Atopic bronchial asthma is an allergic form of a chronic inflammatory disease that affects the upper respiratory tract. Its course is accompanied by asthma attacks that 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
Disease of bronchial asthma is widespread in the world and reaches 6-7% of the total population. Especially often it affects children 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 health problems in the form of atopic diseases (dermatitis, rhinitis, food allergies), then the likelihood of developing such a disease greatly increases.
The development of atopic forms of bronchial asthma depends on many external factors:
- poor environmental conditions;
- heredity;
- accommodation in regions with a cold climate of high humidity;
- Unhealthy Lifestyle;
- infectious diseases;
- active and passive smoking;
- long-term treatment with potent drugs;
- sudden changes in air temperature;
- harmful chemical odors.
Asthma attack
Bronchospasm or an asthmatic attack is a response of the patient 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 airways. The ongoing pathological processes are accompanied by bronchial obstructive syndrome, in which swelling of the membranes of the bronchi and a strong secretion of mucus occur. It fills the passages and limits the flow of oxygen to the lungs.
The result of this is suffocation when a person begins to suffocate. The attack begins from the first minutes of contact and lasts up to 2 hours. You can remove it only with the help of a medicine in the form of an inhaler.
Late asthmatic reactions cause inflammatory processes in the walls of the bronchi, causing irreversible changes at the cellular level. In severe cases, the patient develops an asthmatic status that looks like a long-term suffocation that is not removed by the medicine. The patient cannot exhale, which causes a slight fainting or loss of consciousness. If urgent measures are not taken, this could lead to disability and could result in death.
Symptoms of the disease
Signs and symptoms of atopic bronchial asthma are pronounced and can clearly identify this disease:
- the occurrence of cough;
- the appearance of whistling during breathing;
- shortness of breath and regular sneezing;
- itching in the nose;
- rapid breathing and difficulty breathing out;
- chest pains and squeezing.
Such signs may appear with every contact with an irritating allergen.
Degrees of atopic asthma
Atopic bronchial asthma has 4 stages of disease severity:
- A mild degree (intermittent) is manifested by rare attacks (1 time per week - in the daytime, less than 2 per month - at night), which do not adversely affect the patient's body.
- With the subsequent development of the disease, seizures become more frequent, they can be accompanied by suffocation, which requires treatment in accordance with its manifestations.
- Atopic bronchial asthma of moderate severity is manifested by daily bronchospasm, which negatively affects the patient’s sleep and condition, night attacks are possible every week.
- The most severe degree of the disease is accompanied by regular attacks several times in the daytime and nightly.
However, even with the fourth stage, with appropriate treatment and the implementation of all the recommendations of doctors, the patient can recover.
Allergens and varieties of the disease
Atopic bronchial asthma is an allergic disease, the immediate cause of which is a variety of allergens that can cause choking and other negative reactions.
Irritants (triggers) that provoke bronchospasm can become:
- pollen on flowers of plants;
- various types of dust (home, building, wood, etc.);
- mold and spores of fungi;
- feathers that are present as fillers in pillows and mattresses;
- aerosol products;
- animal hair;
- emissions of harmful production in the atmosphere, etc.
Depending on the listed allergens, the varieties of this disease are also divided. Today, the most common is household (dust) asthma, which worsens in the winter, when heating systems are turned on. This type of disease is easily determined by the cessation of seizures after a person goes into fresh air.
The fungal type of asthma is distinguished by nocturnal seizures and is seasonal in nature, since spore formation of fungi occurs in certain periods.
An asthmatic reaction to pollen is often accompanied by rhinitis or conjunctivitis, which can turn into suffocation.
The epidermal form of the 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, allergies to cats are now considered a common type of illness.
An attack of suffocation with atopic bronchial asthma can last from 5 minutes. up to 2-3 hours. If it is too long, then it can provoke the development of asthmatic status, which is manifested in insufficient supply of oxygen and cyanosis to the body. With 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. In mild cases of atopic bronchial asthma, complaints of patients usually include the presence of dry cough, which appears at night or in the morning, which is associated with an increase in muscle tone of the bronchi in the period 3-4 hours at night. Often, such symptoms and when listening to wheezing in the chest can already be a preliminary diagnosis.
To identify the latent form of bronchospasm, specialists use beta-adrenergic agonists, which relax the muscles. The volume of expired 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 asthma attacks occur due to the action of negative factors, and before exacerbation the patient feels various symptoms: itching, runny nose, dry throat, which makes breathing difficult. A characteristic feature is the difficulty to exhale, 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.
To clarify allergic irritants in the atopic form of bronchial asthma, skin tests are performed that will clarify the factors and causes of seizures for the patient.
To make an accurate diagnosis, bronchography is often used - an x-ray of the respiratory tract after the administration of contrast agents (iodinated oils, etc.). However, this method has contraindications: the patient has cardiovascular decompensation, sensitivity to iodine, and kidney disease.
Treatment
Therapy of atopic bronchial asthma consists of drug treatment and measures to increase the patient's immunity. In this case, an integrated approach is important in which patients understand their own responsibility for the correct implementation of all the requirements and prescriptions of the doctor.
Medications:
- Glucocorticoids - hormonal drugs to relieve the inflammatory process: "Alzedin", "Bekotid", "Beklazon", "Budesonide", "Ingacort", "Intala", "Pulmicort", "Tileda" and others.
- Bronchodilators and beta2-agonists (long 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 - are prescribed for a long time.
- Bronchodilator drugs - used to relieve an attack.
Persistent form
Persistent atopic bronchial asthma is accompanied by a severe course of the disease, which lasts a long time in the patient. For many years, a person feels heaviness in the chest, accompanied by coughing and difficulty breathing. After several seizures, a period of remission may begin when there are no signs of the disease.
With severe complications, the patient needs hospitalization and inpatient treatment, because massive attacks lead to sleep disturbances, insomnia and severe malfunctions of the body's biorhythms.
Therapy of this form of asthma involves 5 steps:
- Antileukotrienes: Montelukast, Hafirlukast, Aerolizer, Formoterol.
- Inhalations with corticosteroids will help relieve bronchospasms and prevent an attack: Tafen, Flixotide, Novolizer, Clenil, Bekotid.
- Drugs with a long therapeutic effect: "Theophylline" and others;
- In severe cases, hormonal and other drugs are administered intravenously under the supervision of a physician.
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 instruments for determining the maximum air speed during exhalation - peak flow meters. Measurements are taken daily in the morning before taking the medicine and are recorded in the diary. Depending on the indicators, the doctor makes a decision on the subsequent correction of treatment:
- more than 70% - indicates proper therapy;
- 50-70% - you need to see a doctor and improve treatment;
- Less than 50% - there is a risk of exacerbation, it is urgent to adjust medication and take measures to prevent an attack.
First aid for an asthma attack
If the patient has an unexpected bronchospasm, which is characterized by suffocation and other negative symptoms, then the following actions must be taken:
- Remove possible allergenic irritants.
- To unfasten fasteners on clothes, to let in fresh air, having opened a window.
- Use a bronchospasmolytic inhaler or nebulizer: Berodual, Berotek, Salbutamol, etc.) in an amount of 1-2 doses with an interval of 2 minutes.
- Take the medicine "Eufillin" if there are no contraindications.
- If necessary, repeat inhalation after 20 minutes.
- If all else fails, call an ambulance.
Bronchial asthma in children
According to statistics, allergic reactions occur in 9 out of 10 children, and this can happen in any age period. The prevalence rate of atopic asthma in some regions is up to 20%.
The cause of asthma is the influence of allergic irritants, which provoke inflammatory processes in the respiratory tract, which may cause shortness of breath and bronchospasm.
For young patients, the diagnosis of the disease is complicated by the fact that the symptoms of atopic bronchial asthma in children are very similar to obstructive bronchitis. The first sign of the development of the disease is hoarse breathing with a whistle, which is heavier with a deep breath. A dry, irritating cough may also indicate asthma, in which a small amount of sputum may be released. With this form, a cough variant of the disease is diagnosed.
Most attacks occur at night, and shortness of breath is also present during physical activity. This option is called asthma of physical stress.
For diagnosis, the doctor after a consultation prescribes skin allergy tests and an x-ray of the child’s chest, in which there is a slight increase in the lungs.
When an incorrect diagnosis and erroneous therapy are made, complications may develop in the form of emphysema or cardiac and pulmonary insufficiency. Such chronic diseases can lead to severe asthma, disability, and even death.
Asthma therapy 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 great advantage is safety compared to medications.
Medications for therapy:
- Glucocorticoids - help relieve the inflammatory process.
- Bronchodilators and beta2-agonists - eliminate muscle spasms.
- Cromones or derivatives of cromoglic acid - are used only for the treatment of asthma in children, are available in the form of aerosols, powders and capsules for ignition.
- Antihistamines.
- Bronchodilators - to relieve the attack and improve the general condition of the child.
For most procedures, nebulizers are used - special devices for inhalation, in which the drug turns into steam, which increases its penetration into the bronchi.
Prevention of asthma attacks
To reduce the frequency of occurrence of asthma attacks in atopic asthma, it is necessary to follow measures to prevent them, trying to reduce irritating factors:
- reduce physical activity;
- abandon carpets and soft toys in the apartment;
- put on hypoallergenic covers on pillows and mattresses, wash bed linen in hot water weekly;
- to control the humidity of the room (not more than 40%);
- do not use allergenic products containing dyes and synthetic fillers;
- keep books only in closed cabinets;
- carry out regular wet cleaning of all rooms, without the addition of chemical cleaning liquids, only bio-agents are permissible;
- remove flowering plants from home.
With the right selection of treatment and compliance with all the rules and preventive measures, the prognosis of treatment of atopic bronchial asthma is favorable for the patient.