Respiratory & Breathing Problems

Breathing problems are among the most common reasons adults seek medical care. A cough that will not settle, breathlessness on exertion, wheezing, chest tightness or repeated chest infections can all disrupt daily life — and sometimes they are the first sign of a long-term condition such as asthma or COPD. The aim of this service is to find the underlying cause, treat it correctly, and help you keep your lungs healthy over the long term.

This service covers the full range of respiratory concerns seen in an Internal Medicine / General Physician practice — acute and chronic cough, shortness of breath and difficulty breathing, wheezing, asthma and its follow-up, COPD and chronic bronchitis, acute bronchitis, chest congestion and tightness, respiratory tract infections and pneumonia, recurrent respiratory infections, post-viral cough, allergic respiratory symptoms, and snoring with sleep-related breathing concerns. Where a problem overlaps with fever and infection, cardiovascular risk, or weight, Dr. Nayak connects the care across the relevant services.

Common respiratory concerns

Most people come in with one of a few common concerns: a cough that has lasted longer than expected, breathlessness that is new or worsening, wheezing or a whistling chest, a feeling of chest tightness or congestion, or chest infections that keep returning. Some already carry a diagnosis of asthma or COPD and want their treatment reviewed; others have a new symptom they cannot explain. Each of these is explored in its own page below.

Cough and breathing problems

Cough is the single most common respiratory symptom. It may be acute (lasting less than three weeks), persistent (three to eight weeks) or chronic (beyond eight weeks), and it may be dry or productive of phlegm. The character and duration of a cough point to very different causes — from a simple viral infection to asthma, acid reflux, post-nasal drip, bronchitis or even a side-effect of blood-pressure medicines. Reading the cough correctly is the first step to treating it.

Shortness of breath

Shortness of breath (dyspnoea) — a sense of not getting enough air or having to work harder to breathe — can come from the lungs or the heart, and sometimes from anxiety or low blood count. New or worsening breathlessness always needs assessment. The pattern matters: breathlessness that comes on with exertion and settles with rest differs from breathlessness at rest, at night, or that wakes you from sleep. Difficulty breathing is a more severe form of the same problem and, with certain features, is a medical emergency.

Wheezing and chest symptoms

Wheezing is a whistling sound made by air moving through narrowed airways, and is a hallmark of asthma and COPD — though it can also occur in acute bronchitis or with a foreign body. Chest tightness and chest congestion are common accompanying feelings; chest tightness in particular can come from the airways or, importantly, from the heart, so it is assessed carefully and linked to cardiovascular care when needed.

Common respiratory infections

Respiratory tract infections range from the common cold and viral sore throat to acute bronchitis and pneumonia. Most upper respiratory infections are viral and settle on their own; pneumonia and some lower respiratory infections need antibiotics and, sometimes, hospital care. Recurrent respiratory infections warrant a structured review for an underlying cause. These infections often overlap with fever, and are linked to the Fever & Infectious Diseases service.

Chronic respiratory conditions

Asthma and COPD are the two common long-term airway conditions. Asthma is often allergic in origin, fluctuates over time, and responds well to inhaler-based treatment. COPD (chronic obstructive pulmonary disease) — which includes chronic bronchitis and emphysema — is usually related to long-term smoking or biomass-fuel exposure, causes persistently reduced airflow, and needs ongoing treatment and smoking cessation. Both benefit from accurate diagnosis, the right inhalers, and regular monitoring.

Medical evaluation

Your evaluation begins with a detailed history — the nature and duration of your symptoms, triggers, smoking and exposure history, allergies, occupational factors, and any existing conditions or medicines. A thorough examination of the chest follows, listening for wheeze, reduced air entry or signs of infection. Dr. Nayak then selects the tests that will genuinely clarify the picture rather than ordering a blanket panel.

Relevant investigations

• Spirometry (lung function test) — the key test for asthma and COPD; measures how much and how fast you can exhale.
• Peak flow monitoring — useful for diagnosing and tracking asthma over time.
• Chest X-ray — for pneumonia, persistent cough, suspected tuberculosis or other structural concerns.
• Pulse oximetry — a quick check of blood oxygen level.
• Complete blood count — for infection, allergy (eosinophils) or anaemia contributing to breathlessness.
• Allergy testing where an allergic trigger is suspected.
• Sputum examination when a persistent productive cough or tuberculosis is suspected.
• ECG and relevant cardiac tests when breathlessness or chest tightness may be cardiac in origin.
• Sleep study (polysomnography) referral when sleep-related breathing concerns such as sleep apnoea are suspected.

Treatment and management approach

Treatment is tailored to the cause. Simple viral coughs and acute bronchitis are managed supportively — rest, hydration, steam and symptom relief — with antibiotics only when a bacterial infection is confirmed or strongly suspected. Asthma is managed with reliever and preventer inhalers, trigger avoidance and a written action plan. COPD is managed with bronchodilator inhalers, smoking cessation, vaccinations and pulmonary rehabilitation. Pneumonia and bacterial infections are treated with targeted antibiotics. Post-viral cough and allergic symptoms are managed with targeted symptomatic and preventive measures. The principle is to treat specifically and to avoid unnecessary or repeated antibiotics.

Prevention and long-term respiratory health

Long-term lung health rests on a few practical measures: avoiding tobacco and biomass-smoke exposure, managing allergies and triggers, staying up to date with flu and pneumococcal vaccinations, maintaining a healthy weight (excess weight worsens breathlessness), and keeping long-term conditions such as asthma and COPD under regular review. Good control of acid reflux and nasal allergies also reduces chronic cough. These are woven into every follow-up plan.

Warning signs and when urgent medical evaluation is important

• Severe breathlessness at rest, or breathlessness that comes on suddenly — seek emergency care.
• Chest pain or tightness that may be cardiac in origin, especially with sweating, nausea or pain radiating to the arm or jaw — emergency.
• Bluish lips or fingertips, or very low oxygen on a pulse oximeter — emergency.
• Coughing up blood (haemoptysis) — needs prompt assessment.
• High fever with breathlessness, confusion or drowsiness — possible pneumonia or severe infection.
• Breathlessness that wakes you from sleep or forces you to sit upright to breathe.
• A severe asthma attack not responding to your reliever inhaler — emergency.
• Drowsiness, confusion or collapse with any breathing problem.

In-clinic and teleconsultation

Consultations are available both in-clinic in Bhubaneswar and over teleconsultation. Stable cough, mild breathlessness, asthma and COPD follow-up often suit teleconsultation, while new or worsening breathlessness, suspected pneumonia, coughing blood or chest tightness are best assessed in person with examination and tests. A flat ₹500 fee applies to either format. Use any “Book an appointment” button on this page to schedule your visit.