Bronchial asthma (abbreviated as BA) is a chronic inflammatory pathology of the lower respiratory tract that can occur at any age. Due to the many provoking factors, it can be called a polyetiological disease requiring differential diagnosis and complex treatment. In most cases, the first episodes of choking, chronic cough, and other clinical manifestations of asthma force a person to see a family doctor or local therapist. If these doctors suspect an asthmatic cause of these symptoms, they will refer the patient for examination and consultation with other specialists. Which doctor treats asthma in a particular case will become known after specifying the cause of the disease.
Which doctor can I contact
The most common factor in the origin of an asthmatic condition is allergy, therefore, the first narrow specialist whom a local doctor advises to contact if asthma is suspected is called an allergist. Thanks to specific examination methods, the allergist will determine the type of asthma. Determining the type of asthma is critical when choosing a therapeutic regimen, since the disease is:
In atopic type of asthma, the human respiratory system reacts to allergens (dust, pollen, animal hair, etc.), pollutants (atmospheric pollutants), irritants (household chemicals).
Infection-dependent asthma is exacerbated by respiratory infections – ARVI, influenza, diseases of the ENT organs.
With a mixed type, allergic and all other factors influence the tone of the bronchi.
It should be understood that the key link in BA therapy is the elimination of the causes that provoke asthma attacks. This is why it is so important to find out which doctor will treat your specific asthma.
If the allergic nature of asthma is not confirmed, it will be treated by a general practitioner or therapist. The competence of this specialist includes diagnostics and treatment of diseases of the main body systems:
- cardiovascular (cardiology);
- urinary (nephrology);
- digestive (gastroenterology);
- respiratory organs (pulmonology) and some others.
Before starting treatment, the therapist will suggest that the patient take the tests necessary to clarify the diagnosis and pathogenesis of asthma: CBC (general blood count), LHC (biochemical), sputum analysis and others.
If necessary, the therapist can refer an asthmatic person to one of the specialized specialists (cardiologist, pulmonologist) for consultation and treatment of concomitant pathologies or complications of asthma.
The primary care in the relief of asthmatic attacks is also provided by a therapist.
Pulmonologists are engaged in the diagnosis and treatment of diseases of the respiratory system – pneumonia, bronchitis, bronchial asthma, smoker’s cough. The diagnosis is made on the basis of more in-depth studies (X-ray, CT, provocative tests). If background diseases are detected on the part of the cardiovascular or endocrine system, the patient can receive a referral from a pulmonologist to another specialist.
If asthmatic symptoms are found in a child, the first specialist to see is a pediatrician or pediatrician. Taking anamnesis (medical history, studying hereditary factors), initial consultation on diseases of all areas, writing prescriptions for drugs and referrals for tests – all this is the area of competence of the pediatrician. In children, in most cases, asthma is of hereditary origin, especially on the maternal side, so the pediatrician is usually interested not only in the well-being of the sick child, but also in the health of his parents.
How is the appointment with the doctor
When a person is going to a doctor’s appointment, he should first think over what complaints need to be voiced, what important information about his condition to provide to the doctor. All this is extremely necessary information for the diagnosis and selection of adequate treatment. If a person took any medications, the doctor should be sure to notify the doctor about this, indicating the names of the drugs.
Sometimes, symptoms similar to an asthmatic attack are manifested by side effects of certain medications (antihypertensive drugs, diuretics, and others), therefore, any information on taking medications should be provided to the doctor.
After talking with the patient, the doctor will proceed to his direct examination:
- auscultation (listening to the lungs with a phonendoscope);
- percussion (finger tapping of the chest).
Auscultation makes it possible to hear wheezing in the bronchi, to determine wheezing and other signs of an asthmatic condition.
Percussion is performed over the anterior, posterior and lateral regions of the lungs when the patient is in a supine or seated position. This procedure allows you to determine:
- the height of the apex of the lungs in front and behind;
- zone of percussion sounding above the tops (the so-called width of Kroenig fields );
- lower boundaries of the lungs;
- dynamism of the lower edge of the respiratory organs.
To make a diagnosis of BA, the patient will have to undergo several more diagnostic procedures, which will be directed by the attending physician.
The first and obligatory studies that are needed to clarify the diagnosis:
- general and biochemical blood tests;
- sputum analysis;
- immunological examination of blood samples.
The exacerbation of asthma is manifested by changes in laboratory tests – eosinophilia (increased content of a small fraction of leukocytes – eosinophils) and a moderate increase in the erythrocyte sedimentation rate (ESR).
Biochemical analysis during exacerbation shows an increase in the concentration of alpha-2 and G globulins, haptoglobulin , fibrin, seromucoid , sialic acids.
Sputum of asthmatics is also characterized by eosinophilia and the presence of Kurshman coils and Charcot-Leiden crystals.
An immunological blood test reveals a high level of immunoglobulins B and the passivity of T-suppressor lymphocytes.
What all this means will be explained by the doctor who will treat asthma, but for the patient himself, decoding the tests is not so important as determining the type and etiology of asthma. To do this, you need to go through additional diagnostic procedures:
Radiography of the lungs
- assessment of the allergic status (introduction of an allergen under the skin by the application, intradermal or scarification method);
- assessment of the gas composition of arterial blood (asthma is manifested by hypercapnia – an increased level of carbon dioxide and arterial hypoxemia – a low level of oxygen);
- X-ray of the lungs – in the acute form, emphysema is detected (low position of the diaphragm, increased transparency of the lungs);
- study of FVD (function of external respiration) to confirm or exclude respiratory failure due to obstruction (narrowing of the lumen) of the bronchi.
In modern conditions, FVD is investigated in several ways:
- pneumotachography ;
- peak flowmetry ;
- bronchodilatory tests.
The last of the listed diagnostic measures is a provocative test, when the FVD indicators are recorded before the use of an inhaled bronchodilator (a means that dilates the bronchi) and after. The listed diagnostic procedures are performed on an outpatient basis or in a hospital setting.
If you suspect a pulmonary pathology called bronchial asthma, you should contact your local therapist, pulmonologist or allergist. To determine the type and pathogenetic factors of asthma, the patient should undergo an in-depth examination as prescribed by the doctor.
The relevance and effectiveness of therapy for the disease depends on the correctness of the diagnosis and identification of the etiology of AD.