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Bronchial asthma: causes, symptoms, treatment and prevention

The actual prevalence of asthma in the world is quite high - more than 5%. Studies conducted in large cities of Russia reveal the presence of symptoms of this disease in 5-7% of the population.

The late detection and later treatment of bronchial asthma leads to an increase in the incidence of bronchoconstriction, reduced quality of life, increases the likelihood of disability and shortens life expectancy.

It is important to seek medical attention in a timely manner. Modern allergology has a wide arsenal of tools and methods for treating this pathology.

Content

Bronchial Asthma - What is it?

What is Bronchial Asthma?

From the Greek language the word "asthma" is translated as "heavy breathing, shortness of breath." In bronchial asthma in the respiratory tract, under the influence of a large number of factors, the process of inflammation develops.

It becomes chronic and is not associated with the microbial flora (aseptic inflammation as a result of impaired immune system). Clinically, this leads to the appearance of episodes of bronchial obstruction — a temporary narrowing of the bronchial lumen of varying severity.

Bronchial obstruction causes a violation of the respiratory function in the form of difficulty in exhalation, accompanied by cough, shortness of breath, wheezing.

Characteristic nocturnal appearance (important diagnostic feature).

At the onset of the disease, respiratory failure may be resolved spontaneously, but more often medication is required. Patients suffering from bronchial asthma should always be on hand (in the first aid kit).

Causes of bronchial asthma

The factors that form chronic inflammation in the airways are called inducers and are divided into internal and external. This classification is necessary for their effective elimination in the course of treatment.

1. Internal:

  • Genetic predisposition - the probability of getting sick, having a relative with asthma 35 - 70%;
  • Allergic reaction - excessive body reactivity, which develops when various substances, called allergens, enter the blood. Patients with asthma have an unfavorable genetic background of the immune system. Clinically, this results in a severe narrowing of the airways through the inhalation of allergic agents;
  • Hyperreactivity - an increased bronchial response to irritation and inflammation, which leads to a strong narrowing of their lumen;
  • Sex and age features. So, up to 10 years among children, boys are more often ill; in transitional and adulthood, the disease is more often detected in women;
  • Obesity. Currently, this metabolic disorder is considered as an endocrine disease, since it is always accompanied by hormonal disorders. And they, in turn, create the background for inadequate response of the immune system.

2. External (environmental factors):

  • Substances that cause a reaction in the bronchi. Most often, these are respiratory allergens: house dust mites, animal dander, mold and yeast fungi, cockroach allergens, etc .;
  • Tobacco smoke, incl. and passive inhalation, vehicle exhaust gases (therefore, the prevalence of asthma in cities is higher than in rural areas);
  • Occupational hazards such as inhalation of dust, acid fumes, cold or hot air;
  • Viruses. In children, a common cause of asthma is a respiratory syncytial viral infection. These microbial agents change the local immunity in the bronchi, causing an increased allergic mood;
  • Increased susceptibility to ozone, nitrogen dioxide and sulfur;
  • The predominant use of products of high degree of processing in combination with a low amount in the diet of vegetables and fruits. So, in the majority of such "harmful" products contain preservatives, stabilizers, animal fats of poor quality, negatively affecting the immune system.

Symptoms of asthma by stages of development

Symptoms of bronchial asthma

1. Stage of predisposition or biological defects

It has no particular manifestations and is clinically a hidden, internal stage, which is characterized by the presence or effect on humans of inducers of bronchial asthma, described above.

At this stage, the development of the disease can be prevented if laboratory diagnostics are performed in time and internal biological defects that indicate the possibility of developing asthma are detected.

For example, in people with bronchial hyperresponsiveness at this stage, a large number of eosinophils (leukocytes) are detected in washings from the mucous membrane of the bronchi and sputum.

Further, the identification of the most probable allergens and their elimination by specific antiallergic methods and lifestyle changes are required.

2. The stage of predastmy

There are no typical clinical manifestations yet, but the risk factors that affect a person already trigger a mechanism that alters the normal functioning of the respiratory tract.

In humans, respiratory diseases can become more frequent, obstructive bronchitis appears (bronchial patency is disturbed), cases of difficulty breathing are recorded, an allergic reaction occurs in the form of a runny nose, edema, and urticaria.

In the blood test, an increase in eosinophils can be detected already at this stage.

Measures taken to identify the causes of disorder of the respiratory system, and the elimination (if possible) of risk factors for asthma, reduce the likelihood of further progression of the changes that form the disease.

3. The stage of clinically severe asthma

asthma attack Symptoms typical of asthma appear, and treatment must be carried out in full. It is also necessary to minimize the influence of inductor factors.

The severity of symptoms depends on the severity of the disease, the extent of the influence of risk factors and exacerbation trigger factors (triggers). Triggers are all respiratory allergens, paints, aerosols, emotional stress, physical exertion, acute respiratory viral infections, non-steroidal anti-inflammatory drugs, beta-blockers.

The severity of bronchial asthma is determined by the frequency of coughing and difficulty breathing, as well as the need for use and the dose rate of the drugs used, after which the condition improves (if hormones are required, how often short-acting bronchodilators are used)

Mild asthma is manifested by coughing episodes, which occur sporadically (when exposed to inducers and are aggravated by triggers).

Patients have fatigue, decreased activity, deterioration of exercise tolerance. Such symptoms of an allergic condition as nasal congestion or runny nose, lacrimation, sneezing accompany cough.

Distinctive features of these conditions is the slimy nature of pathological secrets. If the cause is bacterial agents, then the secret becomes purulent.

Medium and severe asthma has persistent symptoms.

Coughing joins difficulty in breathing, which may increase to the development of an attack of suffocation. Asthma is characterized by difficulty exhaling, not inhaling! This is the main symptom of bronchial obstruction.

There are dry whistling wheezing, shortness of breath. In severe cases, respiratory failure occurs. It manifests itself in an increase in the size of the chest in the form of distention, cyanosis of the skin, palpitations, difficulty in speaking.

Reference diagnostic criteria for the detection of bronchial asthma:

  1. Repetition of episodes of wheezing that can be heard from a distance;
  2. Tormenting night cough;
  3. Wheezing and coughing always appear under the influence of the same factors - dust, odors, wool, aerosols, medication, etc. (as a result of the causative allergen);
  4. Cold and SARS of protracted nature (more than 10 days). These conditions always lead to bronchitis;
  5. Relief brings only anti-asthma drugs (hormonal or non-hormonal, depending on the severity of the disease).

Treatment of bronchial asthma

Asthma therapy Therapy of this disease is always long and complex, with a complete cure mono achieved only in childhood, if the necessary measures are taken in time. In the adult state, therapy is aimed only at preventing attacks and preventing the progression of the disease.

Treatment of asthma in adults should be combined with a 100% cessation of smoking. All patients need to take care to prevent contact with allergens and provoking factors.

It is necessary to establish the so-called "hypoallergenic life" - eliminate all sources of dust and other allergens. These are carpets, draped curtains, soft toys, pillows with down, open bookshelves, home flowers, etc.

It is recommended to remove old things, furniture, which are the favorite habitat of house dust mites. It is desirable that the material of the walls allowed to carry out their wet cleaning.

It is important to follow a hypoallergenic diet, which excludes both products that are allergic, and refined, fatty, canned products and everything sweet. Preference should be given to natural foods.

In bronchial asthma, treatment with pharmacological drugs involves the following areas:

1. Elimination of seizure

Treatment of bronchial asthma

Bronchodilators salbutamol, terbutaline, fenoterol are used (B 2 - short-acting agonists). Their action consists in the rapid expansion of the bronchi and the elimination of difficulty breathing and suffocation.

They are usually used independently in the form of aerosols, and in the case of inpatient treatment through a nebulizer. These are emergency drugs.

2. Treatment of exacerbation

In the period of exacerbation, use drugs that eliminate inflammation. The most effective are hormones - inhaled glucocorticoids.

These include beclomethasone, fluticasone, budesonide, rarely flunisolide and triamcinolone. In severe cases, systemic glucocorticoids, such as prednisone, are used.

The strategy for treating bronchial asthma in case of exacerbation consists in applying two approaches: “step up” or “step down”, both of which are stepwise in nature.

With the “ step up ” or “ bottom-up ” approach, a small dose of the drug is first prescribed and it rises to the first signs of clinical improvement. In the absence of the effect of the drug is replaced by a stronger.

With the “ step down ” or “ top down ” approach, the initial dose of the anti-inflammatory drug used is the maximum. Once a positive effect is achieved, the dose is reduced to the minimum, which provides a steady improvement.

This approach quickly eliminates the manifestations of exacerbation of asthma, reduces the time and cost of treatment. Therefore, it is preferred.

3. Basic therapy, exacerbation warning

Consists in the constant use of anti-inflammatory drugs in a small, maintenance dose. The following range of drugs is used:

  1. Hormones –glucocorticoids of systemic or inhalation action;
  2. Long-acting bronchodilators (2 - long-acting agonists (salmeterol, formoterol), long-acting theophyllines;
  3. Cell membrane stabilizers (cromoglycate, nedocromil);
  4. Leukotriene modulators (zafirlukast, montelukast, zileuton).

The most effective combination for the control of asthma is a combination of a corticosteroid with an inhalation route of administration and B2 - long-acting agonists, for example, fluconazole + salmeterol.

This combination is possible when using two inhalers with appropriate drugs, but in practice, combined drugs, such as Seretid Multidisk, have a greater effect and convenience.

4. Treatment of asthmatic status - severe attack, which is not removed by the usual patient drugs.

This emergency treatment involves a complex of therapeutic measures in the hospital. Apply hormones with an intravenous route, bronchodilators through a nebulizer, masked oxygen, mechanical ventilation, antibiotics.

Additional treatments are aimed at general strengthening of the body. Therefore, the following are recommended: a complex of physical therapy, breathing exercises, su-jok, sanatorium-resort mountain-climatic treatment, halochamber, blood ultraviolet irradiation, phytotherapy.

An important role is teaching patients the right way of life. For this, special “schools of bronchial asthma” have been created. They also tell how to provide emergency assistance on their own.

Prevention of asthma

Primary prevention is the prevention of the formation of an allergic predisposition in a child during the prenatal and postnatal periods.

It consists of the following activities:

  • exclusion of exposure to allergens and smoking pregnant (including - passive);
  • breastfeeding for at least 6 months (it contributes to the proper formation of the child’s immune system);
  • limit the effects of allergens on children at high risk of developing allergies in the first years of life.

Secondary prevention - is to eliminate contact with the allergen. Its implementation is possible only when establishing its type and the occurrence of an allergic reaction for the first time (sensitization stage).

Tertiary prevention - implies the prevention of complications of asthma. The activities of this stage are implemented through the timely detection and proper treatment of the disease.

Bronchial asthma, ICD code 10

In the International Classification of Diseases of the 10th revision of the ICD 10, asthma is (full path to the code):

Class X. Respiratory Diseases (J00 — J99)

J40-J47 - Chronic lower respiratory tract diseases

Code J45 - Asthma

  • J45.0 Asthma with a predominance of the allergic component
  • J45.1 Non-allergic asthma
  • J45.8 Mixed Asthma
  • J45.9 Asthma, unspecified
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