Chronic breathlessness may be caused by a wide range of ailments. Some, such as asthma and emphysema, are lung diseases; others, like cardiovascular disease and anemia, impair breathing indirectly.

Many people with lung or breathing problems don't even know they have it. That is partly because shortness of breath often develops so slowly that people blame it on aging, and partly because many doctors fail to evaluate patients' breathing complaints. Even when lung disorders are discovered, many people, especially older ones, are not treated adequately or are not taught the breathing exercise that can help compensate for damaged lungs. Such exercises may even help people with healthy lungs, by reducing stress and hypertension.

In this story, we lay out the steps that can help prevent breathing disorders, detect them at an early stage (when they are most treatable), and, if they do arise, control the symptoms and treat the underlying cause.

How is your breathing?
If you at least occasionally have any of the symptoms listed below, you should see a physician to have your breathing checked and to undergo spirometry, a test for lung function.

• Coughing or difficulty breathing during physical activity
• Difficulty sleeping due to shortness of breath or coughing
• Inability to catch a good, deep breath (when you are not anxious)
• Wheezing
• Tightness in the chest
• Bouts of coughing unrelated to colds
• Difficulty breathing due to dust, pollen, tobacco smoke, fumes, strong odors, pets, or cold weather
• Frequent spread of symptoms to the chest when you catch cold

Test your lungs
A test called spirometry – in which you exhale into a tube as hard and fast as possible – can identify astham, COPD, and other breathing disorders before symtoms appear.

People who perform poorly on spirometry will be advised to undergo additional testing to pinpoint the cause of the problem.

Asthma
The incidence of asthma in has been rising in recent years. While the disease occurs mainly in children, adults can develop it, too, either as a recurrence of childhood asthma or for the first time, sometimes apparently due to smoking or infection, and sometimes spontaneously.

Unfortunately the disease tends to be more deadly in older people, because lung function declines with age and they often have other diseases.

If you have asthma, the best treatment is inhaled coritco steriods, which help prevent the underlying lung inflammation from worsening. You should also receive inhaled broncho dilating drugs, which can relieve the attacks.

In addition, limit you exposure to the substances that can trigger attacks, such as pollen, mold, smoke, animal dander, cockroaches, and dust mites. If cold weather sets off the attacks, wearing a scarf over the mouth and nose, particularly during exercise, can help.

If asthma episodes are triggered by exercise, be sure to warm up and take the appropriate drugs before working out, and to cool down afterwards. If attacks are set off by well-identified allergens (particularly pollen, dust mites, and cockroaches) you may benefit from allergy shots.

Chronic Obstructive Pulmonary Diseases (COPD)
Few doctors actively help their patients give up cigarettes, the most common cause of COPD, emphysema and chronic bronchitis or prescribe the drug that can control the symptoms. There is a higher incidence of COPD among the lower economic groups because they have a larger number of women smokers. 25 percent of people who smoke get COPD while another 20 percent do not get affected at all. 30 to 45 percent get lung cancer while the remaining suffer from other breathing disorders. Smoking is the primary cause of COPD, while bio-mass cooking is the next dominant cause.

Smokers should ask their doctor to prescribe a nicotine nasal spray or inhaler, or use an over-the-counter nicotine gum or patch. Such products work better when combined with anti-smoking counselling programmes. Inhaled bronchodilator or steroids, also relieve the symptoms. Supplemental oxygen can help ease severe symptoms.

Beyond the lungs
Sometimes breathing problems stem from disorders outside the lungs.

Heart disease: People having a heart attack often experience sudden, severe shortness of breath. But heart disease can lead to a more insidious, progressive breathing problem, too. Congestive heart failure insufficient heart pumping due to coronary artery or valve disease can allow blood to back up into the lungs. Controlling coronary risk factors, such as hypertension and high cholesterol, and having the doctor check regularly for valve disorders can help prevent the disease.

Blood clots: A pulmonary embolism is a potentially fatal blood clot that travels from the lower body to one of the lungs. Obesity, pregnancy, birth control pills, supplemental estrogen, inflammatory bowel disease (IBS), internal cancers, and certain genetic blood disorders all increase the risk of emboli. If you have any of those risk factors, watch out for swelling, pain, or redness in a leg, which could signal a blood clot. Emboli are especially likely to develop during prolonged immobilisation. Which is why you need to stop periodically during long car rides, walk around during plane or train rides, and get out of bed as soon as possible after illness or surgery.

Anemia: Lots of children, adolescents and pregnant and non pregnant women are anemic. Any decline in the number of oxygen bearing red blood cells can eventually cause shortness of breath. Anemia stems most often from chronic blood loss due to heavy menstruation, colon polyps, or colon cancer, or to gastrointestinal bleeding caused by ulcers, aspirin, or other nonsteroidal anti inflammatory drugs (NSAIDs). Treatment focuses on correcting the underlying cause of the bleeding and, if necessary, taking iron supplements to build red blood cells.

Protect your lungs
A number of steps can help reduce the risk of developing the most prevalent lung diseases: asthma; chronic obstructive pulmonary disease or COPD (including emphysema and chronic bronchitis); infections, including influenza and pneumonia; and cancer.

Avoid irritants: The most common lung threatening substance is tobacco smoke (even secondhand), which is strongly linked to COPD and lung cancer, and possibly linked to asthma. But some people with COPD are particularly sensitive to other airborne irritants, including dust and pollutants.

Test for tuberculosis: Annual TB test is recommended for people at high risk for tuberculosis because they either care for TB patients; work in a nursing home; have compromised immune function; or are addicted to alcohol or tobacco.

Eat antioxidants: Airborne substances can harm your lungs in part by causing oxidation, a type of chemical damage. Some studies suggest that a diet high in antioxidants. including lots of produce (fresh fruit and veggies). may help prevent COPD, asthma and lung cancer.