What triggers bronchial asthma, including acid reflux (GERD)?

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

As you have already mentioned, your father is suffering from bronchial asthma. The key to treating asthma is the use of inhaled medications. For adequate asthma control, it is important to use the appropriate inhalers at the correct dose with the proper technique, and they should be used regularly.

Suggested Investigations that should be done are:

1. Complete blood count.
2. Serum total IgE.
3. Chest X-ray.
4. Pulmonary function test (spirometry, pre and post bronchodilator).

The causes of repeated exacerbations include:

1. The presence of comorbid conditions like allergic rhinitis, gastroesophageal reflux disease (GERD), and obesity.
2. Incorrect inhaler technique or irregular use of the inhaler.
3. The use of incorrect inhaled medications.

I suggest the following:

1. Start using inhalers regularly (MDI Budetrol 200/6, two puffs twice daily with a spacer, followed by a mouthwash). Inhalers should be used daily without interruption for at least six months. No doses should be skipped unless advised by a pulmonologist.
2. Use a spacer with the inhaler (the technique for using it can be learned online).
3. Consult a pulmonologist regularly, either physically or virtually, at least once a month.
4. Take vaccinations appropriate for his age if not already done.
5. Control comorbid conditions, such as allergic rhinitis, uncontrolled allergic rhinitis, and GERD, often exacerbate asthma, leading to poor control. Adequate control of gastric symptoms is essential for proper asthma management.
6. Ensure that he has a written asthma action plan outlining how to manage his symptoms and what to do in an emergency. This can help him feel more in control.
7. Avoid triggers: Identifying and avoiding triggers (such as smoke, pollution, pets, or certain foods) can significantly improve his condition. Smoking cessation is essential to prevent asthma exacerbations.
8. Pulmonary rehabilitation: Some programs offer education and exercises to improve lung function and overall fitness.
9. Lifestyle changes: Regular exercise (as tolerated), maintaining a healthy diet, and managing stress can all contribute to better asthma control.
10. Monitoring and technology: Using a peak flow meter to monitor his lung function can help detect worsening asthma early. There are also smartphone apps that can help track symptoms and medication use.
11. Emergency preparedness: Ensure he has an emergency plan in place, including access to emergency medications and knowing when to seek urgent care.

Please complete all the investigations and follow up after one week with the results. We will then evaluate whether his asthma is under control.

Follow up with the investigations or if you have further questions.

Thank you.