Q: I am a asthmatic for past 20 years. I am 23 years old now. My asthma was initially bad but after using the asthalin inhaler (from the past 9 years) I am much better, and the asthma was not causing any problem. But over the past year I have been feeling an increase in the breathlessness, mainly due to the formation of phlegm, causing me to take much more puffs of asthalin as a result. How do I get rid of this phlegm?

A:Firstly we have better inhalers now than Asthalin for long term management of asthma. Your phlegm is directly due to chronic inflammation of airways and spasm. In many cases asthma tends to worsen over the years but asthma starting in childhood, as in your case, is usually very responsive to treatment. You should: 1. Get your lung functions tested and an X-ray chest done. 2. Get TLC\DLC done to rule out other conditions like Eosinophilia. 3. Use Foracort-200 inhaler - 2 puffs twice daily through a spacer device on a regular basis for a couple of months to begin with. 4. Add tablet Deriphylline 450 mg once daily with breakfast. 5. Nasal allergies, if any, must be controlled. Avoid exposure to dust, smoke, pollution, strong smells, very cold liquids and fried food.