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Allergic asthma. Symptoms and treatment of allergic bronchial asthma Bronchial asthma of allergic origin

Bronchial asthma is a very common disease that affects approximately 6% of people. It is characterized chronic course with periodic exacerbations, during which a pronounced narrowing of the lumen of the bronchi occurs and the corresponding clinical picture.

Allergic bronchial asthma is the most common form of this disease, which accounts for the vast majority of clinical cases. Many children and adults are allergic to certain substances, which can cause the development of the disease. What is especially dangerous is that mild forms of asthma are often not detected in a timely manner and long time are out of sight of specialists.

Disease severity

Depending on the severity of symptoms, doctors distinguish 4 degrees of severity of the disease, on the basis of which treatment is planned.

Intermittent asthma (stage 1) – daytime attacks of the disease are extremely rare (no more than once a week), and at night the disease bothers the patient no more than 2 times a month. Exacerbations pass very quickly and have virtually no effect on the patient’s physical activity.
Mild persistent asthma (stage 2) – the disease occurs more often than once a week, but less than once a day, and night attacks occur at least 2 times a month. During an exacerbation, the patient's sleep may be disturbed and activity may be limited.
Persistent asthma of moderate severity (stage 3) - the disease worsens almost daily, and night attacks occur more than once a week. At the same time, the patient's sleep and physical activity are severely disturbed.
Severe persistent asthma (stage 4) - both daytime and nighttime attacks of the disease occur very often. Human physical activity is sharply reduced.

What happens in the body during allergic asthma?

The pathogenesis of bronchial asthma has not yet been fully studied. It has been established that many cells, structures and substances are involved in the development of a pathological response from the bronchi.

When an allergen enters the body, individual blood cells are activated and released biologically. active substances responsible for the body's inflammatory reactions.
The muscle cells in the walls of the bronchi of patients with asthma are initially predisposed to contraction, and the receptors on them are more sensitive to any influence of active substances.
As a result, a spasm of the smooth muscles of the bronchi occurs and the lumen is significantly reduced respiratory tract. The patient cannot breathe fully and develops shortness of breath, which in the most severe cases can lead to death.

All reactions occur quite quickly, which leads to a sharp deterioration in a person’s health. The patient can feel an approaching attack within a few minutes after contact with the allergen.

Reasons for the development of the disease

Allergic asthma can develop for various reasons.

Compounded heredity - often patients have close relatives who also have allergies or suffer from asthma. It has been proven that if one of the parents has asthma, then the likelihood of the child developing it is about 20-30%. If the disease is diagnosed in both the father and mother, then the child will face asthma with a 70% probability. It is important to understand that the disease itself is not inherited, but the child only receives a tendency to develop it.
Frequent infectious diseases of the respiratory tract can provoke hypersensitivity of the bronchial wall.
Adverse environmental conditions and occupational hazards.
Smoking, including passive smoking. This suggests that smoking parents significantly increase the likelihood of their child developing allergic bronchial asthma.
Consumption of large amounts of preservatives, dyes and other additives in food.

A direct attack of suffocation develops when the sensitive bronchi come into contact with an allergen, which may be different for each patient. Most often, asthma attacks are provoked by:

plant pollen;
animal hair;
mold spores;
house dust;
food products are a rare cause that still should not be overlooked;
substances with strong odors (perfumes, household chemicals, etc.);
Smoke and cold air also act as irritants.

Clinical manifestations of the disease

The symptoms of allergic asthma are not particularly specific and practically do not differ from the manifestations of asthma of non-allergic origin.

Difficulty breathing - the patient feels that it is difficult for him to inhale and exhale (and exhalation is difficult). Most often, shortness of breath occurs literally a few minutes after the patient comes into contact with the allergen and during physical activity.
Wheezing wheezing that occurs as a result of air passing through severely narrowed airways. They can be so strong that they can be heard at a considerable distance from the patient.
The characteristic posture of a sick person during an attack of suffocation. Since the respiratory muscles cannot satisfy all the body’s air needs, the patient is forced to involve additional muscle groups in the act of breathing. To do this, he rests his hands on the windowsill, table, wall and any other convenient surface.
Paroxysmal cough that does not bring relief. There is a variant of the course of the disease in which the patient only has a cough. Often people do not pay attention to this symptom and think that the cough occurs for another reason. It is important to know that a normal reflex cough goes away after a few minutes, since during this time all mechanical irritants have time to leave the airway.
Discharge of a small amount of clear and viscous (glassy) sputum.
Status asthmaticus is a severe exacerbation of the disease, characterized by a prolonged attack of suffocation, during which the patient does not respond to traditional treatment. If timely assistance is not provided, then due to a lack of oxygen, a person may gradually lose consciousness and fall into a coma. In the most severe cases, death develops.

Since we are talking about allergic asthma, all the above symptoms appear after the patient encounters the allergen. Depending on which allergen the patient develops an asthma attack in response to, different frequency and duration of exacerbation. An example is an allergy to pollen: the patient practically cannot avoid contact with the allergen, which at this time is everywhere. The result is a characteristic seasonality of exacerbations.

Diagnosis of allergic bronchial asthma

To begin with, the doctor interviews the patient in detail, records all his complaints and collects anamnesis. If a patient is seen during an attack, the doctor may listen for wheezing and notice shortness of breath. Later, specialized methods are used to obtain information about the respiratory organs.

Spirometry is an examination method during which a special apparatus characterizes in numbers the main parameters of lung activity. Forced expiratory volume is very important for doctors, since it is the most difficult thing for a patient with asthma to exhale.
Study of sputum produced during coughing. In patients with bronchial asthma, eosinophils, Cushman spirals and Charcot-Leyden spirals can be found there - specific for of this disease particles.
Since we are talking about allergic bronchial asthma, it is always necessary to find out which substance provokes an exacerbation. To do this, a special allergy test is carried out - small scratches are applied to the skin, and then a small amount of solution with the suspected allergen is dripped onto them. The body reacts to the allergen by redness of the skin and the development of slight inflammation.

Treatment of the disease

Treatment of allergic asthma can be carried out with the same substances that are used to prevent and eliminate other forms of pathology. Of course, the allergic nature of the disease leaves its mark on the therapy process.

If the patient knows that he has an allergy, then it is very useful to take antihistamines in a timely manner, which are now available in a wide range in pharmacies. The substance blocks the receptors that histamine usually acts on, and the effect of its release into the blood is not observed or is less pronounced. If it is clear that contact with the allergen cannot be avoided, then it is advisable to take the medicine in advance and reduce the likelihood of an exacerbation.
There is also a technique according to which the allergen is introduced into the body in gradually increasing quantities under the supervision of a doctor. As a result, susceptibility to this allergen is reduced, and it is less likely to provoke attacks of the disease.
Inhaled glucocorticoids and β2-adrenergic receptor blockers long acting– the most common basic therapy drugs that allow you to control the disease over a long period of time.
Antibodies that are antagonists of immunoglobulin E allow long-term elimination of increased sensitivity bronchi and prevent exacerbations.
Cromones are a group of drugs that are actively used in the treatment of children, since they do not give the desired result in adults.
Methylxanthines.
In case of exacerbation of the disease, fast-acting adrenoreceptor blockers, adrenaline, and oral glucocorticoids are used.

Preference is always given to inhaled drugs, which, using a special device, enter directly into the patient’s respiratory tract and exert their therapeutic effect there almost instantly. This allows you to get rid of side effects that can develop when taking drugs orally.

Patients with allergic asthma should understand that their priority is prevention of exacerbation, that is, avoiding contact with the allergen. It is enough to follow these recommendations:

regularly carry out wet cleaning in residential premises;
If you are allergic to wool, avoid keeping pets;
avoid using perfumes with strong odors;
change your job to one where you don’t have to inhale a lot of dust and other harmful substances.

The disease is characterized by rapid chronicity, due to which periodic exacerbations occur (usually May-June), which is manifested by a pronounced narrowing of the lumen of the bronchi with an increase in characteristic clinical signs.

It is known that the disease occurs as an immediate sensitization reaction:

immunological stage . When the antigen first enters the body, the production of class E immunoglobulins begins. At this stage, there are no symptoms yet. However, over time, after repeated contact with allergens, the formation of specific antigen-antibody immune complexes occurs, which are fixed on mast cells, on the membrane of basophils;
pathochemical stage . Previously formed immune complexes damage the walls mast cells and activate their enzymes. Next comes the formation and production allergic mediators, including histamine, MRSA, serotonin and others;
at the pathophysiological stage Target cells located in the muscle tissue of the bronchi begin to be affected by allergic mediators, products of incomplete cell breakdown and the immune complex. This causes spasm of the bronchial muscle tissue, swelling of the mucous layer of the walls, active production of viscous discharge from the bronchi, which greatly disrupts the ventilation activity of the lungs and manifests itself characteristic features suffocation.

These stages replace each other quite quickly, so there is a rapid deterioration in the patient’s general well-being. As a rule, the patient feels an increase in signs of an approaching attack within 5-10 minutes after contact with allergens.

Etiology

The allergic form of bronchial asthma develops when:

genetic predisposition, that is, the patient’s immediate relatives also have asthma or suffer from allergic reactions;
frequent lesions of the respiratory system of an infectious nature, which provokes the appearance of hypersensitivity of the bronchial mucosa in relation to allergic factors;
unfavorable environmental conditions;
prolonged contact with an aggressive allergic environment (dust, mold, dry air);
if professional activity is related to harmful substances affecting the respiratory system;
passive and active smoking;
abuse of some medicines;
abuse of products containing preservatives, dyes, flavors, that is, those substances that can provoke the rapid development of sensitization in the form of asthmatic attacks.

The cause of an asthma attack may be different for each asthma patient. However, most often such allergens are mold spores, plant and tree pollen, wool, house dust, and any substances that have a strong aroma.

Symptoms

Allergic asthma does not have specificity or any characteristic symptoms that would differentiate this form from others of a non-allergic nature. The clinical picture includes:

reversible obstruction, that is, narrowing of the lumen of the bronchi, which is the most characteristic symptom;
difficulty breathing, that is, it is difficult for the patient to fully inhale and exhale. Such shortness of breath appears within 10-15 minutes after contact with the allergen, as well as during severe physical exertion;
you can hear wheezing sounds that appear when air passes through abnormally narrowed airways;
The peculiarities of the patient’s body position during the development of an attack of suffocation are noted. Since the patient cannot take a full breath using only the respiratory muscles, he has to involve other muscle groups. To do this, he rests his hands on any hard surface;
obsessive paroxysmal cough that does not bring relief to the patient;
discharge of viscous transparent sputum of a small volume;
the development of status asthmaticus, that is, an exacerbation of the disease, which is characterized by a prolonged attack of suffocation that is not controlled by standard medications.

Such symptoms gradually increase after the patient comes into contact with allergens. The frequency and duration of exacerbation depends on the type of allergen and how often the patient is forced to come into contact with them.

Types and forms of allergic asthma

There are several classifications of the disease, which is determined by the causes of the development of the disease and the severity of symptoms.

By origin they are distinguished:

exogenous form, attacks of which are provoked by allergens that enter the body through inhalation or through food;
endogenous form provokes external negative influences in the form of inhaling cold air, stress, physical activity;
mixed form, arising under the influence external factors and inhalation of the allergen.

According to the form of severity, allergic bronchial asthma “passes through” 4 stages:

intermittent: attacks occur once every 7-10 days, but at night they occur a maximum of twice a month, exacerbations pass quickly without the use of specific medications and have virtually no effect on the general well-being of the patient;
mild persistent: attacks occur more often than once a week, at night - 2-3 times a month, during exacerbation the patient notes sleep disturbance, his activity is slightly limited;
medium persistent: attacks occur almost every day, at night - at least once every 7-10 days;
severe persistent: attacks occur almost daily.

An allergist determines the severity of allergic bronchial asthma only after conducting an appropriate examination. In the treatment of each form and degree of the disease, separate sets of methods and drugs are used.

Diagnostic measures

If symptoms of bronchial asthma appear, you should contact an allergist, who will first collect an anamnesis. As an attack develops, the doctor will be able to listen for characteristic wheezing and note shortness of breath.

The doctor will also order an analysis of the sputum that comes out when you cough. In patients, Charcot-Leyden spirals, eosinophils, and Cushman spirals are found in the biomaterial, which are specific sign diseases.

If you suspect the allergic nature of bronchial asthma, an allergy test is recommended. This study will help identify the allergen that leads to attacks.

Treatment

Treatment of the allergic form of bronchial asthma simultaneously includes 2 directions - basic and symptomatic.

Basic treatment drugs prevent asthmatic attacks.

Symptomatic treatment is aimed at eliminating the symptoms of the disease. Drugs of this type eliminate attacks by affecting the smooth muscles of the bronchial tree.

Additionally, the patient is recommended to take antihistamines (Aleron, Cetrilev, Erius).

Some allergists practice the following technique: an allergen is gradually introduced into the patient’s body under the supervision of the attending physician. This method is called allergen-specific immunotherapy. This significantly reduces the body's sensitivity to this substance.

The components of basic treatment are inhaled forms of glucocorticoids (Beclomethasone, Fluticasone) and long-term β2-adrenoreceptor blockers (Salbutamol, Ventolin). It is these drugs that allow you to control the disease for a long time.

In addition, medications containing antibodies to IgE are prescribed. The direction of their action is to eliminate the hypersensitivity of the bronchi to the effects of allergens and timely prevention of exacerbation of the condition.

Preference is always given to inhalation forms. Thanks to a special device, the components of the product enter directly into the respiratory tract, resulting in an almost instantaneous effect.

Patients should understand that it is better to prevent the development of an attack than to eliminate its consequences. To do this, you must follow these recommendations:

carry out wet cleaning of the apartment daily;
if you are sensitized to wool, you should stop keeping any pets;
Do not use perfumes that have a strong aroma.

The World Organization for Research on Asthma, or GINA, indicates the need for periodic review of treatment management for each individual patient every 3 months.

This will make it possible to timely adjust the dosage of medications and replace medications with more effective ones, which will have a positive impact on the patient’s health.

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All information is presented for educational purposes. Do not self-medicate, it is dangerous! Only a doctor can make an accurate diagnosis.

Allergic asthma is the most common type of bronchial asthma, occurring in both children and adults. The allergic form of the disease accounts for three quarters of cases of diagnosing bronchial pathology. The danger of the situation lies in the fact that at the initial stage the symptoms are mild.

Signs of asthma often coincide with the clinical picture of lung diseases and do not immediately come to the attention of doctors. It is important to know how asthma manifests itself and how to treat it. This will avoid the development of serious complications and stop dangerous symptoms in a timely manner.

Allergic (atopic asthma) is the response of the bronchopulmonary system to exposure to allergens. Once in the body, these irritants cause inflammatory reaction, which leads to narrowing and swelling of the bronchi. The disease is manifested by attacks of coughing and suffocation, the frequency of which increases as bronchial obstruction develops.

The period of exacerbation of the disease is associated with the development of allergies. Attacks appear after contact with a certain type of allergen. The body's reaction occurs immediately. The patient's condition worsens. A severe stage of the inflammatory process causes serious complications; an asthma attack can cause death.

Mechanism of development and causes of allergic asthma

The pathogenesis of bronchial allergic asthma still raises questions among specialists. Reply inflammatory process on the side of the bronchi is formed with the participation of many cellular structures under the influence of an allergen.

When an irritating substance enters the body, individual blood cells are activated. They produce substances that are responsible for inflammatory processes in the body. Receptors of bronchial muscle cells respond to any influence of active substances.

The smooth muscles of the bronchi contract. The resulting spasm leads to a decrease in the lumen of the airways. The patient experiences difficulty breathing, especially when exhaling. Shortness of breath and an attack of suffocation appear, the outcome of which cannot be predicted.

Depending on what type of allergen caused the disturbance, there are several forms of allergic asthma:

Household

The body is sensitive to components contained in house dust. It can be dust mites, fragments of insect bodies, saliva and fur of domestic animals, particles of epithelium and human hair, bacteria, tissue fibers.

The period of exacerbation occurs in winter. The attack is long. Relief occurs after eliminating the source of the allergy. An allergic reaction to dust can also trigger the development of chronic bronchitis. This is one of the most common allergens, which is very difficult to cope with.

The premises must be kept perfectly clean. Daily wet cleaning using a minimum amount of cleaning products is prerequisite life of an allergy sufferer. Household asthma is often accompanied by allergies to chemicals contained in cleaning products.

Pollen

It worsens during flowering of plants. First there is a runny nose, then suffocation. It is impossible to avoid allergies in the spring, since the allergen is widespread in the inhaled air.

In some cases, attacks appear at other times of the year when any flowering plants are nearby. A patient with a pollen form of an allergic disease should always have medicine on hand. It is important not to lead to an attack of suffocation and to take the drug on time.

Fungal

Increased sensitivity to mold spores. Allergies occur at any time of the year. In winter, relief is felt. Attacks often occur at night and during rainy periods. This is the most difficult type of disease to diagnose.

For a long time, the patient does not even realize what provokes the body’s reaction. This form of asthma can be caused by mold that forms in damp places. Therefore, thorough cleaning of areas in living spaces where there is high humidity is necessary.

Regardless of what caused the allergy or in what form it manifests itself, asthma can cause serious complications in the functioning of other organ systems.

Among the reasons causing the inflammatory process in the bronchi, it should be noted:

chronic infectious diseases of the respiratory system;
long-term use of medications that affect the respiratory system;
poor environmental conditions in the area of human residence, when the surrounding air contains particles that irritate the bronchial mucosa;
professional activities related to chemical production or interaction with chemicals (often a disease of people involved in the perfume and pharmaceutical business);
unbalanced diet, which includes foods high in preservatives and other substances (many nutritional supplements, for example, in semi-finished products, fast food products may be an allergen);
hereditary predisposition (if there are cases of asthma among relatives, the likelihood of developing the disease is higher).

If most of the causes contributing to the formation of the asthmatic inflammatory process can be eliminated, then hereditary factor causes changes at the cellular level. Pathology can manifest itself in a newborn child. In this case, comprehensive measures will be required to eliminate dangerous symptoms. It is important to prevent the development of status asthmaticus.

Allergic asthma in a child develops faster, since the immune system cannot cope with the body's reaction. The disease in childhood requires a special approach to treatment, taking into account individual characteristics and the impossibility of using the entire range of medications in children.

Risk factors include tobacco smoking (active and passive), smoke from fireworks, candles, aromatic substances in perfumes, eau de toilette, and air fresheners. An allergic reaction can occur due to severe psycho-emotional shock.

Disease severity

Depending on the severity of symptoms, medical science distinguishes 4 degrees of severity of the disease:

1st stage – .

Attacks rarely bother the patient: during the day - once every 7-10 days, at night - once every two weeks. The period of exacerbation does not last long and usually does not limit a person’s life activity;

Stage 2 – easy.

The frequency of attacks increases: up to 5-7 cases per month during the daytime, more than 2 cases per month during night period. At the same time, the patient’s activity decreases, attacks prevent sleep;

Stage 3 – persistent asthma of moderate severity.

Coughing and asthma attacks occur every day. Nocturnal exacerbation occurs once a week. As the disease progresses to stage 3, the patient is forced to give up his usual lifestyle. He is severely limited in physical activity; during an exacerbation it is impossible to sleep at night;

Stage 4 – persistent asthma in severe form.

Attacks of suffocation bother the patient day and night. Their number increases to 8-10 times a day. A person experiences difficulty moving, loses the ability to fully inhale and exhale, which can lead to loss of consciousness.

Treatment of severe asthma using traditional methods does not bring results. During times of exacerbation, urgent medical attention may be needed.

Symptoms of manifestation

Symptoms of the allergic form of asthma in adults are not specific. With non-allergic asthma, the patient experiences the same sensations.

Manifestations of allergic asthma are expressed in the following:

difficulty breathing in and out. At the same time, exhaling is more difficult than inhaling;
severe shortness of breath, which appears a couple of minutes after contact with the allergen;
wheezing and whistling when breathing. The slow passage of air through the narrowed breathing passages causes characteristic sounds;
paroxysmal cough with the release of viscous sputum. Sometimes this single symptom is ignored or interpreted as a sign of a cold;
the specific position of the patient during an attack, when he rests his hands on a horizontal surface.

Seizures during allergic form Asthma can have varying degrees of severity. With severe exacerbation, the likelihood of status asthmaticus is high. This is a condition where a person experiences prolonged suffocation and drug therapy does not bring relief. On the background oxygen starvation the patient may lose consciousness and even die. Immediate hospitalization to a hospital department is required.

Before the attack begins, the patient's condition changes. There are the first signs indicating the approach of an attack and the progression of the disease:

cough, especially at night;
insomnia;
increased breathing;
during physical activity - shortness of breath, weakness and fatigue;
symptoms colds(runny nose, watery eyes, headache).

These symptoms resemble the onset of respiratory diseases. The patient does not pay attention to the characteristic cough and begins to take cold medicine, aggravating the condition.

Diagnostics

Diagnosis of the disease is given Special attention, since it can be easily confused with other pathologies. The doctor takes into account the patient’s complaints and characteristic symptoms.

Information about allergic asthma can be provided following methods research:

spirometry (respiratory function is examined);
cytological examination of sputum;
tests to determine the type of allergen;
X-ray examination of the chest area;
blood test for biochemical parameters.

Having found out which substance caused the allergy, the doctor prescribes appropriate treatment. Its main goal is to minimize the reaction to the allergen.

Treatment

Limiting contact with the allergen is the main principle of treating allergic bronchial asthma. To prevent or minimize the occurrence of attacks, medications are prescribed. They help keep symptoms under control and cope with worsening conditions.

Symptomatic treatment includes taking medications of different spectrum of action - bronchodilators, anti-inflammatory, antihistamines, leukotriene modifiers.

Bronchodilators

The main mechanism of action is associated with relaxation of the smooth muscles of the bronchi and their expansion.

Bronchodilators are used to relieve an attack and are long-term or short acting. Typically, drugs in this group are used for short-term use. They only alleviate symptoms and should always be at hand. Constant use of drugs in this group reduces the effectiveness of therapy.

Anti-inflammatory drugs.

The therapeutic effect is achieved by influencing substances involved in the development of inflammation. As a result, the sensitivity of organs to irritants decreases.

These medications must be taken every day until a lasting therapeutic effect appears.

Antihistamines.

Used to eliminate allergy symptoms. They reduce the body's response to histamine, which is involved in the mechanism of development of the main allergic manifestations.

Leukotriene modifiers.

Leukotrienes are substances that are produced

in our body. Due to their impact, the lumen of the respiratory tract narrows. This produces excess mucus. Modifiers inhibit these processes and prevent bronchospasm.

Inhalation agents

Inhaled drugs are very popular in treatment for adults and children. Their long-term use allows you to control the manifestations of asthma by reducing the sensitivity of the bronchi.

Inhalers may contain different substances:

Glucocorticoids. The drugs are used in treatment. They have side effects and are prescribed by a doctor taking into account the body’s individual intolerance to the components of the drug. Inhaled drugs are more effective.
Sympathomimetics. The main action is aimed at increasing the lumen of the bronchi. Instant neutralization of an attack and rapid removal of the drug from the body are the main characteristics of drugs in this group.
Methylxanthines. Used during asthmatic exacerbation. By blocking adrenergic receptors, the drugs relieve spasm of smooth muscles, which makes breathing easier for the patient.

Allergic asthma must be treated at the first signs of the disease.

If a patient with bronchial asthma also has chronic work disorders of cardio-vascular system, you must notify your doctor about this. Many medications prescribed for heart disease are contraindicated for asthma.

Breathing exercises

An integral part of therapy for asthma of an allergic nature is breathing exercises. Usually Buteyko gymnastics is prescribed, which allows you to quickly and effectively get rid of asthmatic manifestations.

In the process of performing tasks, the depth of breathing and the amount of carbon dioxide contained in the patient’s blood decreases. It is its excess and lack of oxygen that is a consequence of the narrowing of the lumen of the bronchi.

Before performing exercises, you should consult your doctor. Gymnastics requires preparation, during which the patient performs simple actions:

sits straight on any hard surface (chair, sofa, floor), relaxing;
performs inhalation and exhalation quickly, superficially;
exhales weakly through the nose;
holds his breath as much as possible.

All actions are carried out within 10-12 minutes. The procedure may be accompanied by slight dizziness. The patient feels that he does not have enough air. After all the manipulations are completed, you can begin to complete the tasks.

At the initial stage of performing the exercises, the patient experiences unpleasant feelings: lack of air, inability to breathe fully, fear. But this should not be a reason to stop studying. Gymnastics should be done daily. Over time, these symptoms will weaken and disappear.

There is a treatment method based on eliminating the allergic reaction - SIT therapy. This procedure is carried out during the absence of exacerbation. This usually occurs in the autumn-winter time, when the patient feels relief. Target therapeutic method is to form the body's immunity to allergens that cause the development of pathology and its exacerbation.

The essence of the method is that a substance to which the patient is allergic is introduced into the patient’s body over a certain period of time. Gradually its dosage increases. As a result, the allergen is no longer perceived as an irritant and does not lead to bronchospasms. The earlier the allergen is introduced, the higher the effectiveness of this method.

Allergic asthma is treated with various groups drugs. When using medications, it is important to consider contraindications. Most medications should not be taken by children under 6 years of age.

Allergic asthma in children

Allergy has its own characteristics. This is due to the fact that children's body has not yet formed. The disease can appear in a child at any age.

It often has symptoms similar to chronic bronchitis. If an allergic nature of coughing attacks is suspected, periods of exacerbation are monitored throughout the year. If there are more than five, you need to see a specialist.

Prevention of allergic asthma

There are no specific preventive measures against allergic asthma. To reduce the frequency of exacerbation periods, it is necessary to eliminate contact with allergens. Following simple recommendations will help avoid the development of asthmatic manifestations:

maintain the necessary air humidity in the room;
carry out wet cleaning on time;
eat right, eliminating allergen-containing foods from your diet;
change bed linen weekly.

Patients with asthma need to remember that preventive actions will not relieve their illness, but will only reduce the frequency of exacerbations. Allergies tend to occur at any time.

Only Attentive attitude to your health will help you avoid dangerous manifestations.

Allergic asthma is the most common type of allergy. It affects most children and almost half of the adult population. It is caused by allergens - particles that a person inhales along with the air. The medical term for this disease is atopic. What does it represent allergic asthma? And how to deal with such a disease?

Characteristics of the pathology

Allergic and the treatment of which requires detailed study, is characterized by inflammation of the respiratory system. This condition is provoked by the presence of allergens in the air and food. These respiratory irritants do not harm most people. But the immune system of individual organisms reacts abnormally to them.

The disease usually occurs in childhood. From time to time it makes itself felt throughout the entire period of growing up. Sometimes adults are also susceptible to allergic asthma. It is worth noting that the number of people suffering from this disease has been steadily increasing recently.

The development of pathology occurs as follows:

Allergens enter the body with inhaled air or food.
They irritate the smooth muscle mucosa of the respiratory tract. The latter, in its normal state, is usually relaxed. It allows air flow easily.
When an irritant appears, the immune system reacts to it as if it were a virus. Antibodies begin to be produced to protect the body, which provoke inflammation.

Causes of the disease

Provocateurs that are the source of the disease are divided into the following categories:

Indoor allergens. The culprits for their appearance may be: pets (wool, feathers); cockroaches (scales and excrement); mycelium (fungus and mold); (their droppings that float in the air with dust).
Allergens of open space. Such provocateurs are caused by pollen from trees and grasses. Accordingly, the disease develops during flowering. This is usually spring and early summer.
Food allergens. Most often they are found in products containing antigens similar to plant pollen. These can be eggs, milk, peanuts, shellfish, strawberries, and some types of fruit.

The rarest type of allergic asthma is a reaction to food irritants. But at the same time, this form of the disease is accompanied by very strong manifestations, which are impossible to cope with on an outpatient basis. Therefore, to eliminate the patient, they are hospitalized. Sometimes allergic asthma triggered by food can be life-threatening.

The causes of pathology in individual individuals have not been established. It is believed that this is the influence of the genetic predisposition of the organism and ecology.

Predisposing factors

Typically, an attack develops very quickly in a pathology such as allergic asthma. Symptoms appear literally within a few minutes after the provocateur enters the body. This is due to hypersensitivity immune system to this type of allergen.

Heredity is also a cause of the development of the disease. According to statistics, if there is an allergy sufferer in the family, there is a 40% chance that his relatives will experience similar reactions.

The progression of the disease is due to the following reasons:

respiratory system infections;
smoking (passive also);
close contact with allergens;
long-term medication use.

Symptoms of an attack

How does allergic asthma manifest? Symptoms are usually prodromal. Most often they appear in the evening hours.

Signs of the threshold of an attack are:

dry cough;
runny nose;
painful sensations in the abdominal area.

This is the first stage of manifestation of the disease. Then allergic asthma begins to progress.

Symptoms in adults are as follows:

difficulty breathing;
dyspnea;
noisy wheezing when breathing;
pain and tightness in the chest area;
dry cough with the release of a small amount of sputum, which intensifies when a person lies down.

Atopic asthma can also occur against the background of existing respiratory tract diseases, such as rhinitis or bronchitis.

Degrees of the disease

There are four forms of development of atopic asthma:

Intermittent. The disease appears approximately once a week. At night, attacks occur no more than twice a month.
Persistent. Manifestations of the disease bother a person more often than once every 7 days. Because of this, he cannot get enough sleep. Accordingly, his active activity decreases.
Average. Symptoms of the disease occur every day. This has an even more destructive effect on sleep and the physical condition of the body. At this stage, it is recommended to take the drug "Salbutamol" to prevent further development of the disease.
Heavy. The constant manifestation of allergic asthma, frequent suffocation, daytime and night attacks make normal human existence impossible.

The most dangerous is considered to be in a progressive form. This is a severe form of the disease known as allergy this state consist in a constant increase in attacks and an increase in their duration. In this case, emergency medical attention is necessary, since the person may faint or even die due to severe difficulty breathing.

Complications

Allergic asthma is usually easily controlled. Treatment prescribed by a doctor can stop the development of negative symptoms.

But sometimes it happens that an attack develops rapidly. As a result, quite severe consequences can be observed:

There is a sudden stop in breathing or this process is extremely difficult. The man loses consciousness. This condition can even lead to death.
Interruption of the breathing process due to obstruction is the cause of respiratory failure. This disease is treated in a hospital using emergency intubation and forced ventilation. Without such measures, death is possible.
In the future, rupture of the alveoli of the lungs may occur. But this happens very rarely. With this complication, intubation is required to remove the air that prevents the expansion of the lungs from the pleura.

Diagnosis of the disease

Allergic asthma is determined in three steps:

The doctor finds out everything about the patient’s lifestyle. Studying the symptoms of the disease.
A blood test for immunoglobulins allows you to determine the presence of the disease.
Conducting allergy tests to identify a specific provocateur that caused an unpleasant reaction in the body.

How to cure the disease

Every person is interested, if he has been diagnosed with allergic asthma, how to treat such an ailment.

To successfully fight the disease or at least reduce the number of attacks, it is necessary, if possible, to eliminate from the environment all objects that are provocateurs.

The following measures are usually taken:

All things in which dust can accumulate are removed - carpets, thick curtains.
Frequent, thorough house cleanings are simply necessary.
Using a dust-proof coating for mattresses and pillows.
Windows are kept closed to prevent dust from entering the house from outside.
Air conditioners are used with replaceable filters.
The humidity in the house should be no more than 50%. When this indicator is exceeded, a comfortable environment for the development of ticks is created.

If the measures taken do not help to completely get rid of the symptoms of the disease, then medications are used. But it is important to remember that allergic asthma cannot be treated on its own. Treatment medications should only be recommended by a doctor.

Drug therapy

What medications are used to treat allergic asthma?

Drugs to combat the disease are divided into:

Inhalation, which does not produce a therapeutic effect, but simply relieves suffocation. The patient may be recommended medications such as Terbutaline, Fenoterol, Berrotek, and Salbutamol.
Inhalation agents that provide treatment and have an anti-inflammatory effect. Effective medications are “Intal”, “Tailed”.
Inhalation medicinal. Excellent results will be provided by the drugs “Pulmicort”, “Serevent”, “Oxis”.
Combined. The patient's therapy includes the drugs "Seretide", "Symbicort".
Antihistamines. If it leaks in mild form allergic asthma, treatment may include the use of the drug Zyrtec.

Breathing exercises

The methods described above are not the only methods of combating such a serious illness. What other treatment is effective for a diagnosis of allergic asthma?

It has a good therapeutic effect in combating the symptoms of the disease. Special exercises help alleviate attacks. In addition, such gymnastics is successful prophylactic use to avoid the development of further complications.

Should be done systematically. Otherwise, their effectiveness will not be complete. Many people, wondering (if they are faced with a diagnosis of “allergic asthma”) how to treat this disease at home, resort to help breathing exercises. After all, such a complex allows you to restore health. According to reviews from people and doctors, it is quite effective in the fight against serious illness.

An approximate set of exercises for respiratory organs in the treatment of allergic asthma:

In the morning, without getting out of bed, lie on your back. Pull your knees towards your chest. When performing, exhale measuredly through your mouth.
Take a standing position. Feet - shoulder width apart. Take a deep breath while spreading your arms out to the sides at shoulder level. Then exhale sharply through your mouth, lower your arms along your body, slapping them on your thighs.
Take slow steps in place. When taking the first step, raise your arms to the sides. Inhale slowly. When taking the second step, exhale noisily, lowering your hands.
Starting position - sitting on the floor. Stretch your legs forward. Inhaling through your mouth, raise your arms to the sides. Then return upper limbs to the starting position. At the same time, slowly exhale through your mouth and pronounce the sound “F” with slightly parted lips.
Stand with your hands on your belt. Inhale slowly. At the same time stick out your stomach. Then exhale sharply. The stomach should be pulled in with force. When performing this exercise, a person must breathe through the nose.
Inhale air through the straw. Then lower it into a container of water and exhale. Do the exercise throughout the day, the duration of one session is 10 minutes.
Position - standing. Stand on your toes. Move your arms raised up a little back. Interlace your fingers. Then sharply lower your entire foot, leaning forward. At the same time, lower your clasped hands as if you were chopping wood. Be sure to take a deep breath.
Take a standing position. Feet - shoulder width apart. Raise your arms, moving them back a little. Open your palms, as if trying to push something away. Then suddenly move your arms, hugging yourself and clapping your shoulder blades. At this stage, take a deep breath and tighten your chest.
The “Skier” exercise is performed standing. You need to spread your legs a little. Stand on your toes, leaning forward and stretching out your hands, clenched into fists. The pose resembles a skier going down the mountain. Then stand on your full foot and, exhaling, squat. The arms are alternately lowered and pulled back. It is necessary to imitate the movements of ski poles. When returning to the starting position, take a deep breath.
Lying on your back, place your hands under your buttocks. Exhaling slowly and deeply, draw in your stomach. Then inhale forcefully. Stick out your belly.
Standing on your toes, raise your arms to the sides. Move them up and arch back. Then stand on your feet, leaning forward and rounding your back. Take a deep breath. At this time, you should hug yourself with your arms.
Inhale intermittently through your nose. Exhale through your mouth, clenching your teeth. At the same time pronounce “Z” or “F”.
I. p. - standing, hands at your sides. Raise your shoulders slowly, counting to four. Then exhale strongly, lowering them just as slowly.
While standing, bend your arms slightly. Take a deep breath, spreading your upper limbs to the sides. Then you need to bring your hands together, while pulling in your stomach. Exhale while making the sound “SH”.
Exercise "Balls". Light enough. You need to inflate the balloons until they burst. Repeat the procedure throughout the day. It is recommended to inflate up to three balloons per day.

Allergic asthma is a fairly severe and serious illness. However, even with such a pathology you can learn to cope. To do this, you should strictly follow the recommendations of doctors, eliminate allergens from your life and do breathing exercises. It should not be forgotten that only regular methods of struggle will bring the long-awaited result.

Bronchial asthma

Cause of bronchial asthma

atopic dermatitis .

Symptoms of bronchial asthma

In some patients, exercise asthma(old name) or about bronchoconstriction

1) . Manifestations of the disease occur less than once a week, night attacks occur twice a month or less. Peak expiratory flow (PEF) more than >
2) . Symptoms of the disease occur more often than once a week, but less than once a day. Frequent exacerbations disrupt daily activities and sleep. Night attacks occur more often than twice a month. PSV>
3)
4)

Most

emphysema, pulmonary and heart failure

Bronchial asthma– one of the most common and severe allergic diseases, one of the so-called “big three allergic diseases”. The incidence of this pathology is growing every year. Currently, at least 6% of the total population has bronchial asthma of varying severity. The proposed article contains full information on the symptoms, diagnosis and treatment of this disease and will be able to answer many questions from patients, their family members, and maybe even doctors.

Bronchial asthma– chronic, inflammatory disease upper respiratory tract. The main manifestation of bronchial asthma is reversible (on its own or after exposure to drugs) obstruction of the bronchi, manifested by suffocation.

The first complete description of the disease was made by our compatriot G.I. Sokolovsky in 1838. But now the palm in the development of methods for treating allergic bronchial asthma has been lost and currently in Russia they use (or should use) protocols copied from international recommendations, for example from GINA.

The prevalence of bronchial asthma is about 6%. The huge number of undetected forms of the disease is of great concern. As a rule, these are mild forms of bronchial asthma, which can be hidden under diagnoses of “obstructive bronchitis” or simply “ Chronical bronchitis" The incidence among children is even higher and in some regions reaches 20%. Among children, the number of patients with an undiagnosed diagnosis is even higher.

Cause of bronchial asthma

The development of bronchial asthma is based on the pathogenetic mechanism of immediate-type hypersensitivity (IgE-dependent immune response). This is one of the most common mechanisms for the development of allergic and atopic diseases. It is characterized by the fact that only a few minutes pass from the moment the allergen arrives until the symptoms of the disease develop. Of course, this applies only to those who already have sensitization (allergic mood) to this substance.

For example, a patient with bronchial asthma and an allergy to cat fur enters an apartment where a cat lives and begins to have an attack of suffocation.

Family history plays an important role in the development of allergic bronchial asthma. Thus, among the closest relatives of patients, patients with bronchial asthma can be found in 40% of cases or more often. It should be taken into account that it is not bronchial asthma itself that is transmitted, as such, but the ability to develop allergic reactions in general.

Factors contributing to the occurrence of bronchial asthma include the presence of foci of chronic infection (or frequent infectious diseases) in the respiratory tract, unfavorable environment, occupational hazards, smoking, including passive smoking, and long-term use of a number of medications. Some authors include prolonged contact with aggressive allergens as trigger factors, for example, living in an apartment whose walls are affected by mold.

Thus, bronchial asthma is an allergic disease, in the exacerbation of which contact with allergens plays a leading role. Most often, the disease is caused by allergens that come in by inhalation: household (various types of house dust mites, house dust, library dust, pillow feathers), pollen, epidermal (animal hair and dander, bird feathers, fish food, etc.) , fungal.

Food allergies as a cause of bronchial asthma are extremely rare, but also possible. For food allergies V in this case cross-allergic reactions are more common. What does it mean? It so happens that some allergens of various origins have a similar structure. For example, allergens are birch pollen and apples. And if a patient with asthma and an allergy to birch pollen eats a couple of apples, he may develop an attack of suffocation.

Bronchial asthma may be the last stage of the “atopic march” in children, who have atopic dermatitis on their list of diseases.

Symptoms of bronchial asthma

Main symptoms of bronchial asthma: attacks of difficulty breathing, suffocation, feeling of wheezing or whistling in the chest. Whistling may become worse with deep breathing. A common sign is a paroxysmal cough, often dry or with the discharge of a small clot of light sputum at the end of the attack. A paroxysmal dry cough may be the only symptom of bronchial asthma.

With moderate to severe severity of bronchial asthma, shortness of breath may occur during physical exertion. Shortness of breath increases significantly with exacerbation of the disease.

Often, symptoms appear only during an exacerbation of asthma; outside of an exacerbation, the clinical picture may be absent.

Exacerbations (suffocation) can occur at any time of the day, but the “classic” episodes are nighttime. The patient may notice that there are factors that cause an exacerbation of the disease, for example, being in a dusty room, contact with animals, cleaning, etc.

In some patients, This is especially true for children, attacks occur after intense physical activity. In this case they talk about exercise asthma(old name) or about bronchoconstriction caused by physical activity.

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

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

When listening to the patient using a phonendoscope, a weakening of vesicular breathing and the appearance of high-pitched (wheezing) wheezing are noted. Outside of exacerbation, the auscultatory picture may be unremarkable.

A characteristic symptom of bronchial asthma is a good effect from taking antihistamines(Cetrin, Zyrtec, Erius, etc.) and especially after inhalation of bronchodilators (salbutamol, Berodual, etc.).

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

1) mild intermittent bronchial asthma. Manifestations of the disease occur less than once a week, night attacks occur twice a month or less. Peak expiratory flow (PEF) is more than >80% of the age norm, PEF fluctuations per day are less than 20% (more details about this research method in section IV).
2) mild persistent bronchial asthma. Symptoms of the disease occur more often than once a week, but less than once a day. Frequent exacerbations disrupt daily activities and sleep. Night attacks occur more often than twice a month. PEF>80% of predicted, daily fluctuations 20-30%.
3) moderate severity of bronchial asthma. Symptoms become daily. Exacerbations significantly interfere with daily physical activity and sleep. Nighttime symptoms occur more than once a week. Daily use of short-acting β2 agonists (salbutamol) is required. PEF is 60-80% of the age norm. PEF fluctuations are more than 30% per day.
4) severe severity of bronchial asthma. Persistent symptoms of bronchial asthma. Attacks of suffocation 3-4 times a day or more often, frequent exacerbations of the disease, frequent nighttime symptoms (once every two days or more often). Daily physical activity is noticeably difficult.

Most life-threatening symptom of asthma– development of an asthmatic condition (status asthmaticus). In this case, protracted suffocation, resistant to traditional drug treatment, develops. Choking is expiratory in nature, that is, the patient cannot exhale. The development of status asthmaticus is accompanied by disturbance, and subsequently loss of consciousness, as well as the general serious condition of the patient. If left untreated, the risk of death is high.

What tests will you need to take if you suspect bronchial asthma?

Bronchial asthma is in the area of interest of two medical specialties: allergist-immunologist and pulmonologist. This is a fairly common disease, so mild forms are usually dealt with by general practitioners or pediatricians (depending on the age of the patient). But it’s still better to immediately go to a specialist. The most important component in the examination of a patient with bronchial asthma– identification of those allergens, contact with which causes allergic inflammation. Testing begins with determining sensitivity to household, epidermal, and fungal allergens.

Treatment of allergic bronchial asthma

The following groups of drugs can be used in the treatment of atopic bronchial asthma. Their dosages, combinations and duration of treatment are determined by the doctor, depending on the severity of the disease. Also currently dominant is the concept that asthma treatment should be reviewed every three months. If during this time the disease has been completely compensated, then the issue of reducing dosages is decided; if not, then increasing doses or adding drugs from other pharmacological groups.

The most important component in the treatment of allergic bronchial asthma– carrying out allergen-specific immunotherapy (SIT therapy). The goal is to create immunity to those allergens that cause the patient allergic reaction and inflammation. This therapy can only be performed by an allergist. Treatment is carried out outside of exacerbation, usually in autumn or winter.

To achieve this goal, the patient is administered solutions of allergens in gradually increasing dosages. As a result, tolerance develops towards them. The earlier therapy is started, the greater the effect of treatment. Taking into account that this is the most radical method of treating atopic bronchial asthma, it is necessary to motivate patients to start this treatment as early as possible.

Treatment of atopic bronchial asthma with folk remedies.

Allergic diseases are a group of diseases for which traditional medicine must 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 very methods. If some method helped your friends (by the way, it’s not a fact that it was he who helped, maybe it was a spontaneous remission), this does not mean that it will not cause complications for 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.

Maintaining a special lifestyle and creating a hypoallergenic (allergen-free) environment is an essential component of the treatment of bronchial asthma. Currently, many large hospitals have created so-called schools for patients with bronchial asthma, where patients are taught exactly these activities. If you or your child suffers from this disease, I recommend looking for such a school in your city. In addition to the principles of hypoallergenic living, they teach you how to control your condition, independently adjust treatment, use a nebulizer correctly, etc.

Allergic bronchial asthma in children

Bronchial asthma in children can manifest at any age, but more often it occurs after one year. Increased risk of developing the disease in children with a family history of allergic diseases, and in patients who have already noted allergic diseases in past.

Often bronchial asthma can hide under the mask of obstructive bronchitis. Therefore, if a child has had 4 episodes of obstructive bronchitis (bronchial obstruction) in a year, immediately go to an allergist.

Allergic bronchial asthma and pregnancy.

Measures are taken with particular care to eliminate allergens and create a hypoallergenic environment during pregnancy. It is necessary to exclude active and passive smoking.
The treatment provided depends on the severity of the disease.

Possible complications of allergic bronchial asthma and prognosis

The prognosis for life with proper treatment is favorable. With inadequate treatment or abrupt withdrawal of medications, there is a high risk of developing status asthmaticus. 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 heart failure. Severe forms diseases can lead to disability of the patient.

Prevention of allergic bronchial asthma

Effective measures primary prevention, that is, aimed at preventing the disease, unfortunately has not been developed. If the problem already exists, 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:

Symptoms of allergic bronchial asthma.

Main symptoms of bronchial asthma: attacks of difficulty breathing, suffocation, feeling of wheezing or whistling in the chest. Whistling may become worse with deep breathing. A common symptom is a paroxysmal cough, often dry or with the discharge of a small clot of light sputum at the end of the attack. A paroxysmal dry cough may be the only sign of allergic bronchial asthma. In this case, they talk about the cough variant of bronchial asthma.

With moderate to severe severity of bronchial asthma, shortness of breath may occur during physical exertion. Shortness of breath increases significantly with exacerbation of the disease.

Often, symptoms appear only during an exacerbation of asthma; outside of an exacerbation, the clinical picture may be absent.

During auscultation (listening to the patient using a phonendoscope), a weakening of vesicular breathing and the appearance of high-pitched (wheezing) rales are noted. Outside of exacerbation, the auscultatory picture may be unremarkable.

A characteristic symptom of bronchial asthma is the good effect of taking antihistamines (Cetrin, Zyrtec, Erius, etc.) and especially after inhalation of bronchodilators (salbutamol, Berodual, etc.).

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

Most life-threatening manifestation of bronchial asthma– development of an asthmatic condition (status asthmaticus). In this case, protracted suffocation, resistant to traditional drug treatment, develops. Choking is expiratory in nature, that is, the patient cannot exhale. The development of status asthmaticus is accompanied by disturbance, and subsequently loss of consciousness, as well as the general serious condition of the patient. If left untreated, the risk of death is high.

What tests will you need to take if you suspect allergic bronchial asthma?

Atopic bronchial asthma is in the area of interest of two medical specialties: an allergist-immunologist and a pulmonologist. Bronchial asthma is a fairly common disease, so mild forms are usually dealt with by general practitioners or pediatricians (depending on the age of the patient). But it’s still better to immediately go to a specialist.

When the disease is first diagnosed, and then once or twice a year during clinical observation, you will be asked to take the following tests: clinical blood test, general urine test, blood sugar test, biochemical blood test (total and direct bilirubin, ALT, AST, urea, creatinine ). To exclude concomitant heart pathology - ECG. An annual fluorography will be required.

If there is a productive cough, that is, with sputum discharge, a general sputum test is taken. With a tendency to frequent infectious diseases upper respiratory tract - sputum analysis for microflora with determination of sensitivity to antibiotics. For paroxysmal dry cough - a throat swab for mushrooms.

Functional research is mandatory external respiration(spirography). To do this, you will be asked to breathe into a tube connected to a special machine. It is advisable to refrain from taking bronchodilator tablets (like Eufilin) and inhalers (such as salbutamol, Berodual, Berotec, etc.) the day before. If your condition does not allow you to do without these drugs, then inform the doctor conducting the study so that he can make appropriate adjustments in the conclusion. Smoking before the study is not recommended (in principle, smoking is never recommended for patients with bronchopulmonary diseases). Spirography is performed on patients aged 5 years and older.
If bronchial asthma is suspected, a test with bronchodilators is performed. To do this, spirography is done, then several inhalations of salbutamol or a similar drug and repeated spirography. The goal is to find out how much bronchial patency changes under the influence of this group medicinal substances. When FEV1 (forced expiratory volume in 1 second) changes by more than 12% or 200 ml, the diagnosis of asthma is practically beyond doubt.

A more simplified, but also more accessible and convenient for patients, is peak flowmetry. This is a device that determines the maximum (peak) exhalation flow. The cost of the device is extremely low (from 400-500 rubles), it does not require Supplies, making it very convenient for routine disease monitoring. The obtained indicators are compared with reference values (table with standards for of various ages and height is usually included with the device). Measurements should be taken twice a day: morning and evening. The advantage of the device is that it allows you to predict in advance the onset of an exacerbation of the disease, since the peak expiratory flow rate begins to decrease several days before clinical manifestations of an exacerbation appear. In addition, this is an objective way to monitor the course of the disease.

Considering the high prevalence of concomitant diseases of the nasopharynx, an annual examination by an ENT doctor and x-ray is recommended paranasal sinuses nose

The most important component in the examination of a patient with bronchial asthma– identification of those allergens, contact with which causes allergic inflammation. Testing begins with determining sensitivity to household, epidermal, and fungal allergens.

The following types of diagnostics can be used for this:

1) performing skin tests (prick tests). One of the most informative types of allergy diagnostics. There is no need to be afraid of the procedure. The patient is made several cuts (scratches) on the skin and 1-2 drops of a specially prepared allergen are dripped on top. Or 1-2 drops of the allergen are dripped, and scratches are made through it. The procedure is absolutely painless. The result is known within 30 minutes. But there are a number of contraindications: exacerbation of the disease, pregnancy, breastfeeding. Optimal age for this type of study ranges from 4 to 50 years. Antihistamines (Tavegil, Claritin, etc.) are discontinued at least 3-5 days before the procedure.
If the patient’s condition allows, then this is the best way to identify a causally significant allergen.

2) blood test for specific immunoglobulins E (IgE-specific). This is the identification of allergens using a blood test. There are no contraindications for this type of research. Disadvantages: much higher cost and a fairly large percentage of false results.
Sometimes they also take a blood test for specific immunoglobulins G4 (IgG4-specific immunoglobulins). But the information content of this analysis is questionable, and, according to most experts, it is a waste of money and blood.
It is also possible to perform FGDS (fibro-gastro-duodenoscopy), bronchoscopy, ultrasound thyroid gland, PCR (polymerase chain reaction) of throat swabs for infections such as Chlamydia pneumonia, Mycoplasma pneumonia, blood test for antibodies (IgG) to Aspergillus fumigatus, etc. Full list The tests are determined by the doctor, depending on the specific situation.

Treatment of allergic bronchial asthma:

1) Short-acting inhaled bronchodilators (β2 agonists). The drugs are used to relieve symptoms of suffocation. They do not have a therapeutic effect, they simply relieve symptoms. Drugs: salbutamol, terbutaline, ventolin, fenoterol, berrotec.
Derivatives of ipratropium bromide have a similar effect. These are drugs: Atrovent, Troventol. Bronchodilators can be produced in metered aerosols and in liquid form for inhalation using a nebulizer (a nebulizer is a device that turns liquid into steam, which significantly increases its ability to penetrate the bronchi).
It is not advisable to use drugs from this group more than 4 times a day. If the need for their use is greater, it is necessary to strengthen the “therapeutic” anti-inflammatory component of therapy.

2) Derivatives of cromoglicic acid. Preparations: Intal, Tiled. Available in the form of an aerosol for inhalation, a powder for inhalation in capsules, a solution for inhalation using a nebulizer. The drug has a therapeutic, anti-inflammatory effect. That is, it does not relieve symptoms at the moment, but rather has a therapeutic effect on the inflammatory process as a whole, which leads (or should lead), ultimately, to stabilization of the disease. Therapeutic effect quite weak, used for mild forms of the disease. Drug of choice for the treatment of exercise-induced bronchoconstriction (exertional asthma). Most often, these drugs are used to treat children.

3) Inhaled glucocorticosteroids.
The most commonly used group of drugs. Pronounced therapeutic, anti-inflammatory effect. The drugs can be used in low, medium and high doses (see table No. 1 Doses of inhaled glucocorticosteroids for adults.). They are usually produced in the form of metered aerosols for inhalation or in the form of solutions (pulmicort) for inhalation through a nebulizer.

Table No. 1 Doses of inhaled glucocorticosteroids for adults.

If you have been prescribed a drug from this drug for the treatment of bronchial asthma pharmacological group– be sure to discuss with your doctor how to do inhalation correctly. Carry out the first inhalation in his presence. Improper procedure significantly reduces the effectiveness of the drug and increases the risk of side effects. After inhalation, be sure to rinse your mouth.

4) Long-acting inhaled bronchodilators (β2 agonists). Used as a component of treatment for moderate severity of the disease and severe forms of bronchial asthma. Usually prescribed in combination with inhaled glucocorticosteroids, enhancing their effect. Drugs: Serevent, Foradil, Oxis.
Derivatives of tiotropium bromide (the drug Spiriva) have a similar effect.

5) Combined drugs. Used to treat severe forms of the disease. They contain, as they say, in one bottle, an inhaled glucocorticosteroid and a long-acting inhaled bronchodilator. Drugs: seretide, symbicort.

6) corticosteroids for oral administration. Used only for very severe forms of the disease, when inhalation therapy does not give the desired effect. Short courses, no more than 5 days in a row, are possible during an exacerbation of asthma. Most safe drug Metypred is considered from this group.
Corticosteroid tablets should only be used if all other treatment options have been tried. Long-term use of tablet corticosteroids is almost always accompanied by the development of complications: increased blood pressure, increased body weight, increased blood sugar levels and the possibility of developing diabetes mellitus etc.

7) antihistamines. Relatively recently, recommendations have appeared for the long-term, more than three months, use of tableted third-generation antihistamines (in particular, the drug Zyrtec) in anti-inflammatory treatment regimens for bronchial asthma. This recommendation can be used for patients with mild persistent asthma.

8) leukotriene receptor antagonists. Enough a new group drugs, but has already managed to demonstrate its high effectiveness. An example of this class of medicinal substances is Singulair in tablets of 5 and 10 mg. Prescribed 1 time per day. Recommended for the treatment of cough variants of bronchial asthma, bronchoconstriction caused by physical activity.

The most important component in the treatment of allergic bronchial asthma– carrying out allergen-specific immunotherapy (SIT therapy). The goal is to create immunity to those allergens that cause an allergic reaction and inflammation in the patient. This therapy can only be performed by an allergist. Treatment is carried out outside of exacerbation, usually in autumn or winter.

Treatment of atopic bronchial asthma with folk remedies.

Allergic diseases are a group of diseases in which traditional medicine must be used with extreme caution. And allergic bronchial asthma is no exception. During my work, I witnessed a huge number of exacerbations provoked by these very methods. If some method helped your friends (by the way, it’s not a fact that it was he who helped, maybe it was a spontaneous remission), this does not mean that it will not cause complications for 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.

It has been proven that the course of the disease in patients who have undergone such training is much better than in those who did not attend these schools.

An important issue is quitting smoking. Neither active nor passive smoking is acceptable for patients with bronchial asthma. You should not choose to work in those organizations where there are various industrial hazards: dusty production, contact with chemicals, etc.

None is the most effective and expensive drug treatment will not be effective unless the content of allergens in the environment. Before carrying out activities, an allergological examination is necessary to identify all possible allergens that can cause exacerbations of the disease.

Allergy to household allergens.

House dust mites

The most common household allergens include house dust mites, house dust, book dust, and feather pillows. Control methods: frequent wet cleaning, general cleaning at least once a week, using air purifiers in all rooms and especially in bedrooms, replacing feather-containing bedding with synthetic ones, using acaricidal (mite-killing) drugs. It is necessary to remove from the room things on which dust often settles and which themselves are its source: large soft toys, tapestries, macromes, etc. Replace curtains with blinds, get rid of carpets...

Allergy to epidermal allergens.

The main epidermal allergens: animal hair and dander, feathers and down of birds. Remedy: It is better not to keep animals at home for patients with this type of allergy. After eliminating the animal, it is necessary to apply two or three times spring-cleaning to completely eliminate remaining allergens from the environment.

Allergy to pollen allergens.

Allergy to pollen – enough common reason allergic diseases. Different plants bloom in different months, even without an allergological examination, but knowing the time of exacerbation, you can confidently assume what causes the symptoms.
The central regions of Russia are characterized by the following flowering calendar:

table No. 2 Flowering calendar in the central regions of Russia

Methods for eliminating allergens and, therefore, bronchial asthma: the most radical and the best option– travel to another climate zone during the flowering period of those plants to which you react. If this is not possible: try to leave the house after 11 a.m., use air purifiers at home, do not go out into the “nature” unless absolutely necessary, do not swim in open water, cover the windows with gauze and do not forget to wet it often. Forget about herbal infusions, beekeeping products, cosmetics and herbal medicines.

Sports activities are possible and recommended, but only when there is no exacerbation. Athletics, ball games, cycling, swimming (if there is no reaction to bleach added to water for disinfection), running - these are the sports that are traditionally recommended for patients with bronchial asthma. TO various kinds Martial arts and skiing (due to exposure to cold air) are usually treated with caution. If the child has a tendency towards this, send the child to music school to the wind instrument class.

Breathing exercises, for example, breathing exercises according to Strelnikova, have a good effect.

Allergic bronchial asthma in children.

Bronchial asthma in children can manifest at any age, but more often it occurs after one year. There is an increased risk of developing the disease in children with a family history of allergic diseases, and in patients who have already noted allergic diseases in the past.

They try to start treatment with cromoglycic acid derivatives (cromohexal, intal, tiled). If they are ineffective, they switch to inhaled glucocorticosteroids. Table No. 3 shows the doses of drugs of this pharmacological group. It is recommended to administer medications using a nebulizer. This increases the effectiveness of drugs and facilitates the inhalation process.

Table No. 3 Doses of inhaled glucocorticosteroids for children.

They try to start allergen-specific therapy (SIT) as early as possible (after 5 years). At this age she gives best effect and often allows you to completely get rid of the disease.
Vaccination is carried out at the stage of stable remission of the disease, under the cover of antihistamines (Zyrtec, Cetrin, Erius) drugs. It is advisable to include the pneumococcal vaccine in the vaccination calendar.

Allergic bronchial asthma and pregnancy.

1) mild episodic course of bronchial asthma. Bronchodilators are prescribed as needed. Atrovent is preferred.

2) mild persistent course of bronchial asthma. Inhalation sodium cromoglycate (Intal, Tayled). If ineffective, replace with inhaled glucocorticosteroids in low doses (Table No. 1). For patients during pregnancy, derivatives of beclomethasone and budesonide are preferred. But you can continue taking other corticosteroids in patients if they successfully controlled bronchial asthma before pregnancy.

3) moderate course of bronchial asthma. Inhaled corticosteroids in moderate dosages.

4) severe course of bronchial asthma. Inhaled corticosteroids in high doses. If there is a need for high doses of inhaled corticosteroids during pregnancy, then preference should be given to budesonide and its derivatives. It is possible to prescribe tableted corticosteroids (prednisolone) in intermittent regimens.
Childbirth only in a hospital setting. Electronic fetal monitoring is carried out from the moment of admission to the maternity hospital, although if asthma is well controlled and the patient is not at risk, continuous fetal monitoring is not required. Respiratory function (spirography, peak flowmetry) is assessed from the onset of labor, and then every 12 hours until delivery. Good pain relief reduces the risk of asthma attacks during childbirth. If a cesarean section is necessary, non-ridural anesthesia is preferred; fentanyl is used as an analgesic. Vaginal delivery is preferred, given that cesarean section is associated with a significantly increased risk of exacerbation of the disease.

During breastfeeding, anti-asthmatic therapy carried out during pregnancy is continued. Theophylline and its derivatives are not recommended due to their direct toxic effect on the fetus.

Possible complications of allergic bronchial asthma and prognosis

The prognosis for life with proper treatment is favorable. With inadequate treatment or abrupt withdrawal of medications, there is a high risk of developing status asthmaticus. 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 heart failure. Severe forms of the disease can lead to disability of the patient.

Prevention of allergic bronchial asthma.

Unfortunately, effective measures of primary prevention, that is, aimed at preventing the disease, have not been developed. If the problem already exists, 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 breathing exercises help in the treatment of bronchial asthma?

Yes, definitely. In mild forms of the disease, only these methods can completely stabilize the course of the disease; in moderate and severe forms of the disease, they can significantly alleviate it. Many of my patients relieve attacks solely using breathing exercises, without using medications. Although it is better to keep medications on hand.

A diagnosis of bronchial asthma is made. The doctor prescribed a course of treatment with inhalers (flixotide) for three months. The symptoms disappeared on the fifth day of treatment. Why take medications for so long if the disease no longer manifests itself?

Bronchial asthma is a chronic disease. There are no symptoms, because you are receiving treatment. If you abandon the course halfway, there is a high risk of exacerbation. After three months, your doctor will evaluate your condition and decide whether to continue treatment. Bronchial asthma is an insidious disease, so such long courses are justified.

The hospital prescribed a beclazone inhaler. I read in the instructions that it belongs to hormonal drugs. Is it dangerous to use it? What side effects might there be? How can they (these side effects) be avoided?

Yes it hormonal drug. But it acts specifically on the mucous membranes, relieving inflammation there. Studies have been conducted showing that inhaled corticosteroid daily dose less than 1800 mcg has no effect systemic action on the body. Therefore, there is no need to be afraid of these drugs. But if the inflammatory process is not relieved, the disease can quickly progress to status asthmaticus.
But if the drug is used incorrectly, an infection (most often fungal) may occur on the mucous membranes of the mouth. This is the most common side effect of these drugs. To avoid it, you must rinse your mouth after inhalation. The use of a spacer, which is a plastic tube (adapter), also helps. An inhaler with medicine is attached to one hole of such a tube, and inhalation is carried out through the other. As a result, large particles of the drug, which can cause problems, settle on the walls of the spacer without reaching the mucous membranes.

Allergist-immunologist, Ph.D. Mayorov R.V.

Disease severity

What happens in the body during allergic asthma?

Reasons for the development of the disease

Clinical manifestations of the disease

Diagnosis of allergic bronchial asthma

Treatment of the disease

Etiology

Symptoms

Types and forms of allergic asthma

Diagnostic measures

Treatment

Mechanism of development and causes of allergic asthma

Household

Pollen

Fungal

Disease severity

Symptoms of manifestation

Diagnostics

Treatment

Inhalation agents

Breathing exercises

Allergic asthma in children

Prevention of allergic asthma

Characteristics of the pathology

Causes of the disease

Predisposing factors

Symptoms of an attack

Degrees of the disease

Complications

Diagnosis of the disease

How to cure the disease

Drug therapy

Breathing exercises

Cause of bronchial asthma

Symptoms of bronchial asthma

Cause of bronchial asthma

Symptoms of bronchial asthma

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

What tests will you need to take if you suspect bronchial asthma?

Treatment of allergic bronchial asthma

Treatment of atopic bronchial asthma with folk remedies.

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

Allergic bronchial asthma in children

Allergic bronchial asthma and pregnancy.

Possible complications of allergic bronchial asthma and prognosis

Prevention of allergic bronchial asthma

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

Symptoms of allergic bronchial asthma.

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

What tests will you need to take if you suspect allergic bronchial asthma?

Treatment of allergic bronchial asthma:

Table No. 1 Doses of inhaled glucocorticosteroids for adults.

Treatment of atopic bronchial asthma with folk remedies.

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

Allergy to household allergens.

Allergy to epidermal allergens.

Allergy to pollen allergens.

table No. 2 Flowering calendar in the central regions of Russia

Allergic bronchial asthma in children.

Table No. 3 Doses of inhaled glucocorticosteroids for children.

Allergic bronchial asthma and pregnancy.

Possible complications of allergic bronchial asthma and prognosis

Prevention of allergic bronchial asthma.

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

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