Bronchial asthma: diagnostic methods

One of the most severe forms of allergy is the formation of bronchial asthma in a patient. These are attacks of breathlessness with a painful dry cough, wheezing, and severe shortness of breath, which leads to tissue hypoxia and disturbance of the condition. However, some parasitic invasions (for example, opisthorchiasis) or somatic diseases or infections may be similar to asthma attacks. Therefore, it is important to conduct a thorough diagnosis, blood tests, provocative tests and additional methods in order to establish an accurate diagnosis.

Symptoms of asthma attacks: cough, shortness of breath

Often suspicions about the allergic nature of the pathology are caused by the presence of typical attacks of asthma. A few hours or minutes before the start, many patients notice a kind of precursor – watery, abundant discharge from the nose, sneezing or watering, skin itching. Many have an obsessive paroxysmal cough.But such a scenario is more typical for this form of allergy, such as pollinosis, with its bronchial asthma is one of the options for the course or complication.

The seizure itself begins with a feeling of lack of air, a feeling of pressure in the chest and pressure during inhalation. There are pathological noise during breathing and wheezing. To make it easier to breathe, many assume a forced position, bending the torso forward and leaning their hands on the table, back of the chair.There is a feeling of fear, contact with the patient becomes difficult, the face turns pale. With the onset of a cough, a very thick, vitreous sputum is possible. Against the background of a cough, the face turns red or blue, veins are swollen around the neck. As the attack is relieved, breathing is normalized, the cough becomes more rare with the discharge of a lump of sputum, the feeling of lack of air and tightness in the chest disappears. In cases of mild asthma, there may initially only be dry coughing attacks.

How is bronchial asthma diagnosed?

In order to make sure that it is bronchial asthma, one indication of the presence of allergies, as well as a description of the attacks is not enough. It is important to conduct a number of studies that confirm the diagnosis. These include a number of instrumental studies, laboratory tests, allergy tests and the definition of immunoglobulin E ( Ig E). If there are doubts in the diagnosis, the doctor may prescribe and additional procedures.

First of all, it is important to conduct spirometry – this is the determination of the respiratory volume of the lungs. During the study, patient’s calm breathing and forced breathing are evaluated against the background of the deepest possible inhalation and exhalation. In addition, changes in respiratory indices are evaluated when applying bronchodilators . Against the background of bronchial asthma, these drugs significantly improve performance.

Bronchial asthma also requires pneumotachography . A study using a computer assesses respiratory rates, including during the use of medications. This method allows you to specify the area of ​​bronchial lesions.

Allergy detection and assessment of allergic status

If there are symptoms suspicious of allergies, it is necessary to conduct a series of studies to identify a specific substance that provokes seizures. Most often   allergy   formed on pollen or household dust, household chemicals, animal hair. In some patients, certain allergens are detected during skin tests. If the allergy is not detected in this way or the reactions are doubtful, provocative inhalation tests can be performed. When they evaluate the reaction of the bronchi to mediators of allergies, which in the body provoke bronchospasm ( methacholine or histamine). Also today, laboratories can identify a spectrum of certain allergens based on blood tests. This greatly facilitates the diagnosis of allergies and asthma, especially in children.

Blood tests, sputum, immunoglobulin level

To confirm the diagnosis   bronchial asthma spend   blood test, which can determine the increased level of eosinophils. However, a similar result of blood tests is found in parasitosis , some pathologies, and, moreover , it is not a reliable sign of allergic pathology. More indicative is a blood test for the level of total immunoglobulin E ( IgE ), which increases significantly with asthma and any other forms of allergy. In healthy people, its amount in plasma is extremely small. Class E immunoglobulins are special proteins that are synthesized in response to the contact of an organism of a sensitized person with allergens.

Additionally, a sputum test is also prescribed. It should increase the number of eosinophils and have pathological inclusions typical of asthma.

If it is necessary to determine whether it is asthma or any other respiratory pathologies, an additional x-ray of the lungs, bronchoscopy or computed tomography is prescribed. If necessary, the range of research is expanded, the doctor may prescribe repeated procedures.

Opisthorchiasis: signs that mimic asthma

It is important to know for sure that all changes in the respiratory system are associated with asthma. All this is done because there are pathologies that are very similar in symptoms but that are caused by external influences — infection by parasites, for example. Such pathology as opisthorchosis, widespread in the territories located in the mouths of large Russian rivers, often imitates asthma attacks. When infected with opisthorchosis, pathogens affect the region of the liver and gallbladder, leading to severe allergization of the body, including the formation of bronchial hyperreactivity. At the same time, seizures develop that are very similar in appearance to asthmatic, but having a different nature. Opisthorchiasis can be detected in people who eat thermally unprocessed or partially processed fish. If there are indications of a stay in a similar area or the use of salted, dried fish from this region, the appointment of a blood test for opisthorchiasis and the examination of feces is required. Often the diagnosis of “asthma” in this case is replaced by the diagnosis of ” parasitosis .”

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