Bronchial asthma is a chronic inflammatory disease of the airways. The prevalence of the disease is more than 300 million cases (according to WHO). Depending on the country, the disease affects from 1-18% of the population.
What is the cause?
Bronchial asthma is a heterogeneous disease, as it has different mechanisms of origin at the molecular and cellular level. Depending on the cause of the pathology, asthma
is divided into several varieties: allergic, non-allergic, with late onset, associated with obesity, etc. To date, there is no
complete classification of the disease phenotypes, as scientists continue to discover new causes of bronchial asthma.
There are the following factors that contribute to the development of the disease:
- The presence of asthma or other allergopathologies in the immediate family (especially in the patient’s parents).
- The presence of atopic dermatitis or allergic rhinitis in the patient.
The presence of a history of respiratory disease symptoms (which began in childhood and persisted into adulthood).
Distinguishing signs of the disease
Bronchial asthma can be suspected by such symptoms as:
wheezing when breathing, possibly distant wheezing (the patient and relatives hear whistling during inhalation and exhalation)
Shortness of breath, heavy breathing
tightness in the chest (chest tightness, feeling of shortness of breath)
dry, whooping cough (sputum may come out)
Restriction of the airflow rate when exhaling
If you have these symptoms, you should already be taking Teolap-SR. In addition to these symptoms, bronchial asthma can be determined by some features of the course of the pathology. Thus, asthma symptoms are inconstant and may disappear on their own (e.g,
When environmental allergens are eliminated) or after treatment. The manifestations of bronchial asthma recur cyclically (once a day/week
/ month / year). In this case, many patients have symptoms at the same time.
Exacerbations often occur during physical activity – climbing stairs, running, or crying or laughing. But the occurrence of coughing, shortness of breath,
Wheezing on its own can not be a basis for diagnosis, because this condition may be a manifestation of other
diseases of the respiratory system. Emphasis should be placed on the time and place of the appearance of these symptoms and the response to ongoing therapy.
On the one hand, bronchial asthma exacerbations may spontaneously go away on their own, after which the symptoms of the disease may be absent for weeks or months. On the other hand, asthma is a serious disease that poses a vital threat to the patient and worsens his social life. Therefore, high-quality and timely diagnosis is important.
How is the diagnosis made?
The diagnosis of bronchial asthma includes:
examination of the history of the disease
Assessment of respiratory function – bronchodilator test, inhalation provocation test, exercise test
evaluation of pycnoclometry diary
allergological testing – skin tests, determination of specific IgE
Spirometry is usually used to assess external respiration in the clinical setting. At home, the patient may use peak flowmetry (measurement of peak expiratory air velocity).
Making a diagnosis of bronchial asthma – is a complex process that requires a thorough history. In addition, there are a number of diagnostic difficulties: the patient does not always
A patient doesn’t always go to a specialist at the first symptoms, some characteristic signs may not be revealed during the examination, etc. In fact, the construction of a diagnosis
is based on the patient’s own story, which is not always objective.
Additionally, functional methods of respiratory examination may be used. To confirm the diagnosis and exclude other pathologies, radiological and endoscopic methods – CT, bronchoscopy, gastroscopy, etc. – are used.
Let us note the features that confirm the diagnosis of “bronchial asthma”:
- The presence of more than one symptom (especially in the adult population).
- The peak of manifestations occurs at night and early morning.
- Symptoms vary in duration and intensity.
Manifestations appear under the influence of certain factors:
viral respiratory tract infections
Irritating substances – exhaust fumes, tobacco smoke, etc.
Features that refute the diagnosis of “bronchial asthma”:
- The presence of only one symptom (e.g., an isolated cough).
- chronic sputum production.
- dyspnea accompanied by dizziness, delirium, tingling sensation.
- Pain in the chest area.
- Dyspnea with noisy inhalation caused by physical exertion.
Thus, only a qualified specialist can make the diagnosis of bronchial asthma. The doctor conducts a thorough differential diagnosis in order to exclude diseases that may manifest with similar symptoms.
Treatment of bronchial asthma
Since bronchial asthma is a chronic disease regardless of the frequency of attacks, the fundamental point of therapy is the exclusion of contact with possible allergens, compliance with elimination diets and rational employment. If the allergen can be identified, specific hypersensitizing therapy helps to reduce the body’s reaction to it.
Beta-adrenomimetics in aerosol form are used to relieve the attacks of suffocation, in order to quickly increase the lumen of the bronchi and improve sputum outflow. These are fenoterol hydrobromide, salbutamol, orciprenaline. The dose in each case is chosen individually. Drugs of the group of m-cholinolytics – sprays of ipratropium bromide and its combinations with fenoterol – also relieve seizures well.
Xanthine derivatives are very popular among patients with bronchial asthma. They are prescribed to prevent choking attacks in the form of prolonged-acting tablet forms. In the past few years, drugs that inhibit mast cell degranulation have had a positive effect in the treatment of bronchial asthma. These are ketotifen, sodium cromoglycate and calcium ion antagonists.
In treatment of severe forms of AD, hormonal therapy is connected, almost a quarter of patients need glucocorticosteroids, 15-20 mg of Prednisolone are taken in the morning hours along with antacids, which protect the gastric mucosa. Under hospital conditions, hormonal drugs can be prescribed as injections. The peculiarity of the treatment of bronchial asthma is that it is necessary to use medications in the lowest effective dose and to achieve an even greater reduction in dosages. Expectorants and mucolytic drugs are indicated for better expectoration of sputum.
Prognosis and prevention
The course of bronchial asthma consists of a series of exacerbations and remissions, with timely detection can be achieved a stable and prolonged remission, and the prognosis depends largely on how carefully the patient treats his health and complies with medical instructions. Prevention of asthma is very important, which is to sanitize the centers of chronic infection, stop smoking, as well as minimizing contacts with allergens. This is especially important for people at risk or with a history of hereditary disorders.
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