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    Suggest remedies for bronchiectasis and asthma

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Posted on Mon, 18 Jul 2016 in Lung and Chest disorders
Question: I had my FEV1 and other lungs capacity levels checked recently and I have 60% capacity due to my Bronchiectasis and Asthma. The doctor said that although I have been on Seretide for a year now it has not increased my capacity. Does Seretide take a long time to show results or should I ask my doctor to try a different medication to increase my lung percentage.
doctor
Answered by Dr. Kaushal Bhavsar 38 minutes later
Brief Answer:
You should try ultra LABA and ultra LAMA combination.

Detailed Answer:
Thanks for your question on Health Care Magic.
I can understand your concern.

There are many factors which affect improvement in bronchiectesis and asthma.
In long standing cases, asthma becomes chronic persistent. And this is less likely to improve spirometrically. Bronchiectesis is something irreversible lung damage. So it's effect on lung functions will also not be reversible.

Seretide has salmeterol and fluticasone. And 1 year is enough for Seretide to improve your lung functions. If it doesn't improve beyond a year of treatment, now a days we try ultra LABA (long acting beta 2 agonist) and ultra LAMA (long acting muscarinic antagonist).
Ultra LABA is indacaterol and ultra LAMA is glycopyrolium. Discuss with your doctor about starting indacaterol and glycopyrolium.

Please let me know
1. Do you smoke?
2. Since how many years you are having asthma and bronchiectesis?
Please reply me answers of above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Kaushal Bhavsar 3 hours later
Hello and thank you for your quick answer.
I do not smoke and I have had asthma since I was young. I was diagnosed with Bronchiectasis in 2004 however I probably had it before then.

Would the Bronchiectasis (mild lower left lobe) or the Asthma or age cause the reduced lung function?

Will it keep getting worse or with proper treatment remain the same as I age?

Thank you for your time and effort to answer my questions.
doctor
Answered by Dr. Kaushal Bhavsar 7 minutes later
Brief Answer:
Combination of all three is causing reduced lung functions.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern. Thanks for your kind words.
Combination of all three, asthma, bronchiectesis and age, is causing reduced lung functions.
And honestly speaking, lung functions tend to worsen over the years with age.
But with proper treatment, rate of decline in lung functions can be reduced.
So consult your pulmonologist and discuss about starting ultra LABA and ultra LAMA.
Hope I have solved your query.
If you are not having further queries, then please close the conversation and rate my answer.
You can ask me directly on bit.ly/askdrkaushalbhavsar. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Kaushal Bhavsar 1 hour later
Thank you for your answer again. I have another question...

Can my FEV1 level be improved or not due to lung damage?
If so what can improve it?

Thank you for your help.
doctor
Answered by Dr. Kaushal Bhavsar 6 minutes later
Brief Answer:
For this I need to know few more things first.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
To answer this question, I need to know few more things.
So please let me know
1. What was your last PFT date?
2. Have your values remained same over the period or initially they were high and now 60%?
3. Are your symptoms stable over years or they worsening?
4. Do you have any other Co morbidities like diabetes or hypertension?
Please reply the above asked questions, so that I can guide you better. I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Kaushal Bhavsar 2 days later
Thank you for your reply... here are my answers.

1. What was your last PFT date? Last Wednesday.
2. Have your values remained same over the period or initially they were high and now 60%? My value has been at 60% for just under 2 years. In May 2014 they were 47%
3. Are your symptoms stable over years or they worsening? They seem stable but I wish to improve them.
4. Do you have any other Co morbidities like diabetes or hypertension? No Diabetes (recently tested) and I have mild pulmonary hypertension - RVSP 32mmHg

Thank you for your reply.
doctor
Answered by Dr. Kaushal Bhavsar 7 minutes later
Brief Answer:
Ultra LABA and ultra LAMA will help you.

Detailed Answer:
Thanks for your follow up question on Health Care Magic.
I can understand your concern.
So your disease is almost stable since over 2 years.
In my opinion, you should start ultra LABA and ultra LAMA.
They will definitely help you in improving lung functions.. They also reduce exacerbation risk.
Please let me know, are you vaccinated with Influenza and pneumococcal vaccines?
I will be happy to help you further.
Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Kaushal Bhavsar 47 hours later
Hello again Dr. XXXXXXX Bhavsar,

I also notice that my Asthma is worse when I over eat or have too much sugar. Have you seen a connection between GERD and Asthma? I have reflux and I wonder if this is causing my Asthma to remain prevalent and cause my low FEV1 outcome due to constant inflammation from GERD?
doctor
Answered by Dr. Kaushal Bhavsar 12 minutes later
Brief Answer:
Yes, GERD is a risk factor for asthma.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Yes, GERD is a risk factor for asthma.
It not only cause asthma but it can also precipitate asthma.
Yes, uncontrolled GERD can be the cause for your low FEV1.
So please let me know if you are taking anything for GERD or not.
We need to control GERD to improve your values.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Kaushal Bhavsar 2 hours later
Hello again,

I had an appointment a few years ago to see a gastrointestinal specialist but I did not make the appointment due to a family emergency. When ever my Asthma does not settle for a few days (like now) I take Gaviscon and my Asthma eases.

I have silent reflux and a post nasal drip in the off seasons (Spring and Autumn - now).

I have read conflicting research that GERD is caused by too little acid and NOT too much acid so using antacids is not a good idea long term. What is your professional opinion?

Thank you for your valuable time and replies. It means a lot to me when I am feeling unwell.
doctor
Answered by Dr. Kaushal Bhavsar 55 minutes later
Brief Answer:
You need lifestyle modifications to reduce GERD.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
No need to take antacid always.
With lifestyle modifications you can control reflux.
But before this I need to know if you have some reflux prone behavior or not.
1. Do you smoke?
2. Do you drink alcohol?
3. Do you eat spice food more?
4. Do you sleep immediately after meals?
Please reply me answers of above asked questions, so that I can guide you better.
I will be happy to help you further. Wish you good health. Thanks.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Dr. Kaushal Bhavsar

Pulmonologist

Practicing since :2008

Answered : 14651 Questions

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