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Saturday, June 22, 2013

Prevention of Bronchial Asthma

There are several dietary, environmental, and other triggering factors, which may worsen and increase the frequency of asthma attacks. Therefore, avoiding these triggering factors will help prevent and improve bronchial asthma.


Primary prevention of bronchial asthma

Primary prevention contains measures to prevent the occurrence of bronchial asthma.

Breast-feeding in children
Breast milk may have a possible protective effect against early bronchial asthma. Therefore, breast feeding should be motivated.

Avoidance of cigarette smoking
Passive tobacco smoking increases wheezing in infants and risk of chronic (long-term) bronchial asthma in all children. Some studies show a considerable relationship between maternal cigarette smoking and a raised risk of infant wheezing. Therefore, it is strongly recommended parents and parents-to-be to avoid cigarette smoking.

Weight loss
Weight loss is recommended in obese and overweight individuals. Some studies reveal that increased body mass index (BMI) is linked with the symptoms of bronchial asthma. Body weight reduction helps improve overall health hence bronchial asthma control.

It is difficult to recommend some measures for the primary prevention of bronchial asthma because, there is insufficient or absence of evidence to make any recommendations at present.

They are:
  • Domestic allergen (aeroallergen) avoidance
  • Modified milk formulae for childhood asthma
  • Nutritional supplements (selenium, fish oil, and vitamin E) during pregnancy
  • Immunotherapy
  • Dietary probiotics in pregnancy to prevent childhood asthma
  • Fatty acids and fish oils
  • Electrolytes



Secondary prevention of bronchial asthma

Secondary prevention consists of measures to diagnose as well as treat existent bronchial asthma in earlier stages before it leads to significant morbidity.

Air pollution
Some studies show a relationship between indoor air pollutants and aggravation of bronchial asthma. However, further study is needed on the role of air pollution in relation to bronchial asthma.

House dust mites
House dust mites are associated with bronchial asthma. However, they don’t have a significant effect on bronchial asthma severity. Reduced exposure to house dust mites may help prevent asthma. Frequent vacuuming or cleaning the domestic environment will remove small particles, dust, and house dust mites. It is good to wash stuffed animals, sheets, bed pillows, and covers in hot water (130°F/55°C) weekly. Minimise the use of extra pillows, carpets, and upholstered furniture. Increased humidity and human dander also raise the number of house dust mites. Therefore, using dehumidifiers in damp areas of your house will help reduce exposure to them. Repair any water leaks in the house. It is better to manage dandruff too.

Cigarette smoking
Parents with bronchial asthma should avoid tobacco smoking because, it can harm themselves and their children with bronchial asthma.

Immunotherapy
Some allergen can worsen and increase the frequency of asthma episodes. Allergen specific immunotherapy suppresses the immune response to the particular allergen, which can aggravate bronchial asthma. Therefore, the immunotherapy is effective in the management of people with allergic bronchial asthma. It should be considered in individuals with asthma where a significant allergen can’t be avoided. However, the possibility for severe allergic reactions to the immunotherapy should be fully discussed with asthma patients.

Removing pets from home cannot be recommended at present because, there is insufficient or absence evidence to make any recommendations.


Alternative methods to prevent bronchial asthma

Buteyko breathing technique
The Buteyko breathing technique helps control hyperventilation. Some studies reveal that Buteyko technique reduces asthma symptoms and bronchodilator medication usage. However, it doesn’t improve lung function.

Family therapy
Family therapy may be an effective adjunct to medication in severe childhood asthma.

Some alternative measures are not recommended at present mainly because, there is no sufficient evidence to make recommendations.

They are:
  • Acupuncture
  • Homeopathy
  • Herbal and Chinese medications
  • Relaxation therapies and hypnosis
  • Physical exercise therapy

Muscle relaxation could certainly benefit lung function in people with bronchial asthma. However, larger trials are required before making a recommendation. Air ionisers are not recommended for the management of bronchial asthma.



Related Links:

How to Diagnose Bronchial Asthma in Children?
How to Diagnose Bronchial Asthma in Adults?
Basics of Pharmacological Management of Asthma
Bronchial Asthma: Stepwise Management in Adults
Bronchial Asthma: Stepwise Management in Children Less than 5 Years
Bronchial Asthma: Stepwise Management in Children (5-12 Years) 
Control Your Asthma
Bronchial Thermoplasty and Severe Asthma
Prevention of Allergy
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Dr. Nalaka Priyantha
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Dr. Nalaka Priyantha is the founder and author of 'DRN Health World'. He currently works at the Ministry of Health, Sri Lanka as a senior medical officer. He is blogging about healthy living since 2012.Read More About Dr. Nalaka...