Bronchial asthma is a disease that leads to a lesion of the respiratory system and is non-infectious. The basis of this pathological process is the narrowing of the lumen of the bronchi, which is clinically manifested by severe shortness of breath. This pathology is accompanied by chronic inflammation and can lead to the emergence of asthmatic status. Asthmatic status is a recurring severe attacks of dyspnea, which can not be stopped even with elevated dosages of bronchodilators. In seventeen percent of cases, this condition becomes the cause of death.
Over the past few years the prevalence rate bronchial asthma among the population has grown significantly. Currently, there are about three hundred million people worldwide who are suffering from this disease. According to various data, in the territory of Russia among the adult population the incidence is from three to seven percent. As for children, they have this figure is equal to ten percent. It is worth noting that in childhood boys encounter this pathology more often than girls. However, closer to thirty years, this ratio is aligned.
The basis of bronchial asthma is the increased sensitivity of the bronchi to the effects of allergic or other irritating factors. The mechanism of the development of dyspnea is that after contact with the provoking substance in the lumen of the bronchi begins to produce a large amount of thick mucus. In parallel with this, the bronchial mucosa swells and thickens, and the smooth muscles undergo a sudden spasm. Secreted mucus due to its large number and increased viscosity forms a plug, overlapping the already narrowed lumen of the bronchi. In the event that the disease lasts a long time, there is a possibility of replacement of muscle fibers by the connective tissue component, which further impairs the ventilation capacity of the bronchi.
In most cases, asthma develops due to an allergic reaction. The most commonly identified sources of allergens are dust, present in the home, animal dander and food. Various plants and chemicals can also trigger bronchial obstruction. About twenty percent of people with this disease have an increased sensitivity to certain medicinal substances. In addition, in some cases, even the infectious flora, or rather its metabolic products, can cause an allergic reaction.
There are a number of factors that increase the likelihood of such a pathological process. The main one is hereditary burden. Having close relatives with a similar problem increases the risk of forming bronchial asthma by about twenty percent. In addition, the attack can cause severe stress, smoking, high physical exertion, hypothermia, and much more.
Classification of bronchial asthma
First of all, bronchial asthma is divided into:
- Exogenous variant;
- Endogenous variant;
- Mixed version.
The exogenous variant implies the development of seizures in contact with any external allergens. The endogenous variant is established in the event that the attack is provoked mainly by internal factors, for example, during exercise. In the mixed version, both external and internal irritating moments are present.
In addition, the disease can be intermittent and persistent. The intermittent form is the easiest and implies the appearance of seizures less than once a week. Dyspnea at night occurs no more than twice a month. Persistent form is divided into:
- Mild persistent – seizures occur more than once a week, but not every day;
- The average persistent – shortness of breath is almost daily in nature, and at night it appears no more than once a week;
- Severe persistent – seizures occur daily, at night – very often.
Symptoms of bronchial asthma
As we have said, the main symptom of asthma is an attack of breathlessness. Some time before its occurrence, precursors may appear in the form of nasal discharge, facial hyperemia, and tachycardia. Directly the attack itself begins with a feeling of squeezing in the chest and shortening the breath. As for the exhalation, it becomes much longer, accompanied by noise and whistle. There may be a cough with a discharge of thick and viscous sputum, which is difficult to cough.
On examination of a sick person, symptoms of bronchial asthma, such as intercostal contraction, facial puffiness and swelling of the neck veins, are found. The patient is in a forced position aimed at easing breathing. At auscultation listened to weakened breathing and a large number of dry rales.
When the onset of an attack develops, the symptoms of asthma gradually subside and it becomes easier for the sick person to breathe. Phlegm begins to move away more easily, and wheezing disappears.
Diagnosis of the disease
For the diagnosis of this disease there are a number of specific methods. The main ones are peak flowmetry and spirometry. These methods allow us to estimate the degree of bronchoconstriction and respiratory disorders. Additionally, a complete blood and sputum test, tests with allergens.
Treatment and Prevention
To suppress attacks of bronchial asthma, drugs that stop bronchial obstruction are used. These include beta-adrenergic m-cholinolytics and xanthines. In severe cases, and in the absence of the effect of the previously mentioned drugs, it is necessary to use inhaled glucocorticosteroids.
The main method prophylaxis is to limit contact with allergens. Excessive physical exertion should be avoided, quitting smoking and timely treatment of emerging infectious diseases of the respiratory system.