Asthma

Bronchial asthma is a chronic inflammatory disease of the respiratory tract in which the bronchial tree becomes constantly sensitive (hyperreactive); the disease proceeds with attacks of suffocation (variable obstruction of the respiratory system).

Symptoms

The main symptoms of the disease are:

• difficulty breathing, especially when exhaling;
• mild suffocation;
• rashes or wheezing in the chest;
• a cough (first dry, then with sputum).

Shortness of breath or suffocation can cause the patient a feeling of fear and anxiety, nausea, speech impairment. Acute attacks can lead to increased heart rate (tachycardia). Progressive respiratory failure can cause a bluish tint of the lips and skin. Bronchial asthma is characterized by the absence of its main symptoms during the intervals between attacks of the disease.

Types of asthma

There are three types of asthma.

• Atopic asthma is caused by a reaction of the body to allergens, most often those that a person inhales. This can be a dust mite, pollen, mold spores, animal hair, food and other allergens. As a rule, if contact with an allergen does not occur, a person feels good. Often, this form of asthma can be combined with allergic rhinitis, dermatitis;
• Infectious-allergic asthma develops against a background of chronic infection in the respiratory tract. It can be bronchitis, which is not completely treated, sinusitis, tonsillitis. Constant inflammation, the presence in the body of foreign bacteria and their metabolic products leads to changes in the bronchi. They become more sensitive to all kinds of irritants, their local immunity is violated. As a result, this leads to asthmatic attacks;
• Medicinal asthma is the result of the use of certain medications. It is associated with an individual body reaction to a particular drug (or its component). Such drugs primarily include aspirin and non-steroidal anti-inflammatory drugs, so this type of asthma is often called aspirin-induced asthma.

Causes and risk factors

Asthma occurs due to hypersensitivity to irritants. It can be associated both with a hereditary predisposition to inflammatory processes in the bronchi and with various environmental factors that can cause typical asthma attacks (various allergens, frequent respiratory infections, cold air, etc.). People who have had diseases such as hay fever, neurodermatitis or eczema or who suffer from these ailments, also have a high risk of developing bronchial asthma. Smoking, both active and passive, is simply poison for the respiratory system and makes them vulnerable to various types of diseases. In addition, smoking significantly reduces the effectiveness of medication for asthma. Favorable groud for the occurrence of bronchial asthma is frequent infectious respiratory diseases.

Internal risk factors include viral infections of the respiratory tract, which cause inflammatory processes in the respiratory system, which lead to seizures and the formation of mucus in the bronchi, cough, shortness of breath, etc.

Some medications, such as painkillers (aspirin) or non-steroidal anti-inflammatory drugs (NSAIDs), can also cause an asthma attack. This is not about allergies, but about a hereditary predisposition to intolerance to certain drugs, which from the outside can look like an allergic reaction.

Examination and diagnostics

The diagnosis of asthma can be quickly established by studying the history and typical symptoms of the disease. Diagnosis of pulmonary function in cases of suspected bronchial asthma includes spirometry, pulse oximetry (a non-invasive method for studying hemoglobin oxygen saturation). As a special method, the so-called general plethysmography is distinguished. As already noted, asthma often develops on the basis of allergies, so it is very important to find out if the patient has an increased sensitivity to certain substances. This is done through skin allergy tests and laboratory blood tests. In rare cases, so-called provocative tests are performed, during which the patient inhales the allergen. An x-ray study helps to rule out the presence of other lungs during the diagnosis of asthma. In order to detect an increased content of white blood cells called eosinophils, which often cause allergic reactions and are a sign of asthma, a study of sputum formed in the bronchi is indicated. Based on this analysis, instead of asthma, a bacterial infection of the respiratory tract can be detected. As a diagnostic measure for the allergic form of bronchial asthma, laboratory blood tests to determine the level of immunoglobulin, CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate) are required.

Treatment

Despite the fact that asthma cannot be completely cured, this disease can be successfully controlled with the help of medications. A person can maintain the quality of life at a normal level, optimal treatment methods provide them with full physical performance. Glucocorticoids and beta-sympathomimetic drugs for inhalation(albuterol), methylxanthines (theophylline), leukotriene antagonists, mast cell membrane stabilizers (cromoglycate, nedocromil, lodoxamide) are used as therapeutic agents. With a mild course of bronchial asthma, dosed aerosol medications can be administered orally. During attacks of suffocation and shortness of breath in the later stages of the disease, they must be administered intravenously.

Course and forecast

Therapeutic and preventive measures used in bronchial asthma help keep its symptoms under control. In almost half of all children with asthma, the disease recedes after puberty. There is a possibility that the course of the disease can be stopped if it is diagnosed in a timely manner and appropriate treatment is prescribed. Asthma can be cured in about 20% of adults, and 40% of patients report a significant improvement after a course of treatment.

Important notes

Asthmatic status is a serious, life-threatening complication of bronchial asthma. It is a long (sometimes up to 24 hours) attack that cannot be stopped with medication. In this case, gas exchange in the lungs is disturbed and the patient does not receive enough oxygen. If the medication prescribed by a doctor does not bring relief during severe asthmatic attacks and respiratory failure progresses, the patient needs emergency medical care. Asthmatic status can lead to hyperinflation (distension) of the lungs.

Prevention

Prevention of bronchial asthma should be carried out from childhood, especially in families with a predisposition to allergic diseases.

Prevention includes:

• timely treatment of chronic diseases of the upper and lower respiratory tract;
• smoking cessation;
• proper nutrition;
• hypoallergenic life.

Facts and figures

• Nowadays, about 235 million people suffer from asthma. This is the most common chronic illness among children;
• Most asthma-related deaths occur in low- and medium-low economic development countries;
• The main risk factors for asthma are inhaled substances and particles that can trigger allergic reactions or irritate the airways;
• Asthma can be controlled with medication. Preventing asthma triggers can help relieve asthma;
• Modern medicine can provide a good quality of life for patients with asthma.