Home Gums All about allergic asthma. Allergic bronchial asthma Allergic bronchial asthma symptoms

Gums

All about allergic asthma. Allergic bronchial asthma Allergic bronchial asthma symptoms

Allergic asthma – this form of bronchial asthma is very common. This pathology accounts for the majority of clinical cases. The cause of the development of such asthma is an allergic reaction to a certain substance.. The disease is equally common in both adults and children. The danger is that with a mild course of the disease the diagnosis is not made for a long time and, accordingly, the person does not receive any treatment. In the occurrence of illness significant role Heredity plays a role. It is already known that if one of the parents has allergic asthma, then the child has a very high chance of getting sick, although it also happens that the predisposition is passed on from grandparents.

Degrees of the disease

Allergic bronchial asthma There are 4 forms of severity, the division depends on the severity of general symptoms and the severity of the person’s condition:

Intermittent degree. Attacks of suffocation during the day occur very rarely, no more than once a week. At night, attacks occur no more than 2 times a month. Relapses of the disease pass quickly enough and have virtually no effect on the general health of the patient.
Mild persistent degree. Signs of the disease appear more often than once a week, but not more than once a day. More than 2 night attacks may occur in a month. During a relapse, the patient's sleep is disturbed and his general state health.
Persistent asthma of moderate severity. The disease occurs almost every day, and attacks during sleep occur more than once a week. The patient's sleep quality deteriorates and performance decreases.
Severe persistent asthma. The disease manifests itself very often, both during the day and at night. The patient's performance and physical activity are greatly reduced.

Symptoms and further treatment differ at different stages of the disease. In the mildest cases, it is enough to eliminate the allergen and the patient’s condition improves, but in severe cases of allergic asthma, various medications are prescribed to stabilize the condition.

There are many different allergens in nature. It is not possible to completely protect a person from them.

Pathogenesis of the disease

The mechanism of development of this disease has not yet been fully studied. But it has already been established that the reaction of the bronchi to an allergen occurs under the influence of various cells, structures and components:

As soon as an allergen enters the body, special blood cells are activated. They produce active substances that are responsible for all inflammatory processes.
The muscle mass in the walls of the bronchi of patients is especially predisposed to stable contraction, while the receptors located on the mucosa become susceptible to the effects of biologically active components.
Due to these processes, bronchospasm begins, and at the same time, the lumen of the airways is noticeably reduced. In this case, the patient’s breathing is significantly impaired, severe shortness of breath occurs, which can be fatal.

Allergic asthma rapidly progresses, the condition of the asthmatic gradually worsens. A person with bronchial asthma is not difficult to recognize; he tries to take a comfortable position in which shortness of breath will be less pronounced.

Asthmatics very often feel that an attack of suffocation is approaching, usually this occurs within minutes after short contact with the allergen.

Causes

Allergic asthma occurs for a variety of reasons. Sometimes the cause of the disease is a combination of factors:

Hereditary predisposition. Often, when interviewing a patient, you can find out that his close relatives suffer from allergic pathologies or bronchial asthma. Through research it was revealed that if one of the parents suffers from allergic asthma, then the child’s chance of illness is 30% or more. When two parents are diagnosed with asthma, the child will get sick in 70% of cases or even a little more. You need to understand that allergic bronchial asthma is not inherited, children only receive a tendency to this disease.
If a person often suffers from respiratory and infectious diseases, then the walls of the bronchi become thinner and become more susceptible to irritants.
The disease often begins with bad ecology at your place of residence or while working at industrial enterprises, with large emissions of dust and other harmful substances.
Abuse of tobacco products also leads to the development of the disease. Don't forget about passive smoking. People who smoke in the house significantly increase the child’s chance of developing bronchial asthma.
Abuse of foods that contain a lot of preservatives, food colors and flavor enhancers.

Attacks of suffocation in allergic asthma begin after contact with some irritant. The susceptibility of each patient is individual, sometimes there are several allergens. The most allergenic substances are:

pollen from vegetation, especially flowers from the Asteraceae family;
particles of hair from different animals;
fungal spores, mainly moldy;
particles of house dust containing waste products of dust mites;
cosmetics and some household chemicals, especially substances with a cloying odor that cause attacks;
tobacco smoke and cold air.

Food rarely causes allergic asthma, but it does happen. The most allergenic foods are honey, chocolate, milk, eggs, nuts, crayfish, citrus fruits and tomatoes..

Dry fish food can trigger an asthma attack. If a person is predisposed to allergies, then the fish should be abandoned or fed with fresh food.

Symptoms

The symptoms of allergic asthma in children and adults are not too specific. Signs of the disease are sometimes difficult to distinguish from asthma of non-allergic pathogenesis. The general clinical picture looks like this:

Severe difficulty breathing. It is difficult for the patient not only to inhale, but also to exhale. Each exhalation becomes painful and comes with great difficulty. Severe shortness of breath begins just 5 minutes after contact with an allergenic substance or immediately after physical activity.
Whistling sounds when breathing. This occurs due to the fact that air passes through narrowed airways. Breathing can be so noisy that the whistling sound can be heard several meters away from the person with asthma.
Asthmatics always exhibit a characteristic posture, especially during an attack of suffocation due to allergies. Since the airways are narrowed, a patient with asthma cannot breathe normally only with the involvement of the muscles of the respiratory organs. Additional muscle groups are always involved in the breathing process. During an attack, an asthmatic tries to lean his hands on some stable surface.
The cough occurs in attacks, but it does not bring relief to the person. In some cases, cough is the main symptom of asthmatics. Often people do not even pay any attention to frequent coughing, thinking that it is caused by trivial reasons. You need to understand that a reflex cough goes away without a trace in just a few minutes. This time is often enough for the irritant to leave the respiratory tract.
When you cough, you always produce a little glassy sputum.
Status asthmaticus is a dangerous exacerbation of the disease, when a prolonged attack of suffocation occurs, which is difficult to stop with conventional methods. If during such an attack the patient is not given first aid, he may not only lose consciousness, but also fall into a coma.

In allergic asthma, symptoms of the disease in adults and children appear only after close contact with the allergen. Depending on the type of allergen, the duration of the attack and the intensity of exacerbation of the pathology vary. For example, if a patient is allergic to plant pollen, then in the spring and summer the patient cannot avoid contact with this substance, since flowering vegetation is everywhere. The result of such contact between an asthmatic and an allergen results in a seasonal exacerbation of the disease.

Some asthmatics, knowing which plant causes allergies, prefer to leave their place of permanent residence while it is blooming.

Treatment

Treatment of allergic asthma includes the same medications as therapy for asthma of other origins.. But we must not forget that the course of the disease also depends on the degree of susceptibility to the allergen:

If a person suffers from allergic reactions, he should, if necessary, take antiallergic drugs, which are available in abundance in the pharmacy chain. Such drugs block special receptors that are affected by histamine. Even if an allergen enters the body, allergy symptoms are not as severe or are not observed at all. If contact with an irritating substance cannot be avoided, then you need to take antiallergic medications in advance.
Exists original technique treatment in which doses of the allergen are introduced into the human body in increasing volumes. Thanks to this treatment, a person’s susceptibility to the irritant is reduced, and attacks of bronchial asthma become less frequent.
Inhaled administration of certain hormonal drugs and long-acting β2-adrenergic receptor blockers are the most common methods of treatment. Thanks to such drugs, it is possible to control the disease for a long time.
The patient is injected with specific antibodies that are antagonists of immunoglobulin E. This therapy helps to stop the high sensitivity bronchi and prevent relapses of the disease.
Cromones – these medications are often prescribed to treat asthma. allergic type in children. Treatment of adult patients with such drugs does not bring the desired result.
Methylxanthines.
If the disease is in the acute stage, the patient may be prescribed strong adrenergic receptor blockers. In addition, in such cases, the patient is given adrenaline injections and hormonal drugs are prescribed in tablets.

To relieve an attack of suffocation, special medications are used in the form of inhalations.. This form of the drug goes directly to the site of inflammation and has therapeutic effect instantly. Medicines in the form of an aerosol rarely cause side effects, since they work only locally and do not have a systemic effect on the entire body.

Treatment of patients with allergic bronchial asthma is carried out on an outpatient basis. Only in severe cases can the patient be hospitalized for assistance, most often this occurs during an exacerbation of the disease. Asthmatics are registered with a doctor and are regularly observed by specialists.

Dangerous complications of allergic bronchial asthma include heart and respiratory failure. In severe cases of the disease, the patient may die from suffocation.

Forecast

If treatment is carried out correctly, the prognosis for the patient’s life is favorable. If the diagnosis is made too late or inadequate treatment is carried out, there is a risk of serious complications. These primarily include status asthmaticus, cardiac and respiratory failure. Pulmonary emphysema often occurs. If status asthmaticus develops, the patient's life is threatened.

In case of severe disease, the patient receives a disability group. With disability group 3, an asthmatic can work in a certain list of professions, but with group 1-2, he cannot work.

With allergic bronchial asthma, cases of sudden death can occur. Therefore, the patient should avoid excessive physical activity.

Preventive measures

People suffering from allergic bronchial asthma should understand that their priority is to prevent relapses of the disease. To prevent attacks of suffocation, you must follow simple recommendations:

The home is constantly wet cleaned, wiping all surfaces.
If you are allergic to wool or feathers, you should avoid keeping pets in the house, as well as canaries and parrots.
You cannot use perfumes and various household chemicals with too strong a smell.
Do not use down pillows and blankets.
If an asthmatic works in a hazardous industry with a lot of dust or chemical substances, it is advisable to change your place of work.
Respiratory and other illnesses that may cause asthma relapse should be avoided.

A patient with allergic asthma should reconsider his diet. All highly allergenic foods should be excluded from the menu.

Allergic bronchial asthma can be either mild or very severe. Symptoms and treatment methods depend on the degree of pathology and the presence of various complications. Allergic asthma often leads to disability.

Allergic (other name: atopic) bronchial asthma in one form or another occurs in approximately 5% of humanity. This is an inflammatory disease of the respiratory tract, due to which attacks of suffocation periodically occur for no apparent reason or after physical exertion, in a stressful situation. Sometimes, more often in children, allergic asthma can occur in an erased form; it is often mistaken for other diseases, for example, chronic bronchitis.

Symptoms of atopic asthma

The main symptoms of bronchial asthma against the background of allergies are attacks of suffocation, difficulty breathing and a sore throat. Sometimes, when inhaling, a whistle appears, increasing in direct proportion to the depth of breathing. Also a symptom is a dry paroxysmal cough, less often with the release of a small amount of sputum.
If the patient is tormented only by a cough, then most likely he has a cough variant of infectious-allergic bronchial asthma.
The problem is that often all of the above symptoms manifest themselves only during an exacerbation. The rest of the time a person can feel quite well.
The patient may notice that his attacks begin only after any physical activity or contact with something. For example, with cat hair.
Based on the severity of the symptoms, there are conditionally 4 levels of severity of the disease.

Levels of severity of allergic bronchial asthma

mild intermittent - I degree. This is a mild degree of bronchial asthma. The disease manifests itself very rarely, approximately 1-3 times a month, but night attacks are practically absent.
mild persistent - II degree. The disease manifests itself a little more often: on average 4-6 times a month, night attacks may occur, up to twice a month. The disease disrupts daily life and sleep.
moderate severity - III degree. The attacks occur much more often, almost every day, and at night - 3-4 times a week. A person experiences a noticeable decrease in well-being - unexpected attacks greatly interfere with physical activity.
severe asthma - IV degree. Allergic attacks 3-4 times daily and almost every night. The patient is completely out of touch with the rhythm of everyday life, causing physical and physical activity significantly reduced, and healthy sleep absent at all.

The most dangerous manifestation of allergic bronchial asthma is status asthmaticus, during which the patient develops resistance to conventional drugs, which is why the asthma attack is delayed for a long time. long time, during which the patient cannot exhale.

Status asthmaticus, if detected, requires immediate hospitalization, otherwise the patient may die.

Causes

Hereditary factor. If one parent has an allergy to something or asthma, then the chance that this will be passed on to the child is approximately 25%. If both parents have asthma - 70%. But it is important to understand that the disease itself is not inherited. Only a predisposition is transmitted, which, under favorable conditions, will disappear.
Transferred serious illnesses respiratory tract.
Unfavorable living conditions. For example, living in the city center and inhaling machine fumes. The metropolis itself is harmful for many other reasons, but it is this one that provokes atopic bronchial asthma.
Poor nutrition. Consumption of a large number of chemical additives, sweeteners, and preservatives with food.
Smoking. Even if the person himself does not smoke, tobacco smoke can cause the development of the disease, this especially applies to parents who smoke and children who are forced to breathe smoke.

The attack itself occurs due to contact of the sensitive bronchi with an allergen. Allergens can be completely different, but most often they are:

pollen,
cat and dog hair,
house dust,
flowers and plants with a pungent odor (orchids and others),
mushroom spores,
cold air.

Most often, the period of exacerbation of bronchial asthma occurs in the spring: after all, it is at this time that the concentration of pollen, one of the strongest allergens, is highest in the air.

Diagnosis of bronchial asthma

Bronchial asthma is easily confused with other types of lung diseases. Therefore, you need to visit a doctor as quickly as possible - only he can make the correct diagnosis and prescribe effective treatment. As a rule, the first doctor a patient with suspected asthma turns to is a general practitioner or pediatrician. But if there are assumptions about the allergic nature of the disease, the patient can be referred to an allergist, who, after conducting a special examination, will determine which allergens can provoke asthmatic attacks.

The examination program for diagnosing allergic asthma also includes:

ECG to rule out cardiac asthma;
a complete blood test to exclude the cause of the inflammatory nature of a respiratory disease;
urine and sputum analysis;
chest x-ray.

And other tests until the doctor can confidently give a diagnosis.

It is highly not recommended to treat this disease with home methods, since improper treatment there is a chance of death or the disease progressing to a chronic stage. Consult with an experienced physician before choosing treatment or prevention options.

SIT therapy

The method of allergen-specific immunotherapy consists of subcutaneously administering to the patient doses of the allergen to which the patient has been shown to be sensitive, diluted many times according to a special formula. The dose is gradually increased.
This procedure should lead to specific hyposensitization - a decrease in the body's sensitivity to a given stimulus.

Folk remedies

A good effective expectorant for bronchial asthma and allergies is a decoction of wild rosemary herb. 1 tbsp. l. crushed herbs are placed in a glass of boiled water and left for ten minutes. The resulting decoction is taken 4-6 times a day, one tablespoon at a time.
An effective folk remedy is nettle smoke. It instantly relieves an attack, and with regular use it completely cures the disease.
The following herbal decoctions and traditional methods can also help with an attack or even completely cure the patient:

Decoction of coltsfoot leaves

Tear 30-40 grass leaves; pour 500 mg. vodka; leave to stand in a cold and dark room for about 2 weeks. The resulting decoction is used as a compress. On the first night he is placed on his chest, on the second - on his back, etc. A total of 20 compresses.

Jerusalem artichoke infusion

Take 2 tablespoons of grated (this is important!) Jerusalem artichoke fruits and put them in a glass of boiling water. Take ¼ cup 2-4 times a day.

"Grandfather's method"

Take 35 drops of hydrogen peroxide diluted in 100 mg half an hour before breakfast. water (half a glass). This method will not only help get rid of bronchial asthma, but will also be a good sedative.

Infusion of pine cones

Place 3-4 pine cones, a small amount of resin and half a liter of hot milk in a thermos; stir; leave the infusion to infuse for 5 hours; strain through three layers of gauze. The infusion is ready. Take a glass of it once or twice a day for a month

Drug treatment is effective against all types of asthma, including allergy asthma. It consists either in the use of special medications or in the use of medical devices, for example, inhalers.

Antihistamines

Antihistamines suppress free histamine in the human body, thereby reducing the symptoms and severity of allergic asthma.
All this leads to blocking of receptors, thereby making the body immune to external irritants and allergens. Histamine simply stops being released into the blood, or is released in small, insignificant quantities.
It is better to take such drugs before contact with the allergen and the onset of atopic asthma. For example, people who are allergic to pollen should start taking it a week or a week and a half before the flowering season.
The two most famous antihistamines and, which are suitable for both adults and children:

"Trexil" - fast-acting active drug, suitable for the treatment of allergic bronchial asthma in children and adults. The advantage of this drug is that it has no serious contraindications or side effects. Recommended for use from 6 years of age.
"Telfast" is a highly effective antihistamine that blocks the biological response of receptors to external stimuli. Does not slow down the reaction, but, in rare cases, causes a headache. From the age of 12.

Many antihistamines have by-effect- drowsiness and apathy. Less common: headache, nausea, etc. But the low cost allows the drugs to remain high in popularity for the treatment of allergic bronchial asthma.

Inhalation agents

The most popular and widely used way to combat allergic bronchial asthma is the use of inhaled drugs: glucocorticoids and blockers. They help control the course of the disease for a very long time: special antibodies reduce the sensitivity of the bronchi and prevent exacerbation of asthma.
There are inhalers of various brands (Turbuhaler, Pulvinal, Diskus, Easyhaler, etc.) and with different active substances - they will be discussed further. Please remember that two different inhalers may not contain the same substance. You have to be careful with this.

methylxanthines. They are used during exacerbation of atopic asthma, as they act instantly and effectively by blocking adrenergic receptors. Active substances belonging to this group: theophylline, aminophylline.
sympathomimetics. Thanks to this drug, receptors in the bronchi are stimulated, due to which the lumens in them increase. In the modern world, selective substances are used because they can instantly neutralize an attack and be eliminated from the body just as quickly.
M-cholinergic receptor blockers. Thanks to them, rapid, almost instantaneous relaxation of the bronchi is ensured. You should be careful with this group, because... For allergic bronchial asthma, only one type of blocker is suitable - ipratropium. And then only in the form of inhalation.
glucocorticoids. Drugs that have a powerful anti-inflammatory effect. It is achieved by enhancing the hormone adrenaline and relieving swelling of the bronchial mucosa.

Inhaled drugs are significantly more convenient and profitable than other medications due to their immediate therapeutic effect.

This is a unique breathing exercise of the same name, named after our compatriot who lived in the last century. It allows you to recover from asthma on your own in a short time. But before you do it, be sure to consult your doctor!
All exercises in this procedure are aimed at reducing the depth of breathing and, consequently, the content of carbon dioxide in the patient’s blood. This is due to the fact that with asthma, no matter how deeply the patient breathes, there is still a lack of oxygen in the blood and an excess of carbon dioxide. This causes many of the symptoms of bronchial asthma.
The patient should prepare for breathing exercises by following these simple steps:

Sit upright on a hard surface (not necessarily a chair; a couch, sofa, or bed can do the trick), straighten up, and place your hands on your knees.
Relax.
Breathe quickly, frequently and shallowly, as if there is no way to take a full, deep breath.
Exhale lightly through your nose.

This procedure should be repeated for 10 minutes. The patient may feel a little dizzy and short of breath - this is normal, as it should be.
After the procedure, you should hold your breath for as long as possible (gradually you will be able to do this 1-2 longer than last time). Now it’s time to proceed directly to the breathing exercises themselves.

Repeat 10: inhale for 5 seconds, exhale for 5 seconds and pause. The muscles should relax as much as possible. This exercise stimulates the upper regions of the lungs
Repeat 10 times: inhale for 7-8 seconds, exhale for 7-8 seconds, pause for about 5 seconds. This exercise stimulates all major parts of the lungs.
Repeat 1 time: complete breath holding. Massage of reflexogenic points of the nose.
Repeat 10 times: the same as in exercise 2, but with closing one of the nostrils alternately.
Repeat 10 times: the same as exercise 2, but the stomach is pulled in as much as possible.
Repeat 12 times: inhale and exhale as deeply as possible. Afterwards, a long pause with holding your breath.
Repeat 1 time: deep breath, maximum pause, deep exhalation, maximum hold.
The same as in exercise 7, but now some action is added. For example, walking or running. Repeat from 2 to 5 times depending on the individual physiological characteristics of the patient’s body.
Shallow breathing. Breathe deeply, gradually reducing the depth of inhalation. There should be a feeling of lack of air. Breathe like this for 2.5-10 minutes.

At first, the patient may feel short of breath, fear, etc. unpleasant symptoms. Under no circumstances should you give up breathing exercises. Gradually, these symptoms will disappear, and asthma attacks will become weaker and less frequent.

Video that illustrates the gymnastics process:

Features of the treatment of bronchial asthma in children

In younger children age group There are a number of features in the diagnosis and treatment of bronchial asthma. All of them are associated with the structure of an incompletely formed body.
In the treatment of allergic asthma, preference is given to inhaled drugs, as they are as harmless and fast-acting as possible.
Also known medications that doctors often prescribe for children under six years of age are antileukotriene drugs. Their advantage is availability and price, as well as safety - they do not cause an allergic reaction.
But to find out the full picture, the parent must visit a specialist with the child. No self-medication - mortality in childhood asthma is extremely high if you do not monitor the patient and take no action.

Prevention

Unfortunately, there is no 100% means of preventing this type of asthma, because allergies, as we know, can manifest themselves at any time. But following the following points will significantly reduce the risk of getting sick:

ventilation of the room,
taking antihistamines in advance,
healthy lifestyle (no cigarettes or drugs! Alcohol in moderation),
proper diet (containing a full range of vitamins, especially vitamin D),
playing sports (any kind of sport is useful, as it helps train breathing).

Asthma is a serious disease, but with the proper attitude of the patient towards treatment and prevention, it is quite possible to cure it. The main thing is not to despair, abandoning treatment halfway. Once treatment has been started, you need to complete it, and the positive effect will not be long in coming!

This is a chronic non-infectious allergic lesion of the respiratory tract, developing under the influence of external allergens against the background of a genetically determined tendency to atopy. It manifests itself as episodes of sudden paroxysmal suffocation, cough with scanty viscous sputum. When diagnosing atopic bronchial asthma, anamnesis, data from allergy tests, clinical and immunological blood tests and bronchoalveolar lavage are assessed. For atopic bronchial asthma, a diet, anti-inflammatory, desensitizing therapy, bronchodilators and expectorants, and specific hyposensitization are prescribed.

ICD-10

J45.0 Asthma with a predominance of an allergic component

General information

Atopic bronchial asthma is an allergic broncho-obstructive pathology with chronic course and the presence of a hereditary predisposition to sensitization. It is based on the increased sensitivity of the bronchi to various non-infectious exoallergens that enter the body with inhaled air and food. Atopic bronchial asthma is a very severe manifestation of allergy; its prevalence is 4-8% (5% among adults and 10-15% among children). In recent years, practical pulmonology has seen a progressive increase in the incidence of this variant of asthma. Atopic bronchial asthma manifests itself in more than half of patients already in childhood(up to 10 years), in another third of cases in the period up to 40 years. Asthma in children is predominantly atopic in nature and more often affects boys.

Causes

Atopic bronchial asthma is a polyetiological pathology that develops due to a combination of certain internal and external causes. Great importance attributed to a hereditary tendency to allergic manifestations (increased production of IgE) and bronchial hyperreactivity. In more than 40% of cases, the disease is recorded as familial, and the tendency to atopy is 5 times more likely to be transmitted along the maternal line. In atopic asthma, the incidence of other familial forms of allergies is 3-4 times higher. The presence of the A10 B27 haplotype and blood group 0 (I) in the patient are risk factors for the development of atopic asthma.

The main external factors responsible for the implementation of predisposition to atopic bronchial asthma are non-infectious exoallergens (substances of plant and animal origin, household, food allergens). Household and library dust have the most pronounced sensitizing potential; wool and waste products of domestic animals; poultry feathers; food for fish; plant pollen; food products (citruses, strawberries, chocolate). Depending on the leading cause, they distinguish Various types allergic bronchial asthma: dust (household), pollen (seasonal), epidermal, fungal, food (nutritive). In the initial stage of asthma, there is one pathogenetic variant, but others may subsequently join.

Risk factors:

Exacerbation of asthma is caused by:

smoking, smoke, industrial emissions,
strong chemical odors
significant temperature difference
taking medications

The development of early sensitization in a child is provoked by:

early introduction of artificial formulas
vaccination (especially against whooping cough).

Food sensitization usually occurs first, followed by skin and respiratory sensitization.

Pathogenesis

The formation of asthmatic reactions involves immune and non-immune mechanisms, in which various cellular elements participate: eosinophilic leukocytes, mast cells, basophils, macrophages, T-lymphocytes, fibroblasts, epithelial and endothelial cells, etc. The atopic form of asthma is characterized by allergic reactions of type I (anaphylactic ).

In the immunological phase, the body develops sensitization to the first-time allergen due to the synthesis of IgE and IgG4 and their fixation on outer membrane target cells. In the pathochemical phase, repeated contact of the allergen with target cells triggers a sharp release of various inflammatory mediators - histamine, cytokines, chemokines, leukotrienes, platelet activating factor, etc. An early asthmatic reaction develops (from 1-2 minutes to 2 hours after exposure to the allergen ) in the form of broncho-obstructive syndrome with swelling of the bronchial mucosa, spasm of smooth muscles, increased secretion of viscous mucus (pathophysiological phase). Bronchospasm leads to restriction of intake air flow into the lower respiratory tract and temporary deterioration of pulmonary ventilation.

Late asthmatic reaction is accompanied by inflammatory changes in the bronchial wall - eosinophilic infiltration of the mucous membrane and submucosal layer, desquamation of ciliated epithelial cells, goblet cell hyperplasia, proliferation and hyalinization of the basement membrane. Even with persistent remission of asthma, the bronchial wall maintains chronic inflammation. With a long course of atopic bronchial asthma, irreversible changes are formed with sclerosis of the bronchial wall. Outside of an attack and in an uncomplicated course, changes in the lungs are not observed.

Symptoms of atopic asthma

In children, the first respiratory manifestations of allergies, related to preasthma, can be observed already in the second or third year of life. Typical asthmatic symptoms appear later, between 3 and 5 years of age. The pathognomonic symptoms of atopic bronchial asthma are sudden attacks of obstructive suffocation, rapidly developing against the background wellness. An asthmatic attack may be preceded by nasal congestion and itching, sneezing, runny nasal discharge, sore throat, and dry cough. The attack ends quite quickly spontaneously or after medicinal effects, ending with the discharge of scanty viscous sputum of a mucous nature. During the interictal period, clinical manifestations of the disease are usually minimal.

The most common household form of atopic bronchial asthma is clearly manifested during the heating season due to an increase in dust in the premises and is characterized by an elimination effect - stopping attacks when leaving home and resuming when returning. The epidermal form of asthma manifests itself upon contact with animals, starting with allergic rhinoconjunctival syndrome. Seasonal asthma occurs with exacerbations during the flowering period of grasses, shrubs and trees (spring-summer), fungal asthma - during the period of sporulation of fungi (seasonal or year-round) with temporary relief after snowfall and intolerance to yeast-containing products.

Exacerbation of allergic bronchial asthma is manifested by attacks of varying intensity. With prolonged contact with a high concentration of the allergen, asthmatic status may develop with alternating severe attacks of suffocation for a day or more, with painful shortness of breath, aggravated by any movements. The patient is excited, forced to take a sitting or half-sitting position. Breathing occurs due to all the auxiliary muscles, cyanosis of the mucous membranes and acrocyanosis are noted. Resistance to antiasthmatic drugs may occur.

Complications

Functional changes that develop during severe attacks (hypoxemia, hypercapnia, hypovolemia, arterial hypotension, decompensated respiratory acidosis, etc.) pose a threat to the patient’s life due to the risk of asphyxia, severe arrhythmia, coma, respiratory and circulatory arrest. Pulmonary complications atopic bronchial asthma can become bacterial infections respiratory tract, emphysema and pulmonary atelectasis, pneumothorax, respiratory failure; extrapulmonary - heart failure, cor pulmonale.

Diagnostics

Diagnosis of the atopic form of asthma includes examination, assessment of allergy history (seasonality of the disease, nature of attacks), results of diagnostic allergy tests (skin prick tests and inhalation provocative tests), clinical and immunological blood tests, analysis of sputum and bronchial lavages. Patients with atopic bronchial asthma have a hereditary burden of atopy and/or extrapulmonary manifestations allergies (exudative diathesis, eczema, allergic rhinitis, etc.).

Skin tests can identify potential allergens; inhalation tests with histamine, methacholine, acetylcholine - paroxysmal bronchial hyperreactivity. The allergic nature of bronchial asthma is confirmed by eosinophilia and high titer general and specific IgE in blood serum. Data from bronchoalveolar lavage determine changes in the cellular composition of sputum (eosinophilia, the presence of specific elements - Kurshman spirals, Charcot-Leyden crystals).

Diagnosis of food sensitization in atopic bronchial asthma includes keeping a food diary, conducting elimination diets and differential diagnostic fasting; provocative tests with products; skin tests with food allergens; determination of specific Ig in blood serum. Difficulties in clarifying the dust nature of allergies are associated with the complex antigenic composition of dust. It is important to distinguish atopic bronchial asthma from obstructive bronchitis and other types of asthma.

Treatment of atopic asthma

The management of patients with atopic bronchial asthma is carried out by a specialist pulmonologist and an allergist-immunologist. A necessary condition treatment is the elimination or limitation of exoallergens (refusal of carpets, upholstered furniture and down and feather bedding, keeping pets, smoking), frequent wet cleaning, adherence to a hypoallergenic diet, etc., as well as self-control on the part of the patient.

Drug therapy for atopic asthma includes desensitizing and anti-inflammatory drugs (cromolyn sodium, corticosteroids). For cupping acute attacks bronchodilators are used for asthma. For bronchial asthma, preference is given to inhaled forms of steroids, used in the form of metered-dose aerosol inhalers or nebulizer therapy. To improve bronchial patency, expectorants are indicated.

In mild forms of asthma, symptomatic use of short-acting bronchodilators (orally or inhaled) is sufficient; in severe cases, daily use of anti-inflammatory drugs or inhaled corticosteroids is indicated; long-acting bronchodilators. For status asthmaticus, rehydration therapy, correction of microcirculatory changes and acidosis, oxygen therapy, and, if necessary, mechanical ventilation, bronchoalveolar lavage, and long-term epidural analgesia are prescribed. For atopic bronchial asthma, hemosorption can be used; outside of exacerbation - specific hyposensitization, immunocorrection, exercise therapy, acupuncture, physiotherapy, speleotherapy are carried out, Spa treatment.

Prognosis and prevention

The prognosis of atopic asthma depends on the severity of obstruction and the development of complications; in severe cases possible death from stopping breathing and blood circulation. Prevention of this variant of asthma consists of eliminating occupational hazards, home sources of allergies, drying and fungicidal treatment of damp rooms, following a hypoallergenic diet, and changing the climatic zone during the flowering period of plants.

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. This article contains complete information on the symptoms, diagnosis and treatment of this disease and will be able to answer many questions from patients, their family members, and perhaps doctors.

Bronchial asthma– chronic, inflammatory disease of the 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 the diagnoses “ obstructive bronchitis"or simply "chronic bronchitis." The incidence among children is even higher and in some regions reaches 20%. Among children, the number of patients with 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 chronic infection(or frequent infectious diseases) in the respiratory tract, unfavorable environment, occupational hazards, smoking, including passive smoking, 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 in 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 causing exacerbation diseases, 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 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.

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 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.

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. 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.

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 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:

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.

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.

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.

A study of external respiration function (spirography) is mandatory. 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 consumables, which makes it very convenient for everyday 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.

Given the high prevalence concomitant diseases nasopharynx, an annual examination by an ENT doctor and an x-ray of the paranasal sinuses are recommended.

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. The optimal age for this type of study is 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. Cons: much higher cost and quite a large percentage 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 carry out FGDS (fibro-gastro-duodenoscopy), bronchoscopy, ultrasound of the thyroid gland, PCR (polymerase chain reaction) of throat smears 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 may be available in metered-dose aerosols or 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 in this moment, namely, has a therapeutic effect on inflammatory process in general, which leads (or should lead), ultimately, to stabilization of the disease. The therapeutic effect is quite weak and is 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 pharmacological group for the treatment of bronchial asthma, 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) Inhaled bronchodilators (β2 agonists) long acting. 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.

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 is completely eliminated or at least reduced. 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, two or three times of general cleaning are necessary to completely eliminate the remaining allergens from the environment.

Allergy to pollen allergens.

Allergy to pollen is a fairly common cause of 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

Ways to eliminate allergens and, consequently, bronchial asthma: the most radical and best option is to 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 preparations, bee 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 chlorine added to water for disinfection), running - these are the sports that are traditionally recommended for patients with bronchial asthma. Various types of martial arts and skiing (due to exposure to cold air) are usually treated with caution. If your child has a penchant for this, send your child to a music school to play wind instruments.

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

Allergic bronchial asthma in children.

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 beginning labor activity, 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 continue anti-asthma therapy during pregnancy. 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.

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, this is a 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.

The same allergens that cause people to cough, sneeze, and irritate the mucous membranes of the eyes can cause an asthma attack. It is important for patients to know the triggers and how to quickly self-help in the event of another strangulation attack. Allergic asthma is a common form of the disease and accounts for more than half of the 20 million total cases.

In February 2015, the International Congress of the Russian Association of Allergists and Clinical Immunologists took place in Moscow, at which the need to make changes to the classical definition of bronchial asthma was voiced. Leading experts are convinced that the disease is heterogeneous. This means that in childhood the dominant phenotype is allergic asthma, which develops against the background of the interaction of environmental conditions and genetic heredity.

In the absence of pathologies, the immune system is designed to protect a person from pathogens, otherwise its natural work is disrupted.

Allergic asthma is an immune response to the introduction of antigens.

When it interacts with IgE (specific immunoglobulin E), the substance histamine is released, causing swelling of the mucous membranes and inflammation skin. All this together creates the classic symptoms of allergies: nasal congestion, coughing, sneezing, red watery eyes, spasms in the respiratory tract. This reaction signals the body’s attempts to get rid of the antigen on its own.

Since asthma is a heterogeneous disease, a thorough search for possible allergens is of particular importance. In most cases, attacks of chronic suffocation occur when exposed to animal hair, pollen, fungal and mold spores, and household dust. IN medical practice There are often cases of allergic asthma that develops with light scratches on the skin, frequent inhalation of perfume aromas, caustic household chemicals, and tobacco smoke.

Risk factors

In addition to standard antigens, doctors identify other factors that increase the risk of developing the disease. When inhaling cold air, asthmatics experience bronchospasms. This reaction of the body is explained by the fact that at low temperatures it becomes difficult to breathe through the nose. When cold air is inhaled through the throat, drying and narrowing of the mucous membranes occurs.

It is reliably known that during high-intensity training at temperatures below 15°C, allergic bronchial asthma worsens.

Moreover, doctors claim that even in healthy people in such conditions, without reliable protection difficulty breathing occurs. This does not mean that asthmatics should give up physical activity, but it is necessary to take into account their health characteristics.

The search for true antigens continues in 2017. Based on statistical data, it has been established that since 1990. There is an increase in the incidence of allergic asthma. Many scholars attribute this to a steady increase in demographic change (urban expansion). Air pollution indoors and in the atmosphere adversely affects the functioning of the cardiovascular and respiratory systems.

The most studied allergens are ozone, nitrogen dioxide gases, and volatile organic compounds.

In 10% of cases, asthma attacks and coughing in asthmatics are provoked by medications: beta-blockers, ACE inhibitors, aspirin and other painkillers. Therefore, when prescribing medications, it is important to warn your doctor about the presence of the disease.

Clinical severity

The symptoms of allergic asthma depend on the stage of the pathology. In the initial stages, patients note a squeezing feeling in the chest area, rhinitis and conjunctivitis. The main manifestation of the onset of an attack is swelling of the mucous membranes.

Classic signs of the disease are:

dyspnea;
convulsions;
wheezing in the sternum;
cough, which in most cases is non-productive, but can sometimes be accompanied by the release of a viscous secretion.

With exacerbation of infectious allergic bronchial asthma, to which people aged 35-40 years are most susceptible, the symptoms are somewhat different from the standard. Attacks of suffocation in adult patients with this diagnosis appear after a viral illness or against the background of a recurrent outbreak of the inflammatory process.

In these situations, the upper respiratory tract is most often affected, resulting in the development of purulent sinusitis and bronchitis. Often infectious allergic asthma is preceded by food or drug poisoning. During shortness of breath, patients experience prolonged coughing attacks with the release of purulent sputum from the bronchi. At the same time, motor activity decreases, inhalations and exhalations become more frequent.

Allergic asthma in children can occur at any age. As medical practice shows, in most cases the disease is disguised as chronic bronchitis. For this reason it is important to differentiate the pathology and prescribe the correct treatment. When a baby experiences more than 4 episodes of obstructive bronchitis over the course of one year, you need to consult a doctor.

If your child has an allergic form of asthma, you should definitely consult a specialist.

Symptoms of allergic asthma appear exclusively upon contact with an antigen. Depending on what specific trigger causes the shortness of breath and cough, the frequency and duration of the exacerbation varies.

Medical classification of pulmonary pathology

Allergic bronchial asthma is of two types, depending on the root cause of its development.

The atopic form of the disease occurs as a result of inhalation of certain antigens into the body.

In this case, a classic clinical picture is observed: difficulty breathing, dry cough, wheezing.

Infection-dependent asthma appears in the presence of pathogenic microflora and is accompanied by pronounced attacks of suffocation, expectoration of purulent sputum, and abnormalities of the respiratory tract. To avoid further spread of infection, immediate diagnosis and initiation of adequate therapy is necessary.

Based on the standard signs of the disease, in medicine there is the following classification:

Intermittent and persistent bronchial mild asthma degrees. In the first form, exacerbation attacks occur once a week, and in the second - several times every 7-10 days.
The middle stage of the disease is characterized by the presence of daily attacks of varying intensity. Such frequent symptoms disrupt the usual way of life and significantly worsen the patient’s condition.
When severe allergic asthma is diagnosed, asthma attacks can occur up to several times a day, with exacerbation occurring at night. In patients, motor activity decreases and status asthmaticus occurs.

Diagnostic methods

At the first appointment, the doctor collects anamnesis, analyzes the patient’s complaints, and listens to the chest.

For staging accurate diagnosis the patient must undergo a series of laboratory and instrumental studies:

Diagnostic method	Effectiveness of the procedure
ECG	Allows you to exclude the cardiac form of bronchial asthma
Spirometry	During the examination, the doctor assesses the patient’s lung parameters and forced expiratory volume
Sputum analysis	The presence of Cushman spirals and Charcot-Leyden crystals and eosinophils in the expectorant viscous secretion indicates the development of allergic type bronchial asthma
UAC	Elevated values of red blood cells and hemoglobin indicate respiratory failure
Blood biochemistry	In asthmatics the results laboratory test seromucoids, fibrinogens, sialic acids will be detected in high concentrations
Allergy analysis	Carried out to determine specific immunoglobulin E
Skin tests	Identify potential antigens
Food diagnostics	Consists of keeping a food diary, provocative diets, differential fasting

Therapy tactics

The symptoms and treatment experienced during asthma are inextricably linked. After identifying an allergen that provokes attacks of dry cough and choking, a individual plan treatment. Standard therapy for atopic or infection-related asthma is based on the following medications:

Cromones are medications that affect the level of histamine produced. They are actively prescribed for the treatment of childhood asthma, since their use in adults does not lead to positive dynamics.
Methylxanthines – theophylline, caffeine and theobromine. In recent years, drugs in this group have lost popularity due to possible severe adverse reactions.
Immunoglobulin E antagonists effectively stop increased sensitivity bronchi.
Inhaled glucocorticoids and adrenoreceptor blockers act as basic medications that control the course of allergic asthma. This method of treatment is preferred due to the ease of use of a special device that allows you to quickly respond when an attack of suffocation begins.
Taking antihistamines blocks neural receptors and reduces the intensity of an asthmatic attack. Doctors recommend taking medications that suppress the production of histamine in advance if contact with the antigen cannot be avoided.

Allergen-specific immunotherapy (ASIT) is becoming increasingly popular. To do this, the patient is administered small doses of a substance to which a violent reaction of the bronchi occurs. Gradually, the clinical severity of asthma decreases or stops. It is important to remember that bronchodilators suppress asthma attacks, but lead to drug dependence.

If the dosage is exceeded, there is a high probability of developing a paradoxical reaction, when symptoms intensify after taking the medication.

First aid for asthma attacks

Asthmatics should always carry a bronchodilator inhaler prescribed by their doctor. First of all, you need to remember the need to provide access to fresh air by opening a window or door to the room.

Antihistamines or hormonal drugs will help suppress an attack that occurs when interacting with an allergen. You need to try not to panic and ensure maximum comfort: take a comfortable position, remove excess constricting clothing. It is easier for asthmatics to cope with debilitating bronchospasms by sitting with a tilt on the back of a chair or transferring the weight of their own body to their arms.

Patients getting sick allergic form asthma, must know the technique of proper abdominal breathing, in which the diaphragm is involved. When you inhale, the muscular partition between the abdomen and chest contracts and falls, and when you exhale, it rises. Due to this, more air enters the lungs, and the blood is better saturated with oxygen. Mastery of abdominal breathing techniques can reduce attacks of asthmatic suffocation.

People who suffer from allergic asthma must know the technique of proper abdominal breathing.

Massaging the chest in the area of the heart with a warm towel helps. Doctors warn that this can only be done if there is no pulmonary disease. When the attack of allergic asthma subsides, you need to give the patient warm tea and milk. It should be understood that all these measures help only with the onset of attacks of mild intensity and in the future you will need to contact an allergist or immunologist in order to find out how to treat asthma in each specific case.

A complication of the disease is the state of asthmatic status, when the patient can exhale air and is resistant to medications. This form of suffocation begins with a slight confusion of consciousness, while the general state of health deteriorates significantly. In the absence of adequate drug intervention, status asthmaticus leads to disability and, in some cases, death.

Non-drug treatment

Doctors emphasize that the allergic component makes the disease unstable, and asthmatic attacks occur suddenly. Therefore, it is possible to completely cure the pathology by adhering to medical prescriptions regarding the dosage and list of medications taken.

Non-drug therapy is of great importance, which consists in reducing the intensity of the impact of antigens on the body.

To this end, the following principles must be adhered to:

if you have a food allergy, you need to create a dietary plan;
avoid contact with pets, whose fur acts as an antigen for a patient with bronchial asthma;
be sure to wear a mask when trees are flowering if you have a negative reaction to pollen;
If you are allergic to household dust, you need to remove soft toys and fleecy carpets from the room.

Conclusion

Allergic-type bronchial asthma significantly worsens the quality of life of patients, but with timely initiation of therapy, asthma attacks are successfully stopped. For full recovery It is not enough to take only bronchodilators. To avoid the development of status asthmaticus, accompanied by respiratory failure and placement in the department intensive care, you should remember the importance of preventive measures: regular physical activity, balanced nutrition, spa treatment.

Degrees of the disease

Pathogenesis of the disease

Causes

Symptoms

Treatment

Forecast

Preventive measures

Symptoms of atopic asthma

Levels of severity of allergic bronchial asthma

Causes

Diagnosis of bronchial asthma

SIT therapy

Folk remedies

Decoction of coltsfoot leaves

Jerusalem artichoke infusion

"Grandfather's method"

Infusion of pine cones

Antihistamines

Inhalation agents

Features of the treatment of bronchial asthma in children

Prevention

ICD-10

General information

Causes

Risk factors:

Pathogenesis

Symptoms of atopic asthma

Complications

Diagnostics

Treatment of atopic asthma

Prognosis and prevention

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:

Risk factors

Clinical severity

Medical classification of pulmonary pathology

Diagnostic methods

Therapy tactics

First aid for asthma attacks

Non-drug treatment

Conclusion

New on the site

Most popular

POPULAR SECTIONS