Uncovering Asthma Misconceptions





Uncovering Asthma Misconceptions


Disease Introduction

Asthma is a condition in which airways narrow, swell, and may produce extra mucus thus, makes difficult breathing, a whistling sound during breathing, and shortness of breath. Asthma is a major non-communicable disease affecting both children and adults. It is the most common chronic disease among children.

For some people, it is a minor whereas for others; it can be a major problem as it interferes with daily activities and may lead to a life-threatening attack.

It can't be cured, but symptoms can be controlled as asthma changes over time, it's important to follow up with a doctor to track signs and symptoms and adjust treatment accordingly.


Data of Asthma


  • Worldwide, it is estimated that approximately 334 million people currently suffering from asthma, and 250,000 deaths are attributed to the disease each year.
  • The prevalence of the disease is continuing to grow, and the overall prevalence is estimated to increase by 100 million by 2025.
  • Approximately 25 million people in the U.S. have asthma. This equals about 1 in 13 people.
  • About 20 million U.S. adults age 18 and older have asthma.
  • Around 9.8% of female adults have asthma, compared to 6.1% of male adults.
  • It is a leading chronic disease in children. Currently, there are about 5.1 million children under the age of 18 with asthma.
  • Black children are nearly three times more likely to have asthma compared to white children.
  • Around 8.4% of male children have asthma, compared to 5.5% of female children.


  • According to the latest data published by W.H.O in 2018, Asthma Deaths in Nepal reached 4,434 or 2.66% of total deaths.
  • The age-adjusted Death Rate is 22.69 per 100,000 population ranks Nepal 7 in the world.


Classification of Asthma

  1. Mild intermittent asthma: Mild symptoms less than twice a week. Night-time symptoms less than twice a month. Few asthma attacks.
  2. Mild persistent asthma: Symptoms three to six times a week. Night-time symptoms three to four times. Asthma attacks might affect activities.
  3. Moderate persistent asthma: Daily asthma symptoms. Night-time attacks five or more times a month. Symptoms may affect activities.
  4. Severe persistent asthma: Ongoing symptoms throughout day and night. You have to limit your activities.


Causes Factors

  • Family history (genetic)
  • Gender (more common in males than females)
  • Age (most common in children than adults)
  • Allergens (pollen, dust, pets, and so on)
  • Viral respiratory infections
  • Air pollution, Smoking
  • Occupational exposure (bakers, drug and detergent manufacturers, farmers, plastic and metal workers, woodworkers, millers and so on)
  • Obesity



  • Infections like sinusitis, colds, and the flu
  • Allergens such as pollens, mold, pet dander, and dust mites
  • Irritants like strong odors from perfumes or cleaning solutions
  • Air pollution
  • Tobacco and smoke
  • Exercise
  • Cold air or changes in the weather, such as temperature or humidity
  • Gastroesophageal reflux disease (GERD)
  • Strong emotions such as anxiety, laughter, sadness, or stress
  • Medications such as aspirin
  • Food preservatives called sulfites are found in things like shrimp, pickles, beer and wine, dried fruits, and bottled lemon and lime juices

Signs and symptoms

  • Coughing, especially at night or in the morning
  • Shortness of breath
  • Trouble sleeping because of breathing problems
  • Severe wheezing while breathing
  • Very rapid breathing
  • Chest pain or pressure
  • Tightened neck and chest muscles, called retractions
  • Difficulty talking
  • Feelings of anxiety or panic
  • Pale, sweaty face
  • Blue lips or fingernails


Symptoms in children

Symptoms can vary from episode to episode in the same child.

  • Coughing often, especially during play, at night, or while laughing. This may be the only symptom.
  • Weakness or fatigue or pause to catch their breath while playing.
  • Fast or shallow breathing.
  • Chest pain or feels tight.
  • Whistling sound while breathing.
  • Seesaw motions in their chest because of trouble breathing.
  • Shortness of breath
  • Tight neck and chest muscles



  • History taking related to any allergy, genetic, working area, and so on accordingly to find out the risk factors for developing asthma.
  • Physical examination of the respiratory system thoroughly.
  • Lungs Function test by spirometry (simple breathing test measures how much air you blow out and how fast).
  • Peak flow to measure how well your lungs push out air.
  • Methacholine tests involve using triggers or challenges to find out do you develop any symptoms or not.
  • Exhaled nitric oxide test is used to rule out if the lungs or airways are inflamed or not by connecting a breathing tube to a machine that measures the amount of nitric oxide in breath, but levels could be high if airways are inflamed.
  • Chest X-ray
  • CT scan
  • Allergy test by blood or skin.
  • Sputum eosinophils



  1. Bronchodilators:
  • Beta-2 agonists, ( salbutamol, salmeterol, formoterol and vilanterol)
  • Anticholinergics, (ipratropium, tiotropium, aclidinium, and glycopyrronium)
  • Theophylline

General side effects of bronchodilators include:


  1. Inhaled corticosteroids: Commonly inhaled corticosteroids include

Combination inhaler:

Oral and intravenous corticosteroids: Common oral steroids includes

General side effects of inhaled corticosteroids include


  1. Leukotriene modifiers: Common leukotriene modifiers includes

General side effects of Leukotriene modifiers include

  • Headache
  • Nausea & vomiting
  • Insomnia
  • Irritability.


Home remedies

Medication will probably control asthma, but some remedies at home might be helpful to minimize the symptoms.

  • Avoid triggering factors i.e. GERD, cold, dust, and so on.
  • Exercise regularly i.e. yoga, acupuncture, and biofeedback.
  • Maintain a regular healthy weight.
  • Do breathing exercises to ease symptoms so you need less medication.
  • Balance diet and use of supplements like vitamin A, C, D and minerals and so on.

Diet and Nutritional requirements:

  1. Vitamin D-rich foods, such as milk and eggs.
  2. Beta carotene-rich vegetables, such as carrots and leafy greens.
  3. Magnesium-rich foods, such as spinach and pumpkin seeds.

Impact of certain foods and medicines (Foods to avoid)

  1. Sulfites are found in wine and dried fruits.
  2. Foods that can cause gas, include beans, cabbage, and onions.
  3. Artificial ingredients, such as chemical preservatives or other flavorings.
  4. Common allergens such as dairy products, shellfish, wheat, and tree nuts.
  5. Medicines such as Non-Steroidal Anti-Inflammatory Drugs (NSAIDs), Beta-blockers.

Asthma Prevention

  • Know triggers, and try to avoid them.
  • Follow doctor’s instructions on taking medications.
  • Keep track of conditions and learn the signs that might get worse.
  • Avoid cold, smoke, alcohol, and allergens.
  • Avoid such occupational situations that may lead to or aggravate the attack.
  • Get vaccinated against COVID-19, flu, pneumonia, shingles, or whooping cough.



  • Infectious diseases specialist
  • Lung diseases (pulmonologist)


RN. Luswang Shrestha

Danphe Care