Feeling short of breath when you haven't even climbed the stairs? Do you suffer from constant eye irritation and wheezing? Put that down to the winter smog that's currently enveloping Mumbai and its suburbs — merged with prevalent emissions from motor vehicles, noxious industry fumes and other solvents — making you gasp for breath and resulting in nasal flaring and respiratory conditions.

Huge rise in number of asthma cases

The thick haze that is laced with pollutants triggers different woes from drying out the skin, to eye ailments and throat infections as well as severe respiratory disorders. One of the biggest triggers is asthma, which is usually not detected in time and commonly brushed off as 'small breathing trouble'. Says senior consultant respiratory physician, Dr Sujeet K Rajan, "The cold air (much below body temperature) in winter acts as a trigger for asthma in winter. People who have only intermittent symptoms can get exacerbations (worsenings) of their disease in this season." So, have cases of acute bronchitis doubled since, say, November? "There has been at least a 30% increase in both out-patient consults and indoor admission for acute exacerbations of lung disease in winter. This is usually the case," he says.

Don't confuse asthma with acute bronchitis

While they are both breathing ailments, acute bronchitis (acute symptoms of cough and breathlessness, usually with a normal chest X-ray) is often confused with asthma, warns Dr Rajan. "The former usually lasts for a few weeks at the maximum, and settles with the same treatment as for asthma, but not required regularly. The treatment is just a short course (5 to 10 days) of inhaled bronchodilators and steroids. The problem is that when a patient is prescribed an inhaler, he automatically believes he has been diagnosed with asthma, which is not the case. Here, patient education is key; always ask the right questions," he says.

How harmful is the air you breathe?

The air in Mumbai contains a mix of gases like nitrogen dioxide and particulate matter, which are critical pollutants," says Anumita Roy Chowdhury of the Centre for Science and Environment, Delhi.

In Sion alone, NO2 (nitrogen dioxide) levels have exceeded the standard on 85% of the days in December. The maximum recorded value has gone up by 225 micrograms per cubic meter while the standard is 80.

Peak level for particulate matter has gone up by four times the standard.

How nutrition helps

Eating the right food can prevent further damage, says nutrition expert Dr Nupur Krishnan. "Very often we think only steroids are the answer, but our daily foods are powerful too. First and foremost, caffeine in your coffee works as bronchodilator, which dilates bronchioles, opening the airways. Vitamin C is also crucial; it keeps the lungs powerful, so have a glass of orange juice everyday. Omega 3 in any form — nuts, fish, flax seeds — is helpful for asthmatics as it works to cleanse out the lungs," she informs.

Nutritional therapist Rachna Chhachhi, who attempts to reverse asthma via nutritional therapy, says, "Asthma is an immunity disorder, hence the first thing to reverse it includes increasing immunity along with eliminating the top 5 causes (see box). Second step is flushing out allergens from the body via high doses of antioxidants." She presents tips to avoid attacks:

-Keep away from processed foods, white flour and sugar as these block the airways by causing phlegm.

-Avoid juices from tetra packs and cold drinks as these have additives/artificial colouring

-Stop processed and cured meats

-Have honey and green tea

-Take zinc supplements to flush out allergens from the blood.

For asthmatics, the inhaled steroid must be regularly taken if prescribed. Patients must also keep 'emergency medication' — usually a short course of steroid tablets on hand, especially when travelling.

5 major causes of asthma:

Environmental pollution

Toxins

Artificial colouring

Food additives

Stress

How asthmatics are affected

The inside walls of an asthmatic's airways get swollen or inflamed. This makes the person very sensitive to irritations and can increase his/her susceptibility to an allergic reaction. As the airways narrow, less air passes through them, both to and from the lungs. It results in:

-Wheezing (a hissing sound while breathing)

-Tightness in the chest

-Breathing problems

-Coughing

The way out

Dr Sujeet Rajan presents tips to follow:

-While simple masks do help, people with COPD (Chronic Obstructive Pulmonary Disease) are advised to stay away from very cold areas

-Keep yourself warm, exercise regularly.

-Always carry your relief inhaler with you (if you have asthma or COPD)

-Stay far away from smokers (passive smoke is as bad, if not worse than active smoking).

-Stay away from incense sticks and keep emergency medicine with you, especially when traveling by air. Air travellers with nasal/sinus symptoms can keep a nasal steroid/antihistamine spray handy.