Is it possible to cure the initial stage of bronchial asthma, what is the nature of the disease, what symptoms does it show itself at the stage of an attack - all this information is of interest to a person who has been diagnosed with this. The disease belongs to the category of chronic, has a non-infectious nature and affects the respiratory tract, provoking the formation of inflammatory foci.
General information
Before considering the stages of development of bronchial asthma, one should delve into the very essence of the phenomenon. The disease is accompanied by chronic inflammatory foci, provoking increased activity of the respiratory structures. If organic tissues interact with irritants or compounds that cause an allergic response, obstruction begins almost instantly. The air flow speed decreases, the patient suffers from suffocation. Such an attack usually has precursors. Distinctive features - a short breath, a long, loud exhalation. Usually during an attack, the patient coughs violently, viscous sputum is abundantly separated, and breathing is accompanied by wheezing. Against the background of asthma, pulmonary emphysema, status asthmaticus, cor pulmonale may appear.
From medical statistics on all stages of bronchial asthma in children, adults, it is known that in the last couple of decades, the incidence has increased significantly. The number of asthmatics on the planet is estimated at approximately 300 million. Among other chronic diseases, asthma is one of the most common. It affects representatives of different age groups, persons of both sexes. From the data collected, it can be seen that the disease is characterized by a rather high risk of death. Among children, the incidence of asthma has been growing particularly strongly in the last couple of decades. This allows the disease to be classified as a social problem.
Nuances of flow
At different stages, asthma attacks are disturbed with different frequency. Even the stage of remission does not save from the complete disappearance of manifestations - inflammatory processes in the respiratory system are still present. Spasms of smooth muscle fibers, swelling of the bronchial mucosa lead to obstruction of the air passageways. The secret generated by the submucosal glands clogs the bronchi, as the substance is produced in excessive volumes. Gradually, the muscular bronchial tissue transforms into connective tissue, which leads to sclerosis.
At most stages, the prognosis for asthma is positive if treatment is startedin time. Modern methods and approaches allow to achieve stable long-term remission. The patient will have to constantly monitor his condition in order to prevent another attack in time. Following the doctor's recommendations allows you to reduce the amount of medication used and return to an active lifestyle.
Dangers lurk in everyday life
At any stage, exacerbation of asthma is often explained by the influence of an external factor. The most common allergens are dust, food, wool, dander, plant matter. In medicine, this category is called nutritional. Up to 40% of all cases of asthma monitoring reveal the body's response to medications. About 2% are explained by the influence of aggressive factors in the working environment (perfume salon, production area).
Do not deprive attention of infectious factors. Microscopic life forms, the substances generated by them, are quite strong allergens that increase the sensitivity of the respiratory system. Incessant infection is accompanied by active inflammation, worsening the status of the body. The likelihood of allergies increases when interacting with a rare allergen.
Types and forms: what happens?
It is customary to distinguish between allergy-related asthma and non-allergic factors. There are mixed cases, and sometimes the cause cannot be identified. It is customary to divide patients into groups: persistent mild, moderate or severe, and episodic (officially called intermittent). Assessing the state, the disease is characterized asbeing at the stage of exacerbation, in remission (stable and unstable are distinguished). Based on the response to treatment, it is customary to classify a case as controlled, uncontrollable, or partially controllable.
During an attack, the patient experiences several stages of bronchial asthma: precursors, peak, return to normal. The first stage is most pronounced if the attack is associated with an allergy or infection. The approach of the acute phase can be suspected by the vasomotor activity of the nasopharyngeal region (discharges are generated, the person sneezes). The acute phase can come quite suddenly. It becomes difficult to breathe, there is a feeling of tightness in the chest. The inhalation is shortened, it becomes sharp, and the exhalation is long and loud. When breathing, a person makes wheezing wheezing, coughs. The viscous sputum generated in the respiratory system is difficult to expel, breathing loses its rhythm.
How to recognize an attack?
During the acute stage, a person takes a forced sitting position, tilting the body forward. To alleviate the condition, they rest their elbows on their knees or look for another point of support. The face is puffy, when you try to inhale the air, the veins in the neck swell. Expiratory resistance is sometimes overcome by recruiting muscle tissue.
Percussion allows you to hear a boxy clear sound. The pulmonary borders are displaced, the mobility of the organ is limited. Auscultation reveals vesicular breathing. The lungs become larger in volume, the point of absolute cardiac dullness decreases, the beating tones are muffled.
The attack ends with a stage of reverse development. Phlegm gradually departs, wheezing weakens, suffocation becomes less pronounced.
Main manifestations
Asthma symptoms in the early stages include wheezing when trying to exhale. The tone is high. The phenomenon is especially pronounced in a sick child. Episodes of such wheezing are regularly repeated, breathing difficulties are noticeable, the patient complains of a feeling of tightness in the chest. The cough gets worse at night. A person's well-being and the quality of the respiratory system become worse in certain seasons. As a rule, in the history of the disease of an asthmatic there are references to allergic reactions. Asthma is often accompanied by eczema.
Symptoms of bronchial asthma in the early stages include a tendency to catch colds, which affect the lower respiratory system. The patient's condition improves if you take asthma medications or antihistamines. Upon contact with allergens, a person sharply becomes worse. This can be provoked by smoke and a change in external temperature, physical activity, strong feelings, illness.
Clarification of the diagnosis
If you suspect that there are symptoms of bronchial asthma, in the early stages of the disease, you must contact the clinic for a full check of the condition. A pulmonologist can diagnose asthma by evaluating the patient's complaints and characteristic manifestations. Special tools and methods are used to determine the severity of the disease and its cause. In particular, spirometry is prescribed to clarify the condition of the lungs. This study gives an idea of the obstruction, its nuances, reversibility. In addition, spirometry is the main method for confirming a preliminary diagnosis. In asthma, the forced exit in 1/60 of a minute becomes 12% higher. In order for the research data to be as correct as possible, the analysis should be repeated several times.
Peakflowmetry is another common way to assess the condition of a patient who has come to the clinic with symptoms of bronchial asthma in the early stages of the disease. This method helps to control the state, track changes based on the dynamics of indicators. When using bronchodilator drugs, an increase of 20% or more allows an accurate diagnosis of asthma.
In addition, the patient may be prescribed testing using different allergens. Sometimes it is necessary to check the blood for the ratio of gases. Some are given a lung x-ray, bronchoscopy, and an electrocardiogram.
Clarification of condition: blood and sputum check
With symptoms of the initial stage of bronchial asthma, it is necessary to take blood samples for several types of tests. First appoint a general. At the stage of exacerbation of the disease, the concentration of ESR increases, eosinophilia is possible. In addition, blood should be taken to clarify biochemistry, although such an event does not apply to the main diagnostic methods. The accumulation of data during regular biochemical studies helps to control the development of the condition, to track the nuances of the exacerbation phase. Changesquite general, which forces one to carefully interpret the information received.
No less useful for the symptoms of the initial stage of bronchial asthma for the timely and correct diagnosis of sputum analysis. A general examination under a microscope shows the presence of specific crystalline structures, eosinophils, Kurshman's spirals. If asthma depends on infectious processes, neutral leukocytes can be detected in sputum. This indicates the activity of the focus of inflammation. During an attack, Creole bodies formed by epithelial cells are observed in the sputum.
How to fight?
Treatment is chosen based on the stage of asthma. In adults and children, the disease proceeds in a chronic form, even if the frequency of attacks is extremely rare. The main task of treatment is the exclusion from the everyday life of the patient of factors that can cause an acute phase. Specific diets shown. There are restrictions on possible jobs. If the allergen is established accurately, hyposensitizing therapy is practiced.
Beta-agonists are used to relieve choking. The dosage is chosen strictly individually. Popular drugs - Orciprenaline, Salbutamol. Aerosols are sprayed during an attack. Sometimes the doctor recommends stopping at Ipratropium bromide. Combination preparations with this active compound and fenoterol are commercially available.
To prevent an acute attack, you can take pills with xanthine derivatives. A good effect can be achieved by using agents to inhibit mast cell degranulation. These are Ketotifen, calcium ion antagonists,"Sodium cromoglycate".
With stage 3 bronchial asthma, the patient, as a rule, needs glucocorticosteroids. Such drugs are prescribed on average to one in four. Every morning use 20 mg of "Prednisolone". To reduce side effects on the gastrointestinal tract, the medication is combined with antacids. In inpatient treatment, "Prednisolone" is injected.
Important to know
A specific nuance in the treatment of bronchial asthma is associated with the need to use medications in the lowest possible dosage. The doctor's task is to select such a therapeutic course, which in the future will further reduce the concentration of drugs in the patient's diet.
To activate sputum discharge, mucolytics are prescribed. Bromhexine and Ambroxol have proven themselves well. They are used up to four times daily. The duration of the program is from several days to one month. If the patient's condition is very serious, mucolytics are injected.
If asthma is detected against the background of other chronic diseases, it is necessary to choose an effective course for their treatment. Often, the pathology is accompanied by pneumonia, bronchitis. This requires the use of antibiotics. Specific preparations are chosen based on the nuances of the microflora.
Stages of the disease
The official stage classification is as follows: IIA, IIA+N, IIN. The initial stage of bronchial asthma is pre-asthma. This is the stage of chronic pathological conditions localized in the bronchi and accompanied by bronchial spasms. Often, the pathology is accompanied by allergic reactions affecting the nose, nasal sinuses. Reactivity analysis may show sensitization to certain compounds. Inhalation test for histamine, acetylcholine positive.
At the first stage of bronchial asthma of an infectious, atopic, allergic nature, suffocation appears occasionally. With an infectious form or an allergy, the disease is accompanied by pneumonia, bronchitis in a chronic form. At the first stage, the disease can be mild, severe, or moderate in severity. An easy variant is diagnosed if attacks occur only a couple of times a year, they are short-lived and effectively eliminated with bronchospasmolytic drugs. Between attacks the patient does not suffer from suffocation. An exacerbation is usually observed when the inflammatory process is activated.
Easy flowing atopic form in the first stage of bronchial asthma is characterized by a long remission if a person avoids contact with allergens.
Intermediate and hard levels
With an average severity variant of the disease at the initial stage of bronchial asthma, exacerbation occurs no more than five times a year. Suffocation is quite severe, relief of the condition can be achieved with bronchodilators. Between complications, manifestations of bronchospasm are disturbing.
In a severe form of the current, acute phases are observed annually more than five times, the attacks are long and hard to bear. Possibly an asthmatic condition. Correction is difficult. Asthma is characterized by short-term rare remissions.
Atopic asthma occurs inIn this case, if the allergy is bacterial in nature, the allergic reaction occurs simultaneously with bronchitis or pneumonia in a chronic form.
Second stage
At this stage, there are functional changes in the functioning of the respiratory system. The patient is characterized by inflammation of the lungs in a chronic form, pulmonary emphysema, pneumosclerosis. There is a lack of work of the respiratory system of the second or third degree, low activity of the heart. For this stage of bronchial asthma, remissions are characterized by incomplete and short-term, and asthmatic conditions are delayed for a long time. Gradually, the condition worsens.
Asthma: pathogenesis
It is customary to define the immunological stage of bronchial asthma as the first stage of the disease. This is a step to increase the sensitivity of the body. Cells generate substances that come into contact with the antigen. The duration of the stage is the time it takes to interact with a new allergen. For some, the step is quite short, only a few minutes, for others it reaches tens of years. The duration is determined by individual characteristics, the concentration of the hazardous substance and its nuances.
The next stage is called pathochemical. Under the influence of allergens, complex chemical cellular, humoral transformations are activated. Mast cells generate specific mediators, active compounds. These include serotonin and histamine. Next comes the pathophysiological stage of bronchial asthma. The diagnosis is made by identifying the body's complex response to the allergen. A spasm is observed in the bronchial tree, sputum is secreted in an increased concentration, the mucous membranes swell. Outwardly, this is manifested by a typical clinical picture of asthma.
Asthma: an attack - what is it and how?
Sometimes the aggravation begins gradually, the condition gets worse and worse. Perhaps an abrupt onset, unpredictable and sudden. Between attacks, the patient often does not notice he alth problems at all. Statistics show that seizures often come at night. An asthmatic wakes up with a feeling of tightness in the chest, there is not enough air, there is nothing to breathe, it is impossible to push the air out of the lungs. To alleviate the condition, the patient involuntarily sits down and rests his hands on the bed, on his knees. Some reflexively jump up, lean on the table. Occupying a specific position, thereby a person connects additional muscle fibers of the shoulder and chest to the respiratory act.
The clinical picture of an asthmatic attack is quite specific, it is simply impossible to confuse the condition with others. In a few seconds, shortness of breath begins, wheezing and whistling are clearly audible during breathing, bouts of dry cough come. To relieve the condition, you should sit on a chair facing the back.
During an attack, vitreous sputum is released, breathing becomes frequent - up to 50 acts per minute, and sometimes more. The patient may have pain in the lower chest, a feeling of irritation, fatigue, and anxiety comes. Possible increased heart rate. Sometimes the head hurts, the skin itches, itches in the throat. Frequent sneezing or other vague symptoms are possible. One of the most pronounced manifestations is a cough. Available wet or dry. In the process, sputum is separated: purulent, mucous. It can be a lot or a little.
In the absence of adequate care at the initial stage, asthma progresses. Cough, shortness of breath become stronger, the voice changes, the whistle intensifies. It is possible to change the shade of the integument of the face, the behavior of the patient.
Attack stages
The first stage is a protracted attack. Beta mimetics do not produce the desired effect. The second stage is the formation of silent zones, detected during pulmonary auscultation. In the third stage, hypercapnic coma occurs. The patient's blood pressure drops.
The probability of a fatal attack is a few fractions of a percent. As a rule, death is explained by blockage of the bronchi by secretions of the glands, against which it becomes impossible to breathe. Provoke a lethal outcome can be an acute failure of the functioning of the heart on the right, the circulatory system. Carbon dioxide can accumulate in the blood, due to which the sensitivity of the center responsible for breathing decreases against the background of its overexcitation.
About the approach of the listed complications of an attack, cyanosis, a weak thready pulse, swelling of the veins in the neck signals. Breathing becomes superficial, auscultation is less likely to identify dry rales, the liver swells and responds with pain. This is more likely with a prolonged attack that cannot be stopped, and with an asthmatic condition.
Features of state refinement
When diagnosing, it is important to distinguish between cardiac and bronchial asthma. The whistling rales accompanying a problematic exhalation signal the bronchi as the area of localization of the disease. This may be due to swelling, spasm. Similar manifestations are possible in acute coronary insufficiency and other cases of left ventricular failure. Cardiac asthma can cause bronchial spasm, provoke swelling of the mucous membranes.
Chronic lung disease can often cause aggravation of shortness of breath. It is important to be able to distinguish them from an asthmatic attack. As a rule, the first reason is not characterized by pronounced signs of an attack - the suddenness of the start and the participation of auxiliary muscles in the act of breathing. In the differential diagnosis of asthma and pulmonary chronic diseases, blood, bronchial secretion should be checked for eosinophilia - it is observed only in asthmatics.
