There are several varieties of the disease, which are determined by the conditions of its occurrence, one of these varieties is acquired bronchial asthma.
This diagnosis means that the disease was not inherent in the patient from the moment of his birth, but formed much later under the influence of external causes. It is sometimes believed that a person had asthma initially, but was simply not diagnosed. However, if the disease did not manifest itself for 20 years of life, and then was discovered, this indicates that it is not congenital and has formed recently.
Acquired asthma is practically no different from congenital asthma in its symptoms and signs, and there are no significant differences in the course of treatment. The main difference between acquired asthma and congenital asthma is in the characteristics of its development. In addition to the fact that it manifests itself in adults, the factors that cause its formation differ from those that provoke the congenital type of the disease.
Congenital bronchial asthma manifests itself in children from birth and is caused by the characteristics of the newborn’s body. A child may be born sensitive to external environmental influences, which is manifested in the reaction of his bronchi.
In the case of acquired asthma, everything happens a little differently. The patient's body is exposed for a long time negative impacts, due to which irreversible changes occur in organ tissues respiratory system. As a result, asthmatic symptoms appear. This type of asthma formation is called exogenous, since the pathology is formed under the influence of external causes.
Among these reasons are:
In order to acquire this disease, one of the listed factors is sufficient, although very often they act in combination. Any person who exhibits these characteristics is considered a potential risk group. However, their presence does not necessarily mean the development of asthma. Usually the human body is strong enough to cope with negative impact. It depends on the characteristics of his immunity.
The most harmful external influences include:
If you have an allergic reaction to any of these elements, you need to be very careful and minimize your interaction with it. Otherwise, the allergy may develop into bronchial asthma.
You can suspect this disease by its symptoms, which you need to know. Although only a doctor can draw conclusions after the necessary diagnostic procedures. Therefore, it is not advisable to start self-treatment, until a diagnosis has been made, but it is also unacceptable to ignore the signs of pathology.
The main symptoms of acquired bronchial asthma do not differ from similar symptoms of the congenital form of the disease.
The only difference is that with an acquired disease, symptoms appear in adulthood, and not in early childhood.
These include:
All this may be accompanied by weakness, decreased performance, and headaches. It is worth noting that these signs are similar to the symptoms of bronchitis or ARVI. However, with bronchial asthma there is no elevated temperature; in addition, symptoms arise unexpectedly and then disappear for a while. In any case, if these signs are detected, you should consult a doctor to determine an accurate diagnosis, since the lack of treatment, even with colds can lead to complications such as bronchitis or pneumonia.
Before starting treatment, it is necessary to conduct an examination to identify an accurate diagnosis. For this we use:
In addition to tests, the doctor must find out the features of the patient’s life, such as:
All this will help not only diagnose the disease, but also determine the strategy for its treatment, since its causes will become clear.
It is impossible to completely get rid of any type of asthma, no matter how effective the methods are chosen. The medical effect is to use medications to relieve the most acute manifestations of the disease and avoid their recurrence too often.
In order to prevent exacerbations of the disease, it is necessary to identify the factors that provoke them. After this, their exposure should be eliminated or contact with irritants should be minimized.
To stop asthma attacks, anti-inflammatory drugs (sodium cromoglycate, Nedocromil sodium) and bronchodilators (Salbutamol, Budesonide) are used. With the help of anti-inflammatory drugs, it is possible to stop the active process of mucus production in the bronchi, which reduces the body's sensitivity to harmful influences.
They should be taken regularly, as they improve air conductivity. This reduces the risk of bronchial trauma and reduces the number of asthma attacks. Bronchodilators help relax the muscles of the bronchi, resulting in more air entering the lungs and eliminating asthma attacks. They are usually used to relieve acute manifestations.
It is very important that during treatment you use medications that do not cause side effects. When fighting asthma, long-term use of drugs is expected, so it is necessary to minimize the discomfort from their use. You also need to make sure that they do not cause allergic reactions. This is why a doctor must prescribe medications. Choosing your own treatment is very dangerous.
Prevention is equally important in the presence of asthma. Compliance preventive measures will help avoid exacerbations of the disease and frequent use of strong drugs. Basic preventive actions for acquired asthma are as follows:
Patients with bronchial asthma have to limit themselves in many ways so as not to cause serious deterioration in their health. However, the presence of this disease does not mean that a person becomes inferior. If you follow the rules, take medications in a timely manner and are careful, it is possible to full life without experiencing significant difficulties.
Read better what Honored Doctor of the Russian Federation Victoria Dvornichenko says about this. For several years I suffered from BRONCHIAL ASTHMA - cough, shortness of breath, suffocation, wheezing, audible at a distance, weakness and depression. Endless tests, visits to doctors, hormones and pills did not solve my problems. BUT thanks to a simple recipe, I am HEALTHY again, full of strength and energy. Now my attending physician is surprised how this is so. Here is a link to the article.
Bronchial asthma is a non-infectious chronic disease of the airways. The problem develops under the influence of external and internal factors, the most common of which is dust allergy.
Bronchial asthma is accompanied by increased irritability of the small bronchi. It is similar to inflammation of the organ mucosa (more on this in the “Bronchitis” section).
Each patient may have an attack due to various reasons, including:
You will learn more about what can cause a violation from the articles in this section.
In the early stages the disease manifests itself:
It is impossible to completely get rid of the problem. But with the help modern drugs and therapeutic techniques can control the frequency of attacks. You will find answers to all questions regarding this topic in this section.
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Our immunity is directly dependent on our lifestyle and nutrition. Only a small part of it is initially genetic. Throughout life, a person acquires immune deficiency, which subsequently leads to various kinds of diseases, allergic reactions and poor health. By taking care of your diet, you will also take care of your immunity, which will subsequently save you from many health problems. This test will show you what to pay attention to in your current diet. What to add, what to reduce, and what should be abandoned completely.
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Judging by your diet, you don’t care about your immune system or your body at all. Most likely, you get sick often, suffer from intestinal problems, and are haunted by the feeling constant fatigue. It's time to love yourself and start improving. It is urgent to adjust your diet, to minimize fatty, starchy, sweet and alcoholic foods. Eat more vegetables and fruits, dairy products. Feed the body by taking vitamins, drink more water (precisely purified, mineral). Strengthen your body, reduce the amount of stress in your life, think more positively and the transition to a healthy diet will be much easier, you just need to start.
So far, it’s good, but if you don’t start taking care of her more carefully, health problems may begin (if the prerequisites haven’t already existed). Namely, allergies, frequent colds, intestinal problems and other “delights” of life accompany weak immunity. You should think about your diet, minimize fatty, flour, sweets and alcohol. Eat more vegetables and fruits, dairy products. To nourish the body by taking vitamins, do not forget that you need to drink a lot of water (precisely purified, mineral water). Strengthen your body, reduce the amount of stress in your life, think more positively and your immune system will be strong for many years to come.
You care about your nutrition, health and immune system. Continue in the same spirit and health problems will not bother you for many years to come. Don't forget that this is mainly due to the fact that you eat right. Eat proper and healthy food (fruits, vegetables, dairy products), do not forget to consume a large number of purified water, harden your body, think positively. Just love yourself and your body, take care of it and it will definitely reciprocate your feelings.
How often do you eat fast food?
Do you eat healthy and nutritious food?
How often do you eat foods containing high amounts of sugar?
Are you spending fasting days or any other cleaning procedures?
How many times a day do you eat?
What type of people do you consider yourself to be?
How often do you eat baked goods and pasta made from light flour?
Do you eat a varied diet?
What products do you have for breakfast?
What time do you have breakfast?
Do you have food intolerances?
Do you take vitamins?
How much pure water do you drink per day?
Have you ever had food allergy?
What portions do you eat?
Are you taking antibiotics?
How often do you eat vegetables and fruits?
What kind of water do you drink?
How often do you consume fermented milk products?
Do you always eat at the same time?
An inflammatory disease of the respiratory system with a chronic course and the participation of different groups of cellular elements (T-lymphocytes, mast cells, eosinophils, macrophages, dendritic cells) is called bronchial asthma (BA). It’s as if “bronchial” is adjacent to the word “asthma”, because there is another disease - cardiac asthma. This pathology develops by a different mechanism, and a clarification has been added to distinguish one asthma from another. This text deals exclusively with bronchial asthma.
The disease is quite severe and complex. Its main element is considered to be obstruction (narrowing) of the bronchi. Buying it is much easier than living with it later. However, with timely initiation of treatment, the pathology can be controlled.
Bronchial asthma is caused for various reasons(external and internal), can occur either in a mild form or in an extremely severe form with complications, sometimes it can be controlled, sometimes it is problematic. Depending on these and a number of other factors, several classification signs of the disease have been developed.
The described disease belongs to the category of independent pathologies that interfere with normal breathing. The main mechanism in pathogenesis is considered to be impaired bronchial reactivity, which can be caused by factors:
Mandatory elements of the clinic for making a diagnosis of “bronchial asthma” are:
Attacks of asthma distinguish asthma from diseases such as obstructive and allergic bronchitis. Narrowing of the bronchi can be completely or partially reversible. The process normalizes spontaneously or as a result drug treatment. It is provoked by so-called triggers - factors of the external and internal environment (allergens, stress, strong odors, temperature changes), which trigger the mechanism of bronchial obstruction.
The possibility of self-liquidation of an attack depends on the severity of the disease.
The worsening of the pathological process caused by bronchial obstruction and suffocation is usually divided into stages:
In the first case, attacks bother the patient approximately 1 time/7 days, at night 1–2 times/month. The attacks are short and not severe.
The mild constant (persistent) form is characterized by the repetition of attacks up to several times every 7 days, night attacks occur at least once every 14 days, disturb sleep, and reduce the patient’s physical activity. With a pathology of moderate severity, attacks bother the patient every day. Night attacks are also not uncommon; sleep, activity and quality of life of an asthmatic are significantly deteriorated. A severe form of persistent asthma is characterized by daily daytime and nighttime attacks, the patient is incapacitated, physical activity minimal.
The patient may experience status asthmaticus (a life-threatening condition). It is characterized by:
From suffocation, if the attack is not stopped in a timely manner, the patient may die. With any degree of severity of the disease, it is possible to develop this complication. This is what makes asthma so scary. Moreover, status asthmaticus takes two forms:
The first is much more common and is characterized by slow development from hours to days. The main role in its development is the blockade of bronchial beta2 receptors by intermediate metabolites, sympathomimetics or catecholamines.
The second develops almost instantly directly during contact with the allergen. But, fortunately, the metabolic variant is less common. Triggers include antibiotics, NSAIDs, enzyme preparations, sulfonamides, drugs containing proteins). This form of status is characterized by general bronchospasm and asphyxia.
Sometimes the causes of the disease are obvious, in some cases they cannot be established. But in order to successfully combat the problem, you need to understand what provokes an attack of bronchial asthma. That is why there is a generally accepted classification. Can be classic shapes AD and its special types. Each is worth considering in more detail.
Depending on the factors that caused the disease, it is customary to distinguish the following forms of asthma: allergic (exogenous), non-allergic (endogenous), mixed origin, unspecified.
Bronchial asthma in its exogenous form develops as a result of allergens entering the respiratory system. This capacity may include:
In some cases, exogenous bronchial asthma occurs in a special form - atopic. In this case, the allergic reaction that caused the disease is genetically determined. That is, the patient had a predisposition, which was realized under the influence of provoking factors. It may be early or late. In the latter case, the attack does not begin immediately, but after 60 minutes from the moment of contact with the allergen. The irritant variant of the disease is diagnosed if exposure to certain chemicals provokes an attack, and exacerbations stop if the patient does not come into contact with an irritating chemical environment.
Endogenous bronchial asthma or non-allergic is caused by a number of external triggers:
A mixed version of the pathology can be provoked by a variety of triggers, both external and internal.
If endogenous asthma is infection-dependent, then not only exacerbation can act as a trigger bacterial infection, but also tobacco smoke. With this form of pathology, the following are distinguished:
Most often, the endogenous form of bronchial asthma develops in children prone to recurrent diseases of the upper respiratory tract. In this case, an asthmatic component is added to chronic bronchitis. With the development of the pathological process in this form, pronounced signs of COPD appear.
When the two forms described above are combined, they speak of mixed asthma. If it is impossible to determine the cause of the development of the pathological process, the disease will be designated in the diagnosis as unspecified.
This group includes several separate clinical and pathogenetic types of asthma:
For reflux-induced asthma trigger The reflux itself contributes to the development of the attack. More than half of asthmatic children are diagnosed with GER. It is believed that the pathogenesis of the disease is associated with microaspiration of gastric contents. Attacks of this type of pathology often disturb the patient at night.
Among pseudoallergic conditions, it is customary to distinguish aspirin asthma. This chronic inflammation bronchi, which is provoked by taking non-steroidal anti-inflammatory drugs (NSAIDs). The disease is more common in the adult population, and more patients are women. One of the unpleasant moments in the development of this type of disease is cross-reaction. This means that the attack will develop not only after taking acetylsalicylic acid, but also if you use other NSAIDs (Ibuprofen, Diclofenac, Indomethacin, Ketoprofen, Sulindac, Piroxicam, Naproxen, Mefenamic acid). Moreover, asthmatics with this type of illness need a strict diet, because natural salicylates contained in:
Such patients need to be especially careful when handling canned products. Because if it contains benzoin or salicylic acid, the body may react with an asthma attack. The same reaction is possible to products containing tartazine (a yellow dye).
The professional type of asthma most often affects medical staff, hairdressers, livestock breeders, veterinarians and bakers. The pathology is provoked by constant forced (due to professional activity) contact with allergens.
Bronchial asthma, provoked by physical stress, often worries patients with atopic disease. As a rule, it occurs with rare attacks. Rarely does a typical clinical picture unfold.
Forms of asthma are important for the competent development of therapeutic tactics. To adjust treatment, it is important to know how responsive the disease is to medication. In connection with this factor, the following forms are distinguished:
The first form includes asthma with no exacerbations and maintenance of normal basic parameters that are determined in asthma:
With controlled asthma, improvements are noticeable even in patients with severe forms of the disease. With a partially controlled pathological process, respiratory functions are lost by only 20%.
Attacks are recorded twice a week or more often. At least once a year, asthma worsens. With an uncontrolled form of the disease, the effectiveness of treatment is minimal. This indicates the need for a thorough study of the causes of the pathology and the lack of response to drug therapy.
Since the disease is chronic, it is difficult to even dream of healing. In this case, the main thing is to bring the disease from the exacerbation phase to remission. That is, we can also distinguish 2 forms of bronchial asthma:
The best option is to achieve stable remission by eliminating triggers from Everyday life person. If possible.
Having considered all the options for asthma, it remains to answer one more question that doctors regularly face: is congenital asthma possible, and what disease is considered acquired? Congenital asthma No. But, firstly, there are known precedents for the development of bronchial asthma in newborns (literally from the first days of life). Secondly, there may be cases of hereditary predisposition to this disease. In such a situation, the probability of developing pathology is 50%. In fact, any bronchial asthma is acquired. Quite often, various sources of information associate the endogenous variant of the pathology with acquired asthma.
The incidence of bronchial asthma has doubled in the last ten years in Moscow and some other Russian cities. This increase is among people born after 1960 and appears to be related to their lifestyle.
At one time it was believed that main reason– air pollution, however, other factors are likely more important. One is that children are much less exposed to environmental pathogens than in the past. The human immune system is not adapted to the current cleanliness and, as a result, develops incorrectly.
The influence of other factors is also possible, including the nutrition of infants, who are increasingly receiving artificial formula instead of mother's milk.
Causes of bronchial asthma
The current asthma epidemic mainly affects children, but this disease can develop at any age, especially if you already have another allergy. Both anomalies are caused by an inadequate immune response, or more precisely, a reaction mediated by antibodies from the immunoglobulin E group.
Allergies are combined with asthma in 90% of children and approximately half of adults. The characteristics of the immune system largely determine the extent of inflammation associated with an allergic reaction, including bronchial edema. Accordingly, they influence the severity and duration of asthmatic attacks.
The risk of developing asthma depends on various factors, including a genetic predisposition to allergies in general. If close relatives suffer from them, you should be careful. The risk of asthma increases with abundance in environment mites, as well as through inhalation of spores of a mold of the genus Alternaria common on plants.
Factors that provoke bronchial asthma
However, even people predisposed to asthma can avoid it by taking certain precautions.
Cigarette smoke is one of the main provocateurs of asthmatic attacks. Do not allow smoking in your home or car. Try to avoid tobacco smoke at work, when visiting, and in restaurants. Please note that its harmful substances remain for a long time in fabrics, that is, in your clothes, curtains, carpets, and upholstered furniture.
Formaldehyde vapors, which are irritating to the mucous membranes, are found in combustion products of tobacco and cooking gas. They are also produced by urea, a formaldehyde resin that serves as a binder in particle boards (chipboards) and fibreboards (fibreboards). After purchasing furniture made from them, give it time to air in the fresh air.
An alternative option is solid color. This will protect the slabs from moisture, at the same time reducing the release of formaldehyde. If you work with chipboard or fiberboard, wear a filter mask or respirator.
Symptoms of bronchial asthma
One of the main symptoms of bronchial asthma is suffocation. It is harder for the patient to exhale air from the lungs than to inhale. During an attack, breathing becomes wheezing, exhalation becomes clearly audible at a distance from the patient. This happens because the bronchi are spasmed and air has difficulty passing through them.
It occurs because a large amount of viscous sputum accumulates in the bronchi, which irritates the bronchi and causes painful, prolonged cough. which subsides only after the sputum “goes away”.
Bronchial asthma is characterized by attacks of exacerbation of the disease, which occur quickly and require immediate assistance to the patient, and periods of remission when the symptoms subside.
Diagnosis of bronchial asthma
If you suspect you have asthma, see your doctor when your symptoms worsen. All asthmatics should work with a specialist to create a plan to manage their condition. You must know when and how, firstly, to use preventive and emergency (that is, attack-stopping) medications, and secondly, measure the maximum expiratory flow rate.
Regular determination of this parameter using a portable peak flow meter allows you to predict the approach of an attack.
If you suspect bronchial asthma, you need to undergo a series of examinations. After examining and listening to the lungs, the doctor will prescribe you to undergo an X-ray examination of the lungs, external respiration function using a special device, with drug tests to determine the presence of bronchospasm.
In addition, sputum is examined to determine the presence of pathogens in it. It may be necessary to perform a bronchoscopy to clarify the diagnosis.
Both for diagnosis and for monitoring the course of bronchial asthma, and assessing the effectiveness of treatment, you will have to purchase a peak flow meter device. Your doctor will teach you how to use it yourself at home.
Treatment of bronchial asthma
Currently, the doctor has enough reliable and effective drugs for successful asthma control.
These are, first of all, drugs that dilate the bronchi and improve the passage of air through them. There are drugs with fast, but short action(they successfully stop attacks), as well as drugs that do not begin to act immediately, but for a long time.
These are all kinds of bronchodilators, mainly they are produced in the form of inhalers for instant delivery of medicine directly to the bronchi. The medications, doses and frequency of use of the medications are prescribed by the doctor after the examination.
In addition, so-called basic drugs must be used. Most often, these are hormonal inhalers. They will definitely be prescribed by your doctor; your task is to punctually follow these prescriptions.
It is these drugs that stop immune inflammation in the bronchi and allow asthma to be controlled. Thanks to the use of these drugs, it was possible to reduce the number of asthma exacerbations tens and hundreds of times, and almost get rid of the extreme stage of asthma exacerbation - bronchial status.
Currently, doctors are increasingly prescribing not liquid inhalers, but special powder nebulizers, which allow drugs to be sprayed most deeply into the bronchi and most effectively treat asthma.
Nebulizers are good and reliable assistants in the fight against bronchial asthma. These are small devices that use ultrasound to spray medications into the respiratory tract of a sick person.
Using a nebulizer, you can effectively relieve attacks of bronchial asthma and prevent exacerbations.
Bronchial asthma in children
Children who in the first months of life had various manifestations diathesis or have an unfavorable heredity to allergic diseases, have increased risk diseases of bronchial asthma.
Quite often, with the onset of puberty, the frequency of bronchial asthma attacks sharply decreases, and often stops completely.
Prevention of bronchial asthma
Experts are unanimous that air pollution is one of the main reasons for the growing number of asthmatics. The same factor increases the risk of chronic bronchitis, lung cancer and other respiratory diseases.
Although in Lately measures are being taken to reduce smoke and gas pollution major cities, poor atmospheric quality still remains a serious health threat.
A study in Sydney clearly demonstrated that the higher the level of air pollution, the more children with asthma attacks were admitted to city hospitals. Nitrogen and sulfur dioxides are especially dangerous for asthma.
Increased air pollution during the summer months also increases daily emergency department visits by older adults with other chronic respiratory diseases and myocardial ischemia. Citizens are mainly affected by three types of air pollution.
Below we will look at their sources, especially and measures that can minimize harm.
Alas, even the most careful man, going out onto a city street, inevitably encounters atmospheric pollutants that can cause or aggravate respiratory problems.
The main source of carbon monoxide (CO) is exhaust gases. This colorless and odorless product of incomplete combustion of fuel, binding to the hemoglobin of red blood cells, poisons it, reducing the amount of oxygen carried by the blood. As a result, all cells literally suffocate, which can be fatal.
On heavily polluted highways, the CO level is often higher than the officially permissible level. Particularly dangerous is the one caused carbon monoxide oxygen deprivation for people with congestive heart failure, a chronic disease in which a weak heart pushes too little blood into the arteries.
Even an acceptable concentration of CO in the atmosphere can aggravate their symptoms so much that hospitalization is required. A short-term impact high levels CO can cause an attack of angina in people with coronary heart disease, even with minor exertion.
Proper maintenance helps reduce CO concentrations in the ambient air. own car. This gas is burned in the catalyst to form harmless CO2, but can leak from the engine pipelines, therefore, the condition of the cylinder and exhaust system must be regularly checked.
However, you can get burned even with a normal level of CO in the exhaust if you stay in a stationary running car for a long time or even next to it. If you turn on the ignition in the garage, the garage door must be fully open.
Also make sure that exhaust gases do not enter your home. In tunnels and enclosed parking lots, keep car windows tightly closed. If you smoke, quit – cigarette smoke contains a high concentration of carbon monoxide.
Ozone in top layer The atmosphere (stratosphere) forms a screen that protects us from deadly ultraviolet radiation. However, in the surface air (troposphere) its role is completely different.
Here, ozone (phytochemical smog) is a secondary pollutant that is formed when sunlight acts on combustion gases emitted into the air by cars, industrial plants and other sources. Obviously, it is greatest on clear, windless days on busy streets.
Ozone is highly irritating to the respiratory tract. In high concentrations, it prevents you from taking a deep breath, causing coughing, sore throat and other unpleasant sensations. According to some data, ozone reduces resistance to respiratory diseases, affects the lungs and aggravates their chronic pathologies.
The severity of these effects is proportional to its concentration in the air, the time of exposure and the intensity of breathing. During physical activity, it becomes more frequent, therefore, in an ozone-polluted atmosphere, the lungs suffer more severely. Jogging when the air is full of photochemical smog, even healthy people may suffer from difficulty breathing.
Try to stay in a cool, well-ventilated area on days with poor air quality. Children because of their increased activity more sensitive than adults to ozone pollution. During periods with maximum levels of photochemical smog (windless summer days), plan their walks in the morning, when the air is still relatively clean.
It’s as if “bronchial” is adjacent to the word “asthma”, because there is another disease - cardiac asthma. This pathology develops by a different mechanism, and a clarification has been added to distinguish one asthma from another. This text deals exclusively with bronchial asthma.
The disease is quite severe and complex. Its main element is considered to be obstruction (narrowing) of the bronchi. Buying it is much easier than living with it later. However, with timely initiation of treatment, the pathology can be controlled.
Bronchial asthma is caused by various reasons (external and internal), it can occur either in a mild form or in an extremely severe form with complications, sometimes it can be controlled, sometimes it is problematic. Depending on these and a number of other factors, several classification signs of the disease have been developed.
The described disease belongs to the category of independent pathologies that interfere with normal breathing. The main mechanism in pathogenesis is considered to be impaired bronchial reactivity, which can be caused by factors:
Mandatory elements of the clinic for making a diagnosis of “bronchial asthma” are:
Attacks of asthma distinguish asthma from diseases such as obstructive and allergic bronchitis. Narrowing of the bronchi can be completely or partially reversible. The process normalizes spontaneously or as a result of drug treatment. It is provoked by so-called triggers - factors of the external and internal environment (allergens, stress, strong odors, temperature changes), which trigger the mechanism of bronchial obstruction.
The possibility of self-liquidation of an attack depends on the severity of the disease.
The worsening of the pathological process caused by bronchial obstruction and suffocation is usually divided into stages:
In the first case, attacks bother the patient approximately 1 time/7 days, at night 1–2 times/month. The attacks are short and not severe.
The mild constant (persistent) form is characterized by the repetition of attacks up to several times every 7 days, night attacks occur at least once every 14 days, disturb sleep, and reduce the patient’s physical activity. With a pathology of moderate severity, attacks bother the patient every day. Night attacks are also not uncommon; sleep, activity and quality of life of an asthmatic are significantly deteriorated. The severe form of persistent asthma is characterized by daily daytime and nighttime attacks, the patient is incapacitated, and physical activity is minimal.
The patient may experience status asthmaticus (a life-threatening condition). It is characterized by:
From suffocation, if the attack is not stopped in a timely manner, the patient may die. At any severity of the disease, the development of this complication is possible. This is what makes asthma so scary. Moreover, status asthmaticus takes two forms:
The first is much more common and is characterized by slow development from hours to days. The main role in its development is the blockade of bronchial beta2 receptors by intermediate metabolites, sympathomimetics or catecholamines.
The second develops almost instantly directly during contact with the allergen. But, fortunately, the metabolic variant is less common. Triggers include antibiotics, NSAIDs, enzyme preparations, sulfonamides, drugs containing proteins). This form of status is characterized by general bronchospasm and asphyxia.
Sometimes the causes of the disease are obvious, in some cases they cannot be established. But in order to successfully combat the problem, you need to understand what provokes an attack of bronchial asthma. That is why there is a generally accepted classification. There may be classic forms of asthma and its special types. Each is worth considering in more detail.
Depending on the factors that caused the disease, it is customary to distinguish the following forms of asthma: allergic (exogenous), non-allergic (endogenous), mixed origin, unspecified.
Bronchial asthma in its exogenous form develops as a result of allergens entering the respiratory system. This capacity may include:
In some cases, exogenous bronchial asthma occurs in a special form - atopic. In this case, the allergic reaction that caused the disease is genetically determined. That is, the patient had a predisposition, which was realized under the influence of provoking factors. It may be early or late. In the latter case, the attack does not begin immediately, but after 60 minutes from the moment of contact with the allergen. The irritant variant of the disease is diagnosed if exposure to certain chemicals provokes an attack, and exacerbations stop if the patient does not come into contact with an irritating chemical environment.
Endogenous bronchial asthma or non-allergic is caused by a number of external triggers:
A mixed version of the pathology can be provoked by a variety of triggers, both external and internal.
If endogenous asthma is infection-dependent, then not only an exacerbation of a bacterial infection, but also tobacco smoke can act as a trigger. With this form of pathology, the following are distinguished:
Most often, the endogenous form of bronchial asthma develops in children prone to recurrent diseases of the upper respiratory tract. In this case, an asthmatic component is added to chronic bronchitis. With the development of the pathological process in this form, pronounced signs of COPD appear.
When the two forms described above are combined, they speak of mixed asthma. If it is impossible to determine the cause of the development of the pathological process, the disease will be designated in the diagnosis as unspecified.
This group includes several separate clinical and pathogenetic types of asthma:
For reflux-induced asthma, the trigger mechanism for the development of an attack is the reflux itself. More than half of asthmatic children are diagnosed with GER. It is believed that the pathogenesis of the disease is associated with microaspiration of gastric contents. Attacks of this type of pathology often disturb the patient at night.
Among pseudoallergic conditions, it is customary to distinguish aspirin asthma. This is a chronic inflammation of the bronchi, which is provoked by taking non-steroidal anti-inflammatory drugs (NSAIDs). The disease is more common in the adult population, and more patients are women. One of the unpleasant moments in the development of this type of disease is cross-reaction. This means that an attack will develop not only after taking acetylsalicylic acid, but also if other NSAIDs are used (Ibuprofen, Diclofenac, Indomethacin, Ketoprofen, Sulindac, Piroxicam, Naproxen, Mefenamic acid). Moreover, asthmatics with this type of illness need a strict diet, because natural salicylates contained in:
Such patients need to be especially careful when handling canned products. Because if it contains benzoic or salicylic acid, the body may react with an asthma attack. The same reaction is possible to products containing tartazine (a yellow dye).
The professional type of asthma most often affects medical staff, hairdressers, livestock breeders, veterinarians and bakers. The pathology is provoked by constant forced (due to professional activity) contact with allergens.
Bronchial asthma, provoked by physical stress, often worries patients with atopic disease. As a rule, it occurs with rare attacks. Rarely does a typical clinical picture unfold.
Forms of asthma are important for the competent development of therapeutic tactics. To adjust treatment, it is important to know how responsive the disease is to medication. In connection with this factor, the following forms are distinguished:
The first form includes asthma with no exacerbations and maintenance of normal basic parameters that are determined in asthma:
With controlled asthma, improvements are noticeable even in patients with severe forms of the disease. With a partially controlled pathological process, respiratory functions are lost by only 20%.
Attacks are recorded twice a week or more often. At least once a year, asthma worsens. With an uncontrolled form of the disease, the effectiveness of treatment is minimal. This indicates the need for a thorough study of the causes of the pathology and the lack of response to drug therapy.
Since the disease is chronic, it is difficult to even dream of healing. In this case, the main thing is to bring the disease from the exacerbation phase to remission. That is, we can also distinguish 2 forms of bronchial asthma:
The best option is to achieve stable remission by eliminating triggers from a person’s daily life. If possible.
Having considered all the options for asthma, it remains to answer one more question that doctors regularly face: is congenital asthma possible, and what disease is considered acquired? There is no congenital asthma. But, firstly, there are known precedents for the development of bronchial asthma in newborns (literally from the first days of life). Secondly, there may be cases of hereditary predisposition to this disease. In such a situation, the probability of developing pathology is 50%. In fact, any bronchial asthma is acquired. Quite often, various sources of information associate the endogenous variant of the pathology with acquired asthma.
Bronchial asthma is considered a chronic disease with frequent relapses and with the obligatory symptom of suffocation, due to spasm and/or swelling of the bronchial mucosa.
The main cause of an attack of bronchial asthma is acquired increased sensitivity (sensitization) to external irritants (for example, allergens), which causes the immune system to protect the body, even with harmless influences, which, in turn, leads to an allergic reaction, and - bronchospasm, swelling of the bronchi and asthma attack.
The main signs and symptoms of bronchial asthma in adults and children are suffocation, wheezing whistling when breathing, shortness of breath, a feeling of chest congestion, cough - in some cases there may be other allergic reactions, such as urticaria, Quincke's edema, food allergies..., maybe be sinusitis (inflammation paranasal sinuses nose) and polyposis (polyps - benign neoplasms in the nose), which speaks of the so-called asthmatic triad (aspirin-induced bronchial asthma).
During a prolonged attack, pain in the lower chest may occur due to tension in the diaphragm, cyanosis of the skin and mucous membranes, and palpitations.
A common symptom of bronchial asthma in children is a cough, usually at night, but it can also be bronchitis.
Any treatment, including bronchial asthma, begins with diagnosis and examination. An experienced doctor can make a preliminary diagnosis based on symptoms and signs that indirectly prove the presence of asthmatic disease. But in order to prescribe adequate and most effective treatment for asthma, the doctor may refer you for additional examination.
Symptomatic treatment- the use of bronchodilators (or bronchodilators - medicinal dilators of the bronchi during their spasm and narrowing due to inflammation) during an asthma attack in the form of suffocation.
Medicines against bronchospasm, asthma allergic origin- these are glucocorticoids used as a strong antiallergic drug, usually used when other drugs do not help (usually in severe forms of the disease):
These medications are used only as prescribed by a doctor.
Basic treatment of asthmatic disease:
Other methods of drug treatment of bronchial asthma are also used - according to indications after a complete diagnosis.
The type, degree and severity of bronchial asthma will be determined by professional diagnosis of the disease, on the basis of which a method of basic treatment, prevention and increase in remission will be determined for you..., right up to complete recovery.
What people especially pay attention to when diagnosing “bronchial asthma”:
Also, a preliminary diagnosis can be made based on the general clinical picture (take an asthma test online)
It is possible to get bronchial asthma at any age - it depends on various external (exogenous) and internal (endogenous) factors.
People who are obese are more likely to develop asthmatic disorder.
The main substances that activate exacerbation of asthma are allergens, pollutants and non-steroidal anti-inflammatory drugs.
Especially, the listed allergens affect the disease of asthma in children under 3 years of age.
Non-steroidal anti-inflammatory drugs, such as aspirin (acetylsalicylic acid), can also provoke bronchial asthma and other allergic reactions.
This diagnostic bronchial asthma is based on the same signs and symptoms of the disease that your doctor will diagnose at your appointment (a doctor, of course, is better).
In the results you will see a preliminary diagnosis, but the main and accurate diagnosis, which will show the type, degree and severity of bronchial asthma, is possible only after full examination in the clinic as prescribed by a doctor.
Attention! Only after complete medical diagnostics and only a specialist (doctor) can prescribe adequate pharmacological treatment bronchial asthma.
Emergency care during an attack of bronchial asthma consists, first of all, in providing medical care: As a rule, asthmatics already have special inhalers that relieve bronchospasms and/or other antiallergic (antihistamine) drugs and others pharmacological agents, often prescribed individually by a doctor.
Secondly, by eliminating the provoking source, usually a person with asthmatic attack must leave the room where there is an allergen or other provocateur, for example cold air, or, during physical activity, go into a state of rest...
If necessary, call an ambulance and/or go to a medical facility.
The first psychological aid for an asthma attack is to provide emotional support and possible reassurance to a person experiencing stress and possibly fear of death from suffocation...
It is important for the person providing psychological support be more or less calm (especially for parents of small children), because With your fears and worries, you can increase the patient’s feelings and attack of bronchial asthma (and in a child, fix in his head the expectation of something terrible and terrible).
An extremely effective method of treating bronchial asthma exogenous (external), allergic type is psychoanalysis and psychotherapy. This can often be combined with medication, drug therapy, especially on initial stage psychotherapeutic intervention.
The thing is that many, acquired in childhood or during adult life, allergic diseases, including exogenous asthma, often become chronic, with short remission and constant relapses, precisely because of psychogenic factors.
For example, a person, as a small child, lived in conditions that provoke the disease bronchial asthma (constant influence of allergens due to the environment, poor nutrition, polluted or vice versa, ultra-clean rooms washed with bleach, etc.) and he developed a certain disease, manifested only in the form of cough, especially at night.
Doctors suspected bronchitis or asthma, maybe others allergic manifestations and said “horror things” to the parents, who, greatly frightened and worried, passed on their fear to the child - the emotion of fear was fixed with its source, as it were, a cough, and remained for many years in the subconscious.
Having experienced stress, fear and nervous shock, the child, as he grows up and becomes stronger psychological reactions Even with an ordinary, non-pathological cough, he began to “wind up” and intensify his fears and, along with them, allergic and asthmatic manifestations.
The allergy began to develop almost in geometric progression, having brought the disease to attacks of suffocation and the inability to tolerate the most harmless allergens, the disease began to be psychosomatic in nature, although it was still treated with pharmacology (which, of course, did not lead to success).
Then it could come to panic attacks, intensifying the attacks, sometimes to such an extent that the usual medications no longer helped... which caused new stress and fears. As a result, a vicious circle of panic could form (fear of the fears themselves, activating bronchial asthma and/or other allergies out of nowhere.
In other words, the key to triggering asthma attacks is not in the body, which reacts to allergen irritants, but in the psyche, or more precisely, in the subconscious.
In short, psychotherapeutic treatment of exogenous, allergic asthma in many cases leads to success - full recovery, and in extreme, severe cases - to complete control of attacks with a minimum of medications.
If you want to finally get rid of bronchial asthma and other allergies, contact a psychoanalyst online (make an appointment on the main page of the website http://Psychoanalyst-Matveev.RF)
Psychological assistance, online consultation with a psychologist: psychoanalysis, psychotherapy
Bronchial asthma today does not have any generally accepted definition, but despite this, there are certain criteria underlying this disease, on the basis of which it is, in fact, distinguished. Bronchial asthma, the symptoms of which distinguish it as a chronic relapsing disease, is accompanied by a predominant lesion of the respiratory tract with a concomitant change in bronchial reactivity against the background of the influence of an immunological and/or immunological mechanism.
This definition of the disease, which we will consider today, is, of course, extremely general, and precisely in order to clarify in more detail general provisions According to it, we, in fact, invite you to familiarize yourself with the contents of this article.
So, first of all, we note that bronchial asthma is characterized by certain clinical manifestations, such as an attack of suffocation, as well as current asthmatic status. And if the reader can form a certain idea “offhand” based on what an attack of suffocation is, then the asthmatic status in highlighting the signs accompanying bronchial asthma requires appropriate explanation.
Thus, status asthmaticus is such a severe complication of the disease in question that it poses a serious threat to life for the patient. Status asthmaticus develops, as a rule, against the background of a long-term uncorrectable (unremovable) attack of bronchial asthma, accompanied by swelling of the bronchioles and the concomitant accumulation of thick sputum in them, due to which, in turn, an increase in the attack of suffocation occurs in combination with hypoxia. Hypoxia is a condition accompanied by a decrease in oxygen content in the body or a decrease in it in separately considered tissues/organs. Against the background of the processes accompanying it, vital organs experience a number of irreversible changes, including to the greatest extent the liver, heart, central nervous system, kidneys. Status asthmaticus, which initially interests us, requires the immediate implementation of intensive care measures; it is also important to take into account the fact that this condition has a 5% mortality rate.
As for the prevalence of bronchial asthma, it is largely determined by natural and climatic conditions relevant to the patient’s place of residence. What is noteworthy is that in developed countries, the incidence rate significantly exceeds the number of cases in comparison with the indicators obtained for underdeveloped countries. According to various data, the prevalence of the disease in the adult population ranges from 6%. A significant cause for concern is the fact that there are many different undetected forms of the disease we are considering. This mainly includes mild forms, masked under diagnoses such as “chronic (obstructive) bronchitis.” For children, the incidence reaches even higher rates, exceeding 20% in some regions. Similarly, for children, there is an undetected form of the disease; accordingly, the rates for such morbidity are even higher. Additionally, we can add that in recent years there has been an increase in incidence, which is relevant both for our country and for foreign countries.
The basis for the development of bronchial asthma is the following: pathogenetic mechanism, in which hypersensitivity of an immediate type of manifestation develops, such a mechanism is most often triggered at the basis of allergic diseases. It is characterized by the fact that from the moment the allergen enters until the moment when symptoms corresponding to the disease begin to develop, a minimum of time passes - it’s almost a matter of minutes. This option, however, is relevant only for those patients who have appropriate sensitization to a specific substance (that is, an allergic predisposition to it). Thus, a patient with bronchial asthma with a current allergy to cat fur, finding himself in an apartment in which a cat lives, begins to experience the corresponding manifestations of the disease, which consist in the occurrence of an attack of suffocation.
Bronchial asthma can develop due to the relevance of a number of the following predisposing factors:
Considering these factors in a slightly more abbreviated version, it is possible to determine a classification for them in accordance with the principles of influence. So, if attacks occur against the background of exposure to an allergen that enters the respiratory tract through external environment(molds, animal hair, dust mites, plant pollen, etc.), this, in turn, determines exogenous bronchial asthma. Atopic bronchial asthma, provoked by a hereditary predisposition, is considered as a special variant of exogenous asthma. If attacks develop against the background of exposure to factors such as physical activity, infections, psycho-emotional effects or exposure to cold air, then we are talking about a form of the disease such as endogenous bronchial asthma. And, finally, a combination of influencing factors for both of these forms of asthma, that is, when exposed to these factors and when exposed to an allergen on the respiratory tract, an option such as bronchial asthma of mixed origin is considered.
Bronchial asthma can develop according to two main variants of manifestation, which distinguishes two corresponding states for it, this is the state of pre-asthma and the clinically defined state of bronchial asthma. The state of pre-asthma (we will discuss it in more detail below) is a condition in which there is a threat of developing asthma, which is important for acute or chronic forms of bronchitis, for pneumonia (acute or chronic), for vasomotor edema, urticaria, vasomotor rhinitis, neurodermatitis, migraine and some combinations of these conditions. As for the indicated clinically defined condition, bronchial asthma itself, here we are already talking about asthma itself, indicated by the appearance of the patient’s first attack or by identifying the corresponding status for this disease.
Depending on the current pathogenetic features that provoked bronchial asthma, the following variants of the mechanisms of development of this disease are distinguished. In particular, this is an atopic mechanism, in which a specific allergen/allergens is indicated, an infection-dependent mechanism, in which specific infectious agents are indicated, and the features of the nature of the infectious dependence are also highlighted, an autoimmune mechanism, a dishormonal mechanism (in this case, a specific endocrine organ, undergoing changes in its functions). In addition, this is a neuropsychiatric mechanism, the identification of the characteristics of which is accompanied by the definition of a specific type of neuropsychiatric disorder. Other types of mechanisms, including their combinations, are also allowed.
Depending on the severity of symptoms, bronchial asthma can manifest itself in the following ways:
There are also separate phases during the course of the disease, these are an exacerbation phase, a subsiding exacerbation phase, and a remission phase.
Bronchial asthma can, like other diseases, provoke certain complications. Thus, complications of bronchial asthma are divided into two main groups, these are pulmonary complications (pulmonary failure, emphysema, pneumothorax, etc.), as well as extrapulmonary complications (heart failure, cor pulmonale, myocardial dystrophy, etc.).
Preasthma: symptoms, main features
We will consider the symptoms of bronchial asthma below; as another part of this disease that has not yet been considered, we still have the state of pre-asthma, so we will highlight the main features that characterize it. First of all, we note that preasthma is characterized by the presence of several main groups of symptoms, there are four in total: clinical symptoms, laboratory symptoms, functional symptoms and anamnestic symptoms.
Clinical symptoms imply the appearance in patients of symptoms accompanying bronchitis, as well as the appearance of allergic type syndromes. In the vast majority of cases, patients in a state of pre-asthma already have a chronic form of obstructive bronchitis, less often they are diagnosed with asthmatic chronic bronchitis, as well as recurrent bronchitis.
Patients with obstructive chronic bronchitis in a state of pre-asthma differ from those patients who also develop this condition, but with asthmatic or recurrent bronchitis, the differences, in particular, lie in gender and age characteristics, as well as in the nature of the course of their disease. These are mainly men belonging to the older age group, that is, their age ranges from 47 years. For the most part, this group of patients has been in unfavorable conditions for a long time due to the characteristics of their professional activity, or they have a long “experience” in terms of exposure to a slightly different factor, such as in this case smoking is considered. Basically, when studying such patients, it was determined that their cough preceded the development of a pre-asthma state, a medicinal form of allergy was often diagnosed, and sometimes there was a hereditary predisposition to allergic diseases.
As for patients in a state of pre-asthma with actual asthmatic or recurrent bronchitis, this group of patients mainly includes women of a young age group (32-35 years), without exposure to factors in the form of hazardous industries or smoking. In this case, according to the results of a study of patients, a significant role is assigned to the hereditary factor in relation to allergic diseases, this factor is especially relevant for asthmatic bronchitis. These patients mostly had some form of allergy. Thus, for more than half of them, food allergies were relevant, in a third of patients polyallergy was relevant, and in a slightly rarer number of cases, an existing drug allergy was diagnosed.
Allergic syndromes diagnosed in patients as part of pre-asthma are reduced mainly to the occurrence of vasomotor rhinitis (about 65% of patients), as well as urticaria (on average about 56%). Quincke's edema occurs much less frequently (about 9%), as well as migraine (on average, 3% of patients).
In general, the condition of pre-asthma, based on some available data, is relevant on average for the adult population ranging from 5 to 10%. Based on data obtained during a 15-year follow-up period, it was found that approximately 18% of patients with pre-asthma subsequently acquired bronchial asthma. This, in turn, allows us to assert that the risk of such a transformation is quite real for the general group of patients with pre-asthma. What is noteworthy is that for the indicated number of patients in whom such a transformation took place, appropriate treatment measures were implemented, which, apparently, did not turn out to be effective for the subsequent development of the disease. The risk of transition from pre-asthma to bronchial asthma also increases when this condition is reinforced by factors that aggravate it (the reasons that provoke the disease, which we discussed earlier).
The main symptoms of the disease are the following: difficulty breathing, turning into an attack of suffocation, the appearance of whistling or wheezing in the chest. Increased whistling may occur during deep breathing. A fairly common sign of bronchial asthma is also paroxysmal cough, mainly by the nature of the manifestation, such a cough is dry, but it is also possible for a certain amount of light-colored sputum to be discharged, which in particular occurs towards the end of the attack. In addition, we note that a dry paroxysmal cough may be the only sign on the basis of which one can suspect bronchial asthma in a patient. If the disease manifests itself in this way, then bronchial asthma is divided into a separate, cough form.
Moderate severity of bronchial asthma, as well as severe severity, can determine such an additional symptom of this disease as shortness of breath. It occurs during physical activity, and its intensification is observed during exacerbation of asthma.
What is noteworthy is that it often happens that the symptoms of the disease appear only during periods of exacerbation, thus being absent the rest of the time. Exacerbations themselves can develop at any time of the day, but exacerbations at night are practically “classical”. This is accompanied by the identification of factors by the patient himself, aggravation of provoking ones, which, for example, may consist of being at a particular moment in a room in which there are animals, in a dusty room, as well as in a room in which cleaning is being carried out, etc.
Some patients (this is especially true for pediatric patients) experience seizures after undergoing significant physical activity. This variant of the manifestation of asthma distinguishes it into its corresponding form - this is asthma of physical exertion. Meanwhile, this definition is somewhat outdated, therefore also attacks directly related to physical activity, and, accordingly, asthma, is usually defined as bronchoconstriction.
Periods of exacerbation in patients are combined with a more intense reaction to non-specific irritants, which are considered, for example, the smell of smoke, temperature changes, strong odors etc. This feature indicates the activity of the inflammatory process in the bronchi, which, in turn, determines the need for the implementation of appropriate measures of drug therapy.
As for the frequency of exacerbations, it is based on the specific type of allergen that provokes the reaction, as well as how often the patient comes into contact with such an allergen. For example, an allergy to pollen determines for patients a clearly traceable seasonality of exacerbations for the corresponding periods (spring/summer).
While listening to the patient, his weakened state is revealed vesicular respiration, as well as the presence of a whistling type of wheezing. During periods not associated with exacerbation of the disease, such listening may not have any specific features. As characteristic symptom, accompanying the manifestations of bronchial asthma, the apparent effectiveness achieved through the use of antihistamines, and especially when inhaled using drugs that promote bronchodilation, is considered.
Let us dwell in more detail on an attack of suffocation, or more precisely, on what it is and how, in fact, it manifests itself. During an attack of suffocation during bronchial asthma, the patient takes a forced position, leaning forward slightly and holding the table or nearby objects with his hands, the upper shoulder girdle is in an elevated position. The chest also changes - it becomes cylindrical in shape. The patient's short breaths are accompanied by painful exhalations that do not bring relief, combined with wheezing. Breathing in general requires the involvement of auxiliary muscles from the chest, abdominals and shoulder girdle. There is an expansion of the intercostal spaces, their elongation and horizontal location.
An attack of suffocation can also be preceded by the so-called aura of an attack. By aura in general we mean the appearance of any experiences or sensations regularly occurring before attacks (epilepsy, asthma, etc.), in fact, the aura itself can also act in certain cases as an attack. Returning to the aura accompanying an attack of bronchial asthma, we note that it can manifest itself in the form of coughing, sneezing, runny nose, and hives.
The attack itself, as already noted, may be accompanied by a cough with a certain amount of sputum, which can also be separated towards the end of the attack. Gradually, as the patient loses sputum during an attack, wheezing appears less frequently, and breathing becomes more difficult. It should also be noted that wheezing may not appear at all, which is important for patients with severe exacerbations against the background of severe limitation of ventilation and air flow. Periods of exacerbation may be accompanied by cyanosis (blueness of the skin and mucous membranes), tachycardia (rapid heartbeat), drowsiness and difficulty speaking. The already noted bloating of the chest occurs due to an increase in lung volumes, that is, due to the need to ensure expansion of the airways while simultaneously opening small bronchi.
Also, the already discussed variant of cough bronchial asthma is most relevant for children; more often it manifests itself at night in the absence of manifestations in daytime. Bronchial asthma, attacks of which occur as a result of physical stress, is characterized by some additional features. Attacks generally occur 5-10 minutes after the end of physical stress during exertion, only in rare cases an attack occurs directly during it. In some cases, patients experience a prolonged coughing attack that ends spontaneously within the next few minutes. Seizures primarily occur when running; inhalation of cold, dry air plays a special role in this case. The diagnosis of “bronchial asthma” is indicated, again, by the influence of specific drugs used for attacks, in particular (inhalation); the main diagnostic method for identifying this type of bronchial asthma is an 8-minute run test.
This disease can develop in children regardless of belonging to a specific age group, but most often the manifestation of the disease occurs after 1 year. The risk of developing bronchial asthma is especially high in children with a hereditary history of allergic diseases, as well as in those children who have already had allergic diseases in the past. Often, bronchial asthma is masked in children under obstructive bronchitis, and therefore if there are four episodes of obstructive bronchitis within one year, then this situation can be considered as a signal for a subsequent urgent visit to an allergist.
In case of an existing disease, the main measures of influence are reduced to eliminating or minimizing exposure to allergens while simultaneously creating a hypoallergenic environment during pregnancy. Smoking, both its active and passive forms, must be excluded. Treatment measures are determined based on the severity of the disease.
For example, in mild and episodic cases, drugs that promote bronchi dilatation are prescribed; their use is based on individual needs. Atrovent is preferable in this embodiment.
The next variant of the course of bronchial asthma is a persistent mild form of bronchial asthma. In this case, sodium cromoglycate (inhalation form) is prescribed - Tailed, Intal. The lack of effectiveness when using drugs of this type requires replacement, which comes down to the use of inhaled glucocorticosteroids in small dosages. For patients during pregnancy, budesonide and beclomethasone derivatives are considered the most preferable options for use. In addition, a different type of corticosteroid may be considered for patients who have achieved successful disease control with corticosteroids before becoming pregnant.
For moderately severe disease, average dosages of inhaled forms of corticosteroids are prescribed.
A special place is occupied by the severe form of bronchial asthma. In this case, high doses of corticosteroids are prescribed in inhaled form. If necessary, use large dosages inhaled corticosteroids During pregnancy, budesonide and its derivatives are considered the most preferable option. Tablets of corticosteroids (in particular, prednisolone) are also allowed to be prescribed in accordance with an intermittent regimen of its consumption.
Childbirth should take place exclusively in a hospital setting. Immediately upon admission of a woman in labor to the maternity hospital, electronic monitoring of the fetus is provided, but this condition can be excluded as mandatory if it is possible to achieve a sufficiently effective degree of control of bronchial asthma. Assessment of respiratory function is carried out from the very beginning of labor in a woman in labor, then every 12 hours from the moment of delivery. With sufficient pain relief, the risk of possible development of suffocation attacks in women in labor directly during labor is reduced. If there is a need for a cesarean section, then the most preferable option is epidural anesthesia, the analgesic used for this is fentanyl. It is better if delivery occurs naturally - a caesarean section determines quite high risks for possible exacerbation of bronchial asthma.
Regarding the period breastfeeding, then it consists in implementing anti-asthma therapy measures during pregnancy. An undesirable option for use is Theophylline, as well as its derivatives, which is caused by the direct toxic effect it has on the fetus.
Diagnosis of bronchial asthma upon the appearance of a primary attack requires testing standard type tests, and this is a blood test (for sugar, biochemical and general analysis), a urine test. To identify or exclude concomitant cardiac pathologies, an ECG is performed. Fluorography is also considered as a mandatory further measure of general diagnostics. In case of a productive cough (that is, with a cough that is accompanied by the release of sputum from the patient), a general sputum analysis is performed. If there is a predisposition to frequent occurrence of diseases infectious nature in the respiratory tract area, it is also necessary to take a sputum test - this time to study its microflora with the concomitant identification of the degree of sensitivity to antibiotics. A dry paroxysmal cough requires taking a smear from the patient for the presence of fungus.
As a mandatory research method, a method is considered in which the study of external respiration functions is carried out, it is called spirography. During this diagnostic method, the patient needs to breathe into a tube connected to special equipment. There are some recommendations for this procedure, in particular, they consist in the exclusion of inhalers (Berotek, salbutamol, etc.) and bronchodilators (euphilin, etc.) before it is carried out. In addition, you should also exclude smoking before this procedure (here, of course, some addition can be made: smoking, in principle, is not recommended for those patients who have certain bronchopulmonary diseases). Spirography is indicated for patients aged 5 years and older.
If the patient is suspected of having bronchial asthma, a special test is performed using bronchodilators. It consists of performing spirography, then several inhalations (salbutamol or an analogue), then repeated spirography. The main goal in this scheme is to determine the degree of bronchial patency caused by the influence of this group of drugs.
A somewhat more simplified and also much more accessible method is peak flowmetry using an apparatus that determines maximum speed exhalation produced by the patient. Such a device is purchased for independent daily monitoring; it does not require additional consumables, and its cost is quite affordable. The indicators obtained when using it are compared with a table of reference values. The main advantage of using this device is that it can be used to determine in advance when an exacerbation of the disease will begin - the peak expiratory flow rate decreases several days before it actually begins to manifest itself. In addition, this method allows not only to diagnose an upcoming exacerbation, but also makes it possible to objectively monitor the course of bronchial asthma.
Based on the significant prevalence of diseases accompanying bronchial asthma affecting the nasopharynx area, it is additionally recommended to visit an otolaryngologist, as well as monitor the condition of the paranasal sinuses (X-ray).
An extremely important direction in examining patients for bronchial asthma is a study focused on identifying specific allergens that provoke the patient through contact with them. allergic inflammation. Testing is carried out to determine sensitivity to the main groups of allergens (fungal, household, etc.). For this purpose, the staging method can be used skin tests or a blood test for the presence of a specific type of immunoglobulin.
Treatment of bronchial asthma can be based on the use of several main groups of medications, which we will consider below. Dosing, duration of use and the possibility of combination - all these points are determined in each specific case by the attending physician, based on the severity of the disease and other factors accompanying its course. Separately, we note that today the most dominant principle of treatment is the principle in which the methods of treating bronchial asthma and, in fact, the measures taken to address this disease are subject to review every three months and, if necessary, adjustments. As for specific drugs used in the treatment of bronchial asthma, these include the following:
One of the most important areas in the treatment of the disease we are considering is the implementation of allergen-specific immunotherapy, aimed at achieving immunity to the effects of allergens that provoke the development of inflammation and an allergic reaction in the patient. Such therapy is carried out exclusively by a specialist, during the non-exacerbation period (mainly in autumn/winter). This therapy consists of administering allergen solutions to patients while gradually increasing their dosages, which, in turn, leads to the gradual development of tolerance to them. The earlier such therapy is started, the more effective the results are.
If symptoms indicating bronchial asthma appear, you should contact an allergist-immunologist, pulmonologist or your attending pediatrician/general practitioner.
If you think that you have bronchial asthma and the symptoms characteristic of this disease, then doctors can help you: an allergist, a pulmonologist, a pediatrician.
We also suggest using our online disease diagnostic service, which selects probable diseases based on the entered symptoms.
Barrett's esophagus, also called Barrett's metaplasia, is a serious complication of gastroesophageal reflux disease (GERD). Moreover, it is Barrett's esophagus, the symptoms of which we will look at in this article, that is identified as a major risk factor for the subsequent development of esophageal cancer.
The allergy condition is increased sensitivity, which the body possesses, manifested in a kind of specific reaction that occurs in response to contact with certain elements that act as allergens in the environment. Allergy to dust, the symptoms of which we will consider below, is one of the most common types of allergies, and it is observed in about 80% of patients diagnosed with bronchial asthma, as well as in 46% of patients diagnosed with allergic rhinitis and conjunctivitis.
Asthma is a chronic disease characterized by short-term attacks of breathlessness caused by spasms in the bronchi and swelling of the mucous membrane. A certain risk group and age restrictions this disease does not. But, as medical practice shows, women suffer from asthma 2 times more often. According to official data, today there are more than 300 million people with asthma in the world. The first symptoms of the disease most often appear in childhood. Elderly people suffer from the disease much more difficult.
Tracheitis and bronchitis are often interrelated, combining into one pathological condition– tracheobronchitis. This is a disease, as a result of which the inflammatory process covers the trachea and bronchi. According to ICD-10, the disease is coded J06-J21. It can only be fully cured in a hospital setting. Self-medication using folk remedies (without a doctor’s prescription) is unacceptable.
Bronchiolitis is an inflammatory disease that affects exclusively the small bronchi (bronchioles). As this disease progresses, the lumen of the bronchioles narrows, which can lead to the development respiratory failure. If bronchiolitis is not treated in a timely manner, the connective tissue in the bronchioles of various sizes will begin to grow and clog the pulmonary vessels.
With the help of exercise and abstinence, most people can do without medicine.
Symptoms and treatment of human diseases
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All information provided is subject to mandatory consultation with your attending physician!
Questions and suggestions:
If the doctor prescribes treatment using a nebulizer, you need to learn how to use it and instruct all family members and nursery workers. If the child is small, then it is advisable to use nebulizers specially made for children.
Breathing with a nebulizer is done through a mouthpiece and/or through a face mask. During mask inhalation, part of the medicine may be lost, settling in the child’s nasal cavity. Therefore, a face mask is used for infants. Unless your child is experiencing a sudden severe asthma attack, you should first put on the mask and then turn on the compressor. If your child is having a severe attack, hold the mask close enough to their face, then slowly put it on. If you hold the nebulizer a few centimeters from the child’s face, the desired effect will not be achieved, because an insufficient amount of the drug will enter the respiratory tract. The sprayed drug should go directly into the lungs, so the mask should be pressed tightly to the child’s face and cover not only the mouth, but also the nose. The air passing through the compressor can frighten a child. Try to distract the baby's attention - turn on music or a cartoon, give him toys or come up with any other types of entertainment.
If you fail, remain firm and persistent until you provide the child with the required dose of medicine. Even the youngest children quickly learn that nebulizer therapy brings them relief and begin to behave more calmly during the procedure.
Some children may experience dizziness or cough during inhalation. In these cases, it is necessary to stop inhalation and allow the child to calm down and rest. In case of more serious reactions, you should immediately consult a doctor.
Rules that make nebulizer therapy effective and protect your child from unpleasant accompanying reactions:
For children of this age, the use of a nebulizer is key. The features of its use are the same as for infants. However, it must be borne in mind that during mask inhalation, part of the medicine may be lost, settling in the child’s nasal cavity. Therefore, it is preferable, when carrying out treatment with a nebulizer, to replace the mouthpiece of the mask as quickly as possible (according to age).
Children over 5 years old can usually use a peak flow meter. This device allows you to objectively assess the position of the child’s lungs.
Daily peak flowmetry gives the doctor the opportunity not only to identify the onset of an exacerbation of asthma and prescribe appropriate therapy, but also to obtain an objective idea of the effectiveness of the treatment. In a conversation with a doctor, parents can support their description of the child’s asthma symptoms with specific indicators characterizing the degree of bronchial obstruction, which improves mutual understanding between the doctor and the parents of the little patient, increasing the effectiveness of treatment in general.
Many asthmatic children over the age of 12 worry about their appearance, and their desire to be just like everyone else can lead to their asthma being undertreated (or ignored altogether). Sometimes teenagers do not want to use an inhaler even during an exacerbation of the disease.
To avoid such dangerous situations, it is necessary to persistently explain the importance of timely treatment, to use drugs that act for 12 or more hours a day, so that the child takes them in the morning before and in the evening after attending school. Talking to other teens with asthma can also be beneficial.
Without a doubt. A diagnosis of asthma does not mean your child is destined to stay away from the playing field. Physical education is vital for a child's development, whether he or she is healthy or has asthma. Sports activities should take into account the nature of the disease; in particular, you cannot exercise in the cold air.
In addition, the doctor prescribes preventive medications. When exercising, it is very important that the load be gradual. Performing warm-up exercises will reduce the risk of worsening symptoms.
One of the common diseases of the respiratory system is bronchial asthma. She happens to be chronic disease, during which there is a constant inflammatory process in the tissues of the bronchi, which causes breathing problems.
There are several varieties of the disease, which are determined by the conditions of its occurrence, one of these varieties is acquired bronchial asthma.
This diagnosis means that the disease was not inherent in the patient from the moment of his birth, but formed much later under the influence of external causes. It is sometimes believed that a person had asthma initially, but was simply not diagnosed. However, if the disease did not manifest itself for 20 years of life, and then was discovered, this indicates that it is not congenital and has formed recently.
Acquired asthma is practically no different from congenital asthma in its symptoms and signs, and there are no significant differences in the course of treatment. The main difference between acquired asthma and congenital asthma is in the characteristics of its development. In addition to the fact that it manifests itself in adults, the factors that cause its formation differ from those that provoke the congenital type of the disease.
Congenital bronchial asthma manifests itself in children from birth and is caused by the characteristics of the newborn’s body. A child may be born sensitive to external environmental influences, which is manifested in the reaction of his bronchi.
In the case of acquired asthma, everything happens a little differently. The patient’s body is exposed to negative influences for a long time, which causes irreversible changes in the tissues of the respiratory system. As a result, asthmatic symptoms appear. This type of asthma formation is called exogenous, since the pathology is formed under the influence of external causes.
Among these reasons are:
In order to acquire this disease, one of the listed factors is sufficient, although very often they act in combination.
Any person who exhibits these characteristics is considered a potential risk group. However, their presence does not necessarily mean the development of asthma. Usually the human body is strong enough to cope with the negative influence. It depends on the characteristics of his immunity.The most harmful external influences include:
If you have an allergic reaction to any of these elements, you need to be very careful and minimize your interaction with it. Otherwise, the allergy may develop into bronchial asthma.
You can suspect this disease by its symptoms, which you need to know. Although only a doctor can draw conclusions after the necessary diagnostic procedures. Therefore, it is undesirable to begin independent treatment until a diagnosis has been made, but it is also unacceptable to ignore the signs of pathology.
The main symptoms of acquired bronchial asthma do not differ from similar symptoms of the congenital form of the disease.
The only difference is that with an acquired disease, symptoms appear in adulthood, and not in early childhood.
These include:
All this may be accompanied by weakness, decreased performance, and headaches. It is worth noting that these signs are similar to the symptoms of bronchitis or ARVI. However, with bronchial asthma there is no elevated temperature; in addition, symptoms arise unexpectedly and then disappear for a while. In any case, if these signs are detected, you should consult a doctor for an accurate diagnosis, since the lack of treatment, even for a cold, can lead to complications in the form of bronchitis or pneumonia.
Before starting treatment, it is necessary to conduct an examination to identify an accurate diagnosis. For this we use:
In addition to tests, the doctor must find out the features of the patient’s life, such as:
All this will help not only diagnose the disease, but also determine the strategy for its treatment, since its causes will become clear.
It is impossible to completely get rid of any type of asthma, no matter how effective the methods are chosen. The medical effect is to use medications to relieve the most acute manifestations of the disease and avoid their recurrence too often.
In order to prevent exacerbations of the disease, it is necessary to identify the factors that provoke them. After this, their exposure should be eliminated or contact with irritants should be minimized.
To achieve this, anti-inflammatory drugs (sodium cromoglycate, Nedocromil sodium) and bronchodilators (Salbutamol, Budesonide) are used. With the help of anti-inflammatory drugs, it is possible to stop the active process of mucus production in the bronchi, which reduces the body's sensitivity to harmful influences.
They should be taken regularly, as they improve air conductivity. This reduces the risk of bronchial trauma and reduces the number. Bronchodilators help relax the muscles of the bronchi, resulting in more air entering the lungs and eliminating asthma attacks. They are usually used to relieve acute manifestations.
It is very important that during treatment you use medications that do not cause side effects. When fighting asthma, long-term use of drugs is expected, so it is necessary to minimize the discomfort from their use. You also need to make sure that they do not cause allergic reactions. This is why a doctor must prescribe medications. Choosing your own treatment is very dangerous.
No less important. Compliance with preventive measures will help avoid exacerbations of the disease and frequent use of strong drugs. The main preventive measures for acquired asthma are as follows:
Patients with bronchial asthma have to limit themselves in many ways so as not to cause serious deterioration in their health. However, the presence of this disease does not mean that a person becomes inferior. If you follow the rules, take medications on time and be careful, it is possible to lead a full life without experiencing significant difficulties.
An inflammatory disease of the respiratory system with a chronic course and the participation of different groups of cellular elements (T-lymphocytes, mast cells, eosinophils, macrophages, dendritic cells) is called bronchial asthma (BA). It’s as if “bronchial” is adjacent to the word “asthma”, because there is another disease - cardiac asthma. This pathology develops by a different mechanism, and a clarification has been added to distinguish one asthma from another. This text deals exclusively with bronchial asthma.
The disease is quite severe and complex. Its main element is considered to be obstruction (narrowing) of the bronchi. Buying it is much easier than living with it later. However, with timely initiation of treatment, the pathology can be controlled.
Bronchial asthma is caused by various reasons (external and internal), it can occur either in a mild form or in an extremely severe form with complications, sometimes it can be controlled, sometimes it is problematic. Depending on these and a number of other factors, several classification signs of the disease have been developed.
The described disease belongs to the category of independent pathologies that interfere with normal breathing. The main mechanism in pathogenesis is considered to be impaired bronchial reactivity, which can be caused by factors:
Mandatory elements of the clinic for making a diagnosis of “bronchial asthma” are:
Attacks of asthma distinguish asthma from diseases such as obstructive and allergic bronchitis. Narrowing of the bronchi can be completely or partially reversible. The process normalizes spontaneously or as a result of drug treatment. It is provoked by so-called triggers - factors of the external and internal environment (allergens, stress, strong odors, temperature changes), which trigger the mechanism of bronchial obstruction.
The possibility of self-liquidation of an attack depends on the severity of the disease.
The worsening of the pathological process caused by bronchial obstruction and suffocation is usually divided into stages:
In the first case, attacks bother the patient approximately 1 time/7 days, at night 1–2 times/month. The attacks are short and not severe.
The mild constant (persistent) form is characterized by the repetition of attacks up to several times every 7 days, night attacks occur at least once every 14 days, disturb sleep, and reduce the patient’s physical activity. With a pathology of moderate severity, attacks bother the patient every day. Night attacks are also not uncommon; sleep, activity and quality of life of an asthmatic are significantly deteriorated. The severe form of persistent asthma is characterized by daily daytime and nighttime attacks, the patient is incapacitated, and physical activity is minimal.
The patient may experience status asthmaticus (a life-threatening condition). It is characterized by:
From suffocation, if the attack is not stopped in a timely manner, the patient may die. At any severity of the disease, the development of this complication is possible. This is what makes asthma so scary. Moreover, status asthmaticus takes two forms:
The first is much more common and is characterized by slow development from hours to days. The main role in its development is the blockade of bronchial beta2 receptors by intermediate metabolites, sympathomimetics or catecholamines.
The second develops almost instantly directly during contact with the allergen. But, fortunately, the metabolic variant is less common. Triggers include antibiotics, NSAIDs, enzyme preparations, sulfonamides, drugs containing proteins). This form of status is characterized by general bronchospasm and asphyxia.
Sometimes the causes of the disease are obvious, in some cases they cannot be established. But in order to successfully combat the problem, you need to understand what provokes an attack of bronchial asthma. That is why there is a generally accepted classification. There may be classic forms of asthma and its special types. Each is worth considering in more detail.
Depending on the factors that caused the disease, it is customary to distinguish the following forms of asthma: allergic (exogenous), non-allergic (endogenous), mixed origin, unspecified.
Bronchial asthma in its exogenous form develops as a result of allergens entering the respiratory system. This capacity may include:
In some cases, exogenous bronchial asthma occurs in a special form - atopic. In this case, the allergic reaction that caused the disease is genetically determined. That is, the patient had a predisposition, which was realized under the influence of provoking factors. It may be early or late. In the latter case, the attack does not begin immediately, but after 60 minutes from the moment of contact with the allergen. The irritant variant of the disease is diagnosed if exposure to certain chemicals provokes an attack, and exacerbations stop if the patient does not come into contact with an irritating chemical environment.
Endogenous bronchial asthma or non-allergic is caused by a number of external triggers:
A mixed version of the pathology can be provoked by a variety of triggers, both external and internal.
If endogenous asthma is infection-dependent, then not only an exacerbation of a bacterial infection, but also tobacco smoke can act as a trigger. With this form of pathology, the following are distinguished:
Most often, the endogenous form of bronchial asthma develops in children prone to recurrent diseases of the upper respiratory tract. In this case, an asthmatic component is added to chronic bronchitis. With the development of the pathological process in this form, pronounced signs of COPD appear.
When the two forms described above are combined, they speak of mixed asthma. If it is impossible to determine the cause of the development of the pathological process, the disease will be designated in the diagnosis as unspecified.
This group includes several separate clinical and pathogenetic types of asthma:
For reflux-induced asthma, the trigger mechanism for the development of an attack is the reflux itself. More than half of asthmatic children are diagnosed with GER. It is believed that the pathogenesis of the disease is associated with microaspiration of gastric contents. Attacks of this type of pathology often disturb the patient at night.
Among pseudoallergic conditions, it is customary to distinguish aspirin asthma. This is a chronic inflammation of the bronchi, which is provoked by taking non-steroidal anti-inflammatory drugs (NSAIDs). The disease is more common in the adult population, and more patients are women. One of the unpleasant moments in the development of this type of disease is cross-reaction. This means that an attack will develop not only after taking acetylsalicylic acid, but also if other NSAIDs are used (Ibuprofen, Diclofenac, Indomethacin, Ketoprofen, Sulindac, Piroxicam, Naproxen, Mefenamic acid). Moreover, asthmatics with this type of illness need a strict diet, because natural salicylates contained in:
Such patients need to be especially careful when handling canned products. Because if it contains benzoic or salicylic acid, the body may react with an asthma attack. The same reaction is possible to products containing tartazine (a yellow dye).
The professional type of asthma most often affects medical staff, hairdressers, livestock breeders, veterinarians and bakers. The pathology is provoked by constant forced (due to professional activity) contact with allergens.
Bronchial asthma, provoked by physical stress, often worries patients with atopic disease. As a rule, it occurs with rare attacks. Rarely does a typical clinical picture unfold.
Forms of asthma are important for the competent development of therapeutic tactics. To adjust treatment, it is important to know how responsive the disease is to medication. In connection with this factor, the following forms are distinguished:
The first form includes asthma with no exacerbations and maintenance of normal basic parameters that are determined in asthma:
With controlled asthma, improvements are noticeable even in patients with severe forms of the disease. With a partially controlled pathological process, respiratory functions are lost by only 20%.
Attacks are recorded twice a week or more often. At least once a year, asthma worsens. With an uncontrolled form of the disease, the effectiveness of treatment is minimal. This indicates the need for a thorough study of the causes of the pathology and the lack of response to drug therapy.
Since the disease is chronic, it is difficult to even dream of healing. In this case, the main thing is to bring the disease from the exacerbation phase to remission. That is, we can also distinguish 2 forms of bronchial asthma:
The best option is to achieve stable remission by eliminating triggers from a person’s daily life. If possible.
Having considered all the options for asthma, it remains to answer one more question that doctors regularly face: is congenital asthma possible, and what disease is considered acquired? There is no congenital asthma. But, firstly, there are known precedents for the development of bronchial asthma in newborns (literally from the first days of life). Secondly, there may be cases of hereditary predisposition to this disease. In such a situation, the probability of developing pathology is 50%. In fact, any bronchial asthma is acquired. Quite often, various sources of information associate the endogenous variant of the pathology with acquired asthma.
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