A 35-Year-Old Male Overcomes Bronchial Asthma Through Medication and Lifestyle Changes

Living with chronic respiratory conditions like bronchial asthma can be challenging, especially when symptoms begin to interfere with daily life. This case study explores the journey of a 35-year-old male patient who experienced persistent coughing and chest tightness that worsened with physical activity. Initially self-medicating without success, he eventually sought professional care at The First Affiliated Hospital of Harbin Medical University in May 2022. After thorough diagnostic testing—including pulmonary function tests and bronchodilator response assessment—he was diagnosed with moderate bronchial asthma. With a comprehensive treatment plan combining medication and lifestyle adjustments, his condition improved significantly within just one week of hospitalization, and lung function returned to normal levels.

Patient Profile and Clinical Presentation

Age & Gender: 35-year-old maleDiagnosis: Bronchial Asthma (Moderate Severity)Hospital: The First Affiliated Hospital of Harbin Medical UniversityTreatment Duration: 7 days inpatient care followed by outpatient follow-upOutcome: Symptom resolution and restored pulmonary function

Initial Assessment and Diagnostic Process

One month prior to admission, the patient began experiencing a dry cough and increasing chest tightness, particularly during physical exertion such as climbing two flights of stairs. Despite being overweight and attempting self-treatment with over-the-counter antibiotics, his symptoms did not improve. Notably, he did not report nighttime awakenings due to breathlessness or difficulty lying flat, which are common signs of more severe respiratory compromise.

A pulmonary function test revealed an FEV1% (Forced Expiratory Volume in 1 second) of 67.5%, indicating moderate obstructive ventilatory dysfunction. A high-resolution CT scan of the chest showed no structural abnormalities, ruling out other potential causes such as infections or tumors. Further investigation uncovered a history of allergic rhinitis, along with intermittent episodes of unexplained chest tightness that had previously resolved on their own—classic red flags for undiagnosed asthma.

To confirm the diagnosis, a bronchodilator reversibility test was conducted post-admission. The results were positive, confirming airway responsiveness typical of asthma. Additional tests showed elevated fractional exhaled nitric oxide (FeNO) levels and serum immunoglobulin E (IgE) exceeding 1000 IU/mL—both strong indicators of eosinophilic airway inflammation commonly seen in allergic asthma.

Comprehensive Treatment Strategy

Based on these findings, the medical team classified the patient's asthma as moderate-to-severe acute exacerbation and initiated a multi-pronged pharmacological approach aimed at rapid symptom control and long-term stabilization.

Medication Regimen

The in-hospital therapy included:

• Inhaled Budesonide Suspension via nebulizer: To reduce airway inflammation.

• Ipratropium Bromide Solution for nebulization: A bronchodilator that helps relax airway muscles.

• Doxofylline Injection: Administered intravenously to enhance bronchodilation with fewer side effects than traditional theophylline.

• Methylprednisolone Sodium Succinate: An IV corticosteroid used to quickly suppress systemic inflammation during flare-ups.

As symptoms improved, the treatment plan transitioned toward maintenance therapy with:

• Budesonide/Formoterol Dry Powder Inhaler: A combination inhaler providing both anti-inflammatory and long-acting bronchodilator effects.

• Montelukast Sodium Tablets: An oral leukotriene receptor antagonist effective in managing allergic triggers and reducing nocturnal symptoms.

Positive Treatment Outcomes

Within seven days of consistent treatment, the patient showed remarkable improvement. His shortness of breath subsided, exercise tolerance increased, and repeat pulmonary function tests demonstrated normalization of FEV1 values. Blood gas analysis also returned to normal, confirming adequate oxygen exchange in the lungs. Immunoglobulin markers stabilized, reflecting reduced systemic inflammation.

Before discharge, the patient received detailed education about ongoing asthma management. He was instructed to continue using the budesonide/formoterol inhaler twice daily and take montelukast orally each evening. A follow-up appointment was scheduled for four weeks later to reassess lung function and adjust medications if necessary. At this visit, spirometry confirmed sustained recovery, with no signs of obstruction.

Ongoing Management and Lifestyle Modifications

While medication plays a central role in asthma control, long-term success depends heavily on patient engagement and lifestyle choices. The treating physician emphasized several key strategies for maintaining remission:

Self-Monitoring and Early Detection

The patient was taught how to use a peak flow meter to track airflow regularly and maintain an asthma diary. Recording daily symptoms, peak flow readings, and medication use allows early detection of worsening trends and improves communication with healthcare providers.

Allergy Evaluation and Trigger Avoidance

Given his elevated IgE and history of allergic rhinitis, allergen testing was recommended to identify specific environmental triggers—such as dust mites, pollen, or pet dander—that could provoke future attacks. Once identified, avoidance measures or immunotherapy may further reduce risk.

Weight Management and Physical Activity

Obesity is a known contributor to poor asthma control. The patient was encouraged to adopt a balanced diet and engage in regular aerobic exercise such as jogging or recreational sports. Exercise, when properly managed, strengthens lung capacity and enhances overall respiratory health—even in asthmatics.

Smoking Cessation and Environmental Protection

Although this patient was not a smoker, avoiding secondhand smoke and air pollutants remains crucial. Indoor air quality improvements—like using HEPA filters and minimizing exposure to strong odors or cleaning chemicals—can help prevent irritation and flare-ups.

Clinical Insights and Long-Term Perspective

Bronchial asthma is a lifelong condition that currently has no cure, but it is highly manageable with appropriate care. As this case illustrates, even patients with moderate-to-severe exacerbations can achieve full functional recovery when treated promptly and comprehensively.

Adherence to prescribed therapies is critical. Many asthma flare-ups occur not because treatments fail, but because patients stop taking medications prematurely when symptoms improve. Consistent use of controller medications—even during symptom-free periods—is essential to prevent relapses and protect lung function over time.

Moreover, proactive monitoring, trigger identification, and healthy lifestyle habits empower individuals to live actively and confidently despite their diagnosis. With the right support and mindset, asthma does not have to limit one's quality of life.

Early intervention, accurate diagnosis, and personalized treatment plans make all the difference. For anyone experiencing recurring cough, chest tightness, or breathlessness—especially during exertion—seeking timely medical evaluation is vital. Don't wait until symptoms become severe. With modern medicine and informed self-care, optimal asthma control is well within reach.