Bronchial asthma is allergic - Causes, symptoms and treatment. MF.

Bronchial asthma is one of the most common and severe allergic diseases, entering the so-called "Big Three Allergic Diseases".The incidence of this pathology is growing every year. Currently, at least 6% of the total population have bronchial asthma of varying degrees of severity. The proposed article contains complete information on the symptoms, diagnosis and treatment of the disease and will be able to answer many questions from patients, their families, or maybe doctors.

Bronchial asthma is a chronic, inflammatory disease of the upper respiratory tract. The main manifestation of bronchial asthma is reversible( alone or after exposure to medications) bronchial obstruction, manifested by asphyxiation.

The first complete description of the disease was made by our compatriot GI.Sokolovsky in 1838. But now the palm tree in the development of methods for the treatment of allergic bronchial asthma is missed and now in Russia they use( or should use) protocols written off international recommendations, for example, with GINA.

The prevalence of bronchial asthma is about 6%.Of great concern is the huge number of unidentified forms of the disease. As a rule, these are light forms of bronchial asthma, which can be hidden under the diagnoses "obstructive bronchitis" or simply "chronic bronchitis."The incidence among children is even higher and in some regions reaches 20%.Among children, the number of patients with not diagnosed is even higher.

Cause of bronchial asthma

The pathogenetic mechanism of immediate type hypersensitivity( IgE-dependent immune response) is the basis of development of bronchial asthma. This is one of the most frequent mechanisms of development of allergic and atopic diseases. It is typical for him that from the moment of receipt of the allergen to the development of the symptoms of the disease are few minutes. Of course, this applies only to those who already have sensitization( allergic mood) to this substance.

For example, a patient with bronchial asthma and having allergies to the cat's fur enters the apartment where the cat lives, and his suffocation begins.

An important role in the development of allergic bronchial asthma is played by a hereditary burden. So among the nearest relatives of patients, patients with bronchial asthma can be found in 40% of cases and more often. In this case, it should be taken into account that not the bronchial asthma itself is transmitted, as such, but the ability to develop allergic reactions in general.

The factors contributing to the occurrence of bronchial asthma include the presence of foci of chronic infection( or frequent infectious diseases) in the airways, adverse ecology, occupational hazards, smoking, including passive, long-term use of a number of medications. Some authors consider starting factors as long-term contact with aggressive allergens, for example, living in an apartment whose walls are affected by mold fungus.

Thus, bronchial asthma is an allergic disease, in the aggravation of which the leading role is played by contact with allergens. Most often, the disease causes allergens that come inhalation: household( various varieties of house dust mites, house dust, library dust, feather pillows), pollen, epidermal( wool and animal dander, bird feathers, fish food, etc.), fungal.

Food allergy, as the cause of bronchial asthma, is extremely rare, but it is also possible. For food allergies in this case are more typical cross-allergic reactions. What does it mean? It so happened that some allergens of different origin have a similar structure. For example, pollen allergens of birch and apples. And if a patient with asthma and having an allergy to birch pollen will eat a couple of apples, then he may develop a suffocation attack.

Bronchial asthma may be the last stage of the "atopic march" in children who have atopic dermatitis in their list of diseases.

Symptoms of bronchial asthma

The main symptoms of bronchial asthma : bouts of shortness of breath, suffocation, sensation of wheezing or whistling in the chest. Whistles can intensify with deep breathing. A common symptom is paroxysmal cough, more often dry or with the departure of a small clot of light sputum at the end of an attack. A paroxysmal dry cough may be the only symptom of bronchial asthma.

With moderate to severe bronchial asthma, dyspnea may occur with physical exertion. Dyspnea significantly increases with exacerbation of the disease.

Often, the symptoms appear only at the time of exacerbation of asthma, without exacerbation the clinical picture may be absent.

Exacerbations( choking) may occur at any time of the day, but "night" episodes are "classical".The patient may notice that there are factors that cause an exacerbation of the disease, for example, being in a dusty room, contacting animals, cleaning, etc.

Part of the patients, , especially this is typical for childhood , seizures occur after intense physical exertion. In this case, they say about asthma of physical stress ( old name) or about bronchoconstriction , caused by physical exertion.

During the exacerbation the patient begins to react to so-called nonspecific irritants: sharp odors, temperature changes, smell of smoke, etc. This indicates an active inflammatory process in the bronchi and the need to activate medication.

The frequency of exacerbations is determined by the type of allergen to which there is a reaction and by how often the patient contacts it. For example, with allergies to plant pollen, exacerbations have a clear seasonality( spring-summer).

When listening to a patient with a phonendoscope, weakened vesicular breathing and the appearance of high( wheezing) wheezing. Without exacerbation, the auscultative picture can be without features.

A characteristic symptom of bronchial asthma is a good effect of taking antihistamines( cetrine, zirtek, eryus, etc.) and especially after inhalation of bronchodilators( salbutamol, berodual, etc.).

Based on the severity of the symptoms, four degrees of severity of the disease are identified.

1) light intermittent bronchial asthma .Manifestations of the disease are observed less than once a week, night attacks 2 times a month or less. Peak expiratory flow rate( PSV) is> 80% of the age norm, fluctuations in PSV per day are less than 20%( for more details on this method of research see section IV).
2) slight persistent bronchial asthma .Symptoms of the disease are more common 1 time per week, but less often 1 time per day. Frequent exacerbations disrupt daily activity and sleep. Nocturnal seizures occur more than 2 times a month. PSV & gt; 80% of the due, daily fluctuations of 20-30%.
3) moderate severity of bronchial asthma .Symptoms become daily. Exacerbations perceptibly disturb daily physical activity and sleep. Nocturnal symptoms occur more than 1 time per week. Daily intake of β2 agonists( salbutamol) of short action is required. PSV 60-80% of the age norm. Oscillations of PSV over 30% per day.
4) severe severity of bronchial asthma .Constant symptoms of bronchial asthma. Attacks of suffocation 3-4 times a day and more often, frequent exacerbations of the disease, frequent nocturnal symptoms( once every two days and more often).Daily movement is noticeably difficult.

Most life-threatening symptom of bronchial asthma - development of asthmatic status( asthmatic status).At the same time, prolonged, resistant to traditional medicamentous treatment, suffocation. Choking of an expiratory nature, that is, a patient can not exhale. The development of asthmatic status is accompanied by a violation, and subsequently a loss of consciousness, as well as a general severe condition of the patient. In the absence of treatment, the likelihood of a lethal outcome is high.

What tests should I take if I suspect bronchial asthma

Bronchial asthma is in the sphere of interest of two medical specialties: an allergist-immunologist and pulmonologist. This is a fairly common disease, therefore, therapists or pediatricians are usually engaged in mild forms( depending on the age of the patient).But it's better to get to a specialist at once. The most important component in the examination of a patient with bronchial asthma is the identification of those allergens, contact with which causes allergic inflammation. Begin testing with the definition of sensitivity to domestic, epidermal, fungal allergens.

Detailed list of tests to be taken if you suspect allergic bronchial asthma

Treatment of allergic bronchial asthma

In the treatment of atopic bronchial asthma, the following groups of drugs can be used. Their dosages, combinations and duration of treatment are determined by the doctor, depending on the severity of the disease. Also currently dominated by the concept that the treatment of bronchial asthma should be reviewed every three months. If during this time the disease was completely compensated, then decide whether to reduce dosages, if not, then on increasing doses or on joining medications from other pharmacological groups.

Description and doses of preparations for the treatment of allergic bronchial asthma

The most important component in the treatment of allergic bronchial asthma is the conduct of allergen-specific immunotherapy( SIT-therapy).The goal is to create immunity to those allergens that cause the patient to have an allergic reaction and inflammation. This therapy can be carried out only by an allergist. Treatment is carried out without exacerbation, as a rule, in the autumn or winter time.

To achieve the goal, the patient is injected with solutions of allergens in gradually increasing dosages. As a result, they develop tolerance. The effect of treatment is higher the earlier therapy is started. Considering that this is the most radical way to treat atopic bronchial asthma, it is necessary to motivate patients to start the treatment as early as possible.

Treatment of atopic bronchial asthma with folk remedies.

Allergic diseases - this is the group of diseases in which traditional medicine should be treated with extreme caution. And allergic bronchial asthma is no exception. During my work I witnessed a huge number of exacerbations provoked by these methods. If some way helped your acquaintances( not the fact, by the way, that it was he who helped, maybe it was a spontaneous remission), this does not mean that he will not cause complications in you.
Do sports or breathing exercises. This will give a much better effect.

Features of nutrition and lifestyle of a patient with allergic bronchial asthma.

Observance of a special way of life and creation of hypoallergenic( devoid of allergens) environment is the most important component of the treatment of bronchial asthma. At present, many large hospitals have established so-called schools of patients with bronchial asthma, where the patients are trained precisely in these activities. If you or your child is suffering from this disease, I recommend that you look for a school in your city. In addition to the principles of hypoallergenic life, they are taught to monitor their condition, adjust treatment themselves, use a nebulizer, and so on.

More information on how to relieve the course of allergic bronchial asthma

Allergic bronchial asthma in children

Bronchial asthma in children can manifest at any age, but more often after a year. An increased risk of developing the disease in children with hereditary inherited from allergic diseases, and in patients who have already noted allergic diseases in the past.

Often, bronchial asthma can hide under the mask of obstructive bronchitis. Therefore, if the child had 4 episodes of obstructive bronchitis( bronchial obstruction) per year - urgently go to the allergist.

Preparations and dosages for the treatment of bronchial asthma in a child

Allergic bronchial asthma and pregnancy.

Special care is taken to eliminate allergens and create a hypoallergenic environment during pregnancy. It is mandatory to exclude active and passive smoking.
Treatment depends on the severity of the disease.

Preparations for the treatment of allergic bronchial asthma during pregnancy and during breastfeeding

Possible complications of allergic bronchial asthma and prognosis

The prognosis for life with proper treatment is favorable. With inadequate treatment, abrupt withdrawal of drugs - the risk of developing asthmatic status is high. The development of this condition already poses an immediate threat to life.

Complications of long-term uncontrolled bronchial asthma can also include the development of emphysema, pulmonary and cardiac failure. Severe forms of the disease can lead to disability of the patient.

Prevention of allergic bronchial asthma

Effective measures of primary prevention, that is, aimed at preventing the disease, unfortunately not developed. With an existing problem, adequate treatment and elimination of allergens is necessary, which allows stabilizing the course of the disease and reducing the risk of exacerbations.

Answers to frequently asked questions on the topic of allergic bronchial asthma:

Does the respiratory gymnastics help Strelnikova and Buteyko in the treatment of bronchial asthma?

They diagnose bronchial asthma. The doctor prescribed a course of treatment with inhalers( fliksotid) for three months. Symptoms disappeared on the fifth day of treatment. Why take drugs for so long if the disease is no longer manifested?

In the hospital, an inhaler was administered to beclazone. In the instructions I read that he refers to hormonal drugs. Is it dangerous to use it? What are the possible side effects? How can these( these side effects) be avoided?