Bronchial asthma in adults: how to recognize and start effective treatment? Bronchial asthma. Causes, symptoms, types, treatment and prevention of asthma These include

Bronchial asthma is a chronic inflammatory disease of the respiratory tract, manifested by attacks of shortness of breath, which are often accompanied by coughing and can develop into attacks of suffocation. This is due to the fact that the airways overreact to various stimuli. In response to irritation, they narrow and produce a large amount of mucus, which disrupts the normal flow of air during breathing.

Bronchial asthma occurs in people of all ages, but most often it manifests itself in children - half of them then "outgrow" their disease. Now more than 300 million people in the world suffer from this disease and their number is constantly increasing.

Due to the high prevalence of bronchial asthma, its ability to reduce the ability to work and cause disability, there are many worldwide and national programs to combat this disease. For example, in the UK, about a billion pounds a year is allocated for such a program. At the initiative of the World Health Organization (WHO), every year on May 4, World Asthma Day is celebrated.

Chronic inflammation, which is observed in patients with bronchial asthma, makes the airways sensitive to allergens, chemical irritants, tobacco smoke, etc. When exposed to them, edema and spasm of the bronchi occur, at this moment bronchial mucus is produced in large quantities. This makes it difficult for air to pass through the airways during breathing.

Depending on the cause of an asthma attack, asthma with a predominance of an allergic component and non-allergic asthma are distinguished.

An indicator that bronchial asthma is allergic in nature is that exacerbations occur upon contact with certain allergens (pollen, wool, house dust, some products), are seasonal. An attack of allergic asthma in humans is often accompanied by a runny nose, symptoms of autonomic dystonia, and urticaria.

In non-allergic asthma, the chronically inflamed airways are overly sensitive. Any irritation causes spasms of the bronchi, and the flow of air through them is limited, which leads to coughing and choking attacks.

There are many causes of an asthma attack. For example, pungent odors - tobacco smoke, household chemicals, soap, perfumes, exhaust fumes, etc. Researchers around the world have come to a disappointing conclusion: every fifth asthmatic owes his illness to his profession.

Asthma symptoms may also appear minutes after exercise - for example, exercise involving the inhalation of cold, dry air - such as jogging outside in winter. In such cases, one speaks of asthma of physical effort.

An attack that occurs when taking aspirin or other anti-inflammatory drugs indicates the so-called aspirin asthma.

The cause of asthma caused by food additives can be, for example, the intake of sulfites (beer, wine preservatives).

If an attack develops both upon contact with an allergen and under the influence of other factors, asthma is called mixed. It is this form that is the most common, especially in the later stages of the disease.

When asthma has no clear cause, it is called unspecified.

How does it manifest itself?

The most characteristic signs of bronchial asthma are:

• cough - can be frequent, painful and persistent. The cough may be worse at night, after exertion, after inhaling cold air;
• expiratory (with predominant difficulty exhaling) shortness of breath - breathing can be so limited that it causes fear of being unable to exhale;
• whistling wheezing, heard at a distance - caused by the vibration of air with the force passing through the narrowed airways;
• suffocation.

In severe or acute bronchial asthma, a person breathes through the mouth during an attack, using the muscles of the shoulders, neck and torso to facilitate breathing through the narrowed airways. Also, when the airways are constricted, it is easier to breathe in than to breathe out. This happens because inhalation is a procedure familiar to our body, and the chest muscles are trained for this movement.

Expiration, on the other hand, normally occurs passively, i.e. without special effort, so the muscles are not sufficiently developed to remove air through the narrowed airways. As a result, air remains in the lungs and they become swollen.

By the way, in young people who have been suffering from asthma for a long time, it is because of this that the so-called “pigeon chest” develops. In severe acute bronchial asthma, a previously "whistling" chest may become "mute", without whistling sounds. This is due to the fact that the amount of air inhaled and exhaled is so small that sounds cannot be heard.

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

ICD-10

J45 Asthma

General information

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

The reasons

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

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

Pathogenesis

Chronic inflammatory processes in the respiratory organs lead to their hyperactivity, as a result of which, upon contact with allergens or irritants, bronchial obstruction instantly develops, which limits the air flow rate and causes suffocation. Asphyxiation attacks are observed at different intervals, but even in the remission stage, the inflammatory process in the airways persists. The following components are at the heart of the violation of the patency of the air flow in bronchial asthma: airway obstruction due to spasms of the smooth muscles of the bronchi or due to swelling of their mucous membrane; blockage of the bronchi by the secret of the submucosal glands of the respiratory tract due to their hyperfunction; substitution of bronchial muscle tissue for connective tissue during a long course of the disease, which causes sclerotic changes in the bronchial wall.

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

In the pathoanatomical examination of the dead during an asthma attack, there is a complete or partial blockage of the bronchi with viscous thick mucus and emphysematous expansion of the lungs due to difficult exhalation. Tissue microscopy most often has a similar picture - a thickened muscle layer, hypertrophied bronchial glands, infiltrative bronchial walls with desquamation of the epithelium.

Classification

Asthma is subdivided according to etiology, severity of the course, level of control, and other parameters. By origin, allergic (including occupational asthma), non-allergic (including aspirin asthma), unspecified, mixed bronchial asthma are distinguished. According to the severity, the following forms of BA are distinguished:

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

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

In the course of asthma, exacerbations and remissions (unstable or stable) are distinguished. When possible, asthma control can be controlled, partially controlled and uncontrolled. A complete diagnosis of a patient with bronchial asthma includes all of the above characteristics. For example, "Bronchial asthma of non-allergic origin, intermittent, controlled, in stable remission."

Symptoms of bronchial asthma

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

During an attack, the patient's position is forced, usually he tries to take a sitting position with the body tilted forward, and find a fulcrum or rests his elbows on his knees. The face becomes puffy, and during exhalation, the cervical veins swell. Depending on the severity of the attack, you can observe the involvement of muscles that help overcome resistance to exhalation. In the period of reverse development, a gradual discharge of sputum begins, the number of wheezing decreases, and the asthma attack gradually fades away.

Manifestations in which you can suspect the presence of bronchial asthma.

• high-pitched wheezing on expiration, especially in children.
• recurring episodes of wheezing, difficulty breathing, chest tightness, and a cough that worsens at night.
• seasonality of deterioration in health from the respiratory system
• the presence of eczema, allergic diseases in history.
• deterioration or occurrence of symptoms upon contact with allergens, taking medications, upon contact with smoke, with sudden changes in ambient temperature, acute respiratory infections, physical exertion and emotional stress.
• frequent colds "going down" to the lower respiratory tract.
• improvement after taking antihistamine and anti-asthma drugs.

Complications

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

Diagnostics

The diagnosis is usually made by a pulmonologist on the basis of complaints and the presence of characteristic symptoms. All other research methods are aimed at establishing the severity and etiology of the disease. During percussion, the sound is clear boxed due to the hyperairiness of the lungs, the mobility of the lungs is sharply limited, and their borders are shifted down. During auscultation, vesicular breathing is heard above the lungs, weakened with an extended exhalation and with a large number of dry wheezing. Due to the increase in the volume of the lungs, the point of absolute dullness of the heart decreases, the heart sounds are muffled with an accent of the second tone over the pulmonary artery. From instrumental research is carried out:

• Spirometry. Spirography helps to assess the degree of bronchial obstruction, to determine the variability and reversibility of obstruction, and to confirm the diagnosis. In BA, forced expiration after inhalation with a bronchodilator increases by 12% (200 ml) or more in 1 second. But to obtain more accurate information, spirometry should be carried out several times.
• Peakflowmetry. Measurement of peak expiratory activity (PSV) allows you to monitor the patient's condition by comparing the indicators with those obtained earlier. An increase in PSV after inhalation of a bronchodilator by 20% or more from PSV before inhalation clearly indicates the presence of bronchial asthma.

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

• blood test. Changes in the KLA - eosinophilia and a slight increase in ESR - are determined only during an exacerbation. Assessment of blood gases is necessary during an attack to assess the severity of DN. A biochemical blood test is not the main diagnostic method, since the changes are of a general nature and such studies are prescribed to monitor the patient's condition during an exacerbation.
• General sputum analysis. With microscopy in sputum, a large number of eosinophils, Charcot-Leyden crystals (shiny transparent crystals that form after the destruction of eosinophils and have the shape of rhombuses or octahedrons), Kurschmann's spirals (are formed due to small spastic contractions of the bronchi and look like casts of transparent mucus in the form spirals). Neutral leukocytes can be detected in patients with infectious-dependent bronchial asthma in the stage of an active inflammatory process. The release of Creole bodies during an attack was also noted - these are rounded formations consisting of epithelial cells.
• Study of the immune status. In bronchial asthma, the number and activity of T-suppressors is sharply reduced, and the amount of immunoglobulins in the blood increases. The use of tests to determine the amount of immunoglobulin E is important if it is not possible to conduct allergological tests.

Treatment of bronchial asthma

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

To stop asthma attacks, beta-agonists in the form of an aerosol are used in order to quickly increase the lumen of the bronchi and improve the outflow of sputum. These are fenoterol hydrobromide, salbutamol, orciprenaline. The dose in each case is selected individually. The drugs of the m-anticholinergic group - aerosols of ipratropium bromide and its combination with fenoterol - also stop seizures well.

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

In the treatment of severe forms of asthma, hormonal therapy is connected, almost a quarter of patients need glucocorticosteroids, 15-20 mg of prednisolone is taken in the morning along with antacids that protect the gastric mucosa. In a hospital setting, hormonal drugs can be prescribed in the form of injections. The peculiarity of the treatment of bronchial asthma is that it is necessary to use drugs in the minimum effective dose and achieve an even greater reduction in dosages. For better sputum discharge, expectorant and mucolytic drugs are indicated.

Forecast and prevention

The course of bronchial asthma consists of a series of exacerbations and remissions, with timely detection, a stable and long-term remission can be achieved, while the prognosis depends to a greater extent on how attentive the patient is to his health and follows the doctor's instructions. Of great importance is the prevention of bronchial asthma, which consists in the rehabilitation of foci of chronic infection, the fight against smoking, as well as in minimizing contact with allergens. This is especially important for people who are at risk or have a burdened heredity.

The diagnosis of "bronchial asthma" is very common. The disease is associated with a chronic inflammatory process in the airways, resulting in their hypersensitivity - an increased tendency to spasm (compression) of the bronchi in response to the action of a wide variety of substances and environmental conditions.

We bring to your attention a review article that will help people with a diagnosis of bronchial asthma to navigate the variety of information, given the links in the text.

Why and how the disease develops

Scientists are still completely unclear. There is a theory about risk factors and predisposing factors under the influence of which the disease manifests itself.

Types of allergens

A person can develop bronchial asthma if he has a hereditary predisposition to this disease, and also comes into contact with an allergen. About half of the patients have a genetic predisposition to the disease. An important role in the appearance of its signs is played by contact with allergens, the main of which are:

• house dust;
• mold spores; particles of skin and animal hair;
• certain foods and medicines (particularly aspirin).

The diagnosis of "bronchial asthma" is more often made to premature babies whose mothers suffered infectious diseases during pregnancy, at the time of the birth of the child, the parents were no longer young and in other situations.

In adults, the disease is often caused by external air pollution, respiratory diseases.

Start the development of external manifestations of the disease trigger factors. These can be infections, exposure to strong odors, smoking, stress, taking certain medications, internal diseases.

With a combination of predisposing and triggering factors, small sections of the respiratory tract are reduced, their wall swells, mucus secretion increases, and chronic inflammation develops. Outwardly, this is manifested by attacks, or.

For more information about the factors that provoke the development of the disease in children and adults, see.

Forms of bronchial asthma

• periodic dry cough, in which viscous sputum is coughed up with great difficulty;
• sometimes worried about suffocation, a feeling of lack of air;
• heaviness and congestion in the chest;
• wheezing, which can even be heard at a distance, especially during exhalation (the patient, as it were, squeezes the air out of himself).

These signs appear more often at night or early in the morning, after contact with the allergen, physical activity, taking aspirin, beta-blockers.

Posture of the patient during an attack

An attack often begins with precursors - itching in the eyes, sneezing, coughing. Then there is shortness of breath and wheezing. The patient's skin is moist, pale, he sits down, resting his hands on the bed. The attack lasts up to several days and in severe cases passes into.

Currently, it is customary to divide the disease according to the severity of the course. Depending on the severity, one or another number of drugs is prescribed. Doctors try to achieve complete control over the disease - that is, even with initially severe asthma, with frequent attacks, poor respiratory function, with regular treatment and measures to eliminate allergens, the patient's health becomes good, and he leads a normal life without significant restrictions.

• blood analysis;
• determination of IgE (both non-specific and specific markers of allergy) in the blood;
• skin tests;
• determination of severity by studying the content of oxygen and carbon dioxide in the blood.

It is of paramount importance for establishing a diagnosis. Self-monitoring requires daily use of a peak flow meter. Without it, the treatment of asthma in modern conditions is unthinkable.

For differential diagnosis with other lung diseases, it is prescribed

Diagnosis of "bronchial asthma" during pregnancy and in children

With a diagnosis of "bronchial asthma", a woman is quite capable of bearing and giving birth to a healthy child. To do this, she must strictly follow the recommendations for the treatment and elimination of allergens. Patients with insufficient control of the disease are at increased risk of complications:

• preeclampsia;
• the threat of termination of pregnancy;
• fetoplacental insufficiency;
• poor health of the newborn baby.

• glucocorticoids (often in the form of inhalers) - beclomethasone, fluticasone propionate, budesonide, flunisolide;
• cromons - Tailed Mint;
• leukotriene inhibitors - zafirlukast;
• combined means - Seretide.

For use:

• short-acting beta-2-agonists - salbutamol, fenoterol;
• ipratropium bromide;
• combined means - Berodual N, Ipramol Steri-neb.

With an increase in the number of required emergency drugs, it is necessary to consult a doctor, this indicates incomplete control of the disease.

Bronchial asthma: video

Bronchial asthma is one of the most common chronic diseases among the population of the entire planet. Whether asthma is treated or not is an open question. Even if we consider that at the moment it is diagnosed in the early stages and current methods of treatment are used.

What is asthma? This is a constantly present inflammatory disease of the airways, which is always accompanied by bronchial hyperreactivity.

The main symptoms of asthma are attacks of suffocation or respiratory discomfort in the form of paroxysmal coughing and/or wheezing and shortness of breath. Due to excessive production of mucus, inflammatory edema and spasm, the bronchus wall thickens, its lumen narrows. Through such a narrowed bronchus, sufficient gas exchange with the environment does not occur, which leads to the characteristic symptoms of asthma.

More than 250 million adults and children on our planet suffer from bronchial asthma, and every year their number is increasing. The disease can worsen and lead to death. In industrialized countries, the incidence is much higher than in underdeveloped countries.

The disease usually begins at an early age. About 50% of children with proper treatment get rid of asthma by adulthood. Understanding how to manage asthma will allow you, with the help of your healthcare provider, to confidently manage your symptoms on a daily basis.

Causes of bronchial asthma

What it is? The reasons why an adult or a child develops bronchial asthma are not fully understood. The development of allergic asthma is based on the pathogenetic mechanism of immediate type hypersensitivity (IgE-dependent immune response). In most cases, the disease develops due to the body's hypersensitivity to external stimuli. The cause that causes bronchial asthma in children older than 3 years, in most cases, is an inhalation allergen.

At present, the chronic inflammatory nature of this disease has been proven, as a result of which mucus secretion increases in the respiratory tract, and the production of a number of biologically active substances is disrupted. Another important reason is frequent infections and inflammations of the respiratory organs, which develop under the influence of viruses, bacteria, etc.

Approximately 1/3 of sick children asthma has a hereditary origin. The occurrence of allergic forms is provoked by various allergens - house dust, plant pollen, bacteria, viruses, fungi. Patients are often allergic to several different allergens.

Forms and degrees

Asthma is divided into forms depending on the cause of occurrence, as well as into degrees, depending on the clinical symptoms.

1. Allergic - its occurrence is associated with an established allergen;
2. Non-allergic - associated with factors of a non-allergic nature, for example, with hormonal changes;
3. Mixed (combines the features of the two above forms).

Depending on the severity of the course, bronchial asthma is divided into three degrees:

1. Mild degree - symptoms of an exacerbation of the disease are observed about once or twice a month and disappear quickly, often without treatment;
2. Medium (exacerbation mainly at night, attacks no more than five times a year, accompanied by mild symptoms);
3. A severe degree of the disease requires the immediate adoption of emergency measures. Frequent exacerbation of the disease, the constant presence of symptoms, performance is severely limited, sleep disturbances, significant impairment of the function of external respiration according to spirometry.

Depending on the degree of the disease, the symptoms of the disease and the methods of treatment will vary.

Symptoms of bronchial asthma

The clinical picture of bronchial asthma is characterized by symptoms such as cough. These signs in adults and children occur after contact with the allergen.

In the vast majority of cases, a person during an attack takes a specific position, as if facilitating for himself a painful breath and especially exhalation.

An asthma attack begins with a feeling of shortness of breath and a dry, painful cough, the breath becomes humming, the exhalation is delayed. The whistles may increase with deep breathing. A common symptom is a paroxysmal cough, often dry or with a small clot of light sputum at the end of the attack.

Under the influence of drugs, the attack is reversible. Mild forms can pass on their own. If left untreated, seizures become frequent and prolonged. Leaving the pathology unattended for a long time becomes the cause of irreversible asthma.

The main symptoms of asthma in adults and children are:

• severe labored breathing;
• tightness in the chest;
• choking attacks - the feeling that you do not have enough air;
• very frequent cough, which is especially strong at night;
• many asthmatics have wheezing;

Most patients experience the first symptoms of asthma at an early age: about half of patients under the age of 10 and about a third before the age of 40. It is worth noting that not all people have the same manifestation of bronchial asthma - the symptoms and treatment of pathology directly depend on the causes provoking the onset of the disease.

Treatment of bronchial asthma

Currently, the treatment of patients with bronchial asthma includes planned treatment in the acute phase, emergency therapy aimed at stopping the attack, as well as treatment in the remission phase.

Drug treatment of bronchial asthma includes the use of drugs of the following groups:

• glucocorticosteroids in inhalation form;
• cromons ("Intal", "Thailed");
• leukotriene-type receptor antagonists ("Acolat", "Singular");
• xanthines (eufillin);
• monoclonal antibodies ("Xolair");
• adrenomimetics.
• expectorants are also used to improve sputum discharge, and other aids.

As a treatment, basic therapy drugs are used that affect the mechanism of the disease, through which adults control the disease, as well as symptomatic drugs that affect only the smooth muscles of the bronchial tree and stop an asthma attack.

The diet for bronchial asthma involves the exclusion from the diet of foods that can provoke an allergic reaction, focusing on eating fresh vegetables, meat, fish and dairy products (if there is no allergy).

During an asthma attack, follow a pre-planned action plan. To stop the attack, it is necessary to take, with the help of an inhaler, a bronchospasmolytic drug and ensure the flow of fresh air to the lungs. If the inhalation did not work and the attack did not go away, it is urgent to call an ambulance.

At the moment, medicine has made a step forward in the principles and methods of treating bronchial asthma, which in time, perhaps, will help cure asthma forever.

How to treat bronchial asthma folk remedies

It is not yet possible to completely cure such a complex disease as bronchial asthma, but to weaken the attacks, to make them shorter, is quite within the power of every sufferer. It should be remembered that folk remedies can be hazardous to health, therefore, before applying them in practice, it is recommended to get medical advice.

1. Grind the ginger root to get about 400 grams of finished powder, it should be infused for 2 weeks in 1 liter of alcohol, shaking occasionally. Strain the resulting tincture, and take 2 times a day for a teaspoon.
2. Grind propolis and pour it with alcohol in a ratio of 1:4. Let it brew for 7 days, remembering to stir once a day. The finished mixture is filtered, and after a day they begin to take 10 drops 3 times a day, 30 minutes before meals. Course: 2 months of admission, 1 rest, then repeat.
3. Chopped hyssop grass is needed, it should be poured into a thermos and pour boiling water. Per liter of water take 4 tbsp. spoons of hyssop. After an hour, you can drink, after straining. Take in the dining room before bedtime, and in the morning 30 minutes before the first meal. The course is 10 days, then it is carried out again.
4. Take a jar in which you should put 250 grams of aloe, then add 500 grams of wine and 350 grams of honey. Stir and let it brew for 9-10 days in the refrigerator. After the resulting tincture should be filtered, and squeeze the leaves. The first 3 days, take a tablespoon 3 times a day, then lower the dose to a teaspoon. An important point - aloe leaves can not be watered for 14 days, before pruning them, then just wipe off the dust without washing under the tap.

Such methods can be effective in relation to the main manifestations of the disease, but alternative medicine also does not answer the question of how to cure asthma completely.

Asthma Prevention

Prevention of the disease should begin in early childhood. If family members have a predisposition to the occurrence of allergies, then the prevention of bronchial asthma is simply necessary. With an already existing problem, adequate treatment and elimination of allergens is necessary, which allows stabilizing the course of the disease and reducing the risk of exacerbations.

(Visited 9 604 times, 1 visits today)

Asthma is a chronic disease, the basis of this disease is non-infectious inflammation in the airways. Both external and internal irritants contribute to the development of bronchial asthma. A number of external factors include various allergens, as well as chemical, mechanical and weather factors. This list includes both stressful situations and physical overload. The most common factor is dust.

Internal factors in the development of bronchial asthma include defects in the endocrine and immune systems, and the cause may also be bronchial reactivity and a deviation in sensitivity, this may be hereditary.

What is bronchial asthma?

is a disease of the bronchial tree of an inflammatory immune-allergic nature, characterized by a chronic, paroxysmal course in the form of broncho-obstructive syndrome and suffocation. This disease has become a really serious problem of society, as it has a progressive course. It is very difficult to heal completely.

Inflammation of the bronchi in bronchial asthma is characterized by strict specificity in comparison with other types of inflammatory processes of this localization. Its pathogenetic basis is based on an allergic component against the background of an immune imbalance in the body. This feature of the disease explains the paroxysmal nature of its course.

A host of other factors join the basic allergic component, which give bronchial asthma its characteristics:

Hyperreactivity of smooth muscle components of the bronchial wall. Any irritant effects on the bronchial mucosa end in bronchospasm;

Certain environmental factors can cause a massive release of inflammatory mediators and allergies exclusively within the bronchial tree. General allergic manifestations never occur;

The main inflammatory manifestation is mucosal edema. This feature in bronchial asthma leads to aggravation of bronchial obstruction;

Scanty mucus formation. An attack of suffocation in bronchial asthma is characterized by the absence of sputum with or its scarcity;

Mainly medium and small bronchi, devoid of a cartilaginous framework, are affected;

Necessarily there is a pathological transformation of the lung tissue against the background of a violation of its ventilation;

There are several stages of this disease, which are based on the reversibility of bronchial obstruction and the frequency of asthma attacks. The more frequent and prolonged they are, the higher the stage.

In the diagnosis of bronchial asthma, they are found under the following names:

Light flow or intermittent;

Moderate course or mild persistence;

Severe course or moderate persistence;

Extremely severe or severe persistent asthma.

On the basis of the above data, bronchial asthma can be characterized as a chronic sluggish inflammatory process in the bronchi, the exacerbations of which are based on a sudden onset of an attack of bronchial obstruction with suffocation, similar to an allergic reaction to environmental irritants. In the initial stages of the process, these attacks quickly arise and just as quickly stop. Over time, they become more frequent and less sensitive to treatment.

The first signs of bronchial asthma

The success of the treatment of bronchial asthma is very often determined by the timeliness of the detection of this disease.

Early signs of the disease include the following symptoms:

Shortness of breath or suffocation. They arise, both against the background of complete well-being and peace at night, and during physical exertion, being in conditions of inhalation of polluted air, smoke, room dust, pollen of flowering plants, and changes in air temperature. The main thing is their suddenness in the type of attack;

Cough. Typical for an asthmatic attack is its dry type. It occurs synchronously with shortness of breath and is characterized by hoarseness. The patient, as if he wants to cough up something, but cannot do it. Only at the end of the attack, the cough can acquire a wet character, accompanied by the discharge of a meager amount of transparent sputum of the mucous type;

Rapid shallow breathing with prolonged exhalation. During an attack of bronchial asthma, patients complain not so much about the difficulty of inhaling, but about the impossibility of a full exhalation, which becomes prolonged and requires great effort for its implementation;

Wheezing on breathing. They are always dry like whistling. In some cases, even remote and you can listen to them at a distance from the patient. With auscultation, they are heard even better;

Characteristic position of the patient during an attack. In medicine, this position is called orthopnea. At the same time, the patients sit down, lowering their legs, firmly grasping the bed with their hands. Such fixation of the auxiliary muscles of the limbs helps the chest in the implementation of exhalation.

The first signal of increased bronchial reactivity can be only some of the typical symptoms of bronchial asthma that characterize its attack, especially when it occurs at night. They can appear for a very short time, pass on their own and do not disturb the patient again for a long time. Only over time, the symptoms become progressive. It is extremely important not to miss this period of imaginary well-being and turn to specialists, regardless of the number and duration of attacks.

Other symptoms of bronchial asthma

Bronchial asthma of any severity in the initial stages of its development does not cause general disturbances in the body. But over time, they necessarily arise, which manifests itself in the form of symptoms:

General weakness and malaise. During an attack, none of the patients is able to perform any active movements, as they increase respiratory failure. All that remains for the patient is to take the orthopnea position. In the interictal period of asthma with a mild course, the endurance of patients to physical activity is not impaired. The more severe the course of the disease, the more pronounced these violations;

Acrocyanosis and diffuse cyanosis of the skin. These symptoms characterize a severe degree of bronchial asthma and indicate the progression of respiratory failure in the body;

Tachycardia. During an attack, the number of heart contractions increases to 120-130 beats / min. In the interictal period with severe and moderate asthma, a slight tachycardia remains within 90 beats / min;

Dystrophic changes in the nails in the form of their bulging like watch glasses and distal finger phalanges in the form of thickening like drumsticks;

Signs of emphysema. This condition is typical for bronchial asthma with a long duration of the disease or a severe course. Manifested as an expansion of the chest in volume, swelling of the supraclavicular areas, expansion of the percussion pulmonary borders, weakening of breathing during auscultation;

Signs of cor pulmonale. They characterize severe bronchial asthma, which led to pulmonary hypertension in a small circle. As a result - an increase in the heart due to the right chambers, the accent of the second tone over the pulmonary valve;

Headache and dizziness. Relate to signs of respiratory failure in bronchial asthma;

Tendency to various allergic reactions and diseases (,);

There are a lot of reasons why small bronchi acquire increased irritability. Some of them act as background conditions that support inflammation and allergization, and some directly provoke an asthmatic attack. It is individual for each patient.

hereditary predisposition. People with asthma have an increased risk of this disease in their children. An aggravated hereditary history is noted in a third of patients with asthma. This type of disease is atopic. It is very difficult to trace the factors that provoke asthma attacks. Such asthma can develop at any age, both childhood and adulthood.

Factors from the group of occupational hazards. An increase in the incidence of bronchial asthma was reliably recorded as a result of exposure to harmful production factors. It can be hot or cold air, its pollution with various small dust particles, chemical compounds and vapors.

Chronic bronchitis and infections. Viral and bacterial pathogens that cause an inflammatory process in the bronchial mucosa can provoke an increase in the reactivity of their smooth muscle components. This is evidenced by cases of bronchial asthma that occurs against the background of bronchitis with a long course, especially with signs of bronchial obstruction.

Inhaled air quality and environmental conditions. Residents of countries with a dry climate and the rural population get sick much less often than residents of industrial regions and countries with a humid and cold climate.

Smoking as a cause of asthma. Systematic inhalation of tobacco smoke leads to inflammatory changes in the mucous membrane of the bronchial tree. Therefore, every smoker is sick with chronic bronchitis. In some of them, the process is transformed into bronchial asthma. Smoking can act as a factor that maintains a constant inflammatory process and as a provocateur of each attack.

Asthma from dust. Scientists have recorded a causal relationship of room dust with the occurrence of bronchial asthma. The thing is that indoor dust is a natural habitat for house dust mites. In addition to these microscopic agents, it contains many allergens in the form of desquamated epithelial cells, chemicals and wool. Street dust becomes a provocateur of bronchial asthma only if it contains allergens: animal hair, pollen from flowers, grasses and trees. Once in the bronchial tree, they provoke a massive migration of protective immune cells into the mucous membrane, which release a large number of mediators of allergy and inflammation. The result is bronchial asthma.

Medications. Medications can sometimes be the culprit of bronchial asthma. It can be aspirin and any non-steroidal anti-inflammatory drugs. Very often, such asthma is of isolated origin with the onset of an attack only when the body comes into contact with them.

How to distinguish asthma from bronchitis?

Sometimes, differential diagnosis between bronchial asthma and bronchitis confuses even the most experienced pulmonologists. The correctness and timeliness of treatment depends on the correct interpretation of the patient's symptoms. The differences between bronchial asthma and bronchitis are shown in the table.

All the distinctive features of bronchial asthma and chronic bronchitis can be traced only in the initial stages of these diseases. Their long existence leads to irreversible bronchial obstruction. In such cases, there is no longer a need for differential diagnosis, since the clinic and treatment are identical. Both diseases are collectively referred to as COPD (chronic obstructive pulmonary disease).

How to treat asthma?

The treatment of this disease is a strictly step-by-step process, which with each stage and stage of the disease must be accompanied by appropriate adjustments in terms of therapeutic measures. Only such an approach will help in the rational use of financial resources with a minimum number of side effects. After all, the main drugs for the treatment of asthma cause a lot of severe manifestations, which can be reduced by the right combination of drugs. Differentiated treatment tactics for bronchial asthma are presented in the table.

In the treatment of bronchial asthma, a pathogenetic approach is used. It involves the mandatory use of drugs that not only relieve the symptoms of the disease, but also turn off the mechanisms for their reappearance. In no case should one limit the use of only one adrenomimetics (salbutamol, ventolin). Unfortunately, this often happens. Patients are attracted by the quick effect of these drugs, but it will also be temporary. As the receptors of the bronchial tree become accustomed, the action of b2-agonists becomes weaker, up to its complete absence. Definitely need basic therapy.

Why do you need hormones for bronchial asthma?

Without the use of glucocorticoids, there can be no talk of controlling the disease. These funds affect the main links in the pathogenesis of asthmatic inflammation in the bronchi. They are equally effective as treatment in emergency cases, and for their prevention. Under their action, the migration of leukocyte and eosinophilic cells into the bronchial system is significantly reduced, which blocks the cascade of biochemical reactions for the release of inflammatory mediators and allergies. At the same time, the swelling of the mucous membrane decreases, the mucus becomes more liquid, which contributes to the restoration of the bronchial lumen. Do not be afraid of taking glucocorticoids. Competent selection of their dose and route of administration, combined with early treatment, is the key to maximum slowing down the progression of the disease. Due to the possibility of inhalation, the risk of systemic side effects is minimized.

New in the treatment of bronchial asthma

A relatively new direction of therapy for this disease is the use of leukotriene receptor antagonists and monoclonal antibodies. These drugs have already passed many clinical randomized trials and are successfully used in the treatment of many serious diseases. In relation to bronchial asthma, scientists have recorded positive effects, but discussions on the appropriateness of their use continue to be conducted.

The principle of action of these drugs is to block their connections between cellular elements during inflammation in the bronchi and their mediators. This leads to a slowdown in the ejection processes and insensitivity of the bronchial wall to action. They are not effective in the isolated treatment of bronchial asthma, therefore they are used exclusively in combination with glucocorticoids, reducing their required dose. The disadvantage of these funds is their high cost.

Diet is important to follow for faster healing. Proper nutrition is one of the basic elements in the fight against bronchial asthma. Since this disease is of an immuno-allergic nature, the diet also implies an appropriate adjustment of nutrition according to the hypoallergenic type. General nutritional rules for bronchial asthma include several points:

Prohibited Products. These include: fish dishes, caviar and seafood, fatty meats (duck, goose, pork neck), honey, beans, tomatoes and sauces based on them, yeast-based products, eggs, citrus fruits, sweet melons, and peaches, chocolate, nuts, alcohol;

Limitation of the use of dishes from premium flour and muffins, sugar and salt, fatty meat, semolina;

The basis of nutrition: hateful soups, any cereals seasoned with butter or vegetable oil, vegetable and fruit salads that do not contain prohibited foods, doctor's sausages and sausages, chicken, rabbit, rye and bran bread, cookies (oatmeal, biscuit), sour-milk products , drinks (compotes, uzvars, teas, mineral waters);

Diet. Food is taken 4-5 times a day. Avoid overeating. Dishes can be baked, boiled, stewed, steamed. The use of fried foods and smoked meats is prohibited. The food you eat should be warm.

An approximate weekly menu for bronchial asthma is presented in the table.

Please note that only lean, not fatty meat is allowed!

Answers to popular questions

Can bronchial asthma be cured? It is impossible to answer this question in the affirmative with absolute certainty. With all the effectiveness of treatment methods and the emergence of modern drugs, it is impossible in practice to completely eliminate the contact of a person predisposed to this disease. However, it is quite possible to control the disease and minimize its manifestations. Timely treatment, active prevention of exacerbations, accessible sports, breathing exercises will help get rid of most of the symptoms of the disease.

Is asthma hereditary? No, asthma is not a genetically determined disease, since the genes of a patient with bronchial asthma are not changed. The structural features of the respiratory system, in particular the bronchi, are genetically transmitted, as well as the increased sensitivity of the endocrine system and human immunity to irritants, that is, the body's predisposition to the appearance of this disease. The combination of risk factors together increases the likelihood of developing asthma.

Can You Exercise With Asthma? There is no consensus among experts on this matter. On the one hand, an incorrectly selected sport, physical education during exacerbations can provoke bronchospasm, on the other hand, dosed physical activity normalizes metabolism, increases immunity and tone of the muscular system. This is especially important for a growing child's body.

Can you smoke with asthma? Both active and passive smoking is absolutely incompatible with bronchial asthma, since tobacco vapors are the strongest allergens, which contain more than 4,000 chemicals. Cartridges of electronic cigarettes are no less harmful for patients with bronchial asthma, as their components are able to provoke an attack. Carbon monoxide released when smoking a hookah has the same effect.

Is it possible to do inhalation with asthma? This form of administration of medicinal preparations into the body is most effective in the treatment of bronchial asthma, given the contraindications: the presence of neoplasms in the respiratory system, hyperthermia, pathology of the heart and blood vessels, diabetes mellitus, a severe form of the underlying disease, a predisposition to nosebleeds. It is important to strictly observe the dosage of essential oils and medicinal plants and fees from them, then inhalation will bring invaluable benefits.

Can I drink alcohol and coffee with asthma? Alcohol does not directly affect the respiratory system, however, its use provokes the development of inflammation, ethyl alcohol toxins negatively affect the state of all systems. In addition, most anti-asthma drugs have an incompatibility with alcohol.

Coffee, on the contrary, improves the function of the respiratory system, provided that it contains caffeine. This effect lasts 3-4 hours after drinking the drink. According to experts, coffee is a mild bronchodilator that improves the respiratory process, expanding the bronchi.

Do they take in the army with asthma? Young men with a history of bronchial asthma are not subject to conscription if this disease has passed into the second or third stages of its development, since the accumulation of sputum in the bronchi, the risk of asthma attacks when in contact with allergens, threatens not only health, but also the life of the conscript. At the first stage of the disease, the draft board gives a deferment from the draft for a year or more, during which a new examination of lung function indicators is carried out. A conscript's desire to serve, backed up by improved health, may result in being offered a light duty option during which asthma treatment is continued.

Education: Moscow Medical Institute. I. M. Sechenov, specialty - "Medicine" in 1991, in 1993 "Occupational diseases", in 1996 "Therapy".