Atopic bronchial asthma - This is a chronic non-infectious-allergic lesion of the respiratory tract, which develops under the influence of external allergens against the background of a genetically determined propensity to atopy. Manifested by episodes of sudden onset of choking, coughing with scanty viscous sputum. In the diagnosis of atopic bronchial asthma, the history of allergy testing, clinical and immunological studies of blood and bronchoalveolar lavage are assessed. In atopic bronchial asthma, a diet is prescribed, anti-inflammatory, desensitization therapy, bronchodilator and expectorant drugs, specific desensitization.
Atopic bronchial asthma is an allergic broncho-obstructive pathology with a 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, there has been a progressive increase in the incidence of this variant of asthma in practical pulmonology. Atopic bronchial asthma in more than half of the patients manifests already in childhood (up to 10 years), in a third of cases in the period up to 40 years. Asthma in children is mainly atopic in nature, often affects boys.
Atopic bronchial asthma is a etiologic pathology that develops with a confluence of certain internal and external causes. Great importance is given to the hereditary tendency to allergic manifestations (increased production of IgE) and bronchial hyperreactivity. More than 40% of cases, the disease is recorded as familial, and the tendency to atopy is 5 times more likely to be transmitted through the maternal line. In atopic asthma, the incidence of other family forms of allergy is 3-4 times higher. The presence of the patient A10 B27 haplotype and blood group 0 (I) are risk factors for the development of atopic asthma.
The main external factors responsible for the implementation of a predisposition to atopic bronchial asthma are non-infectious exoallergens (substances of plant and animal origin, household, food allergens). Home and library dust, wool and waste products of domestic animals, poultry feathers, fish food, plant pollen, and food products (citrus, strawberry, chocolate) have the most pronounced sensitizing potential. Depending on the leading cause, various types of allergic bronchial asthma are distinguished: dust (household), pollen (seasonal), epidermal, fungal, food (nutritive). In the initial stage of asthma, one pathogenetic variant occurs, but later others may join.
Asthma exacerbations contribute to:
- smoking, smoke, industrial emissions,
- harsh chemical odors
- significant temperature difference
- medication intake
The development of early child sensitization is provoked by:
The first usually occurs food sensitization, then skin and respiratory.
Immune and non-immune mechanisms are involved in the formation of asthmatic reactions, in which various cellular elements are involved: eosinophilic leukocytes, mast cells, basophils, macrophages, T-lymphocytes, fibroblasts, epithelial and endothelial cells, etc. The type of asthma is characterized by allergic reactions of type I (anaphylactic ).
In the immunological phase, the development of sensitization of the organism to the first-time allergen occurs due to the synthesis of IgE and IgG4 and their fixation on the outer membrane of 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 factors, 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 edema of the bronchial mucosa, spasm of smooth muscles, increased secretion of viscous mucus (pathophysiological phase). Bronchospasm leads to restriction of the flow of air into the lower parts of the respiratory tract and a temporary deterioration of the ventilation of the lungs.
A 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, hyperplasia of the goblet cells, proliferation and hyalinization of the basement membrane. Even with persistent asthma remission, chronic inflammation is maintained in the wall of the bronchi. With a long course of atopic bronchial asthma, the irreversibility of changes with sclerotherapy of the bronchial wall is formed. Outside the attack and with uncomplicated course changes in the lungs are not observed.
Symptoms of atopic asthma
In children, the first respiratory manifestations of allergy, related to predastme, can be observed already in the second or third year of life. Typical asthmatic symptoms appear later, at the age of 3-5 years. Pathognomonic symptoms of atopic bronchial asthma are sudden bouts of obstructive suffocation, rapidly developing against the background of good health. An asthmatic attack can be preceded by nasal congestion and itching, sneezing, liquid nasal discharge, sore throat, dry cough. The attack quickly terminates spontaneously or after drug exposure, culminating in the discharge of scanty viscous mucus mucus. In the interictal period, the clinical manifestations of the disease are usually minimal.
The most common - household form of atopic asthma is clearly manifested in the heating period due to increased dustiness in the premises and is characterized by the elimination effect - stopping seizures when leaving home and resuming upon returning. Epidermal asthma is manifested by contact with animals, starting with allergic rhinoconjunctival syndrome. Seasonal asthma occurs with exacerbations during the flowering period of herbs, shrubs and trees (spring-summer), fungal - during the sporulation of fungi (seasonally 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 allergens, an asthmatic status may develop with alternating severe asthma attacks 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 auxiliary muscles, cyanosis of the mucous membranes, acrocyanosis are noted. Resistance to anti-asthma drugs may be noted.
Functional changes that develop during severe attacks (hypoxemia, hypercapnia, hypovolemia, hypotension, decompensated respiratory acidosis, etc.) pose a threat to the patient's life due to the risk of asphyxiation, severe arrhythmia, coma, respiratory arrest, and circulation. Pulmonary complications of atopic bronchial asthma can be bacterial infections of the respiratory tract, emphysema and atelectasis of the lungs, pneumothorax, respiratory failure, extrapulmonary - heart failure, pulmonary heart.
Diagnosis of atopic asthma includes an examination, assessment of allergic history (seasonality of the disease, the nature of the attacks), results of diagnostic allergy tests (skin scarification and inhalation provocation), clinical and immunological blood tests, sputum analysis and bronchial washing water. Patients with atopic bronchial asthma have hereditary complications due to atopy and / or extrapulmonary allergies (exudative diathesis, eczema, allergic rhinitis, etc.).
Skin tests allow to establish potential allergens, inhalation tests with histamine, methacholine, acetylcholine - paroxysmal hyperreactivity of the bronchi. Allergic nature of asthma is confirmed by eosinophilia and high titer of total and specific IgE in serum. The data of bronchoalveolar lavage determine the change in the cellular composition of sputum (eosinophilia, the presence of specific elements - Kurshman spirals, Charcot – Leiden crystals).
Diagnosis of food sensitization in atopic asthma includes keeping a food diary, conducting elimination diets and differential diagnostic therapeutic starvation, provocation tests with products, skin tests with food allergens, determination of specific Ig in serum. Difficulties in clarifying the dusty nature of allergies are associated with the complex antigenic composition of dust. Atopic bronchial asthma is important to distinguish from obstructive bronchitis, other options for 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 for treatment is the elimination or restriction of exoallergens (the abandonment of carpets, upholstered furniture and feather-feather bedding, keeping pets, smoking), frequent wet cleaning, adherence to a hypoallergenic diet, etc., as well as self-control by the patient.
Drug therapy for atopic asthma includes desensitizing and anti-inflammatory drugs (cromolyn-sodium, corticosteroids). Bronchodilators are used to relieve acute asthma attacks. In case of bronchial asthma, preference is given to inhaled forms of steroids, used in the form of metered-dose aerosol inhalers or nebulizer therapy. To improve the patency of the bronchi, expectorant drugs are shown.
In mild asthma, symptomatic administration of short-acting bronchodilators (orally or inhalation) is sufficient; in severe cases, daily use of anti-inflammatory drugs or inhaled corticosteroids, prolonged bronchodilators is indicated. In asthmatic status, rehydration therapy, correction of microcirculatory changes and acidosis, oxygen therapy, if necessary, mechanical ventilation, bronchoalveolar lavage, and long-term epidural analgesia are prescribed. In atopic bronchial asthma, plasmapheresis, hemosorption can be used, without exacerbation - specific hyposensitization, immunocorrection, exercise therapy, acupuncture, physiotherapy, speleotherapy, spa treatment can be carried out.
Prognosis and prevention
The prognosis of atopic asthma depends on the severity of the obstruction and the development of complications; in severe cases, death from stopping breathing and blood circulation is possible. Prevention of this variant of asthma consists in eliminating health hazards, home sources of allergies, drying and fungicidal treatment of damp rooms, following a hypoallergenic diet, changing the climatic zone during the flowering period of the plants.
What is allergic asthma?
Asthma, complicated by allergies, occurs most frequently, and remains with the patient for life. The asthmatic respiratory system is particularly sensitive to a variety of safe irritants. Even minor contact with the allergen leads to immediate bronchial spasm. Within a few minutes, a person loses the ability to inhale air with a full breast, an inflammatory process begins in the muscles, accompanied by the release of thick and viscous mucus.
Despite the fact that the symptoms of this disease are completely stopped, it is chronic. Complete treatment of allergic asthma is impossible, since the cause of coughing and asthma attacks lies in the downed tuning of the immune system. The body inadequately perceives small particles, active ingredients and some microorganisms. Instead of ignoring them, immunity tries to fight them. The level of immunoglobin in the blood rises sharply, begins the increased production of histamine. Sensitivity to allergens becomes even higher, shortness of breath begins, and then - suffocation.
The percentage of patients with asthma in cities is steadily increasing due to adverse environmental conditions. Failure to comply with health standards in the workplace and in schools accelerates the development of the disease. If possible, it is recommended to change the place of residence, to spend more time in nature, without fail - to achieve regular wet cleaning of the premises.
Symptoms of the disease
In the early stages, the symptoms of allergic bronchial asthma are easily confused with the manifestations of the common cold. Slight cough, fatigue, pallor - signals indicating the onset of the disease. Asthma can be distinguished by the specificity of the manifestation: the patient coughs next to flowers, pets, during a spring walk. Also, frequent dry coughs can torment at night, making it difficult to fall asleep.
If the disease has passed to the next stage, then an adult patient will be able to recognize it even without prior diagnosis. The following symptoms of allergic asthma are distinguished:
- Symptomatic cough, aggravated while maintaining contact with the allergen.
- Dyspnea, not associated with physical exertion.
- Increased alternation of inhalation and exhalation caused by bronchial spasm.
- Whistling or wheezing, audible when trying to inhale.
- Pain and burning in the chest.
- The feeling of heaviness in the chest, the inability to open the chest in full force.
These signs appear when they collide with the irritant, but in order to remove them, eliminating the substance will not be enough. Infectious-allergic bronchial asthma proceeds like any other allergic reaction, so the reaction that started in the body can and should be stopped with selected drugs. Medicines are selected in accordance with the allergen, but due to the different nature of the stimuli, it is not always possible to find a drug that exactly matches the “aggressor”.
Types of allergens
Atopic (it is also allergic) bronchial asthma manifests itself in different forms. The patient may be extremely sensitive to the organic type of allergens, but insensitive to physical irritants in the air, and vice versa. Successful treatment of atopic asthma depends largely on how quickly and accurately the range of allergens was identified.
The following organic substances are true allergens that most often trigger asthma attacks:
- Pollen. Not only pollen can cause an attack, but also the products of flowering plants, for example, poplar fluff.
- Wool, feathers, skin particles of animals and birds. A reaction to saliva is also possible, especially when in contact with a cat or dog.
- Remains of dust mite activity.It is impossible to notice them with the naked eye, the only remedy against an allergen is regular wet cleaning, washing, freezing or steaming down pillows and blankets.
- Mold spores. Mold accumulates in places with high humidity, as well as in irregularly ventilated areas. Its particles are spread throughout the room, even if it grows in hard to reach places.
But suppose that during the examination you did not have a reaction to allergens. Does this mean that you have non-allergic asthma? Not necessarily. This type of disease is characterized by repeated manifestations in a collision with stimuli. At the same time, the “aggressor” may have an inorganic nature, and not cause an allergic reaction when it enters the wound or inside the alimentary canal. Here are just a few of these irritants:
- Smoke. Particles of burning tobacco or glowing aromatic candles, a dense layer of smoke when the furnace or fireplace is melted, etc.
- Traffic fumes. Residents of large cities are at greater risk due to polluted air in places with heavy traffic.
- Cold. Inhalation of cold air also irritates the bronchi, especially if the breathing is strong, frequent and active - such as during physical exertion.
- Household chemicals and perfumes. Intense chemical fragrances and odors can cause suffocation.
Even if you have non-allergic asthma, try to avoid such irritants. The long term of the disease can increase the sensitivity of bronchial tissues, and accordingly - to expand the list of potential threats.
Allergic Asthma Symptoms
Symptoms of allergic asthma are associated primarily with the work of the respiratory tract, and are the following features:
breathing is accompanied by a whistle
there is severe shortness of breath,
inhale and exhale become more frequent
there are pain in the chest,
the chest has a feeling of constriction.
These are the main symptoms that any of the common allergens can cause:
pollen (or pollen from trees and plants, for example, common poplar fluff),
mold spore particles
animal hair or saliva (skin particles and bird feathers belong to this category),
the presence in the environment of excrement dust mite.
An allergic reaction can be caused by any contact with a irritant substance. For example, a scratch immediately entails local itching and redness of the skin. In extreme cases, if such a substance enters the human body, there may be a real danger, since perhaps the rapid emergence of anaphylactic shock, which is a serious asthmatic attack.
The mechanism of development of atopic asthma can trigger not only allergens. They can cause an attack, and not the allergic reaction itself.
Then the cause of the attack is nothing like the irritant particles in the inhaled air:
smoke from a candle (including aromatic), a fireplace or fireworks,
cold air (including during physical exercises in the open air),
smells of chemicals and their fumes
The severity of symptoms of atopic asthma depends on the severity of symptoms: mild, moderate or severe.
Attack of allergic bronchial asthma
Asthma with a predominance of the allergic component is manifested in the form of an attack with a gradually increasing intensity. The aggravation of the condition occurs in several stages:
- As a result of a collision with an irritant, bronchospasm occurs. It is recognized by doctors as an asthmatic attack. Muscles strengthened contract, losing the ability to move freely and relax.
- Constant contact with oxygen in combination with an inadequate reaction to the allergen causes inflammation in the tissues, accompanied by a burning sensation.
- The body secretes mucus to compensate for the inflammatory processes, which is why the bronchial lumen becomes narrower. The access of oxygen to the lungs is almost completely blocked.
If you or your child has been diagnosed with infectious allergic asthma, you should be ready to take immediate steps to eliminate the attack. Take the following actions:
- Try to calm down (or calm the patient). Panic causes rapid breathing, provoking accelerated deterioration during an allergic attack, since asthma is a psychosomatic illness.
- Use an inhaler with a drug if you can. It will instantly relieve spasm due to the forced relaxation of bronchial muscles, after which you will be able to restore breathing.
- Restore the respiratory rhythm. Like non-allergic asthma, this disease requires the ability to control the rhythm of inhalation and exhalation. Do not try to breathe deeply - instead, increase the duration of inhalation to get more oxygen, and slow the exhale so as not to be in short supply.
- Try to lie down or take a forced pose - sit down and tilt the body slightly forward. Forced posture is only necessary when an attack of moderate or high severity. If the condition remains within the normal range - the ability to speak is retained, skin bluing is absent - it will be enough to lie down.
Infectious-allergic bronchial asthma can provoke asthmatic status if the allergic attack lasts a long time. With this form of choking, a person completely loses the ability to exhale, even a very weak one. The chest cell swells up, the ability to communicate is lost, the patient may fall into a coma. Antiallergic drugs to restore breathing at this stage is impossible. It is necessary to call emergency medical care.
Bronchial asthma is a disease that occurs as a result of chronic inflammation localized in the airways.
The main manifestation of the pathology is an obstruction of the bronchi, leading to the occurrence of suffocation of varying severity.
The number of patients with asthma is increasing year by year, according to the latest data, 6% of the total population of the planet.
There are much more cases of bronchial asthma among children, in some cases the disease is mild and therefore a correct diagnosis is not made for a long time.
In 80% of cases, asthma is an allergic reaction. Allergic asthma has its forms, causes and characteristics of development.
What is allergic (atopic) asthma?
Chronic inflammation in the lower respiratory tract with the development of asthma leads to the fact that there is such a condition as bronchial hyperreactivity.
This term refers to the excessive sensitivity of the bronchial tree to various external factors (allergens) and it is manifested by spasm of the bronchi.
Inflammatory swelling, spasm and excessive mucus production during an allergic reaction cause a thickening of the bronchial walls and, accordingly, their lumen narrows.
The narrowed canal interferes with normal gas exchange and this leads to asthma attacks.
The main manifestations of bronchial asthma include wheezing, coughing, shortness of breath, and all these symptoms of the disease during exacerbation often intensify at night, closer to the morning.
Asthma attacks are reversible, in people with allergic asthma, they occur after contact with an allergen.
In mild cases, all manifestations of the disease stop themselves, but if the disease progresses, the use of certain drugs is necessary to cope with suffocation.
In rare cases, asthmatic status develops, requiring assistance in intensive care units.
Forms of the disease
Bronchial asthma in most cases is a consequence of an allergic reaction of the body, in turn, asthma of an allergic nature of origin is divided into several forms.
This type of pathology occurs when a person has a chronic infection of the respiratory system.
Prolonged inflammation and the influence of infectious agents lead to an increase in bronchial reactivity, as a result of which they begin to react to various types of stimuli.
An infectious-allergic form of the disease is more often detected in people of working age who have a history of chronic bronchitis or obstructive pulmonary disease.
Allergic or atopic asthma in most cases occurs for the first time in young children.
The basis of the mechanism of its development is a hereditary predisposition to allergic reactions.
In the history of the patient revealed the presence of exudative diathesis, atopic dermatitis, various types of allergies.
In about half of the cases, the first attack of atopic asthma develops at the peak of a respiratory infection.
Exacerbation occurs when in contact with the allergen, and most often suffocation begins after a few minutes. Although in some cases allergic reactions of a late type occur - 4-12 hours after exposure to an irritant.
During remission, no changes in the lungs are detected. At the initial stage of the development of allergic asthma, the periods of remission are quite long, and complications develop late.
This type of allergy develops after using medications. The severity of suffocation depends not only on the amount of the drug administered, but also on how sensitive the body is to the intolerable substances.
Replacing a drug with another drug or stopping treatment leads to the fact that the medical form of the disease is completely gone.
An allergic form of bronchial asthma brings a lot of trouble to its wearer, but its manifestations can be controlled. Do you suffer from atopic asthma - or maybe it is someone you know who is sick? Are you able to completely block allergic reactions - or in your circumstances it is impossible to achieve such a result? Share your stories in the comments.
What is atopic asthma?
Atopic (non-infectious-allergic) asthma is a reaction of the human body to a specific allergen. This pathology can cause significant harm to the newborn and the elderly person.
If the immune system functions properly, then the body is not afraid of atopic asthma. As soon as deviations begin to occur, the immunoglobulin is produced in a significant amount. For this reason, destruction occurs including beneficial bacteria. It may happen that the amount of this substance rises in the blood. For this reason, histamine will be produced, which will contribute to an increase in the reflex to the effect of allergens. The result is severe shortness of breath.
Atopic bronchial asthma in children of any age is initially hidden. Parents mistakenly believe that a child has bronchitis. Even a newborn can find this insidious pathology. Therefore, it is extremely important to contact a competent specialist who can make an accurate diagnosis in a timely manner.
The atopic form of mild, moderate and severe bronchial asthma is diagnosed by special tests. When the pathology is hidden, then bronchodilator drugs are used. They allow you to determine the amount of exhaled air before and after taking the medication. Identifying significant differences gives reason to believe that there is bronchospasm in the body. In this situation, there are insignificant wheezing, different noises and whistles.
Now you know what atopic asthma is. It remains to understand why it may occur, what symptoms manifest and how the treatment takes place.
In children, atopic asthma most often occurs due to systematic colds, in adults - due to various household allergens. Major causes include the following:
- abuse and uncontrolled medication for treating colds,
- excessive mucus in the respiratory system,
- mold and fungus in the dwelling,
- adverse environmental factors.
Often this disease occurs due to regular contact with cool air and due to the intake of certain medications. There are people prone to this pathology:
- active and passive smokers,
- living in a region where high humidity and low temperatures are constantly observed,
- living in large cities where there are a lot of enterprises.
Important! Food allergies rarely leads to the development of this disease. Dust and other volatile substances of different origin are the main cause.
A strong cough is the main symptom of atopic asthma. It usually increases due to an increase in the amount of dust in the room and is determined by the elimination effect — reduction of attacks upon leaving the room and their appearance at the time of return. The patient may begin to feel bad while stroking the animal. Some people get worse with the flowering of trees, grasses, flowers and during the breeding season of mushrooms. In such cases, a person begins to feel better only when snow falls.
In children, the initial manifestations of atopic asthma are characterized as predastmic and manifest at 2-3 years of age. Typical symptoms observed in 3-5 years. Often the attack occurs suddenly or immediately after taking the medication. In the period between attacks, the clinical manifestations of the disease are extremely insignificant. In small patients, there is also a dry cough, sore throat, burning in the nose, fluid discharge from the nose, sneezing.
In severe cases, the symptoms of this form of allergy are:
- unequal intensity coughing
- painful shortness of breath, pain in which aggravates even in the case of minor movements.
At the same time, the patient is very agitated, everything irritates him. To alleviate the condition, it is important to take a half-sitting or sitting position. Occasionally, resistance to anti-asthma drugs may occur.
Treatment of atopic bronchial asthma
Appropriate drugs prescribed pulmonologist. In each case requires a personal approach. The duration of therapy depends on the degree of illness. Treatment of atopic asthma should be carried out under the strict supervision of a doctor. The specialist identifies:
- nature of asthma,
- frequency of exacerbations.
Treatment of atopic (non-infectious-allergic) asthma involves the use of inhalation and hormonal agents. In order to eliminate inflammation, medications such as berodual, pulmicort, ingacort, etc. are prescribed. When the disease passes in serious form, additional medications are prescribed. Treatment should be complex. In most cases, it is lifelong.
When the condition worsens during an attack of bronchial asthma, it is extremely important to observe the following conditions:
- unbutton the collar
- air out the room
- avoid contact with likely irritants,
- in case of severe asphyxia, immediately call an ambulance,
- take bronchodilators (the doctor must prescribe a dose).
Attention! If this disease is diagnosed in a pregnant woman, then she should immediately give up cigarettes and alcoholic beverages. It is strictly forbidden to use possible allergens. If these recommendations are not followed, both the woman and the fetus will suffer.
The patient should know that modern medications cause less harm to the body. But the drugs of the old generation are recognized as more invasive. It rarely happens that the patient is required to enter adrenaline when a seizure occurs.
Be sure to share this article in social networks, and then even more people will learn about the features of atopic asthma.
Causes of the disease in children and adults
People with an infectious-allergic form of asthma are more sensitive to viruses, germs, and fungal spores. Allergic predisposition affects the development of the disease less than with atopic asthma.
Choking usually begins to develop at a time when the acute effects of the infectious process begin to subside.
Stress, nonspecific stimuli, previous allergic reactions to medicines and food also affect the relapse of the disease.
Allergic (atopic) bronchial asthma develops when there is hypersensitivity to stimuli, which is formed as an immediate reaction.
Such hypersensitivity is characterized by the fact that the symptoms of the disease occur several minutes after the allergen enters the respiratory tract. Although in some cases there may be a slow reaction.
The main role in the development of atopic asthma belongs burdened heredity. Almost half of the children with this disease have a blood relative, with a history of allergic reactions.
But we must assume that it is not asthma itself that can be inherited - sensitivity to allergens is laid at the genetic level, and in what form it will be difficult to predict.
There are several factors that mainly contribute to the onset of the first episode of allergic asthma, these are:
- Frequent respiratory infections,
- A focus of chronic inflammation in the airways,
- Adverse ecological situation in the place of residence,
- Smoking. This includes passive smoking, that is, a long and constant stay in a smoky room (especially this factor in the development of asthma applies to children)
- Occupational hazards
- Prolonged exposure to aggressive allergens. So bronchial asthma can develop if a person lives in an apartment, the walls of which are affected by mold fungus,
- Long-term medication.
Allergic asthma is caused by different types of allergens, most of them enter the airways by inhalation.
Depending on the etiological factor emit:
- HOUSEHOLD (Dusty) Asthma. Occurs on house dust, exacerbations often occur in the winter months of the year. Relapses of the disease are long lasting, and relief comes when for some time a person leaves the familiar home environment. Dusty asthma is often combined with bronchitis of an allergic nature of origin.
- FUNGAL ATOPIC ASTHMA. This type of disease is year-round or seasonal, which depends on the characteristics of sporulation. The concentration of the spores is higher in the late afternoon, so the seizures occur during the night's sleep. The deterioration is possible in wet weather, some patients with this form of asthma can not tolerate yeast. If the sensitivity to seasonal fungi is increased, then after snowfall the state of health improves significantly.
- DUSTY ASTHMA. It occurs during the flowering season of plants. Usually, the patient initially develops allergic rhinitis and conjunctivitis, and already against the background of these diseases there is an attack of suffocation. In some patients, asthma symptoms occur in different periods of the year when using some vegetable fruits - nuts, sunflower seeds, and cereals.
- EPIDERMAL ATOPIC ASTHMA. The main etiological factor is particles of the epidermis and animal hair. In most cases, this type of asthma develops in people who are in close contact with animals - livestock breeders, employees of hunting grounds. From domestic animals, allergies are most often caused by saliva protein and cat hair, more information about this can be read here. Most often, this type of atopic asthma is combined with the everyday form of the disease. The cause of epidermal asthma can be contact with aquarium fish, with their food. In this case, food allergies to shrimp, crayfish, crabs are possible.
Allergic asthma in rare cases occurs as a reaction to a food allergen. Moreover, an asthma attack is caused not only by the ingress of an irritant into the digestive system, but also by inhalation of its smell.
Allergic asthma in children
The manifestation of allergic asthma in a child can be in different age periods, but most often the disease affects the children's body after a year of life. Allergic reactions of various etiologies are a major risk factor.
Atopic asthma in childhood has an unpleasant feature - it can be hidden under the symptoms of obstructive bronchitis. It is possible to identify asthma by the number of manifestations of the disease during the year. If bronchial obstruction occurs more than four times a year - this is a serious reason to contact an allergist or immunologist.
The specificity of the treatment of atopic asthma in children lies in the paramount importance of inhalation, as the main means. Such procedures not only help eliminate the allergen that triggers the disease, but also increase the body's defenses.
Allergic Asthma Attack
Under the attack of allergic asthma should be understood such a reaction from the human immune system, in which in response to exposure to the allergen appears bronchospasm. It is this that is an attack itself, accompanied by a contraction of the muscle tissue surrounding the respiratory tract. As a result of this pathological condition, the muscles become inflamed and filled with viscous thick mucus. At the same time, oxygen supply to the lungs is severely restricted.
To eliminate the attack of atopic allergy requires a whole range of activities. First of all, they are sent to relieve symptoms of the disease. A calm and relaxed state during an attack is a necessary component; if a person begins to get anxious and anxious, his position is only aggravated. Slow breaths and exhalations, a stream of fresh air (not cold), a horizontal body position will help to cope with an attack of atopic asthma in a matter of minutes.
Ideally, you must have a drug inhaler. Its use will quickly relieve suffocating attacks and restore the work of the smooth muscles of the respiratory organs.
Asthmatic status. Extremely dangerous for human life is this form of manifestation of atopic asthma, in which develops an asthmatic condition, called asthmatic status. It is a long-term, not amenable to traditional drug treatment, suffocation, in which a person is simply not able to exhale air. This state develops from a certain stupefaction to its complete loss. At the same time, the general well-being of a person is extremely difficult. Lack of necessary treatment can lead to disability and even death.
Allergic Asthma Treatment
Treatment of atopic asthma should be carried out under the supervision of a physician. Self-medication may aggravate the disease. This type of asthma is treated with the same means as other forms of asthma, but taking into account the allergic nature of the disease is important.
Timely reception of antihistamines can reduce the manifestation of symptoms and the severity of atopic asthma. The modern pharmaceutical market offers a wide range of such products, so choosing the right product is not so difficult. The antihistamine effect is achieved by blocking receptors, with the result that the release of histamine into the blood is either completely absent, or its dose is so small that it does not cause any response.
If a situation arises when it is impossible to avoid encounters with an irritant, it is necessary to take an antihistamine in advance, then the likelihood of an acute response is greatly reduced.
In medicine, there is a technique in which the substance-allergen is injected into the human body. Gradually the dosage increases. This is how susceptibility to a certain irritant is formed, thereby reducing the likelihood of allergy attacks.
The most common method of dealing with atopic asthma is the use of inhaled glucocorticoids and blockers of long-acting? 2-adrenoreceptors. This is a basic therapy that helps control the course of the disease for a long time.
Immunoglobulin E antagonist antibodies serve to eliminate the hypersensitivity of the bronchi and prevent a possible exacerbation for a sufficiently long period.
A group of drugs called Croons is actively used in the treatment of childhood allergic asthma. However, in adults, treatment with these agents does not bring the desired result.
Methylxanthines are used in the exacerbation of atopic asthma. They act very quickly by blocking adrenoreceptors. The main substances of this group of drugs: adrenaline and oral glucocorticoid.
Against the background of all medications, inhalants are prioritized, which with the help of a special device penetrates directly into the respiratory tract of a person suffering from atopic asthma. When this happens instantaneous therapeutic effect. In addition, inhalations are devoid of the side effects that drugs often have.
Allergic asthma can and should be treated, but therapy should be structured in such a way as to take into account the individual characteristics of the course of the disease. This can be done by a qualified doctor based on the clinical picture of the disease and diagnostic tools. Late treatment or improperly constructed therapy leads to a huge risk of developing pathological conditions in the body, as a result of which atopic asthma can turn into a more severe form or even lead to death or disability.
In general, the prognosis for life with proper treatment is quite favorable. The main complications of atopic asthma include developing pulmonary emphysema, pulmonary and heart failure.
To date, there are no effective preventive measures that could completely eliminate the possibility of allergic asthma. The problem is solved only when the disease occurs and comes down to the elimination of allergens and adequate treatment, whose main task is to stabilize the course of the disease and reduce possible exacerbations.
Education: Diploma RSMU them. N. I. Pirogov, specialty "General Medicine" (2004). Residency at the Moscow State University of Medicine and Dentistry, diploma in "Endocrinology" (2006).
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Allergic Asthma and Allergic Rhinitis
Allergic rhinitis and asthma, many allergists refer to two clinical manifestations of the same pathology in the upper and lower respiratory tract.
It is believed that rhinitis of an allergic nature of origin contributes to the development of attacks of shortness of breath and suffocation, this is especially possible if enough time is not given to the treatment of the first disease.
The cause of asthma and rhinitis are in most cases exogenous allergens, you can determine their appearance using specific diagnostic methods.
There are two forms of allergic asthma and rhinitis, it is seasonal and permanent (year-round). The frequency of exacerbations is associated with the influence of external allergens.
The clear development of bright symptoms of the disease in spring and summer indicates an allergy to pollen of various plants or to fungal spores.
Year-round manifestation of asthma and rhinitis indicates that the main irritant is in the air, house dust, used cosmetics.
The timely start of treatment of bronchial asthma and the use of certain types of drugs can keep this disease under control.
Complications arise if there is no treatment and if the patient does not take medications regularly. With the abrupt cancellation of the medicinal series, the development of asthmatic status is possible - a severe attack of suffocation.
If a patient does not treat his disease, then after a few years he develops emphysema, cardiac and pulmonary insufficiency.
Allergic asthma is manifested by suffocation attacks that occur after an allergen has been exposed to the mucous membranes of the respiratory tract. You can determine the attack by the following symptoms:
- There is difficulty breathing,
- There is a feeling of lack of air and choking,
- There are wheezing and whistling in the chest, they are usually heard from a distance. With deep breathing, whistlers increase,
- A paroxysmal, prolonged cough develops. Most often, the cough is dry and only at the end of the attack can a clear sputum be separated in a small amount and viscous in consistency.
Dry cough may be the only manifestation of allergic asthma, in this case it is a cough variant of the disease.
If asthma occurs in severe and moderate form, then at exertion there is shortness of breath, passing after a rest.
In the period of remission of the disease with mild disease, there are practically no manifestations.
Asthma asthma often develops after contact with animals, while in a dusty, smoky room at the time of general cleaning of the house. It may be preceded by itchy nose, sneezing, tearing, sore throat.
The peculiarities of the course of atopic asthma in children include the development of an attack of the disease after physical exertion - running, outdoor games, playing sports. Such a condition is indicated by the term bronchoconstriction or exercise asthma.
During the period of exacerbation, that is, the recurrence of the disease, an attack of suffocation can be triggered not only by the allergen itself, but also by sharp odors, hypothermia, dust, exercise.
When and in what quantity aggravations will occur, depends, first of all, on how often a person contacts with the main allergen and on the type of stimulus.
Allergic asthma varies in severity of its course, depending on this there are several forms of the disease:
- Asthma intermittent, that is intermittent flow. This form of the disease corresponds to mild severity. Characterized by the occurrence of asthma attacks less than once a week. With such a course of nocturnal seizures, there is no change in the function of external respiration according to spirometry and peak flow measurements.
- Persistent (persistent) mild asthma. Attacks occur once a week and more often, but not more than once a day. It is possible the appearance of choking at night. Spirometry shows normal respiratory rates. Conducting peak flowmetry shows slight irregularities.
- Persistent asthma of moderate severity. Asthma attacks more than once per week, necessarily occur during this time not less than one night episode of asphyxiation. In the period of exacerbation of impaired performance. On spirometry, moderate respiratory function disorders are detected.
- Persistent severe asthma.This form of the disease is characterized by constant attacks of breathlessness for a day; at night, asphyxiation also occurs very often. Strongly limited work and performance. Significant changes are revealed during spirometry and peak flow measurements.
One of the most dangerous manifestations of asthma of any form is the occurrence of an asthmatic condition. The patient develops prolonged suffocation, in which there are difficulties with the exhalation of air.
Asthmatic status leads to a disturbance of cardiac activity, loss of consciousness is possible, and in the absence of medication, a lethal outcome occurs.
This condition is poorly controlled by the use of conventional means used during a normal attack.
Treatment of a child and an adult
Treatment of allergic bronchial asthma should begin with elimination therapy, which involves the elimination of contact with the allergen.
In order to maximally protect oneself from the effects of a stimulus, one should:
- Eliminate contact with animals
- Abandon carpets, feather bedding, soft toys,
- Treat basements and living quarters with anti-mold agents,
- Keep books in closed cabinets,
- Follow a hypoallergenic diet,
- As often as possible to carry out wet cleaning,
- Use air purifiers.
In some cases, in order to get rid of severe attacks of bronchial asthma, a move to another region is required, where there will be no effect of allergenic pollen or other adverse factors.
How to remove the attack.
An asthma attack is difficult to confuse with anything. In addition to the main symptoms, the patient takes a characteristic posture, he bends over and rests against the bed, the chair with his hands.
This position allows you to make more effort to commit exhalation. With the development of suffocation in oneself or a loved one, one should proceed as follows:
- Seat the patient in a chair facing his back. Put a pillow between the chair and chest.
- Provide fresh air.
- Reassure the person. A small child is recommended to stroke the back.
- Use a metered-dose inhaler, of course, if it is already prescribed to the patient. Use quick-acting inhalers with bronchodilator components, these are Salbutomol, Terbutaline, Berotec. First you need to make two inhalations, usually relief occurs within 2-5 minutes. If this does not happen, then after ten minutes two more sprays are carried out. It is not necessary to use more doses, since overdosing causes headache, dizziness, tachycardia.
- Dyspnea and asphyxiation is relieved by a drug like Eufillin, it is available in pill form and in solution. In order to quickly stop an attack, it is necessary to inject Eufillin intravenously.
- You can also take one of the antihistamine drugs in a single dose - Suprastin, Tavegil, Dimedrol. It is best to give them at the very beginning of the attack.
- Severe asphyxiation is removed by drugs such as Prednisolone or Dexamethasone. Therefore, if you see that the treatment undertaken does not help, but these medicines are on hand, then their administration is necessary. Up to 150 mg of Prednisolone can be administered at a time, but it is better to limit it to 60 mg in the first administration.
When an asthma attack is necessary to call an ambulance, it is especially necessary if asphyxiation develops for the first time or in young children.
The treatment regimen for allergic bronchial asthma must be selected by a doctor, the main goal of drug therapy is to control the disease.
Properly chosen drugs and compliance with all the recommendations of the doctor for their use can avoid exacerbations of the disease, eliminate its symptoms - shortness of breath, cough, manifestations of rhinitis and conjunctivitis.
Drugs prescribed to patients with allergic bronchial asthma, are divided into two groups:
- The first group of drugs eliminates muscle spasms and expands the lumen of the bronchi, which greatly facilitates breathing. These medicines are considered first aid and are mainly used to relieve the beginning choking.
- The second group of drugs has anti-inflammatory properties and prevents the occurrence of an attack. This group of drugs for moderate asthma is required to be used regularly, only with such a treatment regimen can the disease be kept under control. It does not make sense to use these medicines during the development of an attack, as their effect develops gradually.
The group of drugs with immediate bronchodilator effect, include:
- Inhalation means - Berotek, Salbutomol, Astmopent, Berodual, Ventolin.
- Tablets preparations - Eufillin, Teopek, Teofedrin.
If drugs from this group are used frequently, this leads to the fact that the bronchi stop responding to them and then using them during an attack is less effective.
To prevent this from happening, continuous or prophylactic treatment with the second group of drugs and minimizing contact with the allergen is necessary.
The second group of drugs used in the treatment of patients with bronchial asthma include:
- Steroids produced in the form of inhalers and turbuhalers - powder inhalers. Most often in the treatment of asthma use Becotid, Fliksotid, Pulmicort, Beclason.
- Bronchodilator drugs with anti-inflammatory mechanism of action. Inhalers Oxis, Serevent.
- Combined drugs that combine steroids and bronchodilator drugs. Example - Symbicort, Seretide.
- Non-steroidal inhalers with anti-inflammatory effect - Intal, Tayled.
When choosing a treatment regimen, different combinations of medicines are used, the combination of medicines depends on the manifestations of asthma, the frequency of exacerbations, the age of the patient, so it is simply impossible to choose an effective and safe treatment without the help of a doctor.
Treatment of children with allergic asthma begin with drugs - derivatives of cromoglitse acid, this is Intal, Cromohexal, Tayled.
And only if there is no effect from their use, they are transferred to inhaled steroids, the child should definitely choose the appropriate age-appropriate dose of the drug.
The introduction of a number of drugs using a nebulizer increases the therapeutic effect many times and quickly alleviates the symptoms of the beginning asthma attack.
After the child turns five, you can use SIT therapy, that is, the gradual introduction of the smallest doses of allergens. If this treatment is started as early as possible from the moment of the first asthma attack, then the complete elimination of the disease is possible.
Any vaccination of the child is carried out only when there is a stable remission. And vaccination is possible only under the guise of taking an antihistamine medication.
Treatment by folk methods
The choice of folk methods of treatment of bronchial asthma must be approached very carefully. Any plant is a potential allergen and therefore various herbal teas can cause an allergic reaction.
Therefore, when using various recipes from the piggy bank of folk treatment methods, it is necessary to start taking decoctions, infusions and other means with small doses and be sure to record all changes in the general state of health.
- In the event that asthma occurs with conjunctivitis and rhinitis, you can use the help of bran. Two spoons of bran are poured with a glass of boiling water, left to swell and then eaten. Before that you should drink one glass of pure water. Bran has cleansing properties and therefore they remove part of the allergens from the body, alleviating the symptoms of the disease.
- In a three-liter jar should be folded kilogram of peeled and chopped garlic. Then water is poured into the jar before the neck; this means should be infused for a month in a darkened and cold place. After this period, filtered infusion drink a teaspoon, which is pre-diluted in half a glass of hot milk. The treatment is carried out in the morning, about 30 minutes before meals. The general course of at least 6 months, during this time you can not miss a single intake of garlic infusion.
Therapeutic breathing exercises
Respiratory therapeutic exercises performed by patients with bronchial asthma can cope with mild forms of the disease and significantly prolong the periods of remission of the disease.
Many techniques of breathing exercises have been developed, the attending physician will be able to choose the right set of exercises.
But no matter what classes are chosen, several things should be taken into account in the behavior of the breathing exercises:
- Breathing during class is only needed through the mouth.
- In case of a complicated disease, manifested by the accumulation of sputum in the bronchi, the exercise should be performed between inhalation and exhalation.
- From training refuse during coughing and starting an attack of suffocation.
- The exercise complexes are repeated twice a day.
People suffering from bronchial asthma, shown and spa treatment. It is recommended to buy a ticket to a sanatorium dealing with the problems of the organs of the respiratory system during remission.
Visiting resorts is contraindicated in acute asthma, a severe form of the disease with frequent attacks.
In sanatoriums, patients with allergic asthma may be offered special recovery programs, including:
- Halo-inhalation therapy.
Improving the health of the patient is achieved by observing the correct daily routine, walking in the fresh air, and general health procedures.
Patients with bronchial asthma can choose one of the following resorts:
- "Yeisk." The sanatorium offers programs for the treatment of various allergies, diseases of the respiratory system and other pathologies. On the territory there are mud baths, balneotherapy, speleotherapy well helps patients with asthma. Yeisk is located next to the sea, and the resort itself has a fully equipped beach.
- "White keys". Located in Karelia near Lake Onega. The sanatorium is located in the forest zone, using natural mud and mineral waters for treatment. People with asthma are offered general methods of healing and cleansing the body, balneotherapy.
- "Belokurikha". Located in the Altai Territory. For the treatment of patients with bronchial asthma, baths with radon water, nebulizer therapy, halotherapy, complexes of therapeutic breathing exercises, physiotherapy are offered. The healing air of the Altai mountains has a positive effect on the condition of the bronchopulmonary system.
Allergic Asthma and Pregnancy
During pregnancy, women suffering from allergic bronchial asthma, be sure to follow the measures to create for themselves a hypoallergenic environment.
It must always be remembered that during the period of childbirth, the body experiences a double burden and therefore even previously safe stimuli can cause an attack.
Expectant mothers are advised to follow a diet, and the attending physician should select those drugs for asthma that do not change the development of the child for the worse.
You should not refuse treatment because it can lead to a severe attack, during which the child will suffer.
A woman should give birth only in the hospital, where they will constantly monitor its function of the respiratory system, and monitor the condition of the fetus during childbirth.
In case of a severe disease, a caesarean section is prescribed.
Excellent immunity, rare respiratory infections, good ecology - with such initial data the likelihood of developing asthma decreases.
If you know that your child has a burdened heredity due to allergies, it is necessary to observe several conditions from the very first day of his birth:
- Correctly introduce lures, exclude in the first years of life the use of products with a high degree of allergenicity,
- At home, create hypoallergenic conditions, that is, remove feather blankets and pillows, cloths, fur products, constantly carry out wet cleaning,
- Without the need not to use drugs,
- Avoid respiratory infections
- Harden the child.
Prevention of the disease for those who already suffer from bronchial atopic asthma, is to exclude contact with the allergen.
Be sure to use the treatment prescribed by the doctor, to avoid asthma attacks.
At hand, at any time of the day or night, there should always be a pocket inhaler necessary to relieve an attack of suffocation.
Allergic asthma is, of course, a serious illness, limiting in some aspects of different activities. But the disease is quite possible to keep under control, if you consult a doctor in time and follow all his prescriptions.