Asthma is a disease of the respiratory tract of an inflammatory etiology of a non-infectious nature, which is characterized by a chronic course. The attack develops after the stage of precursors, its onset is evidenced by a violation of breathing – a short sharp breath and a noisy prolonged exhalation.
Signs characteristic of bronchial asthma are coughing with viscous sputum, loud wheezing. Therapy for asthma involves the use of aerosol beta-adrenergic agonists, m-anticholinergics, ASIT, but if the disease is severe, hormonal drugs are prescribed.
What is bronchial asthma
Bronchial asthma is an inflammatory process in the bronchi of an immunoallergic nature, which is characterized by a chronic course, frequent development of attacks, accompanied by bronchial obstruction and dyspnea.
For the inflammatory process in the bronchi with this pathology, some features are characteristic that make it possible to distinguish it from other types of inflammation that affect these organs.
The basis of pathogenesis is most often an allergic reaction that develops due to a dysfunction of the immune system. This specificity of the disease explains its paroxysmal course.
Signs of a predisposition to asthma
A condition characterized by the risk of developing bronchial asthma is called pre-asthma. It is characterized by the development of allergies of a different nature in combination with inflammation of the respiratory system or vasomotor disorders.
Suspicions of asthma can be caused by the presence of true allergic pathologies of the respiratory system (pollinosis, rhinitis, sinusitis, bronchitis, alveolitis), which are characterized by seasonal exacerbations. Their development is most often triggered by various allergens.
The first signs of the disease
Other pathologies join the basic allergic component, which are the cause of the onset of asthma symptoms:
- increased activity of smooth muscle of the walls of the bronchi. Any irritating effect on the mucous membranes leads to the development of bronchospasm;
- under the influence of some external factors, a massive release of substances involved in the development of an inflammatory and allergic reaction is possible. The usual symptoms characteristic of allergies are not observed in such a situation;
- the main sign of inflammation is swelling of the mucous membranes. Because of this feature, bronchial patency worsens in asthma;
- decreased mucus production. Against the background of an attack of asthma, there is a lack of mucous secretion with cough syndrome or its minimum amount;
- there is a predominant lesion of the middle and small bronchi, which lack a cartilaginous framework.
- with the development of the disease, a pathological transformation of lung tissue is observed due to impaired ventilation.
There are several degrees of severity of this pathology, the classification is based on the reversibility of bronchial obstruction and the frequency of asthma attacks. The more often the attacks occur and the longer the attacks last, the more severe the degree.
When diagnosing the disease, asthma is isolated:
- easy flow (intermittent);
- moderate (persistent mild);
- severe (persistent moderate);
- extremely severe (persistent severe).
Based on the information given above, we can say that bronchial asthma is a chronic sluggish inflammatory disease of the bronchi, the cause of exacerbations in which is a reaction to external stimuli that causes an attack of bronchial obstruction, accompanied by suffocation.
At an early stage of the development of the disease, attacks are rare, they are removed quickly. Over time, they appear more often and are less amenable to therapy.
How successful the treatment of this ailment will be depends on the timely detection of pathology.
At an early stage, patients with bronchial asthma develop complaints about:
- shortness of breath or choking. These signs can appear with complete well-being and rest at night, as well as against the background of physical exertion or if polluted air, smoke, dust, pollen of plants enter the respiratory tract. In addition, the occurrence of such symptoms is possible due to changes in air temperature. The main symptom is their sudden paroxysmal appearance;
- cough. A typical symptom of bronchial asthma is a dry cough. It appears at the same time as shortness of breath, it is characterized by annoyance. The person seems to be trying to clear his throat, but he can’t. Only by the end of the attack does the cough become moist, a scanty transparent mucous sputum appears;
- frequent peripheral breathing with prolonged exhalation. In the process of an asthma attack in adults or children, there are complaints not about difficulty breathing, but about the inability to fully exhale. Exhalation in this case is long; to carry it out, great efforts are required;
- wheezing during breathing. As a rule, they are dry, whistling. Sometimes they can even be heard remotely. In the process of auscultation, they listen better;
- the need to take a characteristic posture during an attack. Doctors gave the name to this position – orthopnea. The patient in this situation sits down with his legs lowered, rests his hands on a horizontal surface. In this position, additional muscles are involved, and it is easier for a person to inhale.
Only some typical signs of the disease characteristic of seizures can signal bronchial hyperreactivity. They are characterized by short duration, independent disappearance, then they do not appear for a long time.
Only over time does the symptomatology become progressive. The main thing is not to miss this moment and consult a doctor in a timely manner, regardless of the frequency and duration of attacks.
The main and accompanying symptoms of bronchial asthma
This disease is actually a serious problem, as it is characterized by a progressive course. It cannot be completely cured.
The main complaints of patients with bronchial asthma:
- shortness of breath, shortness of breath, shortness of breath. They appear, as a rule, after contact with an allergen;
- paroxysmal dry cough, usually at night or in the morning. Sometimes a scanty transparent phlegm resembling mucus is separated;
- dry wheezing – wheezing or squeaky sounds that appear during breathing;
- Difficulty exhaling with full inhalation. To exhale, a person is forced to resort to the orthopnea posture, which was described earlier.
For bronchial asthma development is characteristic:
- acrocyanosis and diffuse cyanosis of the skin;
- enlargement of the heart;
- symptoms characteristic of pulmonary emphysema (barrel chest [M32] , impaired respiratory function);
- pathological changes in the structure of the nail plates – they begin to crack, acquire a convex shape;
- concomitant pathologies – dermatitis, eczema, psoriasis, rhinitis (runny nose).
It should be noted that the main clinical manifestations of the disease are very variable. This even applies to the same patient (in one case, the symptoms quickly disappear, in the other they persist for a long time and appear intensely).
Symptoms vary from patient to patient. For some, the disease does not manifest itself for a long time, and the development of exacerbations is a rare occurrence, others face attacks every day.
Symptoms Not Common to Asthma
Some manifestations characteristic of asthma can appear in other diseases. You can suspect the presence of other pathologies if:
- against the background of suffocation, dizziness appears, darkens before the eyes, limbs grow numb;
- with cough syndrome, sputum is always separated, and there is no suffocation;
- the patient’s voice changes;
- the patient begins to complain of the appearance of symptoms characteristic of asthma only during a cold;
- if a person smokes for a long time;
- if heart problems have been diagnosed causing heart failure.
Signs of an approaching attack
Before an attack, precursors appear in the form of irritability, anxiety, in some cases lethargy, rarely drowsiness and an apathetic state. The duration of this period is 2-3 days.
Also, before the onset of an attack, there may be several signs of bronchial asthma:
- hyperemia of the skin on the face;
- dilated pupils;
- possible nausea and vomiting.
Symptoms during an attack
Bronchial asthma often manifests itself in the form of attacks, which occur in each case in different ways. Moreover, the reasons for this condition are different. In the atopic form of the pathology of the attack, it develops due to contact with allergens.
With an infectious-allergic type of disease, emotional overstrain, a disease of the respiratory organs can provoke the onset of an attack, and occasionally it can occur for no reason.
Symptoms of an asthma attack:
- there is an increase in the size of the chest;
- veins in the neck swell;
- sweating increases;
- breathing is accompanied by whistling and wheezing, heard from a distance;
- when breathing, the muscles of the back, abdomen, limbs are strained, the intercostal spaces are drawn in;
- there is a feeling of squeezing in the chest;
- the patient does not have enough air.
The duration of an attack in each case is different – from 5 minutes to several hours. Respiratory function is restored over time.
The attack ends with a cough, in which a small amount of thick and very transparent mucous sputum is separated. Sometimes pieces of sputum come out in the form of cylinders, repeating the shape of the bronchi.
The development of attacks of bronchial asthma and the severity of manifestations always depend on the form of the disease. With an infectious-allergic type of pathology, the symptoms appear and intensify gradually. For the atopic form of the disease, a lightning-fast deterioration is characteristic immediately after contact with an allergen.
A complication of this pathology is status asthmaticus. It can cause death of the patient. This condition is most severe in elderly asthmatics and in young children.
All sorts of factors can cause the development of status asthmaticus: problems with the respiratory system, discontinuation of prescribed medications.
At first, the patient notes a deterioration in respiratory function, the use of medications does not give an effect, then an even greater aggravation of the condition is observed, the flow of air into the lungs practically stops, the muscles of the respiratory organs “get tired”.
In the absence of timely therapy against the background of this attack, a coma may develop, and in some cases, a lethal outcome is possible.
If the attack lasts too long and there is no effect from the use of the usual medications, you can suspect that this complication is starting to develop.
In such a situation, it is required to immediately call the ambulance team and transport the patient to the hospital. He may need intensive care.
Since bronchial asthma is a pathology characterized by a chronic course, in order to prevent exacerbations, the main thing is to avoid contact with probable irritants, follow an elimination diet and refuse to work in harmful conditions.
In the case of an accurate detection of an allergen, a specific hyposensitizing therapy is prescribed to reduce the body’s response to it.
Treatment of bronchial asthma
To stop asthma attacks, asthmatics are prescribed inhaled beta-adrenomimetics, they contribute to a rapid increase in bronchial lumens and improve the elimination of mucous secretions. The doctor may recommend taking medications containing salbutamol, fenoterol hydrobromide, orciprenaline.
The dosage for each patient is selected taking into account the severity of the disease and the characteristics of his body. M-anticholinergics – ipratropium bromide in the form of an aerosol and combined preparations based on it with the addition of fenoterol – also help to relieve an asthma attack.
Also, asthma treatment involves the use of xanthine derivatives. They are used to prevent asthma attacks. Available in the form of tablets with a prolonged effect.
Prevention of asthma
A disease such as bronchial asthma is characterized by an alternation of increase and decrease in manifestations. If pathology is detected in time, it is possible to achieve stable and long-term remission.
The further state of health of an asthmatic person mainly depends on how the patient monitors his health and whether he adheres to medical recommendations.
Preventive measures play an important role. They imply the remediation of foci of chronic infection, smoking cessation, minimizing the impact of irritating factors.
This is especially true for those who are at risk or have a hereditary predisposition to this disease.