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Bronchial asthma: first signs and symptoms, causes and treatment

Asthma is a chronic disease, the basis of this disease the non-infectious inflammation in the respiratory tract. The development of bronchial asthma contribute to both internal and external irritable factors. To a number of external factors include various allergens as well as chemical, mechanical and weather factors. To this list can be attributed to stress, and physical overload. The most common factor is allergic to dust.

The internal factors for developing asthma are defects in the endocrine and immune systems, and the cause may be a bronchial reactivity and rejection sensitivity, it can carry hereditary.

Contents:


What is bronchial asthma?

Bronchial asthma is a disease of the bronchial tree inflammatory immune-allergic nature, characterized by chronic, paroxysmal over in the form of broncho-obstructive syndrome and suffocation. This disease has become a serious problem of society as a progressive course. It is very hard to cure completely.

Inflammation of the bronchi in bronchial asthma is characterized by a strict specificity in comparison with other types of inflammatory processes of the localization. Its pathogenetic basis is an allergic component to the background present in the body, immune imbalance. This feature of the disease explains pristupoobraznoe its flow.

Allergic to the basic component joins a lot of other factors that make asthma characteristics:

  1. Hyper-reactivity of smooth muscle component of the bronchial wall. Any irritant effect onthe mucosa of the bronchi bronchospasm end;

  2. Certain environmental factors can cause a massive release of mediators of inflammation and Allergy solely within the bronchial tree. Common allergic reactions never occurs;

  3. The main inflammatory manifestation is swelling of the mucous membranes. This feature of bronchial asthma leads to worsening of impaired patency of the bronchi;

  4. Poor sliseobrazutee. Asthma bronchial asthma is characterized by the absence of sputum with cough or scarcity;

  5. It affects mainly the medium and small bronchi, lacking cartilage frame;

  6. Necessarily arises a pathological transformation of the lung tissue against the background of violation of its ventilation;

There are several stages of this disease, which are based on the reversibility of bronchial obstruction and frequency of asthma attacks. The more frequent and prolonged, the higher the stage.

In the diagnosis of asthma they are found under such names:

  1. Mild or intermittirutaya;

  2. Moderate or persistence of mild;

  3. Severe or persistence of the average degree;

  4. Extremely severe or severe persistent asthma.

Based on the above data asthma can be characterized as chronic indolent inflammation in the bronchi, the exacerbations of which is suddenly developing asthma and bronchial obstruction with asthma-type allergic reactions to irritants in the environment. In the initial stages of the process, these episodes arise quickly and just as quickly stopped. Over time they become more frequent and less responsive to therapy.


The first signs of asthma

Successful treatment of asthma is very often determined by the timely detection of the disease.

The early signs of the disease include the following symptoms:

  1. Shortness of breath or suffocation. They occur as on the background of complete well-being and peace at night and during physical exertion, stay in terms of air pollution, smoke,room of dust, pollen, flowering plants, changing the temperature of the air. It was their suddenness on the type of attack;

  2. Cough. Typical of an asthmatic attack is considered to be the dry type. It occurs synchronously with shortness of breath and is characterized by nadeznosti. Sick, as if reluctant to cough up something, but can't do it. Only at the end of the attack coughing may acquire humid character, accompanied by discharge of scant amounts of clear sputum mucous type;

  3. Frequent shallow breathing with prolonged exhalation. During an attack of bronchial asthma patients complain not only to breathing difficulty as the impossibility of a full exhalation, which becomes lengthy and requires great effort for its implementation;

  4. Wheezing when breathing. They are always dry-type whistling. In some cases, even the remote and listen to them at a distance from the patient. Auscultation they heard even better;

  5. The characteristic position of the patient during the attack. In medicine, this position is called orthopnea. At the same time, patients sit down, lowering his legs, firmly grasping hold of the bed. Such a fixation of the support muscles of the limbs helps chest in the implementation of the exhalation.

The first signal of increased bronchial reactivity may be only some of the typical symptoms of asthma, describing its attack, especially if you experience night. They can appear for a very short time, to undergo a long period of time and not to bother the patient again. Only with time the symptoms become progressive course. It is extremely important not to miss this period of imaginary well-being and access to specialists, regardless of the number and duration of attacks.

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Other symptoms of asthma

Asthma of any severity in the initial stages of its development, causes General disorders in the body. But over time they will occur, which manifests in the symptoms:

  1. General weakness and malaise. During the attack none of the patients are not able to perform any active movement, as they increase respiratoryfailure. All that remains is the patient – to take the posture of orthopnea. In between attacks of asthma with mild endurance of patients to physical activity are not violated. The heavier the disease, the more pronounced these violations;

  2. Acrocyanosis and diffuse cyanosis of the skin. These symptoms characterize severe asthma and talking about the progression of respiratory failure in the body;

  3. Tachycardia. During the attack the number of heartbeats is increased to 120-130 beats/min In the interictal period in severe asthma of moderate severity there is a slight tachycardia in the range of 90 beats/min;

  4. Dystrophic nail changes in the form of their vbuhanie the type of hour glasses and the distal finger phalanges into the form of thickening on the type of drum sticks;

  5. Signs of emphysema. This state is typical for bronchial asthma with a long disease duration or severe. Manifested in the form of expansion of the chest in the volume, vbuhanie supraclavicular areas, expansion percutory lung borders, weakening of respiration at auscultation;

  6. Signs of pulmonary heart. Characterize severe asthma, which led to pulmonary hypertension in the small circle. As a result, enlargement of the heart at the expense of the right chambers, the emphasis of the second tone of the pulmonary valve;

  7. Headache and dizziness. Are signs of respiratory distress in bronchial asthma;

  8. Tendency to various allergic reactions and diseases (rhinitis, atopic dermatitis, psoriasis, eczema);


The causes of asthma

The reasons for small bronchi become increased irritability, very much. Some of them act as background conditions supporting inflammation and Allergy, and some directly provoke an asthmatic attack. At each patient individually.

  • Genetic predisposition. People suffering from bronchial asthma have an increased risk of this disease in their children. The weights of hereditary anamnesis is noted in one third of patients with asthma. This kind of disease isatopic in nature. It is very difficult to trace the factors that provoke asthma attacks. Such asthma may develop at any age, as child and Mature.
  • Factors from the group of occupational hazards. Reliably recorded increase in cases of disease of bronchial asthma, as a result of exposure to harmful factors. It can be hot or cold air, watching the various small dust particles, chemicals and vapors.
  • Chronic bronchitis and infection. Viral and bacterial pathogens, causing an inflammatory process in the bronchial mucosa that may cause increased reactivity of their smooth muscle components. Evidence of this are the cases of bronchial asthma, occurring against the background of bronchitis with a long history, especially with signs of bronchial mast.
  • The quality of the inhaled air and ecological environment. Residents of countries with a dry climate and rural population hurts much less than people in industrial regions and countries with a humid and cold climate.
  • Smoking, as a cause of asthma. The systematic inhalation of tobacco smoke leads to inflammatory changes in the mucous membrane of the bronchial tree. Therefore, every smoker ill with chronic bronchitis. Some of them process transformirovalsya in bronchial asthma. Smoking may act as a factor to maintain the inflammatory process and, as a provocateur of each attack.
  • Asthma from dust. Scientists recorded the causal link exactly room dust with the occurrence of asthma. The fact is that indoor dust is the natural environment for the habitat of dust mites. In addition to these microscopic agents it contains many allergens in the form of exfoliated epithelial cells, chemicals and wool. Street dust becomes a provocateur of bronchial asthma only in the presence in its composition of allergens: animal fur, pollen, flowers, herbs and trees. Once in the bronchial tree, they provoke a massive migration of immune cells into the mucosa, which emit large amounts of mediators of Allergy and inflammation. As a result of bronchial asthma.
  • Drugs. Culprits in bronchial asthma sometimes can be medications. These can be aspirin and any funds from a number of nonsteroidal anti-inflammatory. Very often, the asthma is an isolated origin with the occurrence of the attack is only upon contact of the bodywith them.

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How to distinguish asthma from bronchitis?

Sometimes, the differential diagnosis between asthma and bronchitis baffles even the most experienced pulmonologists. On the correct interpretation available to the patient, the symptoms, depends on the correct and timely treatment. The difference between asthma and bronchitis is given in table.

The symptom of the disease

Chronic bronchitis

Bronchial asthma

For

Stable, sluggish with alternating periods of exacerbation and remission. The aggravation lasts for 2-3 weeks. After the relief of stay of the disease in the form of cough.

Alternating current in the form of sudden bouts of different duration (minutes, hours). During his appearance greatly disturbed General condition of the patient. The relief of an attack results in complete restoration of normal health.

Provocation of occurrence

Hypothermia, bacterial and viral infections can provoke exacerbation in the inflammatory process. Provocation of cough caused by physical exertion.

Inhalation of allergenic ingredients with air to cause an attack of bronchospasm and obstruction. Typical night attacks in the state of rest or during exercise.

Shortness of breath

Occurs only in severe or prolonged exacerbation of chronic obstructive bronchitis.

Typical and the main symptom of any form and stage of the disease. Every attack is accompanied by shortness of breath.

Cough

A constant symptom of the disease, as in its exacerbation and in remission. Is mixed with alternation of dry and wet cough, especially in the morning.

Always dry, accompanied by an attack. With its relief of cough small amount of sputum.

Sputum

Muco-purulent, greenish-yellow or light brown, rarely transparent in large quantity.

Slimy, transparent,scarce.

Temperature reaction

Periodically there.

Not typical.


All the distinctive features of bronchial asthma and chronic bronchitis can be seen only in the initial stages of these diseases. Long their existence leads to irreversible bronchial obstruction. In such cases, it is no longer necessary in the differential diagnosis, as the symptoms and treatment are identical. Both diseases are collectively called COPD (chronic obstructive pulmonary disease).

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How to treat asthma?

Treatment for this condition is the exact step-by-step process that every phase and stage of illness should be accompanied by appropriate adjustments in the plan of remedial measures. Only such an approach will help in the rational use of financial funds with minimum amount of side effects. After all, the main drugs for the treatment of asthma cause a lot of severe manifestations, which can be reduced right combination of tools. Differentiated tactics of treatment of bronchial asthma presented in the table.


Kind of drugs

Basic therapy – anti-inflammatory support treatment

Symptomatic relief of asthma attacks

Asthma (submitted by injection and tablet form)

Corticosteroids

Shown when compensated asthma of light and medium flow. Significantly reduce the need for hormone therapy (Singulair, Adalat)

Not effective in cases of emergency, therefore, are not used

Leukotriene antagonists

Occurs only in severe or prolonged exacerbation of chronic obstructive bronchitis.

Typical and the main symptom of any form and stage of the disease. Every attack is accompanied by shortness of breath.

Monoclonal antibodies

Our Department are suffering the drug by injection are shown in marked allergen bronchial componentasthma.

Not used in case of emergency

Xanthine

Tablets: Theophylline, Neofelis, Theopek

Injection mould: high-dose aminophylline.

Asthma inhaler: inhaler pocket and forms for ultrasonic inhalers (nebulizers)

b2-agonists

Used long-acting inhalers: Serevent, berotek

Drugs short-acting: Salbutamol, Ventolin

Cremony

Intal, Tayled. Are assigned only in mild asthma.

Not effective for relieving asthma attack

Anticholinergics

Atrovent, Ipravent, Spiriva

The medications used for quick relief of symptoms

Corticosteroids

Flixotide, Beklazon, Belated

Effective for the relief of status asthmaticus, particularly when inhalation through nebulizer

Tool combination

Berodual (ipratropium bromide cholinolytic+ b2-agonist fenoterol)

Seretide (b2-agonist salmeterol+ glucocorticoid fluticasone)

Symbicort (glucocorticoid budesonide+ b2-agonist formoterol. Used by inhalation through a nebulizer. The effect is very fast


In the treatment of bronchial asthma used pathogenetic approach. It involves the mandatory use of drugs that not only relieve symptoms but also turn off the mechanisms of their re-emergence. In any case, we cannot limit ourselves to using only one of the agonists (salbutamol, ventolin). Unfortunately, as often happens. Patients are attracted to fast effect from these drugs, but it will also be temporary. As the addiction receptors of the bronchial tree, the action of b2-agonists becomes weaker, until its complete absence. Definitely need basic therapy.

Why you need hormones in bronchial asthma?

Without the use of glucocorticoids may not speak of control of the disease. These funds affect the main elements of the pathogenesis of asthmatic inflammation in the bronchi. They are equally effective as treatment in emergency cases and their prevention. Under their action, significantly reduced the migration of leukocyte and eosinophil cells inbronchial system, which blocks a cascade of biochemical reactions in the release of mediators of inflammation and allergies. This reduces swelling of the mucous membrane, the mucus becomes more liquid, which contributes to the restoration of the bronchial lumen. Do not be afraid of taking glucocoricoids. Competent selection of the dose and the route of administration in combination with early treatment refers to a Deposit of maximum deceleration of the progression of the disease. Due to the possibility of inhalation introduction minimizing the risk of side effects of a systemic nature.

New in the treatment of bronchial asthma

A relatively new therapy in this disease is the use of leukotriene receptor antagonists and monoclonal antibodies. These drugs have already been many clinical randomized trials and have been successfully used in the treatment of many serious diseases. In relation to bronchial asthma, researchers recorded positive effects, but the debate on the appropriateness of their use continue to be carried out.

The principle of operation of these funds is to lock them ties between cellular elements during inflammation in the bronchi and their mediators. This leads to a slowing of the processes of emission and insensitivity of the bronchial wall-to-action. They are not effective for the isolated treatment of bronchial asthma, therefore, are used exclusively in combination with glucocorticoids, reducing their required dose. The lack of these funds in their cost.

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Diet

Diet is important to observe for faster treatment. Proper nutrition is one of the basic elements in the fight against asthma. Because this disease is immune-allergic in nature, and the diet involves appropriate adjustment of the power according to the type of hypoallergenic. General rules of nutrition in bronchial asthma include a few points:

  1. Forbidden products. These include: fish dishes, eggs and seafood, fatty meat (duck, goose), honey, beans, tomatoes and sauces based on them, the products based on yeast, eggs, strawberries, citrus, raspberry, currant, sweet melon, apricots and peaches, chocolate, nuts, alcohol;

  2. The restriction of the use of the dishes of flour and baking, sugar and salt, pork, whole milk, sour cream, cottage cheese, semolina;

  3. The basis of nutrition: navaristye soups, any cereals, seasoned with butter or oil, fruit and vegetable salads that do not contain prohibited products, doctoral sausage, and sausage, chicken, rabbit, rye and bread made from bran, cookies (oatmeal, app), products sour-milk series drinks (stewed fruit, compotes, teas, mineral water);

  4. Diet. Food taken 4-5 times a day. To avoid overeating. Meals can bake, boil, to stew, to prepare for a couple. Consumption of fried foods and meats are forbidden. Used food should be warm.

Tentative weekly menu of bronchial asthma presented in the table.



Answers to popular questions

  • Is it possible to cure asthma? It is impossible to answer this question in the affirmative with absolute certainty. Despite the effectiveness of treatment methods and the advent of modern drugs to eliminate completely the contact person predisposed to the disease, in practice, impossible. However, to control the disease, minimize its symptoms is possible. Timely treatment, active prevention of exacerbations, available sports, breathing exercises will help to get rid of most of the symptoms of the disease.

  • Is there any asthma inherited? No, asthma is a genetically determined disease, because the genes of the patient with bronchial asthma has not been changed. Genetically transmitted features of the structure of the respiratory system, particularly the bronchi, as well as increased sensitivity of the endocrine system and the human immune system to stimuli, that is, the predisposition of the organism to the emergence of this disease. The combination of risk factors together increases the likelihood of developing asthma.

  • Can I play sports with asthma? On this score among experts there is no consensus. On the one hand, a wrongly chosen sport, physical exercise during exacerbations can provoke bronchospasm, on the other hand, dosed physical load and normalize the metabolism, improve immunity, and tone the muscular system. This is especially important for growing children's organism.

  • Can I smoke with asthma? Both active and passive Smoking are absolutely incompatible with bronchial asthma, as a pair of tobacco is the strongest allergens, having in its composition more than 4,000chemicals. The cartridges of electronic cigarettes are not less harmful to asthma sufferers, since their components are able to provoke an attack. The same effect has carbon monoxide emitted when Smoking a hookah.

  • Is it possible to do inhalation during asthma? This form of administration of therapeutic drugs most effective in the treatment of bronchial asthma, considering contraindications: the presence of tumors in the respiratory system, hyperthermia, pathology of heart and vessels, diabetes, severe underlying disease, predisposition to nosebleeds. It is important to keep the dosage of essential oils and medicinal herbs and fees from them, then inhalation will bring invaluable advantage.

  • Can asthma drink alcohol and coffee? Alcohol doesn't directly affect the respiratory system, however, its use causes the development of inflammation, toxins ethyl alcohol negatively affect the status of all systems. Besides, most asthma medications have an incompatibility with alcohol.

    Coffee, by contrast, improves the function of the respiratory system, provided that it is composed of caffeine. This effect lasts for 3-4 hours after drinking. According to experts, coffee – soft broncholytic improving the breathing process that expands the bronchi.

  • Do in the army with asthma? Boys with a history of the diagnosis "bronchial asthma", not subject to conscription, if the disease moved to the second or third stage of its development, as the accumulation of phlegm in the bronchi, the risk of asthma attacks when in contact with allergens threatens not only health, but also the life of the recruit. At the first stage of the disease draft Board gives a deferment for a year or a longer period of time, during which conducted a new survey indicators of activity of the lungs. The desire of the recruit to serve, backed by improved health, can lead to the fact that it will offer a lightweight version of service, during which asthma treatment will continue.