Is it possible to cure the initial stage of bronchial asthma, what nature the disease has, what symptoms it gives out at the stage of an attack - all this information interests the person who has been given such a diagnosis. The disease belongs to the category of chronic, has a non-infectious nature and affects the respiratory tract, causing 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 an 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 decreases, the patient suffers from suffocation. Such an attack usually has precursors. Distinctive features - a short breath, a long, loud exhale. Usually, during an attack, the patient coughs heavily, viscous sputum separates profusely, and breathing is accompanied by wheezing. Against the background of asthma, pulmonary emphysema, asthmatic status, pulmonary heart can appear.
From medical statistics on all stages of bronchial asthma in children and adults, it is known that in the last couple of decades, the frequency of cases 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. Representatives of different age groups, persons of both sexes suffer from it. From the data collected it is clear that the disease is characterized by a rather high risk of death. Among children over the past couple of decades, the incidence of asthma has been growing particularly strongly. This allows us to classify the disease as social problems.
Leakage nuances
At different stages, attacks of bronchial asthma are disturbed with different frequencies. 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 airways. The secret generated by the submucous glands clogs the bronchi, as the substance is produced in excessive volumes. Gradually, muscle bronchial tissue is transformed into connective tissue, which leads to sclerosis.
At most stages, the prognosis for asthma is positive if treatment is started on time. Modern methods and approaches allow achieving stable long-term remission. The patient will have to constantly monitor his condition in time to prevent another attack. Following medical recommendations can reduce the amount of medication used and return to an active lifestyle.
Dangers lurk in everyday life
At any stage, exacerbation of bronchial asthma is often explained by the influence of an external factor. The most common allergens are dust, food, wool, dandruff, plant matter. In medicine, this category is called nutritional. Up to 40% of all cases of asthma observation can detect the body's response to medications. About 2% are explained by the influence of aggressive factors in the workroom (perfume salon, production area).
Infectious factors should not be ignored. Microscopic life forms, the substances generated by them, are quite strong allergens that increase the sensitivity of the respiratory system. Continuous infection is accompanied by active inflammation, worsening the status of the body. The likelihood of an allergy when interacting with a rare allergen is growing.
Types and forms: what happens?
It is customary to highlight asthma, due to allergies, as well as non-allergic factors. There are mixed cases, and sometimes it is not possible to identify the cause. It is customary to divide patients into groups: persistent lung, moderate or severe level, and episodic (officially called intermittent). Assessing the condition, the disease is characterized as being at the stage of exacerbation, in the stage of remission (distinguish stable and unstable). Based on the response to treatment, it is customary to classify a case as controlled, not subject to control, or partially amenable to such.
During an attack, the patient experiences several stages of bronchial asthma: precursors, midst, a 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 (secretions are generated, the person sneezes). The acute phase can come quite suddenly. It becomes difficult to breathe, a feeling of tightness arises in the chest. Inhale is shortened, becomes sharp, and exhale is long and loud. When breathing, a person makes wheezing, coughs. Viscous sputum generated in the respiratory system is hardly excreted, breathing loses rhythm.
How to identify an attack?
During the acute stage, a person takes a forced sitting pose, tilting the body forward. To alleviate the condition, the elbows rest on their knees or look for another point of support. The face is puffy, while trying to breathe air, the veins on the neck swell. Exhalation resistance is sometimes overcome by involving muscle tissue.
Percussion lets you hear a boxy, clear sound. Pulmonary borders are displaced, organ mobility is limited. Auscultation allows you to establish 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. Sputum gradually departs, wheezing weakens, asphyxiation becomes less pronounced.
Main manifestations
Symptoms of bronchial asthma in the early stages include wheezing when trying to exhale. The key of sounds 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. Coughing becomes stronger at night. The well-being of a person and the quality of the respiratory system become worse in certain seasons. As a rule, in the history of asthmatic disease there are references to allergic reactions. Asthma is often accompanied by eczema.
Symptoms of bronchial asthma in the early stages include a tendency to colds, in which the lower parts of the respiratory system suffer. The patient's condition improves if asthma drugs or antihistamines are taken. Upon contact with allergens, a person becomes sharply worse. This can trigger smoke and a drop in external temperature, physical activity, strong feelings, illness.
Diagnosis
If you suspect that symptoms of bronchial asthma are observed, in the early stages of the disease it is necessary to contact the clinic for a full check of the condition. A pulmonologist can diagnose asthma by evaluating the patient's complaints, 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 obstruction, its nuances, reversibility. In addition, spirometry is the main method for confirming a preliminary diagnosis. In asthma, the forced output in 1/60 minutes becomes 12% more. To ensure that these studies are as correct as possible, the analysis should be repeated several times.
Peak flowmetry is another common way to assess the condition of a patient who comes to the clinic with symptoms of bronchial asthma in the early stages of the disease. This method helps to monitor the state, track changes based on the dynamics of indicators. When using bronchodilator drugs, increasing the parameter by 20% or more allows you to accurately diagnose asthma.
Additionally, the patient may be prescribed testing using different allergens. Sometimes it is necessary to check the blood for the ratio of gases. Some are prescribed an X-ray of the lungs, bronchoscopy, and an electrocardiogram.
Clarification of the condition: blood and sputum check
With the symptoms of the initial stage of bronchial asthma, it is necessary to take blood samples for several types of tests. First, a general one is prescribed. 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 monitor the development of the condition, to track the nuances of the exacerbation phase. The changes are quite general, which forces us to accurately interpret the information received.
An analysis of sputum is no less useful for symptoms of the initial stage of bronchial asthma for timely and correct diagnosis. A general examination under a microscope reveals the presence of specific crystalline structures, eosinophils, and Kurshman spirals. If asthma depends on an infectious process, neutral white blood cells can be detected in the sputum. This indicates the activity of the focus of inflammation. With an attack in sputum, Creole bodies formed by epithelial cells are observed.
How to fight?
Treatment is selected based on the stage of bronchial asthma. In adults and children, the disease proceeds in a chronic form, even if the frequency of seizures is extremely rare. The main objective of the treatment is the exclusion from the everyday life of the patient of factors that can cause the acute phase. Specific diets are indicated. Limitations are placed on possible jobs. If the allergen is established accurately, hyposensitizing therapy is practiced.
Beta-adrenergic agonists are used to ease choking. Dosage is chosen strictly individually. Popular drugs are 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 on sale.
To prevent an acute attack, tablets with xanthine derivatives can be taken. A good effect can be achieved by using means to inhibit mast cell degranulation. These are Ketotifen, calcium ion antagonists, Sodium Cromoglycate.
With bronchial asthma of stage 3, the patient, as a rule, needs glucocorticosteroids. Such drugs are prescribed on average every fourth. Each morning, 20 mg of Prednisolone is used. To reduce side effects on the digestive tract, the drug is combined with antacids. During inpatient treatment, Prednisolone is injected.
It's important to know!
A specific nuance of the treatment of bronchial asthma is associated with the need to use medications at 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 the discharge of sputum, 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 other chronic diseases, it is necessary to choose an effective course for their treatment. Often, pathology is accompanied by pneumonia, bronchitis. This requires the use of antibacterial drugs. Specific drugs are selected based on the nuances of microflora.
Stages of the disease
The official classification of the stages is as follows: IIA, IIA + N, IIN. The initial stage of bronchial asthma is predastma. This is the stage of chronic pathological conditions localized in the bronchi and accompanied by bronchial spasms. Often, pathology is accompanied by allergic reactions affecting the nose, sinuses. A reactivity test may show sensitization to some compounds. Histamine inhalation test, acetylcholine is positive.
In 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, chronic bronchitis. At the first stage, the ailment can proceed easily, severely, or according to a moderate scenario. An easy option is diagnosed if seizures per year occur only a couple of times, they are short-lived and are effectively eliminated by bronchospasmolytic drugs. Between attacks, the patient does not suffer from suffocation. An exacerbation is usually observed with an activation of the inflammatory process.
An easily occurring atopic form in the first stage of bronchial asthma is characterized by prolonged remission if a person avoids contact with allergens.
Medium and heavy levels
With an average severity of the disease at the initial stage of bronchial asthma, exacerbation occurs no more than five times a year. Suffocation is quite severe, relief can be achieved with bronchodilators. Between complications, manifestations of bronchospasm are disturbing.
In severe forms of the course, acute phases are observed annually more than five times, seizures are long and difficult to tolerate. Perhaps an asthmatic condition. Correction is difficult. Asthma is characterized by short-term rare remissions.
Atopic asthma occurs in this embodiment, if the allergy is bacterial in nature, an allergic reaction occurs simultaneously with bronchitis or pneumonia in a chronic form.
Second phase
At this stage, functional changes in the functioning of the respiratory system are observed. The patient is characterized by chronic pneumonia, pulmonary emphysema, pneumosclerosis. There is a failure of the respiratory system of the second or third degree, low activity of the heart. For such a stage of bronchial asthma, remissions are characterized by incomplete and short-term, and asthmatic conditions are prolonged 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 in contact with the antigen. The duration of the stage is the time required to enter into interaction with a new allergen. In some, the step is very short, only a few minutes, in others it reaches tens of years. 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, histamine. Next comes the pathophysiological stage of bronchial asthma. The diagnosis is made by identifying a complex response to the allergen on the part of the body. In the bronchial tree there is a spasm, sputum is secreted in high 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 exacerbation begins gradually, the condition becomes worse and worse. Perhaps a sharp start, unpredictable and sudden. Between seizures, the patient often does not notice any health problems at all. Statistics show that seizures more often come at night. An asthmatic wakes up from a feeling of tightness in the chest, there is not enough air, there is nothing to breathe, it is not possible 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 when breathing, attacks of dry cough come. To alleviate the condition, you should sit on a chair facing the back.
With an attack, vitreous sputum is released, breathing becomes frequent - up to 50 acts per minute, and sometimes more. The patient may be ill below the chest, there is a feeling of irritation, fatigue, anxiety. Perhaps an increase in heartbeat. Sometimes a headache, skin itching, sore throat. Frequent sneezing or other blurry symptoms are possible. One of the most pronounced manifestations is coughing. Possible wet, dry. In the process, sputum is separated: purulent, mucous. It can be a lot or a little.
In the absence of adequate assistance, asthma progresses initially. Cough, shortness of breath become stronger, voice changes, whistling intensifies. Perhaps a change in the shade of the integument of the face, the patient's behavior.
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 by pulmonary auscultation. In the third stage, a hypercapnic coma occurs. The patient's blood pressure decreases.
The probability of a fatal attack is a few fractions of a percent. As a rule, death is due to obstruction of the bronchi by secretions of glands, against which it becomes impossible to breathe. An acute failure of the functioning of the heart on the right, the circulatory system can provoke a fatal outcome. 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.
The approach of the listed complications of an attack is signaled by cyanosis, a weak filiform pulse, and bloating of veins in the neck. Breathing becomes shallow, with auscultation it is less often possible to identify dry rales, the liver swells and responds with pain. This is more likely with a prolonged attack that fails to stop, and with an asthmatic condition.
Features of the refinement of the state
When diagnosing, it is important to distinguish between cardiac and bronchial asthma. Whistling rales accompanying problematic exhalation signal about the bronchi as an area of localization of the disease. This can be explained by swelling, spasm. Similar manifestations are possible with acute coronary insufficiency and other cases of failure of the left ventricle. Cardiac asthma can cause bronchial spasm, provoke swelling of the mucous membranes.
Chronic pulmonary diseases can often trigger an increase in shortness of breath. It is important to be able to distinguish them from an asthmatic attack. As a rule, the first reason does not have 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 should be checked, the bronchial secretion for eosinophilia - it is observed only in asthmatics.