagnosis remained severe asthma, while in others an additional, overlooked problem was contributing to poor control.

Severe asthma can sometimes be challenging even for experienced pulmonologists, and referral to a dedicated severe asthma clinic is common in difficult cases. If symptoms continue despite adherence to treatment, repeated flare-ups, or ongoing limitation of daily activities, a second expert assessment is medically appropriate.

Hope I have addressed all of your queries and concerns.

Do follow up whenever needed.

Thank you.