Asthma Treatment in Hyderabad

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Most people who come in with asthma have been living with it longer than they realise. The cough that “always comes with the weather change”. The inhaler borrowed from a family member. The nights spent propped up on two pillows. Asthma is common, it’s very treatable, and most people can live with almost no symptoms once it’s properly diagnosed and the treatment fits them.

That’s the job of a pulmonologist, the doctor who specialises in the lungs and airways. In Telugu, many patients know asthma as ubbasam (ఉబ్బసం).

In asthma, the airways (the tubes that carry air into the lungs) are inflamed and over-sensitive. When they meet a trigger, such as dust, cold air, smoke or a cold, three things happen. The muscles around them tighten. The lining swells. Extra mucus is produced. The airway narrows, and breathing out becomes harder. That’s the wheeze.

The defining feature of asthma is that this narrowing is variable and largely reversible. It changes from day to day, and it opens up with the right medicine. That’s what separates asthma from COPD, where the narrowing is mostly fixed.

how asthma differs from COPD

Asthma isn’t only a childhood illness. Many people develop it for the first time as adults, often in their 30s and 40s, sometimes after a bad chest infection or a move to a new city.

• Wheezing: a whistling sound when breathing out
• Cough: often dry, worse at night or early morning, after exercise, or on laughing
• Chest tightness: like a band around the chest
• Breathlessness: on stairs, in cold air or AC, or during a cold
• Symptoms that come and go: fine for weeks, then a bad spell. This pattern matters more than any single symptom.

In some people, the only symptom is a dry cough that won’t go away. There’s no wheeze and no breathlessness. This is called cough-variant asthma. It’s commonly missed and treated as “bronchitis” with repeated antibiotic courses that don’t help. A spirometry or FeNO test usually sorts it out.

There’s no single cause. Asthma usually comes from a mix of inherited tendency and what the airways are exposed to. It runs in families, and it’s much more common in people with nasal allergy (allergic rhinitis) or eczema.

What sets off symptoms varies from person to person. The common triggers we see in Hyderabad:

• House dust mites: in mattresses, pillows, carpets and curtains, and AC filters that aren’t cleaned
• Pollen: including from parthenium (congress grass), which grows widely on open plots and roadsides around the city
• Mould: especially in the monsoon, in damp bathrooms and wardrobes
• Smoke: cigarette smoke (including other people’s), agarbatti, mosquito coils, and cooking smoke
• Air pollution and construction dust: Hyderabad’s average PM2.5 across winter 2024–25 was about 52 µg/m³, according to the Centre for Science and Environment. The WHO guideline for long-term exposure is 5 µg/m³.
• Colds and flu: the commonest trigger of asthma attacks in both children and adults
• Cold air and exercise
• Certain medicines: some people with asthma react to painkillers such as aspirin and ibuprofen, or to beta-blockers taken for blood pressure or the heart. Always tell your doctor you have asthma before starting a new medicine.
• Acid reflux: heartburn can worsen night-time asthma

Part of treatment is working out which of these matter for you, so you can avoid the ones that are avoidable.

Asthma shouldn’t be diagnosed by symptoms or a stethoscope alone. Other conditions can look similar: COPD, heart failure, vocal cord problems, even anxiety. And a lot of asthma in India is never diagnosed at all. In the Global Asthma Network study across nine Indian centres, about 82% of people with current wheeze had never been diagnosed with asthma, and fewer than 2.5% were using a daily preventer inhaler.

The tests that confirm asthma:

pulmonary function test

Asthma treatment has changed considerably over the last few years. If your last proper review was a while ago, your plan may be out of date.

Every asthma plan has to do two things. It has to calm the inflammation in the airways, which needs an inhaled steroid (ICS). And it has to open the airways quickly when symptoms flare.

The biggest change in international guidance is that relying on a reliever inhaler alone is no longer recommended at any stage of asthma. This is the familiar blue salbutamol inhaler, a short-acting bronchodilator (SABA). The GINA 2026 report goes further than before on this point: if a SABA is used as the reliever, an inhaled steroid should always be taken alongside it.

GINA’s preferred approach for adults and adolescents is to use a combination inhaler (ICS-formoterol) as the reliever. For people who need daily treatment, the same inhaler is used as both the daily preventer and the reliever. This is called MART (maintenance and reliever therapy). It means every time you reach for relief, you also get some anti-inflammatory treatment.

Which inhaler, which dose, and which approach suits you depends on how often you have symptoms, your past attacks, your lung function and what you can manage day to day. That’s decided at your consultation, not from a web page. Please don’t change your inhalers based on this section.

The right medicine in the wrong technique doesn’t reach the lungs. In a 2024 study of 183 adults with asthma or COPD at a Bengaluru teaching hospital, more than six in ten got at least one step of using their metered-dose inhaler wrong. The commonest mistakes were not breathing out fully before the puff and not holding the breath afterwards.

At every visit:

• Technique check: you’ll be asked to show how you use your inhaler, and it will be corrected.
• Spacer: for metered-dose inhalers, a spacer usually helps the medicine reach the lungs. It’s also less fussy about timing.
• Right device: if a device doesn’t suit your hands or your breath, there are others. Dry-powder inhalers need a fast, deep breath in; metered-dose inhalers need a slow one.
• Rinse after steroid inhalers: rinse your mouth and spit after using a steroid inhaler, to prevent throat irritation and oral thrush.

The nose and lungs are one airway. In a 2025 study of more than 40,000 Indian patients who saw a doctor for nasal symptoms, 53.7% had allergic rhinitis. The same paper cites Indian survey data showing that two-thirds or more of people with asthma also have nasal allergies.

Untreated nasal allergy makes asthma harder to control. So nasal sprays, used properly, are often part of an asthma plan. Allergen immunotherapy for persistent dust-mite or pollen allergy is considered in selected patients.

Every patient gets a simple written plan with three zones:

• Green: what to take every day when you’re well
• Yellow: what to change when symptoms start creeping up, for example during a cold
• Red: when to go to hospital

Most serious attacks build up over a day or two. The action plan is what lets you act early.

If asthma stays uncontrolled despite treatment, the first step is to check the basics: inhaler technique, whether the medicine is actually being taken, ongoing triggers, nasal disease, acid reflux, and weight. Often the problem is there.

For the minority with truly severe asthma, further tests identify the type of inflammation. Treatment can then add a long-acting add-on inhaler (LAMA) or a biologic injection, which targets specific inflammatory pathways (anti-IgE, anti-IL-5, anti-IL-4/13 or anti-TSLP), as set out in GINA’s severe asthma guidance. These have changed life for many people who used to need repeated oral steroids.

Respiratory infections are the commonest trigger of asthma attacks. A yearly flu vaccine is recommended for people with asthma. Pneumococcal vaccination is advised for many, depending on age and health.

Honestly, no. There’s no permanent cure for asthma today, and any treatment advertised as a “permanent cure” should make you cautious.

What is very achievable is control: no night-time waking, no limits on exercise or work, rarely needing a reliever, and no attacks. Many people reach long periods with no symptoms at all. Childhood asthma often settles in the teenage years, though it can return later.

The goal of treatment is to get you there with the lowest effective dose.

Every June, during Mrigasira Karthi, thousands of people in Hyderabad take the fish prasadam in the hope of relief from asthma. It’s a long tradition, and many families have strong feelings about it.

From a medical point of view, there’s no scientific evidence that it treats or cures asthma. Doctors who have tested patients’ lung function before and after have reported no improvement.

If you choose to take it for personal or cultural reasons, the one thing that matters is this: don’t stop or reduce your inhalers because of it. Stopping preventer treatment is one of the commonest reasons people end up in hospital with an attack.

Asthma is one of the commonest long-term illnesses in children. Wheezing with every cold, a night-time cough, and coughing after running or laughing are typical signs. Diagnosis and treatment in children follow different rules, especially under the age of 5.

Dr. Kishan sees children with asthma at both locations .

Dr. Kishan Srikanth Juvva holds a DM in Pulmonary and Critical Care Medicine, a Master’s in Interventional Pulmonology from the University of Florence, Italy, and a Fellowship in Sleep Medicine. He is a Senior Consultant at Apollo Hospitals, Financial District, and a member of the Indian Chest Society and the European Respiratory Society.

about Dr. Kishan

You can see him for asthma at either location:

• All the inhalers and nasal sprays you use, the devices themselves, plus your spacer if you have one
• Any previous spirometry or PFT reports
• A list of what seems to trigger your symptoms, and when they’re worst
• If you have a peak flow meter, your readings
• Discharge summaries from any hospital visit for breathing problems