Asthma, or reactive airways disease, is a chronic controllable disease. It occurs in all ages and both sexes and affects 30 to 40 per cent of the Indian population. Fatalities are rare but can occur due to ignorance, poor management, lack of adherence to medical advice and a penchant to "doctor shop".

As you breathe in, the chest expands and the airways relax. When you exhale, the muscles and airways force the air out. In asthmatics, this muscular action is uncoordinated and inefficient. The muscles of the airways are always contracted so air cannot enter the lungs freely. Mucous builds up, constricting the airways further. As air escapes from the narrowed airways, it produces a whistling sound - the wheezing typical in asthma.

Asthmatics have inflamed airways even when they are not wheezing. The long-standing, low-grade inflammation eventually damages the lungs. Attacks become frequent, prolonged and resistant to treatment. The airways are extremely sensitive to allergens and prone to viral and bacterial infections.

Inhalers are the mainstay of therapy. Short-acting bronchodilators open up the airways and a non-absorbed steroid reduces the inflammation and keeps the airways open. Nebulizers can be used in severe attacks. They administer the medication in the form of a fine mist. They run on electricity and can be administered at home, in clinics or in hospitals.

Although exercise can trigger an asthma attack, graded exercise under medical guidance is beneficial. Jogging, cycling, running and swimming increase endurance. Swimming corrects breathing and improves muscle coordination. The moist air in the pool helps remove mucous plugs. Martial arts focus on concentrated breathing and forceful expelling of air. Yoga improves lung capacity. A bronchodilator may be required 30 minutes before exercise.

Steam inhalations once or twice a day, even when there is no wheezing, help remove mucous plugs. Hot green tea with cinnamon and ginger is also helpful.

Asthmatics of all ages should take a yearly flu vaccine and the pneumococcal vaccine after the age of 65.