What are the best ways to diagnose and manage asthma?

Question

Hello doctor,

My 45-year-old colleague has a history of asthma and has been experiencing more frequent attacks recently. He works in a high-stress office environment, and we suspect stress or indoor air quality may be contributing triggers.

Could these factors be exacerbating his asthma symptoms?
Would it be advisable for him to explore a different treatment plan or undergo testing for specific allergens or changes in lung function?

We are concerned his symptoms are becoming increasingly difficult to manage.

Thank you.

Answer 1

Hi,Welcome to iCliniq.com.I read your query and can understand your concern.As you already described, your colleague is suffering from bronchial asthma, and the key to its treatment is the use of inhaled medications. For adequate asthma control, appropriate inhalers in the right dose are to be used with the appropriate technique, and they should be used regularly.Investigations to be done on newly diagnosed or uncontrolled bronchial asthma:

Complete blood count.
Serum total IgE.
Chest X-ray.
Pulmonary function test (spirometry pre and post bronchodilator).

Causes for repeated exacerbation include:

- Presence of comorbid conditions like allergic rhinitis, acid reflux, and obesity.
- Incorrect inhaler technique or if inhaler is not being used regularly (most common cause among all).
- If incorrect inhaled medicines are being used.
- Fungal sensitization and hypersensitivity.
- Emotional stress.
- Environmental factors include pollution and pollen.

The following advice is to be followed for uncontrolled bronchial asthma:

- - Start regularly using inhaler MDI (metered-dose inhaler) Budetrol (200/6) 2 puffs twice daily with spacer followed by mouthwash. Inhalers are to be used daily without any break for at least 6 months. No dose is to be skipped unless advised by a pulmonologist.
  - Mac spacer (it is to be attached to the inhaler; the technique of its usage can be learned on internet). It is necessary to use a spacer if you are using an MDI device.
  - Consult a pulmonologist either physically or virtually regularly (at least once monthly).
  - Take vaccinations appropriate for the age if not taken already.
  - Control of co-morbid conditions, if any.

Get the investigation advised and follow up after one week, will then evaluate if his asthma is controlled or not and if it requires any further kind of treatment.

I hope I have answered your query.

Let me know if I can assist you further.

Thank you.