Medical Care ,  Ear Nose & Throat

A new approach against severe asthma

March 27, 2017

A novel treatment for severe asthma is improving patients’ quality of life by significantly reducing asthma attacks


A new approach against severe asthma

 

A 26-year-old Indonesian patient struggled with severe asthma attacks on a daily basis until she found some peace in Singapore.

Despite taking strong oral steroids and using inhalers – the mainstay treatment for asthma - she was hospitalised at least once a month, recalled Dr Kenneth Chan, a respiratory medicine specialist practising at Gleneagles Hospital in Singapore.

Last June, he treated her with bronchial thermoplasty (BT) - a fairly new procedure that did the trick. 

As a result, she doesn’t require hospitalisation anymore and can control her asthma symptoms without taking oral steroids, which may carry long-term side effects like osteoporosis and skin problems.

Asthma is a chronic condition whereby the lining of the airways get inflamed and thicken, thereby narrowing the air passage, explained Dr Chan.

As a result, asthmatic patients often experience breathing difficulties, along with other symptoms such as coughing, phlegm and wheezing.

“The good news with asthma is that when patients use their medicines correctly, nine out of 10 patients will keep their symptoms under control thus having a good quality of life,” he said.

Typically, symptoms are treated with inhalers to help reduce inflammation and bronchial dilators to open the breathing tubes.

However, 10 percent of asthma patients continue to have severe symptoms despite the use of these inhalers. For this group of patients BT may have a role.

 

How the procedure works

During the procedure, a carefully controlled device delivers mild heat to the smooth muscles of the airways in the lungs to reduce the thickness and excessive amount of diseased muscles.

BT is usually performed via a bronchoscope inserted through the nose or mouth and comprises three separate treatment sessions.

“By reducing airway smooth muscles, the airways constrict less, making breathing easier” explained Dr Chan.

Although BT is generally an outpatient treatment, some patients may require hospitalisation for a few days to monitor their post-treatment symptoms.

 

What to expect after the procedure

“BT simply reduces diseased tissue, so it is not a cure to asthma but a way to control its symptoms and allow standard medications to work effectively,” said Dr Chan.

Hence, most patients have to keep taking medications on a regular basis to manage their symptoms after undergoing BT.

During the recovery process, typical asthma-related symptoms may get worse, but they usually resolve within a few weeks.

“Once the breathing tube is completely healed, patients will find that the airway is no longer as sensitive to asthma triggers as it was before undergoing the procedure,” said Dr Chan.

Considering that BT is a relatively new procedure, there are not enough available data to prove that its effectiveness lasts more than five years. However, Dr Chan believes that BT can potentially benefit asthma patients for much longer.

 

Dr Kenneth Chan is a respiratory medicine specialist practising at Gleneagles Hospital in Singapore. Aside from general respiratory medicine, Dr Chan sub-specialises in intensive care medicine and bronchoscopy, with a special interest in advanced technological treatments such as bronchial thermoplasty.

 

Gleneagles Hospital Singapore
6 Napier Road, Singapore 258499
Tel: (+65) 6735 5000
www.gleneagles.com.sg

Respiratory Medical Associates
6 Napier Road #07-14
Gleneagles Medical Centre
Singapore 258499
Tel: (+65) 6473 9984

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