According to experts, this disease in Russia affects about 7 million people (this is 1 person out of 20!)
Since the number of cases is constantly growing, the world community is making great efforts to, if not defeat asthma, then at least curb it. WHO has developed a large international project “Global Initiative on Bronchial Asthma”?
A national program to combat asthma is being created in our country, which includes six main areas, the first of which is the education of the patients themselves. In Moscow, there are five asthma schools organized by the Institute of Pulmonology.
Bronchial asthma is a chronic inflammation and narrowing of the lumen of the bronchi, leading to difficulty breathing, shortness of breath, coughing, and in severe cases – even death. For the first time this disease was described by Hippocrates in the 4th century BC (Greek asthma – heavy short breathing, asphyxiation). In childhood, boys suffer from asthma more often, in adolescence the proportion of boys and girls evens out, women suffer asthma somewhat more often than men, and among older people with asthma, the stronger sex prevails again …
A healthy person who breathes, so to speak, with a full breast, it is not easy to imagine what people suffer from this disease – an attack always appears suddenly, sometimes starting with coughing or sneezing, gradually causing a feeling of lack of air and even suffocation; inhaling and exhaling become frequent and convulsive, the lungs are heavy and seem to be covered with wet cement. It feels like some kind of unknown force squeezes the throat and chest from the inside, and forces you to catch oxygen particles in tiny sips … The time stretches endlessly, you feel every hard and rough second of it, but an attack can last minutes and even hours.
Asthmatics have to face such sensations all the time. If you do not take any measures, in severe cases, asthma can literally strangle a person.
In order to understand what causes asthma, it is easiest to imagine the respiratory system in the form of an inverted tree. The inhaled air moves along the trunk – the trachea, which is divided into two large branches – the bronchi (right and left). The bronchi, in turn, are divided into even smaller branches, the smallest of which are called bronchioles. In our lungs, bronchioles can be up to 8 thousand. And on the tips of these twigs, like leaves, are the alveoli – tiny air sacs, through which air enters the blood.
The respiratory system is the real “tree of life” for man. With its fruits – oxygen, nitrogen, extracted from the air, etc., it supplies the whole body through the circulatory system.
In asthma, the “tree” starts to hurt, more and more growths appear on it, bronchial branches from the inflammation begin to narrow, there is a lot of mucus inside them; all together it blocks the access of air to the alveoli. That is, asthma is nothing like a sharp narrowing of the patency of the bronchi. And this narrowing itself causes allergic mechanisms.
This is the main difference between asthma and respiratory infections, such as bronchitis or tonsillitis, in the development of which only bacterial or viral factors are involved.
Respiratory tract infections are not directly involved in the development of asthma, but can become its catalyst. So appears infectious and allergic asthma. This type of asthma is more common in older and older people and is rare in children. If the infection has become protracted, then under the influence of chronic inflammation there is a change in the structure of the bronchi; the muscular layer thickens, the walls of the bronchi grow through connective tissue, and the bronchi extremely sensitively begin to react to any irritation (smoke, cold air, stress), sharply narrowing its lumen and making it difficult to breathe. In the future, an allergic reaction also joins the infectious mechanism; this is caused by the release of the local regulation of immune responses out of control of the organism.
Infectious-allergic asthma can develop, for example, against the background of chronic bronchitis or chronic obstructive pulmonary disease (COPD).
Atopic asthma has only an allergic nature, and its attacks are directly dependent on the person’s contact with allergens. Among the frequent allergens can be distinguished pollen, house dust, animal hair, detergents, food products. An attack of atopic asthma can instantly occur even with little contact with such allergens. Outside the reach of allergens, a person suffering from this type of asthma will feel practically healthy.
Other allergic diseases can often join atopic asthma, such as urticaria, food allergies, atopic dermatitis, eczema, etc. This type of asthma is most common in children.
With a long course and no treatment, atopic asthma leads to severe changes in the respiratory tract, and infection is also possible.
In general, advanced asthma, without proper treatment and observation, is very dangerous. Gradually, with each attack, the narrowing of the bronchi will become more and more intense, and ultimately can lead to their complete blockage, and this is already a real suffocation.
And finally, the third type of asthma, rather specific – drug asthma. For example, with aspirin asthma, long-term aspirin (acetylsalicylic acid) leads to the accumulation in the body of substances that cause a strong and long-term narrowing of the lumen of the bronchi. As a rule, to get rid of such asthma is quite simple to stop taking a harmful drug.
Asthma, like many other allergic reactions, can be inherited.
If one of your parents had asthma, then the likelihood that he could pass it on to you is about 25 percent. If both parents have asthma, then, as you might guess, in this case the probability of its transmission increases to almost 50 percent. And living a child in a family where there are smokers, whether mother or father, doubly increases his chances of getting asthma compared to the children of non-smoking parents. Also, a child born prematurely is 4 times more likely to be sick than full-term babies.
Already mentioned allergies and recently transmitted infections create the same favorable background for the onset of asthma. Asthma often develops in children after a respiratory viral infection, especially when exposed to respiratory syncytial virus (RSV). Adults often experience worsening asthma after becoming ill with bronchitis or pneumonia.
Identify and win
Unfortunately, at first, asthma can be difficult to detect. This is compounded by the fact that it is similar to many other lung conditions. For example, sometimes instead of asthma you may be diagnosed with chronic bronchitis. The fact is that the intensity of asthma symptoms varies from person to person, and depending on the duration and severity of the disease. For example, in some people, asthma is characterized only by coughing. They have no wheezing during breathing and normal pulmonary function. However, there is a glowing, persistent inflammation that damages the bronchi.
There are several simple signs by which you can determine the possible presence of asthma:
* Dyspnea at any time of the day or night;
* Cough with sputum (especially if the sputum has changed color or is stained with blood);
* Persistent cough;
* Chest tightness or pain.
All these symptoms should alert both you and your doctor, the trip to which should not be postponed.
An experienced doctor at the reception will ask you if you have experienced similar symptoms before. Asthma will become one of the main “suspects” if you report that you have repeatedly had been ill with bronchitis or even pneumonia over the past year.
The doctor will listen to your breath with a stethoscope, and he can also direct you to a chest x-ray or to a scan on a CT scanner.
One of the main ways to detect asthma is spirometry, that is, measuring the amount of exhaled air (FEV). You must perform a check before and after using an inhaled bronchodilator, such as albuterol. If the FEV rate improves by at least 12 percent after applying a bronchodilator, then you almost certainly have asthma. If the result of the test to put the final diagnosis fails, you may be asked to methacholine (provoholin). In people with asthma, this substance causes wheezing, in healthy people this does not happen.
Finally, there is an allergen test. To do this, you must pass a skin prick test or a blood test to see if you are allergic to pollen, dust mites or other allergens.
In modern medicine, asthma has not been sentenced for a long time, many methods have been developed for its treatment or to minimize its symptoms. And no matter how insidious she is, the main thing is to identify it in time and begin a complete treatment.