Causes related to asthma – expert insights by Dr. Baljot Singh in Amritsar

Written for patients and families by the Pulmonology team at Livasa Hospitals, Livasa Amritsar. This comprehensive guide explains what causes asthma, local triggers in Punjab and Amritsar, differences between childhood and adult asthma, how we diagnose it, available treatments, home strategies, cost considerations and when to contact an asthma specialist. For appointments call +91 80788 80788 or book online.

Introduction

Asthma is a chronic inflammatory disorder of the airways that causes intermittent breathing problems due to reversible narrowing of the bronchial tubes. It is characterized by episodes of wheeze, breathlessness, chest tightness and cough. Symptoms may be brief and isolated or recurrent and severe. While asthma cannot always be permanently cured, good diagnosis and long-term management can control symptoms, reduce attacks and maintain normal daily activities for most people.

Globally, asthma affects hundreds of millions of people. According to major health reports, approximately over 250–300 million people worldwide live with asthma, and the burden is significant in large, densely populated countries such as India. In Punjab, seasonal pollution events (including stubble burning), dust storms, and urban emissions contribute to frequent exacerbations and increased healthcare visits for asthma. In Amritsar and surrounding districts, clinicians at Livasa Amritsar routinely manage patients with seasonal and perennial asthma, and we focus on both acute care and preventive strategies.

This article, informed by the clinical practice of Dr. Baljot Singh and the Livasa Pulmonology team, explores causes — genetic, environmental, infectious and occupational — and provides practical, local guidance for patients in Amritsar and Punjab on diagnosis, treatment choices and home-based control measures.

Causes and how asthma develops

Asthma develops from a complex interaction of genetic predisposition and environmental exposures that lead to airway inflammation and hyper-responsiveness. The underlying mechanism is chronic inflammation of the bronchial mucosa with intermittent bronchoconstriction — muscles around airways tighten, mucous production increases and airway lining becomes swollen. Over time, repeated inflammation can cause structural changes (“airway remodeling”) that make symptoms more persistent.

Key causal categories include:

• Genetic predisposition: A family history of asthma, eczema or allergic rhinitis increases risk. Multiple genes are involved in immune regulation and airway response; having a parent with asthma significantly raises a child’s chance of developing asthma.
• Atopy and allergic sensitization: Sensitization to house dust mites, pollens, cockroach, animal dander or moulds triggers allergic inflammation in many patients. Atopic asthma often begins in childhood.
• Respiratory infections: Viral respiratory infections, especially in early childhood, are associated with wheeze and may predispose to persistent asthma in susceptible children. Recurrent lower respiratory tract infections can also worsen the natural history of asthma.
• Non-allergic pathways: Some adults develop non-atopic asthma triggered by airway irritants, drugs (aspirin-exacerbated respiratory disease), hormonal changes, or obesity-related mechanisms.
• Occupational exposures: Repeated exposure to fumes, dusts, chemicals and workplace allergens (e.g., flour, latex, wood dust) is a recognized cause of adult-onset occupational asthma.

On a cellular level, asthma involves increased eosinophils, mast cell activation, Th2 (type 2) immune responses in allergic forms, and cytokines such as IL-4, IL-5 and IL-13. In non-type 2 asthma, neutrophilic inflammation and different molecular pathways dominate. Understanding the subtype matters because it directs targeted therapies — for example, biologic drugs are effective in type 2 asthma with eosinophilia or high IgE.

Many patients have mixed mechanisms; therefore, accurate clinical assessment and tests are essential to determine which causal factors are most important for individual management.

Common triggers in Punjab and Amritsar

Local environmental and seasonal triggers in Punjab and the city of Amritsar are prominent contributors to asthma exacerbations. Patients who are stable for months may flare repeatedly due to local factors. At Livasa Amritsar we counsel patients on region-specific triggers and practical avoidance strategies alongside medical therapy.

Important local triggers include:

• Air pollution and PM2.5/PM10: Urban emissions from traffic, industry and seasonal agricultural stubble burning raise particulate levels. Elevated PM2.5 is strongly associated with increased asthma attacks, emergency visits and hospital admissions. Studies indicate a measurable rise in exacerbations with days of poor air quality — often a 20–30% higher risk during extreme pollution episodes.
• Seasonal pollens: In spring and winter transition months, tree and grass pollens trigger allergic asthma in sensitized individuals. Humidity and winds influence pollen counts in Amritsar.
• House dust mites and indoor allergens: Dust mite allergy is common in humid months; cockroach and mould exposures in poorly ventilated homes are frequent causes of persistent symptoms.
• Cold air and temperature changes: Sudden drops in temperature, common in Punjab winters, can precipitate bronchospasm — particularly in outdoor workers, children walking to school and older adults.
• Biomass smoke and indoor cooking fuels: In homes using traditional stoves or poor ventilation, smoke exposure increases chronic respiratory symptoms and worsens asthma control.
• Tobacco smoke and second-hand smoke: Active smoking increases incidence and severity of adult asthma; second-hand smoke predisposes children to early wheeze and poor control.
• Occupational exposures: Agricultural workers, textile workers and those in small-scale industry may be exposed to inhaled irritants, pesticides or enzymes that cause occupational asthma.

Practical local advice includes monitoring daily air quality index (AQI), limiting outdoor activity on high pollution days, using high-efficiency masks (N95) when pollution is severe, improving indoor ventilation, using covered mattresses and regularly washing bedding to reduce dust mites, and avoiding exposure to smoke. Livasa Amritsar’s pulmonologists provide individualized trigger identification and avoidance plans tailored to patients’ lifestyle and work.

Causes of asthma in children versus adults

Asthma can present at any age, but the underlying causes and patterns often differ between children and adults. Recognizing these differences helps clinicians choose the most effective diagnostic tests and treatments. At Livasa Amritsar, our pediatric and adult pulmonology teams evaluate age-specific factors and create tailored management plans.

In children:

• Genetics and atopy dominate: Children frequently have atopic asthma associated with eczema and allergic rhinitis. A family history of asthma increases likelihood.
• Viral wheeze and early infections: Respiratory syncytial virus (RSV) and rhinovirus infections in infancy can cause recurrent wheeze; some children “grow out” of wheeze while others progress to chronic asthma.
• Environmental exposures in early life: Tobacco smoke exposure, indoor pollutants, and early-life allergen levels influence risk. Breastfeeding, daycare exposure and microbial diversity may modify immune development (hygiene hypothesis considerations).

In adults:

• Adult-onset asthma: Adults may develop asthma with no childhood history. Causes include occupational exposures, hormonal factors, obesity-related pathways, and late-onset allergic sensitization.
• Non-atopic triggers: Some adults have non-allergic asthma triggered by irritants, cold air, exercise or certain medications (e.g., aspirin or NSAIDs in susceptible individuals).
• Comorbidities: Conditions such as chronic rhinosinusitis, gastroesophageal reflux disease (GERD), obesity and obstructive sleep apnea often coexist and worsen asthma control in adults.

The approach to diagnosis varies: in younger children, spirometry may be difficult and clinicians rely on symptom patterns, response to therapy and objective measures when possible. In adults, spirometry, bronchodilator response and additional tests (FeNO, sputum eosinophils) provide clearer phenotyping. Treatment strategies are individualized — children often receive weight- and age-appropriate inhaled medications plus education on inhaler technique and avoidance; adults may require more complex regimens including biologics and treatment for comorbid conditions.

Symptoms, early signs and emergency red flags

Recognizing early signs of asthma and identifying emergency symptoms saves lives. Asthma symptoms vary by intensity and timing. Some patients have mild symptoms for years, while others present with sudden severe attacks (status asthmaticus). Awareness of warning signs helps families seek timely care in Amritsar and beyond.

Common and early symptoms:

• Wheezing: A high-pitched whistling sound when breathing out, especially during exertion or at night.
• Shortness of breath: Difficulty catching breath with activities that were previously easy.
• Chest tightness: A sensation of pressure or constriction across the chest.
• Persistent cough: Often worse at night or early morning; may be the only symptom in cough-variant asthma.
• Reduced exercise tolerance: Children may complain of tiredness or stop playing earlier than peers.

Alarm features and emergency signs (seek immediate care or call emergency services):

• Severe breathlessness at rest or inability to speak in full sentences.
• Rapid worsening of symptoms despite using a reliever inhaler.
• Blue lips or face (cyanosis) — sign of dangerously low oxygen.
• Confusion, drowsiness or extreme agitation — reduced oxygen or high carbon dioxide retention.
• Use of accessory muscles (neck muscles) and visible chest retractions during breathing.

If any emergency signs are present, go to the nearest emergency department immediately. For non-emergent symptoms, schedule evaluation with a pulmonologist at Livasa Amritsar where Dr. Baljot Singh and team can perform diagnostic testing and provide a personalized asthma action plan. Early recognition and prompt treatment can prevent hospitalizations and long-term lung damage.

Diagnosis and tests available in Amritsar

Accurate diagnosis is the foundation of effective asthma care. At Livasa Amritsar, we use a combination of clinical assessment and objective tests to confirm asthma, identify triggers, and phenotype disease for targeted therapy. Diagnosis is particularly important because other conditions (e.g., COPD, bronchiectasis, cardiac disease) can mimic asthma symptoms.

Common diagnostic tests and procedures available locally:

• Spirometry and bronchodilator testing: The first-line lung function test to measure forced expiratory volume in 1 second (FEV1) and FEV1/FVC ratio. A significant improvement after a short-acting bronchodilator supports asthma diagnosis. “Spirometry test for asthma in Amritsar” is widely available at Livasa Amritsar and is the cornerstone of objective assessment.
• Peak expiratory flow (PEF) monitoring: Portable peak flow meters allow home monitoring and help document variability over time — useful in diagnosis and long-term self-management.
• Fractional exhaled nitric oxide (FeNO): Measures airway eosinophilic inflammation and helps predict steroid responsiveness.
• Allergy testing: Skin prick tests and specific IgE blood tests identify sensitization to dust mites, pollens, animal dander, moulds and food allergens, guiding avoidance measures and immunotherapy decisions.
• Chest x-ray and CT scan: Performed when alternative diagnoses or complications are suspected.
• Bronchoprovocation testing (methacholine challenge): Used when spirometry is normal but clinical suspicion persists; tests airway hyper-responsiveness under controlled conditions.
• Sputum eosinophil count and blood eosinophils: Help phenotype asthma (type 2 eosinophilic vs non-eosinophilic) and guide biologic therapy choices.

Livasa Amritsar’s pulmonology unit provides these diagnostic options with same-day spirometry reports, specialist interpretation and personalized recommendations. For many patients, a combination of spirometry and FeNO plus a symptom history suffices to start treatment and monitor response. We emphasize correct inhaler technique and provide training during visits — a small factor that dramatically improves outcomes.

Treatment options and comparisons

Treatment aims to control symptoms, prevent exacerbations, maintain normal activity and minimize side effects. Options range from short-acting reliever inhalers for immediate symptom relief to daily maintenance inhaled corticosteroids (ICS), long-acting bronchodilators (LABA), leukotriene modifiers, and advanced therapies like biologics or bronchial thermoplasty for severe, uncontrolled asthma.

Treatment is individualized based on severity, frequency of symptoms, lung function, exacerbation history and phenotype (e.g., eosinophilic asthma). In Amritsar, Livasa’s pulmonology specialists, including Dr. Baljot Singh, evaluate each patient’s profile and discuss the pros and cons of available choices.

Inhaler choice (metered dose inhaler vs dry powder inhaler vs soft-mist inhaler) depends on patient ability and preference; technique is critical. For many patients in Amritsar, a combination inhaler (low-dose ICS + LABA) once or twice daily provides effective control while minimizing systemic steroid exposure. For those with frequent exacerbations and blood eosinophilia or high IgE, biologic agents offered through specialist clinics can dramatically reduce hospitalizations and steroid dependence.

Anticipated side effects, expected timeline for benefit, and cost considerations will be reviewed in consultation. Livasa Amritsar’s pulmonology team offers multidisciplinary reviews for complex cases, including pediatric, allergy and ENT collaboration when needed.

Management, prevention, home treatment and long-term care

Managing asthma is a long-term partnership between patient and clinician. Effective control combines medical therapy, trigger avoidance, monitoring and education. Below are practical strategies tailored for patients in Amritsar and Punjab, addressing common lifestyle, environmental and cost-related concerns.

Everyday management essentials:

• Personalized asthma action plan: A written plan describing daily medications, how to recognize worsening control, when to increase medications, and clear instructions for emergency care. Livasa Amritsar provides printed action plans after each consultation.
• Inhaler technique training: Incorrect technique is one of the most common reasons for poor control. Our team trains patients and caregivers, using demonstrations and repeat return demonstrations.
• Trigger avoidance: On high pollution days in Amritsar, stay indoors, use air purifiers when feasible, and wear N95 masks outdoors. Reduce indoor dust through regular cleaning, use of allergen-proof mattress covers, and controlling dampness to prevent mould growth.
• Immunizations: Annual influenza vaccination and pneumococcal vaccination when indicated reduce infection-related exacerbations.
• Weight management and exercise: Moderate physical activity improves lung function and overall health; obese patients should be supported with diet and exercise interventions to improve asthma control.
• Smoking cessation: Vital for adult smokers and household members who smoke. Smoking worsens symptoms, reduces response to therapy and increases healthcare costs.

Home remedies and complementary measures can supplement but not replace prescribed therapy. For mild symptom relief, short-acting reliever inhalers and warm, humidified air may help. Some patients seek Ayurvedic or herbal remedies; while these may provide symptomatic relief for some individuals, they should be discussed with the pulmonologist to avoid interactions and ensure they do not delay effective therapy.

Long-term care includes regular follow-up visits, periodic spirometry, assessment of control and adjustment of therapy to the lowest effective dose. For many patients, stepping down therapy may be possible after sustained control; others will need ongoing maintenance. For severe asthma, referral for biologic therapy, specialised physiotherapy and psychological support may be required.

Cost considerations in Punjab/Amritsar:

• Outpatient management costs: For many patients, monthly medication costs (inhalers, spacer devices) range from a modest amount for low-dose ICS to higher for combination inhalers. Generic inhalers and government schemes can reduce costs.
• Specialist care and tests: Spirometry and basic blood tests are affordable at most centres; advanced tests (FeNO, biologic eligibility panels) and biologic drugs are higher cost but may be covered by insurance or patient assistance programs.
• Hospitalization costs: Severe exacerbations requiring admission increase overall cost significantly. Preventive care and adherence reduce exacerbation risk and overall expenses.

If you are concerned about asthma cost in Amritsar or need a full cost estimate for a specific plan (e.g., start of biologic therapy), Livasa Amritsar’s patient coordination team can provide transparent estimates and discuss insurance or financial assistance options.

When to contact a specialist and why choose Livasa Amritsar

You should see a pulmonologist if:

• Symptoms persist despite basic inhaler therapy or increase in frequency.
• Frequent oral steroid courses or emergency visits in the past year.
• Unclear diagnosis despite initial treatment, or suspicion of alternative conditions.
• Severe symptoms or emergency warning signs as described earlier.
• Need for advanced therapies such as biologics, bronchial thermoplasty or occupational assessment.

Why consider Livasa Amritsar and Dr. Baljot Singh:

• Specialized pulmonology services: Comprehensive testing (spirometry, FeNO, allergy testing) and multidisciplinary care for difficult-to-treat asthma.
• Experienced clinicians: Practical, evidence-based approach with a focus on patient education and long-term control.
• Patient-centered care: Personalized asthma action plans, inhaler training, and follow-up support designed for local triggers in Amritsar and Punjab.
• Accessible care: Convenient appointment booking online at Livasa Hospitals or by calling +91 80788 80788.

If you are searching for the best asthma specialist in Punjab or the best doctor for asthma in Amritsar, our team offers second opinions and long-term management plans tailored to working adults, children and older patients. Early specialist involvement improves outcomes for patients with frequent exacerbations or poor response to initial therapy.

Summary and practical takeaways

Asthma is a manageable chronic condition when identified early, correctly diagnosed and treated with a combination of medical therapy and avoidance of triggers. In Punjab and Amritsar, environmental and seasonal factors such as air pollution, stubble burning, dust and pollen contribute heavily to exacerbations; therefore, region-specific prevention strategies are essential.

Key takeaways:

• Recognize early symptoms and act early — chronic cough, wheeze and breathlessness deserve testing.
• Get objective testing such as spirometry and FeNO; identify allergies and triggers.
• Use a personalized asthma action plan and learn correct inhaler technique.
• Reduce exposure to local triggers in Amritsar: monitor AQI, limit outdoor exposure during high pollution, and improve indoor air quality.
• Seek specialist care if control is poor, symptoms are frequent, or you need advanced therapies.

At Livasa Amritsar, our multidisciplinary approach to asthma care combines evidence-based medicine, local environmental guidance and patient education to help you and your family breathe easier. For inquiries or to book an appointment, call +91 80788 80788 or visit our appointment page.