is a chronic inflammatory disease of the respiratory tract, which is manifested by attacks of shortness of breath, wheezing, coughing, and in severe cases - a pronounced and even life-threatening violation of respiratory function. The tactics of patient management and methods of treatment of bronchial asthma have been studied by doctors for a long time.
In recent years, the incidence of bronchial asthma has been steadily increasing, which has led to the successful development of new effective drugs that can achieve control over the clinical manifestations of the disease.
At the moment, properly selected therapy in the absolute majority of cases allows you to maintain a good quality of life of the patient and minimize the symptoms of the disease.
Causes of bronchial asthma
is typically a disease of an allergic nature and is associated with an increased susceptibility of a particular person's body to an allergen substance. That is why bronchial asthma is often combined with allergic rhinitis, conjunctivitis, atopic dermatitis and other allergic diseases. Contact with an allergen activates the cells of the immune system in a special way. This leads to the development of a series of changes characteristic of asthma in the walls of the bronchi: there is an accumulation of immune cells, inflammatory edema develops, hyperreactivity of smooth muscle components of the bronchial wall is observed, the production of mucus (sputum) increases.
These four mechanisms lead to a narrowing of the bronchial lumen, which, in turn, makes it difficult for air to pass through the respiratory tract, causing characteristic attacks of shortness of breath.
An important role in the pathological processes of bronchial asthma is played by the functional state of the autonomic nervous system, the presence of chronic diseases (especially the respiratory system) and bad habits. A direct link between smoking and the severity of the disease has been established.
It has been proven that inhalation of tobacco smoke by a pregnant woman and an infant increases the risk of developing asthma in a child.
Being in an environment with increased air pollution (for example, at work) provokes a more severe course of bronchial asthma.
Classification of the disease
When making a diagnosis of "bronchial asthma", doctors try to clarify the characteristics of the disease in a particular patient as much as possible in accordance with the classification below. This makes it possible to determine the patient's management tactics, the expected response to therapy and prognosis.
is divided into allergic, which is characterized by common mechanisms of development and signs of atopic (allergic) diseases, and non-allergic. Additionally, asthma is characterized by the nature of the allergen causing the attack.
Depending on the frequency of seizures and the ability to control them with the help of ongoing therapy, asthma can be intermittent (transient) and persistent (permanent). The latter, in turn, is divided by severity into light, medium and heavy.
Symptoms of bronchial asthma
A typical manifestation of asthma is bronchial obstruction syndrome (narrowing of the bronchial lumen). Shortness of breath attacks at first develop mainly in contact with a causally significant allergen.
The patient has a dry cough, difficulty breathing (mainly on exhalation), breathing may be accompanied by wheezing.
During an attack, a person, as a rule, experiences a feeling of fear and feels a lack of air. The condition is slightly relieved if you take a forced position - to sit down, slightly bending the torso forward, with your arms stretched out on your knees or the edge of the chair. Visually, there is a barrel-shaped swelling of the chest - it seems to freeze in the position of a deep breath.
In severe cases, due to insufficient oxygen enrichment of the blood, the skin acquires a bluish hue.
As the disease progresses and in the absence of appropriate drug control, asthma attacks begin to develop not only in response to a specific allergen, but also with emotional and physical exertion, a sharp change in ambient temperature, in response to pungent odors, etc.
Diagnosis of bronchial asthma
Diagnosis of bronchial asthma is based primarily on the patient's complaints, medical history and the results of an objective examination. It is extremely important for the doctor to find out in response to what the attack develops, how long it lasts, after what time it stops, how long ago the first symptoms of the disease appeared. To confirm the diagnosis of allergic bronchial asthma, it is important to identify the presence of symptoms of other allergic diseases in the patient and his relatives.
After making a presumptive diagnosis, special instrumental and laboratory tests are carried out.
Among the instrumental methods, peak flowmetry and spirometry play a leading role.
These methods allow us to estimate the volume of inhaled and exhaled air, the rate of exhalation and calculate specific indices (for example, the Tiffno index), which characterize the degree of violation of the passage of air through the respiratory tract. To do this, the patient is asked to inhale and then exhale into a special device for measuring the above parameters. Since these studies require coordinated actions of the doctor and the patient, they are rarely performed for children under 5 years of age.
To make a diagnosis, you need to make a sample with a drug (bronchodilator), therefore, before spirometry, the patient is given medication inhalation. This test shows the response of the bronchi to drugs and allows you to differentiate bronchial asthma from other diseases with similar symptoms.
Of the laboratory tests, the most diagnostically significant is a serological study in order to identify specific antibodies (specific IgE) to possible causally significant allergens.