A serious respiratory pathology is bronchial asthma, in which chronic inflammation and bronchial hyperreactivity is formed. Due to various infectious and allergic lesions at the level of the bronchial tree respiratory disorders develop – cough, shortness of breath, whistling and noise during the period of inhalation and exhalation, which is associated with spasm of muscle elements and narrowing of the lumen of the bronchi, blocking them with viscous lumps of sputum. But are attacks always associated with allergies, can they be provoked by other factors?
Bronchial Asthma: What Causes
Many people believe that asthma occurs when it comes into contact with allergens, and this leads to the development of sensitization of the body. That is, to increase the sensitivity of the immune system to a specific substance with provocation in subsequent attacks. But this is not true in all cases. If we are talking about the atopic variant of bronchial asthma, it is based on the mechanism for the development of chronic inflammation and hyperreactivity of the bronchi under the influence of allergens. But bronchial asthma It may also occur as a result of professional activity in constant contact with irritating compounds ( gases , dust, chemical fumes). They can provoke the development of asthma drugs, a special role is given to non-steroidal anti-inflammatory compounds, including salicylates. Provocative attacks can be drastic changes in the environment, the role of heredity in the genesis of chronic inflammatory lesions of the bronchi, as well as stress and frequent respiratory infections is high.
The role of allergies in the genesis of seizures
If we talk about atopic variant of bronchial asthma – this is one of the options for allergies. There are altered reactions of the immune system to various substances (antigens). In this case, they are no longer called antigens, but allergens. So, allergy in the form of asthmatic attacks is formed by repeated contacts with certain groups of allergens. When they first enter the body, the first stage of the allergy starts – sensitization, a kind of “training” of the immune system and its cells for allergen reactions. Among all possible compounds, there are groups of substances that are allergic to this form (attacks of atopic asthma) are most likely. These are pollen of cultivated or wild plants, household dust and micro-mites in its composition, fungal or microbial allergens, animal dander, cosmetics, perfumery, some food components.
Changes in the bronchi: the development of chronic inflammation
According to the definition of specialists, the development of bronchial asthma and its progression is based on constant inflammation, which is supported by immune cells, biologically active substances and irritation of mucous membranes. The presence of chronic inflammation leads to a state of constant irritability, excessive susceptibility of the mucous bronchi and their smooth muscle elements to various stimuli – the so-called bronchial hyperreactivity.
Under the influence of provoking agents on the background of the creation of external adverse conditions may develop an asthma attack. When it is due to the activation of inflammation, bronchial edema is formed, viscous sputum is synthesized in an excess amount, and a mechanism is triggered, leading to a spasm of smooth muscle elements, which narrows the bronchial lumen. As a result, the air passes through sharply narrowed, swollen, and even partially clogged bronchus of bronchial mucus, which forms the clinical manifestations of an asthmatic attack. Bronchial chronic inflammation is suppressed due to systemic therapy, there is evidence that in some cases it is eliminated spontaneously or after complete separation from provocateurs.
Respiratory disorders during an attack
For asthma typical attacks of difficulty breathing, leading to tissue hypoxia, a significant deterioration and, in some cases, even life threatening. In the development of an attack, it is possible to conditionally distinguish three stages, the duration and severity of which vary significantly among different people. At the beginning, patients may notice reactions similar to colds — watery discharge from the nose with sneezing, tickling in the throat with coughing. This is most characteristic of atopic asthma or infectious genesis of seizures. Gradually difficult breathing, an asthmatic attack is formed with tightness in the chest, feeling of lack of air and noisy breaths. They are usually sharp and short, efforts are needed to inhale. At the same time, exhalation is difficult, it is long and is accompanied by noise, wheezing or whistles that can be heard even without a stethoscope.Difficult breathing may be accompanied by coughing attacks, with an attempt to cough up viscous and thick sputum. The rhythm of breathing is disturbed, typically retraction of the gaps between the ribs, subclavian fossae.
Symptoms of an attack: shortness of breath, cough, anxiety
Against the background of asthma attacks with coughing, shortness of breath and difficulty breathing, patients become extremely restless, they are looking for a position in which it is easier to breathe, aggressive. It becomes somewhat easier when bending forward with support on the arms or knees, while shortness of breath is reduced slightly and exhalation is facilitated. Due to stress, hypoxia and shortness of breath, the face becomes swollen, may redden or acquire a bluish tinge, and the neck veins clearly show through. If the attack is severe, the auxiliary respiratory muscles are actively involved in the breathing process. Listening to the chest reveals dry rales and whistles, heart sounds are muffled.
As soon as the attack is eliminated, breathing is relieved, shortness of breath disappears, cough becomes milder, a lump of thick sputum departs. Gradually, the noise of breathing disappears, wheezing disappears and the rhythm with the depth of breathing level off. Attacks can occur from one or two times a month to several times a day. More often, they are registered in the morning or at night, which can greatly frighten patients, increasing stress.