In this blog will look into the seasonal change and variability of the diurnal changes and its symptoms and exacerbation of the bronchial asthma. It is a reversible airway obstructive disease . Will discuss integrative pulmonary medical perspective with use of Ayurveda to understand the disease at new angle.
Bronchial asthma is the bronchoconstrive disease lung disorder with generally good a bronchodilator response. It is one the common disorder with about 5% of population been affected at varying degree. An improvement of 12% and more than 200ml in Force vital capacity and or First Expiratory volume in first second on Pulmonary function test suggest underlying bronchial asthma. Also if the mechacholine challenge test is done and is positive at a lower concentration in a clinically adequate picture suggest underlying bronchial asthma. This are the general diagnostic criteria for diagnosis or asthma or exclusion of the bronchial asthma.
Bronchial asthma patient have a varying degree of the symptoms based on the degree of the severity of the disorder one has, specially if they have more than 3-5 years of the symptoms. Bronchial asthma could be related to the intrinsic asthma factors or the extrinsic cause or combination of both with allergic symptoms affecting the nasal and sinus passages. The common asthma symptoms are cough, wheezing, post nasal drip and the reflux symptoms.
Patient with moderate to severe persistent bronchial asthma symptoms may see a diurnal variation in their daily symptoms and also see the variability of the symptoms as the weather changes. With the change in the fall to winter, winter to spring or spring to summer they have different variability of the symptoms and it s exacerbation.
Now lets look into the asthma at different angle. Looking at the angle of Ayurveda and its relation with the daily symptoms. It helps to understand the reason for the change as diurnal variable or seasonal variability.
Ayurveda or traditional Indian medicine has documented the day divided into 3 sets of 4 hours and similarly for the night also. This change happens with the movement of the sun and so is the change in the barometric pressure in the daytime and the night time . This will has some effect on the airway in patients with bronchial asthma and change in the wheezing, cough, shortness of breath symptoms.
Ayurveda has describe the day in the Kapha, Pitta, and Vata periods. Kapha is earth and water. Pitta is fire and water. Vata is air and space combinations. Ayurveda describes five basic elements of the universe from which the body and mind is formed. They are the five great elements namely Space, earth, water, fire, and earth. Body is formed with this permutation and combination of this elements based on one’s on genetics. So this five elements when combined in 3 different combination sets will give rise to 3 basic change or called the Dosha in Ayurveda. So there are Kapha dosha, Pitta dosha and the Vatta dosha. This individual dosha again will give rise to the 3 phases of time during the day and similarly during the night. Day time divided equally with the night time so 12 hours of day and night. As there are 3 dosha will again divide the day and night in 3 sets again
The Kapha period ( earth + water component which increased at that time in the body ) is 6am-10am or 6am-10pm where there is increase in flame formation and the mucus secretion. Patients generally have some respiratory symptoms at that time. The Pitta period ( Fire+ water component increased at this time in the body) is 10am-2pm or 10pm -2am and generally have the increase in the acid secretion, GERD symptoms. Genrally there is decrease in the bronchospasm at that time. Respiratory symptoms do get better generally around lunch time or around midnight but may get worse latter. The Vata period ( air+ space increased at this time in the body) is 2pm-6pm or 2am-6am when the gas is more formed and passed, bronchospasm or cough may come back, person with heart problem may get chest tightness symptoms. Also the night time symptoms of use of inhalers in the middle of the night comes back.
As there is weather pattern in the nature and it give rise to the climate. As discussed above period of Kapha, Pitta and Vatta will give rise to the Kapha period of weather in winter time, Vata period in the spring and the fall time and Pitta period in the summer time. So the patient depending on the genetics or the Prakruti of the person will have some phase more worse then the other. Some may have worse time in the spring but summer may not be as bad or symptoms may almost goes away. In some it comes in the fall but winter may be ok. And in some the winter and fall is bad but spring and summer may not be as bad.
By understanding one owns asthma symptoms if one keeps a log of the symptoms and keep a small diary and the peakflow one can understand the pattern of the asthma. This may help as a useful guide to prevent future attacks or at least understand the sequence of events happening and more preventive measure may be taken accordingly. If one shows its pattern to their doctor may further guide accordingly.