How To Manage Asthma Flares?

Non pharmacological interventions to manage Asthma Flares:

There are some non-medical steps that can be taken to control asthma flare ups along with medications.

Cessation of smoking and vaping:

It is extremely important to quit smoking and vaping for the asthma patients because both smoking and vaping make asthma worse, increase chances of hospitalization and effect of medications is also reduced. Also smoking worsens lung function and increases risk of other lung diseases.

Exercise:

For asthmatics regular moderate physical activity has important health benefits including reduction in risk of heart diseases and improved quality of life. Also, we know exercise is an important cause of asthma symptoms in known asthma patients. This can be controlled by :

1. warm up before exercise
2. using low dose steroid plus formoterol/salbutamol inhaler before and during exercise.

Avoidance of occupational or domestic exposures

This is usually seen in adult-onset asthma (asthma that develops later in life). These patients might have allergens at home or at work. For its management it is necessary to identify any allergens at work or at home and avoid them.

Avoidance of medicines that make asthma worse:

There are few groups of medicines that can make asthma worse

1. Aspirin
2. Non-steroidal anti-inflammatory drugs (NSAIDs)
3. Beta blocker (tablets and eye drops form)

These medicines should be stopped only if they make asthma worse or any reaction is reported on first time usage.

Healthy diet:

Patients with asthma should be encouraged to consume diet high in fruits and vegetables for its general health benefits. Studies have proved that fruits and vegetables help in good asthma control and reduces risk of flare ups.

Avoidance of indoor allergens:

Remediation of mold or dampness in homes reduces asthma symptoms and medication use in adults. Other indoor allergens are:

1. House dust mite
2. Furred pets
3. Rodents
4. Cockroaches
5. Carpets

Allergen avoidance strategies benefit children more than adults.

Weight reduction:

Asthma can be more difficult to control in obese patients, also risk of frequent flare ups is more in obese patients. Response of medications is also reduced in obese. Weight reduction with diet and exercise both has shown better control of asthma symptoms.

Breathing exercises:

Breathing exercises improve symptoms and quality of life but have no role in control of flare ups.

Avoidance of indoor air pollution:

Indoor air pollutants are:

1. Smoking (active and passive)
2. Nitric oxide
3. Carbon monoxide
4. Carbon dioxide
5. Sulphur dioxide
6. Formaldehyde

Source of these pollutants are cooking and heating devices using gas and solid biomass fuels. People with asthma should be encouraged to use nonpolluting heating and cooking sources (heat pump, wood pellet burner, flued gas) and for sources of pollutants to be vented outdoors where possible.

Avoidance of outdoor allergens:

Asthmatic patients are advised to keep doors and windows closed and stay indoors when pollen and mold counts are high. Wear mask whenever there is need to go out.

Dealing with emotional stress:

Emotional stress worsens asthma. Hyperventilation associated with laughing, crying, anger, or fear can cause narrowing of airways. Panic attacks have a similar effect. Patients should be encouraged to deal with stress. Deep breathing in stressful situations helps in reducing asthma symptoms. Psychiatrist consultation is necessary in this case.

Avoidance of weather conditions:

During unfavorable environmental conditions (very cold, low humidity or high air pollution), outdoor activities should be avoided. It is strongly advised to stay indoors during such conditions.

Avoidance of food and food chemicals:

Food allergies are common in asthma patients especially children. People with asthma should be asked about symptoms associated with any specific food. Avoidance of such food is advised.

Food chemicals either naturally occurring or added during processing may also trigger asthma symptoms especially when asthma is poorly controlled. Sulfites (common food and drug preservatives found in such foods as processed potatoes, shrimps, dried fruits, beer, and wine) can cause asthma exacerbations. Other dietary substances include benzoate, yellow dye, tartrazine and monosodium glutamate.