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Asthma
Take a shallow breath
Asthma ( `az-muh) n: a chronic respiratory condition marked by spasms in the bronchi of the lungs, causing difficulty in breathing; triggered by hyperreactivity to various stimuli.
By Eugenia Malyshev, CBE
More than 16 million adults and 7 million children in the U.S. have asthma, according to the Centers for Disease Control and Prevention (CDC). That’s three times the total reported just 25 years ago and almost one in 10 children. Asthma, a chronic inflammatory airway disease, is among the top 10 emergency department diagnoses for children in the Twin Cities, according to the Minnesota Department of Health (MDH). Further, one in 10 Minnesota adults report that they have been diagnosed with asthma at some point in their lives.
Despite advances in conventional and alternative health care, asthma remains a puzzling disorder. It ranges widely in severity from very mild to life-threatening, can manifest suddenly at any age, go into short or long remission, and come back unexpectedly. Extensive research adds little to the understanding of the causes of asthma or why it is thriving among the developed countries’ population.
Bronchodilators, corticosteroids
The cornerstone principle of conventional treatment of asthma is to relieve symptoms with bronchodilators and prevent asthma aggravations with corticosteroids. Bronchodilators chemically force constricted airways open for a certain amount of time, while steroids suppress the immune response and fight inflammation. But those powerful remedies come with side effects, and using them daily for years is walking a thin line between benefits and risks. Corticosteroid drugs, especially oral, can cause irreversible immune system damage with prolonged use. The U.S. Food and Drug Administration (FDA) issued a warning in February cautioning that long-acting bronchodilators have the potential to exacerbate asthma by masking inflammation, resulting in an increased risk of hospitalization and death.
A recent nationwide survey of 2,500 asthma patients 12 and older found that, despite better medications and the increased availability of asthma education, there has been little decline in hospitalizations or ER visits for asthma over the last 10 years and little meaningful improvement in key markers of asthma control - hospitalizations, emergency room visits, unscheduled health care visits, and missed school or work days.
Complementary and alternative medicine (CAM)
While a number of non-drug CAM techniques and remedies are suggested to relieve asthma, it can be overwhelming to explore all CAM choices as they usually lack clinical trials and systemized data to reach a solid conclusion as to their effectiveness.
But with a cautious approach and choosing therapies whose value has been documented, complementary techniques can prove invaluable for managing asthma.
The essential difference between complementary and alternative medicine is that complementary methods are used in addition to conventional treatment, while alternative methods are used instead of established medical practice. Therefore, the first rule of safety is to choose complementary, rather than alternative, methods. Of all non-drug asthma treatments, breathing techniques have been studied at greater depth and show more evidence of effectiveness.
The Buteyko Method
The Buteyko Method, named by its creator, Russian Professor of Medicine K.P. Buteyko, is based on the notion that asthma originates from the commonly overlooked problem of chronic hyperventilation (breathing at an excessive depth and rate, which leads to an abnormal loss of carbon dioxide from the blood). By correcting a faulty breathing pattern, the theory holds, a patient can significantly reduce or eliminate asthma symptoms. Unlike other breathing techniques, the Buteyko Method is not just a series of breathing exercises but a comprehensive wellness program aimed at correcting dysfunctional breathing and encouraging healthier lifestyle through stress reduction, nutrition, and exercise. Buteyko therapy is completely safe when taught by a qualified practitioner, and program attendees are required to continue taking their medication as prescribed unless their doctor has approved stopping it.
The Buteyko Method has been studied extensively in eight clinical trials. All have shown it to be effective. One of the trials, in Brisbane, Australia, showed impressive results of 71 percent fewer symptoms, 90 percent reduction in reliever medication use, and 49 percent reduction in use of steroid preventers after three months. In 2008 the British Thoracic Society in its "British Guideline on the Management of Asthma", recommended the Buteyko Method to help patients control the symptoms of asthma and reduce bronchodilator use. It is the only complementary therapy endorsed by this body for the treatment of asthma.
Other breathing techniques
The Papworth Breathing Method was developed by the Papworth Hospital in England during the 1960s. Papworth is somewhat similar to the Butyeko Method in teaching relaxation and diaphragmatic breathing through the nose, but does not emphasize the normalization of breathing volume. A small trial reported in the British journal Thorax concluded that the Papworth Method "appears to ameliorate respiratory symptoms, dysfunctional breathing and adverse mood compared with usual care."
There is no solid evidence on the specific effects of Pranayama breath control on asthma. One randomized, controlled study conducted in Great Britain compared the effects of the Buteyko and Pranayama techniques in 69 patients with mild, stable asthma. The results showed significant improvement in asthma symptoms and reduction in bronchodilator use in the Buteyko group only. However, yoga can increase fitness and reduce stress, which may help with asthma.
Acupuncture
Acupuncture involves the insertion of thin needles to various depths at certain points on your body. While some evidence suggests that asthma symptoms improve with acupuncture treatment, a review of 21 trials concluded that there was no evidence for a clinically valuable benefit for acupuncture as a treatment for asthma and no significant benefit in relation to lung function.
Homeopathy
The goal of homeopathic treatment is to stimulate the body's self-healing response by challenging the immune system to fight disease. In the case of asthma, homeopathic remedies are made from substances that commonly trigger an asthmatic reaction, such as pollen or weeds. Finding the right remedy can be a lengthy and complex process with no guarantee of success, and treatment often requires banning steroid-based medications as they suppress the very immune system homeopathy is trying to stimulate. For those reasons, most experts do not recommend homeopathy for asthma.
Herbal remedies
Although herbal remedies have been used for thousands of years to treat lung conditions, safety is the main concern, especially with combination herbal remedies. Some have shown promise in research, but more studies are needed to find out what works and what's safe. Herbs that have shown promise include butterbur, ginkgo, Pycnogenol (French maritime pink bark extract), and Indian frankincense. Before trying an herbal remedy, consider quality of preparation and drug interactions and consult your doctor and a knowledgeable herbalist.
Diet and supplements
While a healthy diet can help to lessen your symptoms, diet alone will not have a profound effect on asthma. Foods and nutrients that may help reduce asthma symptoms include fruits and vegetables, foods rich in Omega-3 fatty acids, and magnesium. Foods that may worsen asthma symptoms include: animal protein, dairy, foods you are allergic to, and foods containing additives and preservatives.
Managing asthma
Although there is no cure for asthma, excellent long-term asthma control can be achieved through a combination of carefully tailored steroid drug treatment and the Buteyko breathing therapy. With continuous Buteyko practice, medications can be safely tapered down in many cases.
Eugenia Malyshev, CBE, offers respiratory health and wellness programs at the Buteyko Breathing Clinic in Minneapolis.
[Sidebar]
Elements of Buteyko
- Daily breathing exercise routine to relieve and prevent symptoms
- Exercises to unblock the nose naturally
- Instructions for handling an asthma or coughing attack and for breathing during sleep and physical activity to reduce asthma symptoms
- Education regarding nutrition and supplements to aid breathing, how to reduce viral respiratory infections, how to overcome exercise-induced asthma, and how to relieve stress and anxiety
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