Experts: 50% of Asthmatics don’t really have the disease


When seven-year old Deepak was rushed to a Delhi hospital a few years back with worsening asthma symptoms, doctors were puzzled.The boy had been on inhalers and even oral steroids, as suggested by a physician in his hometown, Chandigarh, for the last three years but his condition had not improved. “It turned out that the child did not suffer from asthma at all,” said pulmonologist Dr Arup Basu, who treated Deepak at Sir Ganga Ram Hospital. “The CT scan revealed he had a peanut stuck in the trachea which was causing breathing difficulties.” For three years, the boy had been administered the wrong treatment.

Strange as it may sound, Deepak’s is not the only such case of misdiagnosis of asthma. TOI spoke to pulmonologists and medicine experts who said nearly 50% of all patients labelled as asthmatics by primary-level physicians may actually have wheezing or coughing due to other factors, such as viral infection, allergy or tumour in the upper respiratory tract.

 “Inhalers must not be prescribed without detailed diagnosis and confirmation of asthma. It is linked to severe side-effects on prolonged use,” said Dr Suranjit Chatterjee, senior consultant, internal medicine at Apollo hospital.
 A recent report by two UK experts, Andrew Bush and Louise Fleming of Imperial College and Royal Brompton & Harefield NHS Foundation Trust published online in the journal, Archives of Disease in Childhood (ADC), supports this view. It states that doctors are over-diagnosing asthma, with inhalers frequently dispensed for no good reason. “Inhalers have almost become a fashion accessory ,” the article says. Dr S K Chhabra, the head of cardiorespiratory physiology at V P Chest Institute said inhalers being a fashion accessory may be true for the west but the Indian scenario is a little more complicated since many patients also go undiagnosed, particularly in smaller cities and villages.
 “Stress should be on the right use of inhalers. They are useful in relieving symptoms in correct dosage. But when used wrongly , the inhaler steroids can cause serious side-effects,” Dr Chhabra said. The side effects associated with their misuse include growth suppression and the dampening of immune cell activity in the airways and the subsequent heightened risk of respiratory infections, says the ADC article.
 “Treatment shouldn’t simply be stepped up if the child fails to respond, because there’s a chance the diagnosis might not be right in the first place. A further safeguard is to consider the diagnosis of asthma as dynamic – many children outgrow their symptoms,” the article adds.

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