Asthma is a disease of airflow obstruction caused by an inflammation of the bronchi in individuals who have hypersensitive airways.

Dr. Manoj Goel, Director & Head, Pulmonology, Pulmonary Critical Care & Sleep Medicine, Fortis Memorial Research Institute, Gurugram talks about extrinsic factors called triggers.

"Hypersensitivity in airways is due to a variety of intrinsic factors. But there are several extrinsic factors which stimulate this hypersensitivity precipitating the attacks of bronchial asthma or may contribute to the persistence of symptoms. A patient of asthma should try to identify these triggers and always avoid them to keep the asthma under control, states Dr Goel.

Adding, "However, there are many triggers which may are not avoidable like pollens in the atmosphere. Therefore, patients of asthma should continue their preventive inhalers as per the advice of the doctors. There could be numerous triggers depending upon the home and workplace environments which a patient can identify himself."

Some triggers include:

Tobacco smoke generates oxidative stress and proinflammatory effects on the lungs which in turn increases airway obstruction and accelerates the normal annual decline in lung function. Even secondhand smoke, that is generated can trigger asthma. Smoking can also lead to development of COPD which is a progressive irreversible obstructive airway disease.

Air pollution due to traffic and uncontrolled industrialisation is another important trigger.

Indoor air pollutants like paints, adhesives, flooring chemicals, cleaning products, combustion products from cooking and heater, mosquito coils do contribute in triggering asthma.

House dust mites, which are tiny bugs found in every corner of each home is important trigger for chronic persistent asthma. To cut their exposure, avoid carpets and soft toys at home, wash your pillow covers and bed linens with warm water regularly.

Psychosocial factors such as stress, anxiety, childhood adverse events, depression do contribute as risk factors for asthma.

Some people have mold allergies. Therefore, look for any fungus in the house and repair damp areas in the house.

Cleaning of air conditioners and coolers is required time to time.

Viral infections linked to influenza; respiratory syncytial virus can trigger asthma.

Use of antiflu vaccinations are preventive strategies in fighting asthma exacerbations.

Obesity has shown to increase the risk of uncontrolled asthma. Obesity has been associated with low grade inflammation and the resultant oxidative stress. Studies have shown that weight loss has been associated with significant improvement in asthma control and higher symptomatic remission rate.

Patients suffering from rhinitis and rhinosinusitis are more liable to have asthma supporting unified airway concept. Certain drugs like beta-blockers, aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, may trigger symptoms in some people with asthma.

Lastly asthmatic patients should avoid strong smells like perfumes, cold food and beverages and smoke of any kind even during prayers and aartis.

(Agency)