Bronchial asthma

Resolved question:
Hello doctor,

I am 25. I am from the southern parts of the country,And I have the following troubles Turing winter especially from October to January.

1.severe wheezing and I feel discomfort while inhale..Because of this severe chest pain if I don't use inhaler...
2. Severe cold and running nose is also there.

I have this problem from the past six years. I consulted doctor and they prescribed levolin inhaler
And 2 tablets xyzal and romilast 10 mg.. Doctor told it is allergy...that time it was fine ....now year after year the severity become increased, into 6 th year now and these days using inhaler levolin 5 times daily and taking the two tablets once in 3 days...... Am allergic to what..."..."? What is the best solution


Doctors please advice....much thankful to you.....

Submitted: 4 Days
Category: ENT Specialist

Expert:  Dr. Sunil Jalan replied 4 Days.

Hello,

Thank you for using Ask a Doctor Service from Doctor Spring. I can understand your problem, and will try to help you the best possible


Let me summarize the medical history ->

severe wheezing , cold and running nose – seasonal, uncontrolled

Let me explain the disease first ->

Your diagnosis are
• bronchial asthma - Your symptoms of wheezing, chest discofort.
• Allergic rhinitis (hay fever ) – recurrent cold, running nose and sneezing


Investigation :
• For bronchial asthma – You can do pulmonary function test. It will conform the diagnosis and it will give more information. (Pulmonary function test should be done after discontinuation of Levolin for 72 hours.)

• For Allergic rhinitis (hay fever ) : Allergy skin test (prick test) : can be done to find out probable causative allergen
• CT scan of paranasal sinus : with this we can see that do you have sinusitis also with rihinitis. If yes than we can quanntify it with scan. But you don’t have any symptoms of sinusitis.


Treatment Recommendations, to be followed under the care of your local Doctor ->

• Mometasone (metaspray ) - Nasal spray twice daily for 3 to 6 months
• Continue xyzal 5mg one tab once in night for 10 days.
• Romilast 10 mg once in night for 3 months.
• For asthma two type of inhaler medicine are available –
1. Controller (Budesonide) – it gives long term control over asthma
2. Reliever (levolin) – it gives temporary relief

• Foracort 200 inhalar 2 puff 2 times for 3 months with SPACER (Zerostat – VT spacer).
(Instruction for using inhaler are given in with spacer )




Summary :
• To do pulmonary function test (PFT), allergry skin testing and CT scan of PNS (paranasal sinus) ,if you want detailed evualation. But we can start treatment without this because your diagnosis is so obvious
• Mometasone (metaspray ) - Nasal spray twice daily for 3 to 6 months
• Continue xyzal 5mg one tab once in night for 10 days.
• Romilast 10 mg once in night for 3 months.
• Foracort 200 inhalar 2 puff 2 times for 3 months with SPACER

Hope this helps. Feel free to ask if you have any further queries.

Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA

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Patient replied :

Hello doctor,

Thanks for reply ...much sad to know this.....could you please tell me what could have been caused me this decease?

No body from My family father, mother or grandfathers ,mothers had this issue....I am the one prone to this....

Also I have attended yoga classes last year, they have taught us some pranayama and other breathing exercises .....how effect is breathing exercise for this disease...


Expert:  Dr. Sunil Jalan replied 3 Days.

Hello,
1st i want to reassure that it is very easy control asthma and allergy, and you can live normal life without any restriction.
if you have family history then there are higher chances of getting asthma or allergy, but otherwise also it occurs, No specific reason to explain that why it occur in one person, why not in another.
breathing exercise are not required for treatment, some time it may worsen it (in exercise induced asthma).
So start treatment, No need to worry about this at all.
many celebrites including athletes, politicians, actors have asthma and no body knows about it, they have good active life.

Hope this helps. Feel free to ask if you have any further queries.

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Patient replied :

Thank you a lot doctor.......your words gives me a bit relief.
Sure I will follow your medications.... Every year I have to follow this course once if this situation happens ???...

Is there any course that will cure it permanently?
long term solution would be a better solution .... What is your suggestion doctor?..

Again many thanks..



Expert:  Dr. Sunil Jalan replied 2 Days.

Hello,

you may need same medication in next season also.

Unfortunately no permanent curative treatment is available for asthma and allergy,
but we can control it very easily. If you are using your spray and inhalar
regularly then most of time next year episodes will be less frequent and less
severe and if you start treatment before season ,it will be fully under control.

Again asthma and allergy most of time are young age problem, it will get
controlled automatically within few years.

Hope this helps. Feel free to ask if you have any further queries.

Thank you.
Regards
Dr. Sunil Jalan
MBBS, DLO,MS(ENT), DNB,DAA

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