Atopic asthma is an allergic form of a chronic inflammatory disease that affects the upper respiratory tract. Its course is accompanied by attacks of suffocation, which can occur in adults and children, and in the latter it is much more difficult.
Causes of atopic asthma, differences from other forms of the disease
Asthma is widespread in the world and reaches 6-7% of the total population. Especially often children suffer from it, in whom the first manifestations of the disease occur even before the age of 10 years.
In the development of the atopic form of the disease, the leading role is played by allergens to which the patient develops a reaction, as well as a genetic predisposition, which is transmitted from close relatives. If they had he alth problems in the form of atopic diseases (dermatitis, rhinitis, food allergies), then the likelihood of developing such a disease is greatly increased.
The development of atopic form of bronchial asthma depends on many external factors:
- badecological situation;
- heredity;
- living in regions with a cold climate of high humidity;
- unhe althy lifestyle;
- infectious diseases;
- active and passive smoking;
- long-term treatment with strong drugs;
- sudden changes in air temperature;
- harmful chemical smells.
Asthma attack
Bronchospasm or asthmatic attack is a response of the patient's body to an irritant. The causes of its occurrence are various allergens, as a result of which there is a sharp contraction of muscle tissue in the respiratory tract. The ongoing pathological processes are accompanied by broncho-obstructive syndrome, in which there is swelling of the bronchial membranes and a strong secretion of mucus. It fills the passages and restricts the flow of oxygen to the lungs.
The result of this is suffocation when the person begins to choke. The attack begins from the first minutes of contact and lasts up to 2 hours. It can only be removed with the help of an inhaler medication.
Late asthmatic reactions cause inflammation in the walls of the bronchi, causing irreversible changes at the cellular level. In severe cases, the patient develops asthmatic status, which looks like a long-term suffocation that is not relieved by medicine. The patient cannot exhale, which is whyslight fainting or loss of consciousness. If urgent measures are not taken, it threatens with disability and can cause death of a person.
Symptoms of disease
Signs and symptoms of atopic bronchial asthma are pronounced and clearly identify the disease:
- occurrence of cough;
- appearance of whistling during breathing;
- shortness of breath and regular sneezing;
- itchy nose;
- rapid breaths and difficulty exhaling;
- chest pain and tightness.
Such signs can appear with every contact with an irritating allergen.
Degrees of atopic asthma
Atopic asthma has 4 stages of disease severity:
- Mild degree (intermittent) is manifested by rare attacks (1 time per week - during the daytime, less than 2 per month - at night), which do not adversely affect the patient's body.
- With subsequent development of the disease, attacks become more frequent, they may be accompanied by suffocation, which requires treatment in accordance with its manifestations.
- Atopic bronchial asthma of moderate severity is manifested by daily bronchospasms that negatively affect sleep and the patient's condition, night attacks are possible every week.
- The most severe degree of the disease is accompanied by regular attacks several times a day and nightly.
However, even with the fourth stage, with appropriate treatment and the implementation of all the recommendations of doctors, it is possiblerecovery of the patient.
Allergens and types of disease
Atopic bronchial asthma is an allergic disease, the direct cause of which are various allergens that can cause suffocation and other negative reactions.
Irritants (triggers) that provoke bronchospasm can become:
- pollen on plant flowers;
- various types of dust (domestic, construction, wood, etc.);
- mold and fungal spores;
- feathers, which are present as fillers in pillows and mattresses;
- aerosol products;
- animal wool;
- emissions of harmful industries in the atmosphere, etc.
Depending on the listed allergens, the varieties of this disease are also divided. To date, the most common is household (dust) asthma, which is exacerbated in winter, when heating systems are turned on. This type of disease is easily determined by the cessation of attacks after the person goes out into the fresh air.
Fungal type of asthma is characterized by nocturnal attacks and is seasonal, as fungal sporulation occurs at certain periods.
An asthmatic reaction to pollen is often accompanied by rhinitis or conjunctivitis, which can progress to choking.
Epidermal disease is caused by contact with pet hair. It is more often observed in people whose profession is associated with frequent contact with animals. For example,Allergy to cats is now considered a common disease.
An attack of suffocation in atopic bronchial asthma can last from 5 minutes. up to 2-3 hours. If it is too long, it can provoke the development of asthmatic status, which manifests itself in insufficient supply of oxygen to the body and cyanosis. In a severe form of an attack, anaphylactic shock may occur.
Asthma Diagnosis
To make an accurate diagnosis, the attending physician examines and collects an anamnesis from the patient. With a mild course of atopic bronchial asthma, the complaints of patients usually include the presence of a dry cough that appears at night or in the morning, which is associated with an increase in the tone of the bronchial muscles during the period of 3-4 hours of the night. Often, such symptoms and listening to wheezing in the chest can already make a preliminary diagnosis.
To identify a latent form of bronchospasm, specialists use beta-adrenergic agonists, which relax the muscles. The volume of exhaled air is measured before taking the medicine and after, with a large difference, the doctor determines the presence of bronchospasm.
In more severe forms of the disease, spontaneous attacks of suffocation appear due to the action of negative factors, and before the exacerbation, the patient feels various symptoms: itching, runny nose, dry throat, which leads to difficulty breathing. A characteristic feature is the difficulty in exhaling, as a result of which excess air accumulates in the lungs. When listening to the patient's chest, a characteristic "box" sound is heard, wheezing of various heights.
Forclarification of allergic irritants in atopic form of bronchial asthma, skin tests are carried out, which will clarify for the patient the factors and causes of attacks.
To make an accurate diagnosis, bronchography is often used - an X-ray of the respiratory tract after the introduction of contrast agents (iodized oils, etc.). However, this method has contraindications: the patient has cardiovascular decompensation, sensitivity to iodine, kidney disease.
Treatment
Therapy of atopic bronchial asthma consists of drug treatment and measures to improve the patient's immunity. At the same time, an integrated approach is important, in which patients understand their own responsibility for the correct fulfillment of all the requirements and prescriptions of the doctor.
Drugs:
- Glucocorticoids - hormonal drugs for relieving inflammation: Alcedin, Bekotid, Beklazon, Budesonide, Ingacort, Intala, Pulmicort, Taileda, etc.
- Bronchodilators and beta2-agonists (long-acting and short-acting) - eliminate muscle spasms and help expand the lumen in the bronchi, are usually prescribed for a long course, help relieve inflammation, but have minor contraindications.
- Antihistamines - prescribed for a long time.
- Broncho-dilating drugs - used to relieve an attack.
Persistent form
Persistent atopic bronchial asthma is accompanied by a severe course of the disease, which lasts for a patient for a long time. For many years, a person feels heaviness in the chest, accompanied by coughing and difficulty breathing. After several attacks, there may be a period of remission, when there are no signs of the disease.
With severe complications, the patient needs hospitalization and inpatient treatment, because. mass attacks lead to sleep disturbances, insomnia and severe disruption of the body's biorhythms.
Therapy for this form of asthma involves 5 steps:
- Antileukotrienes: Montelukast, Khafirlukast, Aerolizer, Formoterol.
- Inhalations with corticosteroids will help relieve bronchospasm and prevent an attack: "Tafen", "Flixotide", "Novolizer", "Klenil", "Bekotid".
- Drugs with a long-term therapeutic effect: Theophylline and others;
- In severe cases, hormonal and other drugs are administered intravenously under medical supervision.
Patient control and self-control
Since the disease is chronic, the treatment is carried out at home. The patient must learn to independently control their well-being in order to prevent deterioration.
There are special devices for determining the maximum air velocity during exhalation - peak flow meters. Measurements are taken daily in the morning before taking the medicine and are recorded indiary. Depending on the indicators, the doctor makes a decision on the subsequent correction of treatment:
- more than 70% - indicates the correct therapy;
- 50-70% - need to see a doctor and improve treatment;
- Less than 50% - there is a risk of exacerbation, it is urgent to adjust the medication and take measures to prevent an attack.
First aid for asthma attack
If the patient has an unexpected bronchospasm, which is characterized by choking and other negative symptoms, then the following actions should be taken:
- Remove possible allergenic irritants.
- Open the fasteners on clothes, let fresh air into the room by opening the window.
- Use a bronchospasmolytic inhaler or nebulizer: "Berodual", "Berotek", "Salbutamol", etc.) in the amount of 1-2 doses with an interval of 2 minutes.
- Take the medicine "Eufillin" if there are no contraindications.
- If necessary, repeat the inhalation after 20 minutes.
- If all else fails, call an ambulance.
Asthma in children
According to statistics, allergic reactions occur in 9 out of 10 children, and this can happen at any age. The prevalence of atopic asthma in some regions is up to 20%.
Asthma is caused by the influence of allergic irritants that provokeinflammation in the airways, which may cause shortness of breath and bronchospasm.
For young patients, the diagnosis of the disease is difficult because the symptoms of atopic bronchial asthma in children are very similar to the course of obstructive bronchitis. The first sign of the development of the disease is hoarse breathing with a whistle, which becomes heavier with a deep breath. A dry, irritating cough can also indicate asthma, which may produce a small amount of phlegm. With this form, a cough variant of the disease is diagnosed.
The most frequent attacks occur at night, and there is also shortness of breath during physical activity. This variant is called physical exertion asthma.
For diagnosis, after a consultation, the doctor prescribes skin allergy tests and an X-ray of the child's chest, in which there is a slight increase in the lungs.
When misdiagnosed and treated incorrectly, complications such as pulmonary emphysema or heart and lung failure may develop. These chronic diseases can lead to severe asthma, disability and even death.
Treatment of asthma in children
Treatment of atopic bronchial asthma in children is based on the use of inhalation methods. Such procedures help to remove allergens from the body and increase immunity. Their big advantage is safety in comparison with medications.
Medicinesin therapy:
- Glucocorticoids - help relieve inflammation.
- Bronchodilators and beta2-agonists - eliminate muscle spasms.
- Cromones or derivatives of cromoglycic acid - used only for the treatment of asthma in children, available in the form of aerosols, powders and capsules for injections.
- Antihistamines.
- Bronchodilators - to relieve an attack and improve the general condition of the child.
For most procedures, nebulizers are used - special devices for inhalation, in which the medicine turns into vapor, which increases its penetration into the bronchi.
Prevention of asthma attacks
To reduce the frequency of asthma attacks in atopic bronchial asthma, it is necessary to take measures to prevent them, trying to reduce irritating factors:
- reduce physical activity;
- give up carpets and soft toys in the apartment;
- put hypoallergenic covers on pillows and mattresses, wash bedding weekly in hot water;
- control room humidity (no more than 40%);
- do not use allergenic products containing dyes and synthetic fillers;
- to keep books only in closed cabinets;
- carry out regular wet cleaning of all premises, without adding chemical washing liquids, only bio-products are allowed;
- remove flowering plants from the house.
With the right choice of treatmentand compliance with all rules and preventive measures, the prognosis for the treatment of atopic bronchial asthma is favorable for the patient.
