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Bronchial asthma is designated by the term a respiratory disease of inflammatory character at which there is a bronchial obstruction. That is during an inflammation the gleam of bronchial tubes is narrowed owing to what breath is at a loss, each breath is followed by a characteristic sound, shortage of air leads to fits of coughing. On average on the planet an illness five people from hundred have that grants the right to speak about its prevalence.
Though the obstruction of bronchial tubes is reversible, danger of a disease is that effects of such obstruction can be irreversible. In the long period in bronchial tubes there are morfofunktsionalny disturbances, microcirculation in a reinforced basal membrane changes, and walls of bronchial tubes after passing of an attack do not return to a normality.
In most cases bronchial asthma is peculiar "response" of an organism to irritable influence or, speaking more simply, on allergen. However to claim that the disease has exclusively allergic nature also it is impossible. In medical practice there are many examples when the inflammation of bronchial tubes was caused by damages of a brain of the person.
Types of bronchial asthma
There are several classifications of this disease, each of which is widely used.
On character of the reasons for which bronchial asthma developed allocate infectious and not infectious and allergic forms. The first means that the illness developed as complication of other illnesses of the respiratory tracts having the infectious nature. Most often quinsy, pneumonia, acute pharyngitis can lead to similar negative effects. Two of three cases get to this category.
The second form has especially allergic nature when bronchial asthma appears reaction of an organism to standard irritants for an allergy: flower pollen, dust, dandruff, medical supplies, chemicals and others. It is noted that though on this form less than a half of cases drops out, it is most often descended.
Types of bronchial asthma on degree of complexity represent an easy, medium-weight and severe form. To what look the disease at the patient belongs, is defined by the attending physician in each case on the basis of the multifactorial analysis. So, the result is influenced by the frequency and duration of attacks, what weight of attacks as far as the patient of normally feels between spasms.
Here main characteristic features of each of forms:
Easy form. It is characterized by almost total absence of strong attacks of asthma, some symptoms of bronchial asthma are shown not more often than several weekly and are very short. Night attacks which are considered characteristic of a disease disturb the patient several times a month. Between attacks of the patient conducts normal life.
Medium-weight form. It is characterized same on frequency, but strong attacks of asthma. At night asthma is shown at least several times a month and also is followed by strong attacks.
Severe form. In such form of course of a sharpening of different severity appear at the patient regularly. Some of them, especially dangerous, in the absence of urgent measures can represent risk for life. Between attacks the patient cannot conduct normal life as feels shortage of forces, and symptoms of bronchial asthma though to a lesser extent, have all the same an effect.
It is natural that the easy form over time if there is no appropriate treatment of bronchial asthma, can pass into more severe form.
Symptoms of bronchial asthma
As we already found out, bronchial asthma is a disease of the allergic nature which can have the infectious and not infectious nature. Anyway symptoms of bronchial asthma are shown by sudden attacks, as well as at any other allergy.
During similar attacks the patient has a goose breathing which, however, is noticeable for others only close, there is unproductive cough. The patient can feel an asthma of different force at standard exercise stresses. These symptoms of bronchial asthma are supplemented by a characteristic symptom in the form of night attacks of asthma.
Several other symptoms not of specialists in medicine can mislead. So the obstruction of bronchial tubes leads to long retardation of air in them and to exhale the person should cough. Such cough can suddenly appear, last from a couple of minutes till several o'clock, and also suddenly disappear.
Telling we mentioned about types of bronchial asthma that types are defined by symptoms and their frequency. This classification is detailed in four groups, the signs, including results of analyses are characteristic of each of which.
So, the easiest disease this incidental when attacks appear at most time in several weeks day and night, and even is less. Aggravations if appear, then last rather not for long, and between aggravations breath meets standard. At the same time OFV1 and POS there have to be not less than 80% of norm, and POS fluctuates within 20% of norm per day.
If attacks meet more often than weekly, but at the same time in a day the patient has no two aggravations, say that bronchial asthma already has a constant current in not severe form. Difference from the previous look is also that POS fluctuates per day ranging from 20 to 30%.
At a constant current not heavy bronchial asthma can pass into a moderately severe form. Attacks occur every day in the afternoon, and at night at least once in seven days. The patient cannot manage without β2-агониcтов any more, fluctuations of POS make from 30% per day, at the same time OFV1 and POS make from 60% to 80% of norm.
In the last, most serious form, attacks practically do not leave the patient neither in the afternoon nor at night, values of indicators of OFV1 and POS for 40% and more lag behind norm. The patient in such state cannot maintain normal physical activity any more.
Diagnosis of bronchial asthma
Diagnosis of a disease is carried out in some directions. First, point characteristic symptoms of bronchial asthma of which it was talked above to its existence. Secondly, the noticeable and fast simplification of an attack after inhalation of the drug expanding bronchial tubes is one more index on correctness of the diagnosis. Thirdly, the analysis of a phlegm and a X-ray analysis of respiratory system is carried out.
Special methods is breath research. Diagnosis of bronchial asthma in this case is based on data acquisition about the frequency, force and an inspiratory rate. It is possible to receive own results and to compare them with normal values and in house conditions by means of the device of a pikfloumetr.
When diagnosis of bronchial asthma yielded a positive take, the researches directed to allergen identification are conducted. Are most often limited to skin tests in a type of their efficiency and profitability, but if necessary carry out more complex analyses.
Treatment of bronchial asthma
Before we begin to describe treatment of bronchial asthma, once again we will remind that this disease is almost inseparably linked with an allergy. In other words, similar reaction is the response of immunity of an organism to foreign influence. The essence of this "answer" consists in an inflammation of bronchial tubes. This inflammation brings to all to the symptoms described above, and the main treatment has to go for fight against it.
Bronchial asthma is one of those illnesses with which it is possible to struggle only under the leadership of the experienced doctor. Treatment of bronchial asthma has to be step, that is the set of medical supplies and frequency of their use varies depending on what are shown symptoms at the patient.
As basis for therapy glucocorticosteroids in the form of inhalations most often act. In addition to them the tableted means or injections which are applied both to treatment, and to prevention of an illness can be appointed. Surely read instructions for use inhalers before you begin to apply them independently.
It is natural that the antiinflammatory symptomatic treatment of bronchial asthma is only part of an integrated approach. The second important component – definition of the allergen which caused such reaction, and leveling of its influence.
If allergen has the infectious nature, then the therapy directed to fight against this infection is without fail carried out. If bronchial asthma is caused by noninfectious allergen, then contact of the patient with this substance is as far as possible limited. In certain cases this approach can demand cardinal change of way of life like change of work or moving to other city. At exact definition of allergen it is necessary to listen to recommendations of the doctor whatever heavy for execution they were.
One of problems which treatment of bronchial asthma faces is the abundance of a phlegm in bronchial tubes. It is necessary to get rid of it without fail. It is for this purpose recommended to make frequent pedestrian walks on clean air, to make regular performance of special remedial gymnastics. Correctly picked up gymnastic exercises allow not just to increase ventilation of bronchial tubes, but also teach the patient to manage breath thanks to what symptoms of bronchial asthma though do not disappear completely, but become under control.
Depending on in what direction the volume of drugs, perhaps two approaches to treatment of an illness changes. The first means use of intensive treatment from the very beginning. Most often it allows to receive control over symptoms then intensity of treatment gradually decreases. The second way consists in compliance of treatment to the diagnosed disease form. If the chosen intensity does not lead to positive takes, it gradually increases. Otherwise (if treatment helped), intensity is reduced, but not earlier, than in 3 months of a stable state.
Prevention of bronchial asthma
Prevention of a disease is understood as the package of measures directed to minimization of risk of emergence of attacks and complications. And a basis of prevention of diseases of the allergic nature is disposal of patients of contact with allergen. It is necessary to understand that so far contact will not disappear, practically any treatment of bronchial asthma will have only short-term, limited effect.
The previous recommendation is obligatory for patients of any severity. If at the patient the easy form is defined, then prevention of bronchial asthma is supplemented with sports occupations in the open air in an interval between attacks (these intervals have to be rather big).
It is worth approaching the choice of a sport carefully. On the one hand he has to allow the patient to arrive the maximum time in the open air, and on the other hand it is not necessary to exaggerate exercise stresses. Examples of suitable sports is pedestrian or a cycle tourism with frequent stops, big tennis, rowing, skiing.
In Soviet period to patients appointed sanatorium treatment of bronchial asthma. It is really effective method of prevention, but it works only if the climate in the place where there is a sanatorium, is ideally suited for the patient. Otherwise prevention of bronchial asthma in sanatorium can be unsuccessful.