Bronchial asthma belongs to a class of chronic diseases characterized by inflammatory processes. At the same time, it is considered non-infectious and cannot be transmitted from the carrier to surrounding people. Symptoms of bronchial asthma are suffocation, shortness of breath and cough, which manifests itself most often in the early morning and late evening. The patient experiences a feeling of chest congestion and is unable to exhale normally. By asking the question, ? Often they mean bronchial asthma.
Treatment includes drug therapy, followed by strengthening the immune system of the whole body. The disease bronchial asthma can be identified in the initial stages and treatment can begin before it becomes chronic.

More than three hundred million people around the planet are carriers of the asthma causative agent. Over the past two decades, the number of patients has only increased and continues to grow. We cannot ignore the fact that not only adults, but also children are susceptible to the disease. With insufficient treatment or its absence, it leads to death. There are many reasons for the development of bronchial asthma; representatives of the stronger sex and people with a hereditary predisposition are especially susceptible to it.
Development factors can be internal and external, which to one degree or another influence the manifestation of the first signs. Episodes of severe cough experienced by the patient may appear with varying frequency. This is due to the fact that upon contact with allergens, obstruction of the bronchi is observed (one of the forms of respiratory failure. Occurs due to obstruction of the bronchial tree and improper removal of mucus).
During the development of the disease, the following changes occur in the human body:

• Metabolic disorders in the walls of the bronchi;
• Hyperfunction of the respiratory tract;
• Obstruction of the respiratory tract.

Timely diagnosis and treatment of bronchial asthma leads to positive results. Constant patient monitoring of his condition and drug therapy minimizes the risk of developing pathologies and complications.

Causes and appearance

The causes of bronchial asthma can be external or internal, and the factor of heredity also influences. The causes of bronchial asthma can be divided into several categories:
Internal factors:

• Hereditary predisposition - immediate relatives who suffer from this disease or have had complex types of allergic reactions;
• Obesity – due to improper ventilation of the lungs and a high position of the diaphragm, breathing difficulties may occur;
• Men and boys are more often susceptible to this disease, which can be explained by the anatomical structure of the bronchial tree.

External factors

• Allergic reactions - a person experiences a constant cough, difficulty breathing and cannot exhale correctly;
• Mold and pollen;
• Food products, most often citrus fruits;
• Some medications.

The cause of the pathological process is exposure to an allergen, combined with immune disorders. It is worth noting that tobacco smoking and a polluted environment can also become factors influencing the appearance and development of the disease.

Triggers

Each patient has his own trigger (an irritant that provokes an attack of suffocation), which can cause complications. The list of the most common ones includes:

• Weather. For example, in bright sunlight a person may feel unwell;
• Psychological factors. People suffering from depression and stress are more susceptible to the effects of various diseases;
• House dust mites or other pests;
• Colds and viral infections, if not treated sufficiently, can trigger the development of asthma and also cause asthma attacks;
• Animals and hormones.

The disease progresses differently for everyone. When prescribing supervision, the doctor determines the main reasons that provoke blockage of the bronchi and complications of the disease. Based on the results obtained, a further treatment plan and the possibility of remission are determined.

Classification of the disease

In addition to bronchial asthma, there are also causes, which allows us to classify the disease as one of the types. The initial stage includes episodic asthma, which manifests itself only when triggers and allergens appear. The disease may be:

• Combined with others;
• Non-allergic in nature;
• Unspecified;
• Allergic.

According to the degree of development, it can be distinguished: mild, moderate and severe. In the latter case, bronchial asthma is practically impossible to treat and prevent. Measures to restore health will be effective in the initial and middle stages. The main task of the attending physician is to achieve stable remission.

First signs

During the examination, the doctor must interview the patient. This list includes the frequency of manifestations of the main symptoms, sudden episodes of coughing, etc. Breathing and the manifestation of excitability to various stimuli are also assessed. The initial stage assumes that, based on the results obtained, a full examination of the patient can be continued. begin to appear even at the initial stages, when complete recovery is quite possible and allows you to achieve sustainable results. This:

• Shortness of breath or suffocation. It is characterized by periodically difficult breathing, which occurs when the patient is completely at rest. For example, when a person is sleeping or completely relaxed. May occur during sports activities;
• Breathing in bronchial asthma is intermittent, with prolonged exhalation. Often, it is difficult not to inhale, but to exhale. It takes a lot of effort to make it;
• The chronic form manifests itself in constant. It is classified as dry and occurs synchronously with shortness of breath. At the end of the attack, it may acquire a wet character, with mucus discharge;
• Wheezing when breathing. During the examination of the patient, the attending physician can easily detect wheezing and whistling in the bronchi;
• A certain posture during an attack. The person grabs the bed or armrests with his hands, his feet are flat on the floor. Thus, the body devotes all its strength to the ability to breathe normally. In medicine, this syndrome is called orthopnea.

The first and main cause of bronchial asthma is smoking for many years. It is this category of patients who seek help already at the moderate stage of severity. At the beginning, this seems to be a common reaction to the effects of tobacco, after which attacks torment the patient even during sleep. Bronchial asthma is a chronic disease that requires immediate diagnosis and treatment.

Other symptoms

In addition to the main symptoms and causes of bronchial asthma, there are also side effects. Thanks to them, the specialist will be able to determine the severity and make an accurate diagnosis.

• The presence of bumps on the skin or the manifestation of an allergic reaction;
• Blueness of the skin. Characterizes the last stage of the disease;
• Rapid heartbeat observed during attacks;
• Expansion of the chest. If the problem was not previously of concern and the patient did not pay attention to it;
• Headache and dizziness. May occur after another attack;
• Enlargement of the right chambers of the heart.

Complications of the disease are characterized by pulmonary emphysema and cardiopulmonary failure. With such an outcome, attacks follow one after another, which cannot be completely stopped. In some cases it can cause death.

Treatment and diagnosis of the disease in question

Research and analysis

Syndromes in bronchial asthma are not so difficult to determine. As soon as a person experiences one of the symptoms described above, he should immediately seek help from a qualified specialist. Absolutely anyone who has a predisposition and various allergic reactions can get bronchial asthma.
Therapy for bronchial asthma is prescribed by a pulmologist. The diagnosis is based on the patient’s complaints, tests and x-rays. All studies and analyzes are aimed at identifying the severity of the disease. Symptoms and treatment of bronchial asthma are inextricably linked. The trigger that causes the development of the disease determines the further plan of the clinical picture. The patient needs to undergo tests and studies such as:

• . Functional study of the lungs. Using a spirometric device, lung volume, inspiratory and expiratory capacity are analyzed. Such an examination will help determine bronchial obstruction and confirm the diagnosis. After receiving the results, the procedure should be repeated several more times.
• – allows you to assess airway obstruction in specific types of diseases. This method is aimed at studying the stability of the state and comparing indicators with previous ones.
• Allergen analysis. It is carried out in order to determine the main factors in the onset of the disease and the possibilities of effective treatment.

A general blood and sputum test is also performed. The second is the main one, which will allow us to consider viruses that provoke the disease, Kurshman spirals and other things. In the stage of flared inflammatory process, neutral leukocytes can be identified.
A study of the state of the immune barrier and a biochemical blood test will give a complete picture of how to cope with bronchial asthma. A blood test will allow you to understand what other diseases the patient may have and what processes are already running.

Current methods of control

It's not as simple as it might seem. Only the initial and middle stages, which are characterized by the absence of serious changes in the organ, can be treated. Since it is chronic in nature, exclusion of allergens is fundamental in treatment. The patient may be prescribed a diet and normalization of working conditions and rhythm of life. This method will help determine the main factor influencing the development of the disease and determine the degree of its impact.
If the allergen was identified earlier (or thanks to research), hyposensitizing agents are offered. Their main task is to reduce the impact of the product on the health and general condition of the patient. In addition, medications are used in the form of aerosols. Thanks to them, the clearance between the bronchi and the outflow of pulmonary mucus increases. The dose of the drug is selected individually, taking into account the stage and general reaction of the body. Emergency medications can be used to dilate the bronchi and allow air to pass much faster. Used to eliminate attacks and improve the general condition of the patient.
Long-acting tablets are also used. In some cases, hormonal medications help. They can be prescribed by injection and are necessary for patients in the morning. Treatment with glucocorticoids not only improves the general condition of the immune system, but also has a positive result as a preventive measure. The main goal of the injections is to block various inflammatory processes and reduce the number of leukocyte and eosinophilic cells.
Constant monitoring of the condition, carrying out studies at the appointed time - reduces swelling of the mucous membrane, helps restore the bronchial lumen. Hormonal drugs are especially effective in this regard, therefore, with proper dosing and supervision by the attending physician, stable remission can be achieved. The drugs are administered using inhalers, which makes them much easier to take and minimizes the risk of negative reactions in the body.
During treatment, it should be borne in mind that inhalers must be with the patient at all times. Anti-inflammatory drugs are used only as needed until the attack has completely stopped.

New treatments

The study of bronchial asthma is still ongoing: new and most effective methods are being created. It is impossible to say that the disease can be completely cured, but it is also not worth excluding the fact that after long-term therapy the treatment gives a positive result. In treatment and therapy, new agents can be used in the form of leukotriene receptor antagonists. In addition to them, there are also monoclonal antibodies.
The above method has been tested by many leading clinics, has undergone many tests and has shown positive dynamics. The principle of action is based on the fact that the composition of the drugs affects the cellular elements that cause inflammatory processes. It is worth noting that this will not be effective with the isolation method of treatment, so it can only be done as a complex. It is currently used only in European countries and is still being studied. If the results are positive, this method will become one of the most effective and will help the patient move into a stable positive trend.

Prevention of bronchial asthma

The list of basic means for the prevention of various diseases includes:

• Proper food and healthy lifestyle. This is especially true for pregnant women. If a pregnant woman has multiple allergies, it is prohibited to take allergenic foods while pregnant; contact with the most common allergens should be avoided;
• Adequate physical activity. Swimming, breathing exercises, long walks;
• When the first signs of the disease appear, you should not self-medicate. The course can only be selected by;
• Treatment with folk remedies is possible only if the attending physician has given his consent;
• Normal working conditions and use of personal safety equipment. Applies to representatives of professions who are in constant contact with chemically active substances or toxic elements;
• Constant contact with the doctor in order, if necessary, to respond to an unusual situation.

The presented ones affect not only the disease itself, but also help maintain overall health and increase your immunity. Modern man suffers from many ailments that are caused by environmental influences and bad habits. The appearance of the first signs is a reason to consult a professional and begin treatment for a specific disease. Share the information on social networks, and also leave your comment about your experience in treating the disease described above.

Asthma: causes, signs and symptoms in adults, treatment

In this article we will talk about a disease such as asthma (or as it is also called bronchial asthma). Let's look at what it is, how the disease begins, the first signs, treatment, prevention and much more.

What is bronchial asthma?

Bronchial asthma (heavy breathing, or just asthma) is a chronic inflammatory disease of the airways characterized by increased airway reactivity and reversible airflow obstruction.

Common symptoms include wheezing, coughing and shortness of breath, which can range from mild to severe. Symptoms can be prevented by avoiding irritants.

Today there is a tendency to increase the number of patients with this diagnosis. This is due to an extensive list of reasons that lead to pathological processes in the human respiratory system.

Epidemiology

Documented evidence suggests a low prevalence of asthma in Asian countries such as China and India. The prevalence rate in these countries is only 2-4% compared to developed countries such as Russia, UK, Canada, Australia and New Zealand where the disease prevalence is 15-20%.

WHO estimates in 2018 that the disease affects 235 million people and is a common illness among children.

The occurrence of asthma has increased in recent years, especially since the 1970s. The disease was also found to be responsible for about 400,000 deaths.

What is the difference between bronchial asthma and cardiac asthma?

Those who hear about asthma usually think of bronchial asthma, a chronic inflammatory disease of the bronchial system. In addition to bronchial asthma, there is also the so-called cardiac asthma, which is colloquially called “ cardiac asthma».

Cardiac asthma is a condition of acute left ventricular valve insufficiency. As a result, blood accumulates in the lungs and fluid leaks into the lung tissue. Result: shortness of breath and especially night cough.

Pathophysiology

The pathophysiology of asthma is complex and attacks can be spontaneous or provoked. In any case, the pathophysiology of the attacks is as follows:

• Initially, activation of inflammatory cells occurs, leading to the release of inflammatory mediators from epithelial cells, macrophages and bronchial mast cells;
• increased sensitivity in the smooth muscles of the respiratory tract as a result of changes in the nervous control of muscle tone and disruption of the integrity of the epithelium;
• this provokes the occurrence of symptoms in the form of shortness of breath and whistling in the bronchi.

If the initial attacks do not subside, the condition may progress to a more acute and severe form called diarrhea, which requires hospitalization.

Types of bronchial asthma

• Drug-induced bronchial asthma– this type of bronchial asthma is characterized not only by a problem with respiratory function, but also by the body’s complete intolerance to acetylsalicylic acid and other medications containing a similar substance. In many cases, people with a drug-induced disease are intolerant to aspirin and non-steroidal anti-inflammatory drugs.

Typical medications that can trigger drug-induced asthma are painkillers containing acetylsalicylic acid. About 10% of adults with known nonallergic asthma cannot tolerate these pain medications because it increases their asthmatic distress.

• Bronchial asthma of physical exertion– shortness of breath and suffocating cough occurs with this type of asthma in case of physical exertion. Patients who suffer from a disease of physical effort are prohibited from engaging in such active sports as football, volleyball, tights (large, tabletop), running. Swimming at a slow pace is allowed.
• Dishormonal form– occurs against the background of dysfunction of the endocrine system and imbalance of hormones in the body. In most cases, this type of asthma occurs in older people and in women during menopause and menopause.
• Psychogenic form– arises as a result of prolonged emotional and psychological stress, or experienced shock. These types of asthma in their pure form are extremely rare. As a rule, patients with this type have clinical manifestations of all 4 types. There are cases when during life the disease changes its clinical picture and nature of manifestation.

Causes bronchial asthma

Bronchial asthma in adults, as well as in children, is an acquired disease that occurs as a result of allergies, bad habits and poor ecology.

Often the causes are a previous infection, or one that was not fully cured and entered the chronic stage.

In general, the etiology of asthma has not yet been fully studied.

The relationship between genetic and environmental factors in the occurrence of asthma is still a matter of debate, and many studies are being conducted to establish the connection between allergies and asthma.

Provoking factors

Main risk factors for bronchial asthma:

• hereditary predisposition;
• bad ecology;
• exposure to infections and endotoxins;
• prolonged stress;
• pathologies of the respiratory system;
• immunodeficiency.

It is important to understand that if heredity is not a disease, its presence only indicates that the person is at risk, and in the presence of certain factors, such as immunodeficiency or previous pneumonia, the disease will develop.

Symptoms bronchial asthma

Bronchial asthma is characterized by signs of suffocation, coughing and shortness of breath. Patients with a melon diagnosis find it difficult to exhale air rather than inhale.

Main symptoms of bronchial asthma:

• Choking and shortness of breath. These symptoms can occur at any time, regardless of whether the person is at rest or engaged in physical labor. In most cases, in the early stages of the disease, breathing problems begin to plague a person during night sleep. Choking occurs when you stay in a dusty room for a long time or come into contact with pollen.
• Sudden cough. The nature of the cough is dry. Occurs along with shortness of breath. At the end of a sudden coughing attack, a small amount of sputum may appear. There is a feeling that the person wants to clear his throat, but to no avail.
• Wheezing in the chest. When breathing from the chest, wheezing and whistling sounds are heard, which can be heard even by people around you.
• Shallow breathing and a prolonged process of exhalation. It is with the exhalation of air that a person has problems, while inhalation does not cause any difficulties.
• Cardiopalmus (). during an attack it can reach up to 150 beats per minute. Between attacks, during the period of calm, it is within normal limits.

Acute asthma attack

A sudden narrowing of the airways can cause an acute asthma attack. The first signs of an asthma attack are breathing problems such as wheezing, choking and coughing. Other symptoms:

• increased breathing and heart rate;
• suffocating severe shortness of breath.

In turn, a severe cough can further worsen symptoms. As it progresses and oxygen deficiency occurs, the color of the lips and face becomes bluish, and cold sweat appears.

The duration of an asthma attack varies from a few seconds to several hours, in some cases even up to several days. Then doctors talk about the so-called status asthmaticus.

Between attacks, some adults with asthma have no symptoms, while others constantly feel like they are losing their breath.

Diagnostics

Diagnosis is usually made by assessing the patient's condition, performing a complete physical examination, a thorough medical history, and a pulmonary function test.

An examination is carried out using a stethoscope and sounds in the lungs are listened to. Additionally, various physiological studies are prescribed to assess lung function:

• spirometry;
• analysis of the maximum throughput of the bronchi with a peak flow meter;
• bronchial provocation test.

In addition, additional tests are carried out to rule out other possible diseases. Some of these studies:

• x-ray of sinuses;
• assessment of gastroesophageal reflux disease.

Treatment of allergic and aspirin asthma.

For the treatment of allergic type bronchial asthma, hyposensitization is necessary. This type of therapy allows you to block the body’s pathological reaction to external stimuli.

The essence of this procedure is the introduction to the patient in microscopic doses of an irritating substance to which the patient is allergic, causing asthma attacks. Injections are carried out in a special course, which is calculated by the doctor individually for each case.

Treatment of aspirin-induced asthma is carried out by desensitizing aspirin in order to develop a normal reaction in the body to this drug.

Alternative therapy

For therapy and relief of the general condition of adults, non-traditional methods of therapy are also used.

Important! Any method of alternative medicine cannot be used as an independent method of treating bronchial asthma. Their main task is to relieve severe asthma symptoms and alleviate the condition in adults and children.

Speleotherapy(a type of climatotherapy) - spending some time in salt caves, the microclimate of which has a beneficial effect on the human respiratory system.

After salt caves, attacks of suffocation and cough disappear, the process of mucus removal is activated, and the protective functions of the immune system are increased.

If you have bronchial spasm, you can use the following methods:

• electropuncture (use of electrical impulses);
• tsubotherapy (method of using metal balls);
• acupuncture.

The basis of these methods is the impact on certain points of the human body, due to which attacks are stopped and the functions of the central nervous system are restored.

Respiratory therapy– one of the most effective alternative methods of treating asthma.

The method is based on the development of the lungs and bronchi by performing a special breathing technique and pronouncing guttural sounds.

Treatment with folk remedies at home

Traditional medicine recipes include the use of the following herbs:

• naked licorice;
• thyme;
• pine buds.

Recipe 1:

To prepare the decoction you will need: a tablespoon of dried, crushed herbs, which is poured with a glass of boiling water.

Before use, leave for 60 minutes, strain and cool to room temperature.

Take one tablespoon of decoction in the morning, afternoon and evening.

Recipe 2:

To prepare the second medicinal decoction, you will need 10 g of pine buds, pour a 200 m glass of hot water, and leave for 2-2.5 hours. Strain, take a tablespoon up to 4 times a day.

Pine buds help remove phlegm, relieve inflammation and have an antimicrobial effect.

Recipe 3:

In folk medicine, naked licorice roots are used to treat bronchial asthma, from which a decoction is prepared.

Add a teaspoon of crushed roots to a saucepan, add 0.5 liters of water, and boil over low heat for 30 minutes.

Afterwards, the broth must be cooled, strained, and more water added to return to the original volume, since water evaporates during boiling.

Directions for use: a tablespoon, half an hour before the main meal, 3 times a day.

Important! Without consulting a specialist, it is highly not recommended to use traditional medicine for both adults and children due to possible allergic reactions, which will only worsen the situation of patients.

Prevention of bronchial asthma

Asthmatic attacks can be prevented by reducing the body's exposure to negative factors. To do this, the first step is to identify the triggering factors. Some of these factors are polluted air, allergies, cold air, influenza virus, smoke, different scents of perfumes.

Smoking can also cause asthma attacks and hence smoking in any form should be avoided.

If colds and flu are triggering your asthmatic attack, avoiding crowded places or exposure to cold air will reduce the frequency of asthmatic attacks.

Forecast

Asthma is a chronic disease, and the prognosis in adults usually depends on the severity of the disease. In some cases, the disease may go into longer periods of remission. Typically, in moderate cases of asthma, clinical manifestations may improve over time.

Only about 10% of cases have a very severe and permanent condition that does not respond to therapy. In such patients, there is an irreversible decrease in lung function, as well as changes in the walls of the airways.

Death from asthma attacks is relatively rare and can be prevented by taking medications.

Overall prognosis for bronchial asthma very good. More than half of children with asthma have no symptoms as adults if the disease is caught and treated early, but in some cases asthma can recur even after a decade of absence. In any case, the airways remain vulnerable for life.

Interesting

is a chronic non-infectious inflammatory disease of the respiratory tract. An attack of bronchial asthma often develops after warning signs and is characterized by a short, sharp inhalation and a noisy, prolonged exhalation. It is usually accompanied by a cough with viscous sputum and loud wheezing. Diagnostic methods include assessment of spirometry data, peak flowmetry, allergy tests, clinical and immunological blood tests. The treatment uses aerosol beta-agonists, m-anticholinergics, ASIT; in severe forms of the disease, glucocorticosteroids are used.

ICD-10

J45 Asthma

General information

Over the past two decades, the incidence of bronchial asthma (BA) has increased, and today there are about 300 million asthmatics in the world. This is one of the most common chronic diseases, which affects all people, regardless of gender and age. The mortality rate among patients with bronchial asthma is quite high. The fact that in the last twenty years the incidence of bronchial asthma in children has been constantly increasing makes bronchial asthma not just a disease, but a social problem, against which maximum efforts are directed. Despite its complexity, bronchial asthma responds well to treatment, thanks to which stable and long-term remission can be achieved. Constant control over their condition allows patients to completely prevent the onset of asthma attacks, reduce or eliminate the use of drugs to relieve attacks, and also lead an active lifestyle. This helps maintain lung function and completely eliminate the risk of complications.

Causes

The most dangerous provoking factors for the development of bronchial asthma are exogenous allergens, laboratory tests for which confirm a high level of sensitivity in patients with asthma and in individuals who are at risk. The most common allergens are household allergens - house and book dust, aquarium fish food and animal dander, plant allergens and food allergens, which are also called nutritional allergens. In 20-40% of patients with bronchial asthma, a similar reaction to medications is detected, and in 2% the disease was acquired as a result of working in hazardous industries or, for example, in perfume stores.

Infectious factors are also an important link in the etiopathogenesis of bronchial asthma, since microorganisms and their metabolic products can act as allergens, causing sensitization of the body. In addition, constant contact with infection maintains the inflammatory process of the bronchial tree in the active phase, which increases the body's sensitivity to exogenous allergens. The so-called hapten allergens, that is, allergens of non-protein structure, entering the human body and binding to its proteins also provoke allergic attacks and increase the likelihood of asthma. Factors such as hypothermia, family history and stressful conditions also occupy an important place in the etiology of bronchial asthma.

Pathogenesis

Chronic inflammatory processes in the respiratory organs lead to their hyperactivity, as a result of which, upon contact with allergens or irritants, bronchial obstruction instantly develops, which limits the speed of air flow and causes suffocation. Attacks of suffocation are observed with varying frequency, but even in the remission stage, the inflammatory process in the respiratory tract persists. The disruption of air flow in bronchial asthma is based on the following components: obstruction of the airways due to spasms of the smooth muscles of the bronchi or due to swelling of their mucous membrane; blockage of the bronchi with the secretion of the submucosal glands of the respiratory tract due to their hyperfunction; replacement of bronchial muscle tissue with connective tissue during a long course of the disease, which causes sclerotic changes in the bronchial wall.

The changes in the bronchi are based on sensitization of the body, when during immediate allergic reactions, occurring in the form of anaphylaxis, antibodies are produced, and when the allergen is encountered again, an instant release of histamine occurs, which leads to swelling of the bronchial mucosa and hypersecretion of the glands. Immune complex allergic reactions and delayed sensitivity reactions proceed similarly, but with less severe symptoms. An increased amount of calcium ions in human blood has recently also been considered as a predisposing factor, since excess calcium can provoke spasms, including spasms of the bronchial muscles.

A pathological examination of those who died during an attack of suffocation reveals complete or partial blockage of the bronchi with viscous thick mucus and emphysematous expansion of the lungs due to difficulty in exhaling. Tissue microscopy most often shows a similar picture - a thickened muscle layer, hypertrophied bronchial glands, infiltrative bronchial walls with desquamation of the epithelium.

Classification

Asthma is divided according to etiology, severity, level of control and other parameters. Based on their origin, they distinguish allergic (including occupational BA), non-allergic (including aspirin BA), unspecified, mixed bronchial asthma. Depending on the severity, the following forms of asthma are distinguished:

1. Intermittent(episodic). Symptoms occur less than once a week, exacerbations are rare and short.
2. Persistent(constant flow). Divided into 3 degrees:

• mild - symptoms occur from 1 time per week to 1 time per month
• average - frequency of attacks daily
• severe - symptoms persist almost constantly.

During the course of asthma, there are exacerbations and remission (unstable or stable). If it is possible to control attacks, asthma can be controlled, partially controlled and uncontrolled. A complete diagnosis of a patient with bronchial asthma includes all of the above characteristics. For example, “Bronchial asthma of non-allergic origin, intermittent, controlled, in the stage of stable remission.”

Symptoms of bronchial asthma

An attack of suffocation during bronchial asthma is divided into three periods: the period of precursors, the period of height and the period of reverse development. The period of precursors is most pronounced in patients with an infectious-allergic nature of asthma; it is manifested by vasomotor reactions from the organs of the nasopharynx (copious watery discharge, incessant sneezing). The second period (it can begin suddenly) is characterized by a feeling of tightness in the chest, which does not allow breathing freely. The inhalation becomes sharp and short, and the exhalation, on the contrary, becomes long and noisy. Breathing is accompanied by loud wheezing, a cough appears with viscous, difficult to expectorate sputum, which makes breathing arrhythmic.

During an attack, the patient’s position is forced; usually he tries to take a sitting position with the body tilted forward and find a fulcrum or rest his elbows on his knees. The face becomes puffy, and during exhalation the neck veins swell. Depending on the severity of the attack, you can observe the participation of muscles that help overcome resistance during exhalation. During the period of reverse development, gradual discharge of sputum begins, the amount of wheezing decreases, and the attack of suffocation gradually subsides.

Manifestations in which the presence of bronchial asthma can be suspected.

• high-pitched wheezing when exhaling, especially in children.
• repeated episodes of wheezing, difficulty breathing, chest tightness, and coughing that gets worse at night.
• seasonality of deterioration of health in the respiratory system
• presence of eczema, history of allergic diseases.
• worsening or occurrence of symptoms upon contact with allergens, taking medications, contact with smoke, sudden changes in ambient temperature, acute respiratory infections, physical activity and emotional stress.
• frequent colds that “descend” to the lower respiratory tract.
• improvement after taking antihistamines and anti-asthmatic drugs.

Complications

Depending on the severity and intensity of asthma attacks, bronchial asthma can be complicated by pulmonary emphysema and the subsequent addition of secondary cardiopulmonary failure. An overdose of beta-adrenergic stimulants or a rapid reduction in the dosage of glucocorticosteroids, as well as contact with a massive dose of an allergen, can lead to status asthmaticus, when attacks of asthma come one after another and are almost impossible to stop. Status asthmaticus can be fatal.

Diagnostics

The diagnosis is usually made by a pulmonologist based on complaints and the presence of characteristic symptoms. All other research methods are aimed at establishing the severity and etiology of the disease. On percussion, the sound is clear and boxy due to the hyperairiness of the lungs, the mobility of the lungs is sharply limited, and their boundaries are shifted downward. On auscultation over the lungs, vesicular breathing is heard, weakened with prolonged exhalation and with a large number of dry wheezing rales. Due to the increase in lung volume, the point of absolute dullness of the heart decreases, the heart sounds are muffled with an accent of the second tone above the pulmonary artery. Instrumental studies include:

• Spirometry. Spirography helps to assess the degree of bronchial obstruction, determine the variability and reversibility of obstruction, and also confirm the diagnosis. In asthma, forced exhalation after inhalation of a bronchodilator increases by 12% (200 ml) or more in 1 second. But to obtain more accurate information, spirometry should be performed several times.
• Peak flowmetry. Measuring peak expiratory activity (PEA) allows you to monitor the patient's condition by comparing the indicators with previously obtained ones. An increase in PEF after inhalation of a bronchodilator by 20% or more from PEF before inhalation clearly indicates the presence of bronchial asthma.

Additional diagnostics include allergen tests, ECG, bronchoscopy and chest x-ray. Laboratory blood tests are of great importance in confirming the allergic nature of bronchial asthma, as well as for monitoring the effectiveness of treatment.

• Blood test. Changes in the CBC - eosinophilia and a slight increase in ESR - are determined only during an exacerbation. Assessment of blood gas composition is necessary during an attack to assess the severity of DN. A biochemical blood test is not the main diagnostic method, since the changes are of a general nature and such studies are prescribed to monitor the patient’s condition during an exacerbation.
• General sputum analysis. Microscopy in sputum can reveal a large number of eosinophils, Charcot-Leyden crystals (brilliant transparent crystals formed after the destruction of eosinophils and shaped like rhombuses or octahedrons), Courshman spirals (formed due to small spastic contractions of the bronchi and look like casts of transparent mucus in the form spirals). Neutral leukocytes can be found in patients with infection-dependent bronchial asthma in the stage of active inflammatory process. The release of Creole bodies during an attack was also noted - these are round formations consisting of epithelial cells.
• Immune status study. In bronchial asthma, the number and activity of T-suppressors sharply decreases, and the amount of immunoglobulins in the blood increases. The use of tests to determine the amount of immunoglobulin E is important if allergy tests are not possible.

Treatment of bronchial asthma

Since bronchial asthma is a chronic disease, regardless of the frequency of attacks, the fundamental point in therapy is the exclusion of contact with possible allergens, adherence to elimination diets and rational employment. If the allergen can be identified, then specific hyposensitizing therapy helps reduce the body’s reaction to it.

To relieve asthma attacks, beta-agonists are used in aerosol form to quickly increase the lumen of the bronchi and improve the outflow of sputum. These are fenoterol hydrobromide, salbutamol, orciprenaline. The dose is selected individually in each case. Drugs from the group of m-anticholinergics - aerosols of ipratropium bromide and its combination with fenoterol - are also effective in stopping attacks.

Xanthine derivatives are very popular among patients with bronchial asthma. They are prescribed to prevent asthma attacks in the form of long-acting tablet forms. In the last few years, drugs that inhibit mast cell degranulation have shown positive effects in the treatment of asthma. These are ketotifen, sodium cromoglycate and calcium ion antagonists.

When treating severe forms of asthma, hormonal therapy is included; almost a quarter of patients need glucocorticosteroids; 15-20 mg of Prednisolone is taken in the morning along with antacid drugs that protect the gastric mucosa. In a hospital setting, hormonal medications can be prescribed by injection. The peculiarity of the treatment of bronchial asthma is that it is necessary to use drugs in the minimum effective dose and achieve an even greater reduction in dosage. For better sputum discharge, expectorant and mucolytic drugs are indicated.

Prognosis and prevention

The course of bronchial asthma consists of a series of exacerbations and remissions; with timely detection, a stable and long-term remission can be achieved, but the prognosis depends largely on how attentive the patient is to his health and follows the doctor’s instructions. Prevention of bronchial asthma is of great importance, which consists of sanitizing foci of chronic infection, combating smoking, as well as minimizing contact with allergens. This is especially important for people who are at risk or have a family history.

An attack of bronchial asthma is an exacerbation of a chronic disease, accompanied by difficulty breathing, dry cough, and in the final stages – complete blockage of inhalation. Patients suffering from allergic reactions get used to the constant danger of an attack and learn to respond in time to the first signs of such a condition. At the same time, a person experiencing an asthmatic attack for the first time may be taken by surprise by severe throat spasms and choking.
Everyone should have basic knowledge of the characteristics of acute asthma and methods of responding to emergency situations. If you suspect that someone close to you (or even yourself) suffers from regular attacks, be sure to read the information below, take steps to eliminate the danger, and then contact us for a full course of treatment.

Periodic attacks of coughing and choking with bronchial asthma are almost inevitable. The septum, which is responsible for allowing new portions of air into the lungs, closes in response to various irritants, and it becomes increasingly difficult to take each new breath. The result is oxygen intake with increasingly shorter breaths, prolonged coughing, turning into the inability to breathe. Doctors note the following reasons for the manifestation of acute conditions:

• Contact with an allergen. Sometimes a reaction occurs to a new source of allergy that the patient has not previously encountered. In other cases, the problem is the difficulty of limiting interaction with a dangerous component. Thus, asthma patients are well aware of the complications that arise in the spring, during the flowering period of most plants.
• Incorrectly selected medications or developed immunity to the prescribed drug. Over the years, the body can develop tolerance to the active substance that stops the allergic reaction. This is one of the common causes of asthma attacks in adults: it is time to change the drug, but it is impossible to recognize this need until breathing problems return.
• Acute respiratory tract diseases. An asthmatic reaction can develop in response to diseases that are not directly related to the bronchi, but increase the load on them or contribute to the aggravation of the internal inflammatory process. Comprehensive treatment is required - otherwise, it will continue to return.
• Physical overload of the body. The condition, characteristic of the manifestations of an attack of bronchial asthma, is typical for people who exercise excessively intensely. The greatest danger lies in running: if you don’t watch your pace and breathing, you may end up with a burning, dry cough and the inability to take a full breath for several minutes. But even during a strength training session with exercise machines, you can bring your body to the point of blocking your breathing. In both cases, you need to stop the exercise and try to relax the airways.
• Panic attacks, stress and other aspects. Heavy mental stress also causes breathing problems. If you or someone in your family is subject to constant stress, it is necessary not only to learn how to solve the problem with sedatives, but also to master proper breathing techniques. They are aimed at both restoring the respiratory rhythm and reducing stress load.

It is not always possible to immediately identify the cause of the complication. If a patient has predominantly nocturnal asthma, then it is most difficult for him to identify provoking factors and tell the doctor about them. Additional examinations and laboratory tests will help identify the key factors causing the return of suffocation and promptly take action.

How to identify an asthmatic attack in the initial stage?

Knowing the signs of an asthma attack, you can easily identify this condition, even if it begins without visible provocation from the outside. Keep in mind that a person who has not previously suffered from severe bronchial diseases may begin to choke: the first attack has a chance to happen not only in childhood, but also in adulthood.

Symptoms of exacerbation of allergic asthma

As a rule, allergy sufferers are able to independently recognize their condition and cope with it. However, it is still better to know the main warning signs of choking, especially if you suspect an undiagnosed allergy in your own child:

• Intense coughing that continues for a long time. does not go away, the dry throat remains.
• The nose constantly “drips”: mucus leaves, washing away the dangerous allergen from the internal sinuses.
• Constant sore throat that does not disappear with rest (unlike a cold cough).
• The frequency of sneezing increases according to proximity to the allergen; the patient can sneeze up to 20-30 times per minute.
• The pre-attack state may be accompanied by a dull headache.

At this stage, the exacerbation should be stopped by taking anti-allergen drugs or promptly blocking contact with the allergen.

Symptoms of exacerbation of non-allergic asthma

Not all asthma attacks are accompanied by such obvious symptoms. If the condition is not related to an allergic reaction, then the signs will be less specific and therefore more invisible:

• Increased anxiety. The “aura” of anxiety that surrounds a person before an attack of shortness of breath or suffocation during bronchial asthma should be taken seriously: in this way, the body suggests the need for immediate protection from a health threat. In addition, such a condition indicates emotional overstrain - one of the most common factors in exacerbating asthma in people who do not suffer from allergies.
• Sharp weakness, feeling of fatigue. In the initial phase, the body still copes with regulating breathing on its own, but this load does not go unnoticed. The patient wants to leave everything and go into a state of rest - and this desire should be followed, especially if it is accompanied by dizziness.
• Dry cough. As with allergic forms of the disease, one of the most characteristic signs. You should not increase the dosage of anti-cold medications if you have already found them to be ineffective: consult a doctor to select medications that will help gently eliminate bronchial spasm.
• Sleep problems. Despite the general weakness and exhausted state, the patient is unable to sleep - he is disturbed by a painful cough, instantly disturbing his shallow sleep. As a rule, ARVI is not accompanied by such disorders, so their presence is a sure sign of the need for additional consultation with a doctor.

Even one or two warning signs are enough to speak with confidence about the imminence of an attack of bronchial asthma. The time from the initial to acute phase may vary, but in most cases does not exceed 3-5 minutes. If you start acting at this stage, you can completely stop the exacerbation “in the bud.” This is much simpler and more beneficial for the body than drug withdrawal from the later stages of an attack.

How does an attack of bronchial asthma proceed?

Diagnosis of exacerbation is not difficult. Experts identify the following characteristic signs of an asthma attack:

• Increasing shortness of breath, turning into suffocation. In some cases, the acute phase is limited to this symptom and passes after breathing is restored. Also, shortness of breath can block coughing, which is why the attack is delayed, so this condition should be treated with extreme caution.
• Intense and frequent cough. If you can suppress the urge to cough on your own with a cold, then with asthma it is almost impossible to do this. Coughing occurs in “waves” with short breaks.
• The body is tilted forward, resting on a hard vertical or horizontal surface. This is the forced position of the patient during an acute attack of bronchial asthma, also known as the “forced position.” There is no need to straighten the patient: this position allows you to slightly reduce the load on the respiratory system and restore breathing. At the same time, sneezing, if there was any, intensifies: the body accelerates the elimination of allergens.

Other characteristic, although less noticeable, symptoms of an attack are a sharp increase in the degree of excitability and physical weakness. These signs accompany each other: despite the fact that the body feels exhausted, the psyche reacts excessively to stressful stimuli. This property complicates self-help, which is why asthmatic attacks occurring alone are considered the most dangerous. If you suffer from chronic bronchial diseases and often remain out of contact with your loved ones or your doctor, make sure that those around you are warned about your condition and the signs of an attack, as well as the measures that need to be taken.

The most dangerous stages

A mild asthma attack causes only minor inconvenience, and the patient retains the ability to speak without much difficulty, making it easy to explain the situation or request professional help. At the middle stage, it is no longer possible to speak in full sentences, and one should not count on spontaneous cessation of shortness of breath, but the patient can still formulate a request for help. If a person only “squeezes out” individual short words or says nothing at all between waves of coughing, then he is in one of the most dangerous stages:

• Heavy. It is characterized by a transition to a forced position, refusal to move, pronounced shortness of breath (up to 30 breaths per minute), and an almost complete inability to talk. At the same time, a state of panic develops, decreases (not always), and the heart rate rises sharply (up to 120 beats per minute). The auxiliary muscles unsuccessfully try to compensate for difficulty breathing, and bronchial spasm intensifies over time. Strong drugs in high doses (Dexamethasone, etc.) are immediately prescribed to prevent progression to the next stage.
• . The most dangerous condition that develops as a result of prolonged severe suffocation. An asthma attack completely blocks the functions of the speech apparatus and any physical activity. Consciousness becomes confused, a transition into a coma is possible. Respiratory movements are compensatory and uneven. The pulse drops to 60 beats per minute or less, while the condition remains the same, the costal spaces sink. Treatment at this stage requires promptness and great precision, therefore, after providing first aid measures (intense relaxants, adrenaline to restore heart rate and muscle activity, others depending on the condition), the patient is sent to the intensive care unit.

The danger can be fraught with both habitual “allergenic” and so-called nocturnal asthma. Even a hint of a transition to a severe stage should be enough to call an ambulance, especially if the patient has not previously encountered difficulty breathing. After neutralizing the threat to life and health, preventive treatment is selected.

First aid and prevention measures

If attacks occur to you at least several times a year, make sure in advance that your loved ones are familiar with the basics:

• Immediate use with medication if possible. If not, call an ambulance immediately.
• Elimination of clothing that prevents the free opening of the chest.
• Room ventilation. If possible, open all windows to maximize the flow of fresh air.
• Help in transitioning to the “forced position” that accompanies moderate and severe asthma attacks. This position is a natural reaction of the body, making it easier to restore breathing.
• Communication with the patient. You need to talk to a person suffering from suffocation: remind them of the need for deep and rhythmic breathing, and calm them down. Psychological support in the initial stages leads to the fact that the symptoms of an asthma attack are neutralized with minimal participation of medications.
• If the ambulance team is delayed, restore respiratory function by warming up the feet. Hot water is drawn into a small container (for example, a basin), into which the patient’s legs are placed. Warming up helps to open the damper in the bronchi and restore breathing on your own.

If you already know too well how asthma attacks manifest themselves, then you also know that it is better to avoid such a condition if possible. Doctors give the following recommendations:

• Completion of a full medical course of basic therapy. Antiallergic and restorative drugs should be used even after adverse symptoms have passed.
• Timely treatment of diseases of the respiratory system (bronchitis, laryngitis, etc.)
• Eliminating or minimizing unfavorable factors (encounters with allergens, smoking, increased levels of household dust, etc.)
• Maintain moderation in physical activity. Mastering new complex exercises should be supervised by an instructor who can promptly assess breathing disorders and correct the range of movements. The best solution would be to master the complex.

A smooth psycho-emotional background is also of considerable importance. People suffering from chronic bronchial diseases should avoid stressful situations, as they can provoke suffocation.

Conclusion

Now you know what an asthma attack is and how to behave if you or someone around you goes into such a state. According to statistics, 5% of people on Earth suffer from bronchial asthma. Are you one of them? How do you cope with attacks, and do your loved ones help you with this? Or maybe you have ever personally provided first aid to a person in such a situation? Share your experience in the comments.

May 4th is International Asthma Day, which was proclaimed by the World Health Organization (WHO) and is held annually on the first Tuesday of May at the initiative of the International Asthma Initiative.

Asthma (from the Greek asthma - suffocation) is a chronic inflammatory disease of the respiratory system, expressed in periodically occurring attacks of suffocation of varying strength and duration. The occurrence of an attack is caused by spasms of the small bronchi, swelling of their mucous membranes, and as a result, cough and shortness of breath.

Asthma causes inflammation of the airways through which oxygen enters the lungs, and the inflammation causes them to temporarily narrow. This occurs because the airways, which overreact to various irritants, narrow in response to irritation and produce large amounts of mucus, which disrupts the normal flow of air during breathing.

In Russia this disease is called “bronchial asthma”; in Western countries it is known as simply asthma. Thus, asthma and bronchial asthma are the same disease. There is also the concept of “cardiac asthma,” but it does not mean an independent disease, but attacks of suffocation against the background of heart failure.