What is needed to diagnose asthma in a child? The diagnosis is final and not subject to appeal?! Addressing risk factors for asthma

If a child has been diagnosed with bronchial asthma, this is not a sentence, but a guide to action. An allergist-immunologist at the Clinic talks about the causes of this disease, diagnosis and treatment methods. family medicine"FlamingoMed" Olga Leonidovna Tarbaeva.

Cough and oxygen starvation

In the classical formulation, bronchial asthma is a chronic inflammatory disease of the respiratory system, the main

signs of which are attacks of shortness of breath, coughing, and sometimes suffocation.

But in children this disease occurs somewhat differently than in adults.

— A child can be very active. And the only thing that worries him is a cough,” says Olga Leonidovna. — With bronchial asthma as such, the child does not have an attack of suffocation. Clinically, we see a paroxysmal cough. The child coughs constantly - during the day, in the evening, at night. In addition to problems with lungs bronchial asthma also negatively affects other internal organs.

“It happens that when a teenager is taken to see an allergist, it turns out that he has been suffering from bronchial asthma for three, five, or even seven years. First of all, from chronic hypoxia The central nervous system and the heart suffer, since these organs have a very high need for oxygen. The child may be delayed in development and growth.

Is it always the cat's fault...

More often in children, bronchial asthma occurs “under the guise” of acute respiratory infections with obstructive syndrome. Therefore, it is very important for both pediatricians and parents to take note of the following. If a child suffers from acute respiratory infections with obstructive syndrome more than three times a year, he has allergies in his family, and was observed at an early age atopic dermatitis, it is necessary to confirm or refute the diagnosis of “bronchial asthma”.

It is very important to contact an allergist in time for an examination that will identify the causative allergen in order to exclude the child’s contact with it. To identify an allergen, all kinds of diagnostics are used - these are tests, blood tests for allergens, etc.

In this situation, the question of what to do with pets is always very acute. It is believed that they are most often the cause of childhood illness.

— It is necessary to determine whether an animal is an allergen for a particular child. If you suspect an allergy, it is initially wrong to remove all animals from the house, says an allergist-immunologist. — There is an interesting theory that is confirmed in clinical studies. It turns out that the earlier a child begins to come into contact with animals, the faster he develops sensitivity to allergens, and in the future the child’s body does not react to them.

It happens, on the contrary, that the treatment provided does not bring positive results, because the parents “forgot” to mention that they have two fluffy cats at home rare breed. I would advise before starting pet or try to get rid of it, find out whether the child is allergic to it or not.

The boy grew up and... got better?

If the diagnosis is confirmed, you need to understand that bronchial asthma is chronic illness. It is impossible to completely recover from it, but it is quite possible to put the disease into remission, which can last a lifetime, says Olga Tarbaeva.

When an allergen is identified and therapy is prescribed, it is very important to comply with it. Parents must clearly understand the need for treatment and strictly follow medical recommendations.

— Children's body accepts the treatment with gratitude, he can rebuild his life,” Olga Leonidovna is convinced. “Many of my patients—asthmatic boys—are involved in professional sports, some even competed at world championships. This once again proves that bronchial asthma is not a death sentence.

In addition, according to the specialist, there is light form bronchial asthma. In children early age, especially in the Far North, the provoking factor for its occurrence is a cold - viral or bacterial infection. As a rule, but only in boys after adolescence, the disease can go into long-term remission. As they say, the child “outgrows the disease.”

“Now scientists have already found an explanation for this phenomenon. As a boy grows, the production of the hormone testosterone increases, which reduces allergic inflammation, explains Olga Tarbaeva. “But you can’t just hope that the boy will outgrow it.” It is necessary to take certain measures to relieve allergic inflammation and restore the structure of the lungs.

Except drug therapy exist additional methods treatments, which are also very important. This is sports, if the doctor allows it.

“Playing sports for bronchial asthma is a method of treatment,” emphasizes the allergist-immunologist. — If a child is ready for increased physical activity, you need to start training his lungs. Any sport that puts stress on the respiratory system is beneficial for a child with asthma. It will also be of great benefit Spa treatment. An integrated approach is important here. This includes climatotherapy, when we take a child out of the Far North, this includes swimming, and breathing exercises, and massage. In a coupe this gives a very good effect.

Educational program for parents

When parents learn about the diagnosis of bronchial asthma, they have a lot of questions. They are frightened by the possible disability of the child, they are looking for the cause of the disease, and want to know which treatment methods are the most effective.

— Treatment for bronchial asthma is long-term and specific. And both the child himself and all family members should participate in it, says Olga Tarbaeva. – Firstly, you should not hide his diagnosis from your child. Knowing him, the child must listen to himself, tell adults - parents, teachers, when and why he felt bad. He must know what medications he is taking. For more effective treatment We need feedback between the doctor, the little patient and his parents. It is impossible to provide advice “for all occasions” during one medical appointment.

For this purpose, the FlamingoMed Family Medicine Clinic conducts asthma schools for parents of young patients and for teenagers who are ready to receive information on how to live with this diagnosis. I have been teaching classes in asthma schools for 14 years. Such “educational education” really helps to calmly assess the situation, to know what needs to be done so that the treatment is successful, and subsequently bronchial asthma does not make itself felt.

If you want to visit the ASTHMA SCHOOL in our Clinic, subscribe to the newsletter in our VKontakte group application.

Bronchial asthma (from the Greek “asthma” - suffocation, heavy breathing) is a disease the main symptom of which is periodic attacks of expiratory suffocation caused by pathological hyperreactivity of the bronchi. Hyperreactivity means increased sensitivity of the bronchi to the effects of allergens. Most often, these are household and industrial dust, fungal spores, plant pollen, particles of pet hair, microorganisms, food allergens, etc. Currently, there has been a proven increase in cases of bronchial asthma in the European Union due to the frequent use of synthetic detergents.

Not least of all is heredity. It has been proven that if only one parent has atopic (exogenous, allergic), the probability of the disease manifesting in a child can be 20-30%, and if both parents are sick at once, then it reaches 75%. In almost 1/3 of asthmatics, the disease is hereditary.

How does bronchial asthma manifest?

Under the influence of the allergen, swelling and spasm of the bronchi occur. Clinically we see typical attack suffocation, expressed in difficulty in exhaling. An asthmatic's breathing is wheezing, the face becomes bluish, the veins of the neck are swollen, etc. During auscultation, the doctor listens to a large number of dry rales. They are often clearly audible to the ear and resemble a combination of different pitches of sounds of a playing accordion. The duration of the attack varies. A typical one lasts 1/2-1 hour. After that, shortness of breath decreases, a cough begins and a small amount of glassy, viscous sputum is released.

In almost all cases, an attack is preceded by precursors in the form of a sore throat, itchy skin, congestion and mucous discharge from the nose.

Diagnosis of bronchial asthma

The diagnosis of bronchial asthma is made mainly on the basis of the patient’s complaints and the presence of typical symptoms. In most cases, when an attack occurs, people call an ambulance, and therefore there are no difficulties in confirming the diagnosis.

All patients with bronchial asthma undergo additional studies of the function of external respiration: spirometry, peak flowmetry, as well as microscopic examination of sputum. The sputum itself or bronchial secretion is viscous, often two-layered, with a large number of eosinophils, Charcot-Leyden crystals (neutrophils), Kurshman spirals (represent the interweaving of small bronchi),

After the first serious attack recorded by emergency doctors, the person ends up in a specialized hospital or pulmonology department. This is where the main diagnosis is made. The primary diagnosis of bronchial asthma cannot be made at once at an appointment with a local physician or even a pulmonologist at a clinic. Such a complex diagnosis always requires comprehensive confirmation in a specialized hospital after a comprehensive and comprehensive examination. It happens that the attack does not recur, the tests remain normal, and then they resort to more in-depth examination methods. A study of bronchial reactivity is being carried out. It includes determining respiratory function with pharmacological tests using histamine or bronchodilators. In most patients, skin prick tests can identify the triggering factor.

The diagnosis is final and not subject to appeal?!

The diagnosis of bronchial asthma often leaves an imprint on a person’s social life.

With such a diagnosis, people are not allowed to serve in the army, police, etc. Moreover, patients with bronchial asthma cannot undergo certain physical procedures, go to non-core sanatoriums, work in hazardous industries, children - etc.. It seems that there are no attacks, but there are a lot of restrictions!

If a person really suffers from recurrent asthma attacks and receives medications almost daily, then the question of how to remove the diagnosis of bronchial asthma is not worth it in principle. In a number of cases (albeit very rarely), bronchial asthma was diagnosed in what is called “combat conditions”, i.e. without appropriate confirmation, after a single suspected asthmatic attack. This happens when a diagnosis is made in places remote from specialized hospitals, in the absence of the possibility of conducting in-depth examinations, etc. As a result, there are no more attacks - the diagnosis is incorrect.

Often the diagnosis of bronchial asthma is removed in old age, because previously it was exhibited almost exclusively on a clinic basis. In this case, people most often experience a clinical picture similar to asthma. When carrying out more modern survey it is currently unconfirmed.

So, what to do if there are no attacks or other manifestations of bronchial asthma, but there is a diagnosis?

How to remove the diagnosis of bronchial asthma? Method one

To begin with, you should simply go to the clinic at your place of residence. If there is a pulmonologist there, then go straight to him, and if there is no specialist, then go to a therapist. Depending on the capabilities of the clinic, a number of examinations can be completed at your place of residence.

Upon receipt of specific examination results, the specialist makes a conclusion confirming the diagnosis of asthma. In case of questionable results of tests and examinations, the pulmonologist suggests hospitalization in a hospital. It is there that the need for further examination will be decided. You should notify the doctor in advance about why you need such an examination, etc. This will avoid overdiagnosis and incorrect interpretation of the examination results in favor of confirming the diagnosis. Also, during the examination, you must be as attentive as possible and listen to the medical professional. staff. The results of a respiratory function test may be misinterpreted if the patient was inattentive before the examination, during the examination and did not listen to the doctor’s recommendations.

If all tests are negative, the diagnosis of bronchial asthma is removed. This is the most correct way.

We remove the diagnosis. Option two

Many people advise “get rid” of the diagnosis of bronchial asthma in a radical way. If it’s easier, steal the card and throw it away. This is not so difficult to do if the medical institution is not equipped with an electronic file cabinet, but you should think about the consequences. Will you destroy the official medical document, show up with a blank card, and everything will be fine? Yes, everything will really be fine if the doctor has never seen you and is working on the first day. In most cases, the question always arises about the availability of previous medical documentation. You will still have to provide some information about yourself. In case of passing medical commissions such a scheme is practically unacceptable. When applying for a job, especially in hazardous industries, you will be required to go through a series of additional examinations, in which certain deviations will be identified. Again, grueling tests and visits to specialists will follow until a diagnosis is made.

The third way to remove the diagnosis

Some people believe that one of the simplest options is financial solution question, or, more simply, a bribe. One of the positive aspects is that it is not burdened with examinations. And from the negative ones? If in case of loss outpatient card You can get away with a “slight fright” and a quarrel with the doctor, then even an attempt to give a bribe is already a criminal offense. In addition, no one will give you a guarantee that when you undergo repeated commissions, you will not be diagnosed with bronchial asthma.

Which scheme to choose is up to you. Naturally, it is worth remembering that bronchial asthma is quite serious illness, requiring constant supervision by a specialist, treatment adjustment, adherence to a certain lifestyle, . Is it worth removing the diagnosis for the sake of employment, and then finding yourself without qualified medical care and supervision? In some cases, this can lead to worsening of the disease and even. If nothing really bothers you, then go the most correct and official way: go necessary examination. And if you yourself do not doubt your diagnosis, is it worth the risk?

about the author

Olga is a young journalist with a great interest in medicine in general and homeopathy in particular. Olga graduated from Bryansk State University named after Academician I.G. Petrovsky and now runs news sections in several local medical newspapers.

Asthma- respiratory diseases of various etiologies, the main symptom of which is suffocation. There are bronchial, cardiac and dyspeptic asthma.

In today's article we will look at bronchial asthma, as well as its causes, symptoms, forms, severity, diagnosis, treatment, folk remedies and prevention. And at the end of the article or on the forum we will discuss this disease. So...

What is bronchial asthma?

Bronchial asthma– chronic inflammatory disease, the main symptoms of which are attacks of shortness of breath, coughing, and sometimes suffocation.

The term “ἆσθμα” (asthma) from the ancient Greek language is literally translated as “shortness of breath” or “heavy breathing”. For the first time, records of this disease are found in Homer, Hippocrates

Symptoms of bronchial asthma appear later negative impact on cells and cellular elements (eosinophils, mast cells, macrophages, dendritic cells, T-lymphocytes, etc.) of the body respiratory tract various pathological factors, such as allergens. Further, the hypersensitivity of the body (cells) to these factors contributes to the narrowing of the airways - the lumen of the bronchi (bronchial obstruction) and the production of copious amounts of mucus, which subsequently disrupts normal air exchange, and the main clinical manifestations appear - wheezing, coughing, feeling chest congestion, shortness of breath, heaviness of breathing, etc.

Attacks of bronchial asthma most often occur at night and early in the morning.

The cause of bronchial asthma is a combination of external and internal factors. External factors - allergens ( house dust, gas, chemical vapors, odors, dry air, stress, etc.). Internal factors - disturbances in the functioning of the immune, endocrine and respiratory system, which can be either congenital or acquired (for example,).

The most common causes of asthma are: working in places with strong chemical odors (household chemicals, perfumes), smoking.

Epidemiology

According to statistics from the World Health Organization (WHO), the number of patients with bronchial asthma ranges from 4 to 10% of the population on Earth. The highest percentage of which are residents of Great Britain, New Zealand, Cuba, which is due primarily to the local flora, as well as high concentration allergens transported to these territories by ocean air masses. In Russia, the incidence rate in adults is up to 7%, in children – up to 10%.

An increase in the incidence of asthma has been noted since the mid-1980s. Among the reasons, there is a deterioration in the environmental situation - air pollution from petroleum products, deterioration in the quality of food (GMOs), as well as a sedentary lifestyle.

On the first Tuesday of May, since 1998, WHO has established World Asthma Day, which is held under the auspices of the Global Initiative for Asthma (GINA).

Bronchial asthma. ICD

ICD-10: J45
ICD-9: 493

The causes of bronchial asthma are very diverse, and their number is quite large. However, as already noted, they are all divided into 2 groups - external and internal.

External causes of bronchial asthma

Dust. House dust contains a large number of different particles and microorganisms - dead skin particles, wool, chemicals, pollen, dust mites and their excrement. All these dust particles, especially dust mites, are known allergens that, when they enter the bronchial tree, provoke attacks of bronchial asthma.

Poor environmental conditions. Doctors note that residents of industrial areas, cities where there is a large amount of smoke, exhaust gases, harmful fumes, as well as people living in places with a cold, humid climate, suffer from bronchial asthma more often than residents of villages and places with a dry and warm climate .

Professional activity. An increased percentage of asthma sufferers has been observed among workers in chemical production, craftsmen working with building materials (especially plaster, drywall, paint, varnish), workers in poorly ventilated and polluted areas (offices, warehouses), beauty salon technicians (working with nails, painting hair).

Smoking. Systematic smoke inhalation tobacco products, smoking mixtures, lead to the development of pathological changes in the mucous membrane of the respiratory system, which is why smokers often suffer from diseases such as chronic asthma, bronchial asthma, etc.

Household chemicals and personal care products. Many cleaning and detergents, as well as personal care products (hairspray, eau de toilette, air freshener) contain chemicals that can cause attacks of coughing, choking, and sometimes asthma.

Respiratory diseases. Diseases such as chronic bronchitis, as well as their causative agents - infections, contribute to the development inflammatory processes in the mucous membranes and disruption of the smooth muscle components of the respiratory organs, bronchial obstruction.

Medications. Taking certain medications can also disrupt the normal activity of the bronchial column and lead to asthma attacks, especially Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs).

Stress. Frequent stressful situations, as well as the inability to overcome and adequately respond to various problems lead to. Stress weakens immune system, making it more difficult for the body to cope with allergens and other pathological factors that can lead to the development of bronchial asthma.

Nutrition. It is noted that when good nutrition, mainly food, plant origin, enriched and – fresh fruits, vegetables, juices, food with minimal heat treatment, minimizes the body's hyperactivity to allergens, thereby reducing the risk of developing asthma. In addition, such food improves the course of bronchial asthma. At the same time, as well as foods rich in animal proteins and fats, refined easily digestible carbohydrates, worsens the clinical course of asthma, and also increases the number of exacerbations of the disease. Can also cause asthma attacks nutritional supplements, for example, sulfites, which are preservatives used by many manufacturers in wine and beer.

Internal causes of bronchial asthma

Hereditary predisposition. If future parents have bronchial asthma, there is a risk of this disease developing in the child, and it does not matter at what age after birth. Doctors note that the percentage of asthma due to a hereditary factor is about 30-35%. If a hereditary factor is established, such asthma is also called - atopic bronchial asthma.

Disturbances in autonomic functioning nervous system(ANS), immune and endocrine systems s.

The signs or symptoms of bronchial asthma are often similar to the symptoms of bronchitis and other diseases, therefore, we will designate the first and main signs of bronchial asthma.

Important! Asthma attacks tend to get worse at night and in the early morning.

The first signs of bronchial asthma

Shortness of breath, especially after physical activity;
, first dry, then with clear sputum;
Sneeze;
Rapid shallow breathing, with a feeling of difficulty in exhaling;
Orthopnea (the patient, sitting on a bed or on a chair, holds on tightly to it, his legs are lowered to the floor, so it is easier for him to exhale completely).

At the first signs of bronchial asthma, it is best to contact medical care, because even if the symptoms of the disease appear and then disappear on their own, each time, this can lead to a complex chronic course with exacerbations. Besides, timely assistance will warn against pathological changes in the respiratory tract, which are sometimes almost impossible to reverse into a completely healthy state.

Main symptoms of bronchial asthma

, malaise;
Heart rhythm disturbance () - the pulse during illness is within the range of up to 90 beats/min., and during an attack, it increases to 130 beats/min.;
Wheezing when breathing, with whistling;
Feeling of chest congestion, suffocation;
Pain in the lower chest (with prolonged attacks)

Symptoms of severe disease

Acrocyanosis and diffuse bluishness of the skin;
Enlarged heart;
Signs of pulmonary emphysema – chest enlargement, decreased breathing;
Pathological changes in the structure of the nail plate - nails crack;
Drowsiness
Development of secondary diseases – , .

Bronchial asthma is classified as follows:

By etiology:

exogenous bronchial asthma– asthma attacks are caused by allergens entering the respiratory tract (dust, pollen, animal hair, mold, dust mites);
endogenous bronchial asthma– asthma attacks are caused by internal factors – cold air, stress, physical activity;
bronchial asthma mixed origin – asthma attacks are caused by the simultaneous impact on the body of both external and internal factors.

By severity

Each degree has its own characteristics.

Stage 1: Intermittent asthma. Asthma attacks occur no more than once a week, and a short time. There are even fewer night attacks, no more than 2 times a month. Forced expiratory volume in the first second of the forced expiratory maneuver (FEV1) or peak expiratory flow (PEF) - more than 80% of the indicator normal breathing. The spread of PSV is less than 20%.

Stage 2: Mild persistent asthma. Attacks of the disease occur more than once a week, but not more than once a day. Night attacks – 2-3 per month. Exacerbations are more clearly identified - the patient’s sleep is disturbed and physical activity is inhibited. FEV1 or PEF, as in the first degree, is more than 80%. The spread of PSV is from 20 to 30%.

Stage 3: Moderate persistent asthma. The patient is plagued by almost daily attacks of the disease. Night attacks are also observed more than 1 per week. The patient has disturbed sleep and physical activity. FEV1 or PSV - 60-80% of normal breathing, PSV range - 30% or more.

Stage 4: Severe persistent asthma. The patient suffers from daily asthma attacks, with several night attacks per week. Physical activity is limited, accompanied by insomnia. FEV1 or PSV is about 60% of normal breathing, the spread of PSV is 30% or more.

Special forms of bronchial asthma

There are also a number of special forms of bronchial asthma, which differ in clinical and pathological processes in the body. Let's look at them.

Atopic bronchial asthma. The disease develops against the background of a hereditary factor.

Reflux-induced bronchial asthma. The disease develops against the background of gastroesophageal reflux (GER), or the entry of stomach contents into the respiratory tract (lumen of the bronchial tree). In addition to asthma, the entry of acidic stomach contents into the respiratory tract sometimes leads to the development of diseases such as bronchitis, pneumonia, pulmonary fibrosis, and sleep apnea.

Aspirin-induced bronchial asthma. The disease develops while taking medications such as Aspirin, as well as other non-steroidal anti-inflammatory drugs (NSAIDs).

Bronchial asthma of physical effort. The disease develops against the background of physical activity, mainly after 5-10 minutes of movement/work. The attacks are especially intensified after working in cold air. It is accompanied mainly by a cough, which goes away on its own after 30-45 minutes.

Occupational asthma. The disease develops due to working in contaminated places, or when working with substances that have a strong chemical odor/vapor.

Nocturnal asthma. This form of asthma is only a definition of nocturnal attacks of the disease. At the moment, the causes of bronchial asthma at night are not fully understood. Among the hypotheses put forward are the supine position of the body, more active influence on the body of allergens at night.

Cough variant of asthma. Characterized by special clinical course diseases – present only. Other symptoms are absent or present, but minimally. The cough form of bronchial asthma is observed mainly in children. Symptoms usually worsen at night.

Diagnosis of bronchial asthma

Diagnosis of bronchial asthma includes following methods examinations and features:

Patient's history and complaints;
Physical examination;
Carrying out spirometry (respiratory function test) - FEV1 (forced expiratory volume in 1 second), PEF (peak expiratory flow), FVC (forced vital capacity);
Breath tests with bronchodilators;
Study for the presence of eosinophils, Charcot-Leyden crystals and Kurshman spirals in sputum (bronchial secretions) and blood;
Installation allergy status(skin, conjunctival, inhalation and nasal tests, determination of general and specific IgE, radioallergosorbent test);
(x-ray) of the chest;
Daily pH-metry if the reflux nature of bronchial asthma is suspected;
8 minute run test.

How to treat asthma? Treatment of bronchial asthma is a painstaking and lengthy work, which includes the following methods of therapy:

Drug treatment, which includes basic therapy aimed at supportive and anti-inflammatory treatment, as well as symptomatic therapy aimed at relieving the symptoms accompanying asthma;
Elimination of disease development factors (allergens, etc.) from the patient’s life;
Diet;
General strengthening of the body.

It is very important not to use only one when treating asthma. symptomatic remedies(short-term relief of the disease), for example, beta-adrenergic agonists (“Ventolina”, “Salbutamol”), because the body gets used to them, and over time the effectiveness of these drugs decreases, and sometimes is completely absent, while pathological processes continue to develop, and further treatment, as well as a positive prognosis for full recovery, become more complicated.

1. Drug treatment of asthma. Asthma medications

Basic therapy for bronchial asthma affects the mechanism of the disease, it allows you to control it. Basic therapy drugs include: glucocorticosteroids (including inhaled ones), cromones, leukotriene receptor antagonists and monoclonal antibodies.

Symptomatic therapy allows you to influence the smooth muscles of the bronchial tree, as well as relieve asthma attacks. Symptomatic therapy drugs include bronchodilators: β2-adrenergic agonists and xanthines.

Let's look at medications for bronchial asthma in more detail...

Basic therapy for bronchial asthma

Glucocorticosteroids. They are used in the treatment of mild and moderate asthma, as well as to prevent exacerbations of its course. This series of hormones helps to reduce the migration of eosinophilic and leukocyte cells into the bronchial system when an allergen enters it, which in turn leads to a reduction in pathological processes in the lumen of the bronchi and edema. In addition, glucocorticosteroids slow the progression of the disease. To minimize side effects, glucocorticosteroids are used as inhalation. During exacerbations of the disease, their use is not effective.

Glucocorticosteroids for asthma: “Akolat”, “Singulair”.

Leukotriene receptor antagonists (leukotrienes). They are used for all degrees of asthma severity, as well as in the treatment of chronic obstructive bronchitis. Effectiveness has been observed in the treatment of aspirin-induced bronchial asthma. The principle of action is to block the connection between cells that migrate into the bronchial tree when an allergen enters it and the mediators of these cells, which actually lead to a narrowing of the bronchial lumen. Thus, swelling and secretion production by the walls of the bronchial tree are stopped. The disadvantage of drugs from a number of leukotriene receptor antagonists is their lack of effectiveness in the treatment of isolated asthma, which is why they are often used in combination with hormonal drugs (glucocorticosteroids), which, by the way, increase the effectiveness of these drugs. Another disadvantage is the high price of these products.

Leukotriene receptor antagonists for asthma: zafirlukast (“Acolat”), montelukast (“Singulair”), pranlukast.

Cromons. They are used for stage 1 (intermittent) and stage 2 (mild) bronchial asthma. Gradually this group drugs are replaced by inhaled glucocorticosteroids (ICS), because the latter, with a minimum dosage, have better efficiency and ease of use.

Cromones for asthma: sodium cromoglycate (Intal), nedocromil sodium (Tyled).

Monoclonal antibodies. It is used in the treatment of stages 3 (moderate) and 4 (severe) bronchial asthma, and allergic asthma. The principle of action is the specific effect and blocking of certain cells and their mediators in the disease. The disadvantage is the age limit - from 12 years. It is not used during exacerbations of the disease.

Monoclonal antibodies for asthma: Xolair, Omalizumab.

Allergen-specific immunotherapy (ASIT). It is a traditional method of treating exogenous bronchial asthma in patients aged 5 to 50 years. ASIT is based on the transfer of the body's immune response to an allergen from the Th2 type to the Th1 type. At the same time, the allergic reaction is inhibited, and the hypersensitivity of the tissues of the bronchial lumen to the allergen is reduced. The essence of treatment using the ASIT method is the gradual introduction, at certain intervals, of a small dose of allergens. The dose is gradually increased, thereby developing the resistance of the immune system to possible allergic agents, for example, dust mites, often contained in house dust. Among the introduced allergens, the most popular are mites, tree pollen and fungi.

Symptomatic treatment of bronchial asthma

Short-acting β2-adrenergic agonists (beta-agonists). They are the most effective group of drugs (bronchodilators) to relieve exacerbations and attacks of bronchial asthma, without limitation age group patients. The fastest effect (from 30 to 120 minutes) and with fewer side effects is observed in inhalation form beta-agonists. Well protects against bronchospasms during physical activity.

Short-acting β2-adrenergic agonists for asthma: salbutamol (Ventolin, Salamol Steri-Neb), terbutaline (Bricanil), fenoterol (Berotec).

β2-adrenergic agonists (beta-agonists) long acting. They are used to relieve asthma attacks and exacerbations, as well as their frequency. When drugs based on the substance salmeterol are used to treat asthma with respiratory complications, cases of death have been observed. Formoterol-based drugs are safer.

Long-acting β2-adrenergic agonists for asthma: salmeterol (Serevent), formoterol (Oxis, Foradil), indacaterol.

Xanthines. They are used for emergency relief of asthma attacks, but mainly in cases where other drugs are not available, or to enhance the effectiveness of beta-agonists. However, β2-agonists are gradually replacing the xanthines that were previously used before them. The effectiveness of the simultaneous use of xanthines, for example drugs based on theophylline, together with ICS or SGCS has been noted. Xanthines are also used to eliminate daytime and nighttime asthma attacks, improve lung function, and reduce the dosage of hormones in severe asthma in children.

Xanthines for asthma: Teopec, Theotard, Theophylline, Euphylline.

Inhalers for bronchial asthma

Asthma inhalers are small (pocket) inhalers that can quickly deliver the active drug for asthma to the desired location in the respiratory system. Thus, the product begins to act on the body as quickly as possible, which in some cases allows minimizing acute attacks with all the consequences that come from the attack. Inhalers for asthma include the following:

Inhaled glucocorticosteroids (ICS): non-halogenated (budesonide (Benacort, Budenit Steri-Neb), ciclesonide (Alvesco), chlorinated (beclomethasone dipropionate (Bekotide, Beclazon Eco), mometasone furoate (Asmanex)), fluorinated ( azmocort, triamcenolone acetonide, flunisolide, fluticasone propionate).

b2-adrenergic agonists: short-acting (Ventolin, Salbutamol), long-acting (Berotek, Serevent).

Anticholinergics:"Atrovent", "Spiriva".

Cromons:"Intal", "Tailed".

Combined drugs:"Berodual", "Seretide", "Symbicort". They have a very fast effect that relieves attacks of bronchial asthma.

Other medications for the treatment of bronchial asthma

Expectorants. Helps reduce the viscosity of sputum, loosen mucus plugs, and remove sputum from the respiratory tract. Efficiency is noted through the use of expectorants through inhalation.

Expectorants: Ambroxol, Codelac Broncho.

Antibacterial agents (antibiotics). They are used when asthma is combined with infectious diseases of the respiratory system (sinusitis, tracheitis, bronchitis, pneumonia). Antibiotics are contraindicated for children under 5 years of age. Antibiotics are selected based on diagnosis, depending on the type of pathogen.

Among the antibiotics we can note: “”, “” (for mycoplasma infection), penicillin and cephalosporin (for).

2. Non-drug treatment of bronchial asthma

Addressing risk factors for asthma

Without a doubt, eliminating factors that contribute to the risk of developing, as well as exacerbating attacks of bronchial asthma, is one of the fundamental stages in the treatment of this disease. We have already discussed the risk factors for the development of bronchial asthma at the beginning of the article, in the paragraph “Causes of bronchial asthma,” so here we will only briefly list them.

Factors contributing to the development of asthma: dust (house and street), dust mites, plant pollen, nitrogen oxides (NO, NO2), sulfur oxides (SO2, O3), carbon monoxide(CO), atomic oxygen O, formaldehyde, phenol, benzopyrene, pet hair, smoke from tobacco and smoking mixtures (smoking, including passive), infectious diseases (,), some medications (“Aspirin” and others NSAIDs), dirty air conditioner filters, fumes from household chemicals (cleaning agents and detergents) and cosmetics(hairspray, perfume), working with building materials (gypsum, drywall, plaster, paint, varnishes), etc.

Speleotherapy and halotherapy

Speleotherapy– a method of treating asthma and other respiratory diseases, based on the patient’s long stay in a room that provides a microclimate of natural karst caves, in which there is air containing salts and other minerals that have a beneficial effect on the respiratory system.

Halotherapy– is actually an analogue of speleotherapy, the only difference is that halotherapy involves treatment only with “salty” air.

Some resorts, as well as some healthcare facilities, have special rooms that are completely lined with salt. Sessions in salt caves relieve inflammation of the mucous membranes, inactivate pathogens, enhance the production of hormones by the endocrine system, reduce the content of immunoglobulins (A, G, E) in the body and much more. All this leads to an increase in the period of remission, and also helps to reduce the dose of drug therapy for asthma.

Diet for bronchial asthma

A diet for asthma helps speed up the treatment process and also increases the positive prognosis for treating this disease. In addition, the diet allows you to exclude from the diet foods that are highly allergenic.

What not to eat if you have asthma: fish products, seafood, caviar, fatty meats (poultry, pork), smoked meats, fatty dishes, eggs, legumes, nuts, chocolate, honey, tomatoes, tomato-based sauces, yeast-based foods, citrus fruits (oranges, tangerines, pomelo , grapefruits), strawberries, raspberries, currants, apricots, peach, melon, alcohol.

What should be limited in use: bakery products from the highest grades of flour, baked goods, sugar and salt, dairy products (milk, sour cream, cottage cheese).

What can you eat if you have asthma: porridge (with butter), soups (unrich), chicken, low-fat sausages and sausage (doctor’s), Rye bread, bran bread, oatmeal or biscuits, vegetable and fruit salads, compotes, mineral water, tea, coffee (if it contains caffeine).

Diet– 4-5 times/day, without overeating. It is better to cook food by steaming, but you can also boil, stew, or bake. Eat only warm.

With minimal heat treatment, food loses the least amount of vitamins contained in food products, because many vitamins are destroyed when exposed to boiling water, or simply water. An excellent household appliance is a steamer, which takes into account many features dietary nutrition, not only for asthma, but also for many others.

Forecast

The prognosis for the treatment of bronchial asthma is positive, but largely depends on the degree at which the disease is detected, careful diagnosis, the patient’s accurate compliance with all the instructions of the attending physician, as well as restrictions on factors that can provoke attacks of this disease. The longer the patient self-medicates, the less favorable the treatment prognosis.

Important! Before using folk remedies for treating bronchial asthma, be sure to consult with your doctor.

Treating asthma with water (Dr. Batmanghelidj's method). The essence of the treatment is to drink water according to the following scheme: 2 glasses 30 minutes before meals, and 1 glass 2.5 hours after meals. In addition, you need to drink water throughout the day to quench your thirst. Water can be alternated, first salted (½ tsp. sea salt per 2 liters of water), then melted, boiled water cannot be used. Efficiency increases by placing a few crystals of sea salt under the tongue after drinking water, as well as with additional intake vitamin complexes. To relieve attacks, you can put a pinch of salt under your tongue and then drink a glass of water. During treatment, the consumption of alcoholic and caffeine-containing drinks is not allowed. Drug treatment is maintained.

Ginger. Grate about 4-5 cm of dried ginger root and pour it over cold water. Next, heat the mixture in a water bath until it begins to boil, then cover the mixture with a lid and simmer the product for about 20 minutes. Next, set the container with the product, with the lid tightly closed, aside, and let it sit until it cools down. You need to take a decoction of ginger root warmed, 100 ml before meals. It can also be added to tea.

For severe attacks, you can use ginger juice. To do this, you need to squeeze it out of fresh ginger root, add a pinch of salt to 30 g of juice, and drink the product. Before going to bed, a mixture of 1 tbsp also has a beneficial effect. spoons of ginger juice and honey, which can be washed down herbal tea or warm water.

Can be used as inhalation essential oil ginger

Oats. Sort and peel 500 g of oat grains, then wash them thoroughly and add to a boiling mixture of 2 liters of milk and 500 ml of water. Cover the pan with a lid and cook the product for 2 hours over low heat. After boiling, you should have about 2 liters of product left. Next, add 1 teaspoon and 1 teaspoon to 150 ml of broth butter. You need to drink the product on an empty stomach, hot. You can store the product in the refrigerator. The course of treatment is 1 year or more.

Salt lamp. As already written, a little earlier, in paragraph “ Non-drug treatment“bronchial asthma”, inhalation of salt air has proven itself in the fight against this disease. To do this, you can visit special salt caves. You can also install a salt lamp in the patient's room, which can be purchased at home improvement stores. If you have financial means, you can set up a salt room in your dacha; for this, you can search online for diagrams, as well as sellers of rock salt. Halotherapy helps not only treat asthma, but also many other diseases, and also generally strengthens the body.

Prevention of bronchial asthma includes the following recommendations:

— Try to choose for your place of residence, and, if possible, work, places with a clean ecological environment - away from industrial areas, construction sites, large cluster Vehicle;

— Stop smoking (including passive smoking), alcoholic beverages;

— Do wet cleaning in your home and workplace at least 2 times a week;

— Remember, the biggest collectors of dust, and then breeding grounds for pathogenic microflora, are natural carpets, duvets and pillows, air conditioner and vacuum cleaner filters, and upholstered furniture fillers. If possible, change bedding to synthetic ones, reduce the amount of carpeting in the house, and do not forget to periodically clean the air conditioner and vacuum cleaner filters.

— If a large amount of dust often collects in the house, install an air purifier;

— Ventilate the room in which you live/work more often;

— Do you have a favorite pet at home? Cat, dog, rabbit or chinchilla? Great! But don't forget to take care of them. It is better to comb out the faded fur yourself rather than have your pet do it all over the apartment;

- Don't let things happen respiratory diseases;

— Take medications only after consulting a doctor;

- Move more, toughen up;

— Place a salt lamp in your home, it is both useful and an excellent piece of furniture;

— Try to relax at least once a year in environmentally friendly places - at the sea, in the mountains, in forests.

Which doctor should I consult for bronchial asthma?

Video about bronchial asthma

Asthma is a very serious disease of immuno-allergic origin, which develops as a result of non-infectious inflammation in the respiratory system(the so-called “bronchial tree”). Bronchial asthma is characterized by a chronic progressive course with periodic attacks, in which bronchial obstruction and suffocation develop.

Pathology appears as a result of a combination of a number of endo- and exogenous factors. Among external factors– psycho-emotional stress, excessive physical activity, unfavorable climate, as well as exposure to chemical irritants and allergens. TO internal factors include disorders of the immune and endocrine systems, as well as bronchial hyperreactivity.

Many patients have a family predisposition to the disease.

Nowadays, bronchial asthma in adults and children, unfortunately, is quite common, and it is extremely difficult to cure this disease completely.

The inflammatory process that develops in the bronchial tree during asthma is characterized by high specificity. The cause of the pathological process is the effect of the allergic component in combination with immune disorders, which causes the paroxysmal course of the disease.

Note: every third person suffering from asthma has a family history. At hereditary predisposition elements that provoke attacks of suffocation are very difficult to trace; the disease is atopic in nature.

In addition to the main (allergic) component, there is whole line additional factors that determine the course of the disease and the frequency of asthma attacks.

These include:

increased reactivity of the smooth muscle elements of the walls of the bronchial tree, leading to spasm with any irritation;
exogenous factors that cause a massive release of mediators of allergy and inflammation, but do not lead to a general allergic reaction;
swelling of the bronchial mucosa, worsening airway patency;
insufficient formation of mucous bronchial secretions (cough in asthma is usually unproductive);
predominant damage to small-diameter bronchi;
changes in lung tissue caused by hypoventilation.

Important:One of the leading factors leading to asthma is ordinary house dust. It contains a large number of microscopic mites, the chitin of which is a powerful allergen.

Stages and forms of bronchial asthma

It is customary to distinguish 4 stages of asthma development:

intermittent (characterized by a relatively mild course);
mild persistence (moderate);
moderate persistence (severe course);
severe persistence (extremely severe form).

On early stages attacks develop relatively rarely and can be quickly stopped. As the exacerbation progresses, people become less sensitive to drug therapy.

According to etiology (origin), the following forms are distinguished:

exogenous (asthma attacks are provoked by contact with an allergen);
endogenous (attacks are triggered by infection, hypothermia or stress);
asthma of mixed origin.

The following clinical and pathogenetic forms are considered special forms:

aspirin (due to the intake of salicylates);
reflux-induced (against the background of gastroesophageal “reverse reflux”);
night;
professional;
physical exertion asthma.

Atopic (allergic) bronchial asthma– this is the most common form of pathology, caused by the increased sensitivity of the respiratory system to various kinds allergens. Defensive reaction immune system provokes a sharp spastic contraction of the muscular elements of the bronchi, i.e. bronchospasm develops. Atopic asthma is a separately considered variant of the exogenous form. The leading role in its pathogenesis is played by a genetic predisposition to allergies.

Symptoms of bronchial asthma

Choking or shortness of breath at rest or with exertion. The appearance of such symptoms can be caused by inhalation of plant pollen, sudden changes in ambient temperature, etc. Important distinctive feature asthma attacks at an early stage of the disease is the suddenness of their development.
Shallow breathing of the expiratory type (with prolonged exhalation). Patients are concerned that they cannot exhale completely.
Dry hacking cough that develops in parallel with shortness of breath. It takes a long time to clear the throat; only at the end of the attack is the discharge of a small volume of mucous bronchial secretion (sputum) noted.
Dry wheezing when breathing. In some cases, they can be detected at a distance, but are better heard during auscultation.
Orthopnea– a characteristic forced posture that facilitates the process of exhalation. The patient has to take sitting position with your legs down and holding onto the support with your hands.

Important:testify about pathological increase Bronchial reactivity can only occur with some of the signs mentioned above. As a rule, at first the attacks are short-lived and do not develop again for a long time. In this case we're talking about about the "period imaginary well-being" Gradually, the symptoms will become more pronounced and occur frequently. Seeing a doctor early when the first signs appear is the key to the effectiveness of therapy.

In the early stages, clinical manifestations are not accompanied by general disorders, but as the disease progresses, they will certainly develop.

In this case, the following concomitant bronchial asthma is distinguished: characteristic symptoms:

and dizziness. Symptoms may occur with moderate bronchial asthma and indicate the presence of respiratory failure;
general weakness. If a person suffering from bronchial asthma tries to perform active movements during an attack, the lack of air increases. With a mild course between attacks, patients normally tolerate adequate physical activity;
rapid heartbeat (tachycardia) noted during an attack. Heart rate – up to 120-130 per minute. In patients with moderate to severe asthma, slight tachycardia (up to 90 beats/min) also occurs between attacks;
blue extremities (acrocyanosis) and diffuse cyanosis skin . The appearance of this clinical sign due to pronounced increasing respiratory failure and indicates a severe form of asthma;
characteristic change in the shape of the terminal phalanges of the fingers (« Drumsticks") and nail plates ("watch glasses");
emphysema symptoms. Changes are characteristic of a long and (or) severe course of the disease. The patient's chest width increases and the supraclavicular areas protrude. When percussing, an expansion of the boundaries of the lungs is determined, and when listening, a weakening of breathing is determined;
symptoms of cor pulmonale. At severe course asthma develops a stable increase in pressure in the pulmonary circulation, which leads to an enlargement of the right ventricle and atrium. Auscultation in the projection of the pulmonary valve can reveal an accent of the second tone;
tendency to allergic reactions and diseases of allergic origin.

Important:Status asthmaticus is a prolonged suffocation that is not relieved by traditional drug therapy. The condition is accompanied by impaired consciousness, up to complete loss. Status asthmaticus can be fatal.

Diagnosis of asthma

The diagnosis of bronchial asthma is made based on the presence of symptoms characteristic of this disease. It may be somewhat difficult differential diagnosis asthma with chronic The latter is characterized by alternating phases of exacerbation (lasting 2-3 weeks) and remission.

Asthma is characterized by sudden attacks of varying duration (from several minutes to several hours), between which the patient regains normal health. Sudden night attacks at rest are not typical for bronchitis. Shortness of breath is a “classic” symptom of an asthma attack, regardless of the severity, and with bronchitis it develops only with a long-term obstructive form or a very severe exacerbation.

Cough accompanies bronchitis both during exacerbation and during remission, and in asthmatics this symptom occurs only directly during an attack. An increase in body temperature often accompanies an exacerbation of bronchitis, but hyperthermia is not typical for asthma.

Note: differential diagnosis is important initial stages chronic bronchitis and bronchial asthma. The prolonged course of both pathologies inevitably leads to similar changes in the respiratory system - bronchial obstruction.

Treatment of bronchial asthma

Treatment of bronchial asthma is carried out in stages. Each stage of development requires adjustments to the plan therapeutic activities. To assess the dynamics of asthma and the degree of control of the disease, a peak flow meter should be used.

The main medicines used to treat asthma, there are a number of side effects. The occurrence of undesirable effects can be minimized by using the most rational combinations drugs.

Basic (main) therapy involves supportive treatment aimed at reducing the inflammatory response. Symptomatic therapy is measures taken to relieve attacks.

Experts note that the prescription of hormonal drugs (glucocorticosteroids) makes it possible to control pathological process. Medicines in this group not only relieve symptoms during an attack, but are also able to influence the main links in pathogenesis, blocking the release of mediators of allergy and inflammation. Rational hormonal therapy, started as early as possible, significantly slows down the development of asthma.

The main groups of drugs used to treat bronchial asthma:

glucocorticosteroids. These drugs are prescribed for mild to moderate compensated course of the process. IN in case of emergency in tablets they are ineffective, but inhalations with these pharmacological drugs help to relieve the patient’s asthmatic status;
leukotriene antagonists (prescribed for bronchial obstruction);
methylxanthines. For basic therapy, tablet forms are used, and to relieve attacks, injections are required (Eufillin in high dosages);
monoclonal antibodies. Injections are indicated when allergic component. They are not used to relieve attacks;
Cromons Inhalations of drugs in this group are indicated for basic treatment light forms. The attack is not relieved;
b2-adrenergic agonists. Long-acting inhalers are used for maintenance treatment, and short-acting drugs (Salbutamol, Ventolin) are used to relieve an attack;
anticholinergics. In special inhalers are indicated for emergency assistance with bronchial asthma during an attack.

Combined inhalation agents can be prescribed both for emergency care (Symbicort) and for regular use (Seretide, Berodual).

Bronchial asthma in children

In children, it is not always possible to make a diagnosis on time, since bronchial asthma often manifests itself with the same symptoms as. It is characteristic that with asthma the temperature does not rise, and the so-called. "harbingers".
Premonitory symptoms:

restless behavior of the baby 1-2 days before the attack;
mucous-watery discharge from the nose in the morning immediately after waking up;
frequent sneezing;
a few hours later - a mild dry cough.

An attack in children usually develops before going to bed or immediately after waking up. The intensity of the cough is reduced if the child is seated or vertical position. Breathing becomes intermittent with shortened, frequent breaths.

Note:Children over 1 year of age may experience such atypical symptoms such as watery eyes, itchy skin and rashes.

Boys are more likely to suffer from bronchial asthma in childhood, since the diameter of the bronchial tubes in them is narrower than in girls.

Obesity in children increases the risk of developing asthma because the diaphragm is higher and ventilation is difficult.

Modern medications do not completely cure bronchial asthma in children, but the drugs help relieve an attack and minimize allergic and inflammatory reaction. The specificity of the therapy is that it is indicated as the main method of administering medicinal substances.

Bronchial asthma in children is described in detail in this video review:

Asthma during pregnancy

During pregnancy, an asthma attack not only negatively affects a woman’s body, but can also cause hypoxia (oxygen starvation) of the fetus.

Disease control minimizes possible risk for the unborn child. Basic therapy should not be interrupted. Of course, we cannot refuse the funds necessary for emergency care for bronchial asthma. Loss of control threatens preeclampsia (with damage to the placenta), hypermesis (pronounced toxicosis), complications during childbirth and premature birth. Delay possible intrauterine development fetus

Most drugs used to treat this disease are practically safe for the fetus.

Note:The safest hormonal (corticosteroid) drug for inhalation is Budesonide.

In the second half of pregnancy, asthma may become more severe. The expectant mother needs constant monitoring of her pulmonary function. In severe cases, after the 32nd week of pregnancy, an ultrasound of the fetus is required.

Prevention of bronchial asthma

Unfortunately, currently not sufficiently developed effective measures for the prevention of bronchial asthma. Persons with a hereditary predisposition may be advised to minimize contact with allergenic substances,, if possible, avoid hypothermia and pay increased attention to changes in well-being.

It is recommended to breastfeed children until at least 1 year of age. If it is necessary to transfer the baby to artificial feeding mixtures should be selected after consulting with a pediatrician. It is not advisable to have pets if there is a small child in the house. Even an aquarium should not be kept, since dry food is a powerful allergen. Use pillows, blankets and mattresses only with hypoallergenic padding.

Hardening and balanced nutrition will help strengthen protective forces body, which will reduce the likelihood of an inadequate immune response.

Experts talk about the problem of increasing the number of patients with bronchial asthma and methods of diagnosis and prevention of this disease:

Konev Alexander, therapist

Bronchial asthma is a disease in which the excitability and reactivity of the bronchi increases, which leads to their swelling and spasm, resulting in difficulty breathing. Attacks of suffocation often develop at night or in the early morning hours and begin with a painful cough with phlegm difficult to clear. Shortness of breath appears, which is characterized by difficulty in exhaling. A variety of dry and moist rales are heard in the lungs. The patient's lips turn blue, he takes a forced position, trying to alleviate his condition, auxiliary muscles are involved in inhalation. These symptoms characterize a full-blown attack of bronchial asthma.

Causes of asthma:

The predominant form of bronchial asthma in children is atopic asthma. Allergens most often include house dust, plant pollen, and animal fur.
In some cases, bronchial asthma is accompanied by food allergies, especially in children of the first years of life. Many patients do not tolerate low temperatures, household chemicals And tobacco smoke. Besides, viral diseases sharply increase the sensitivity of the bronchi to various irritants. Hereditary predisposition plays a certain role in the development of the disease.

How to help a child?

Ventilate the rooms more often, make sure that there are no wet spots in the room, since mold spores and various fungi are also irritants. Encourage your child to engage in moderate exercise to help him grow strong, stay fit, and resist stress. It is necessary for the child to adhere to healthy diet, and also did not consume foods that most often cause allergies.
For example, nuts, wheat, dairy products. Don't expose your child to stress: emotional distress can make symptoms worse.

Don't smoke around your baby because even if your baby doesn't have asthma symptoms, they may appear when one or both parents smoke. Keeping animals or birds in the house can worsen asthma symptoms. Don't let your home become a haven for dust mites. Do wet cleaning and vacuuming at least 2 times a week. Wash your baby's bedding and stuffed animals frequently. Beat out carpets and wash curtains, which are also very often a haven for flares.

Symptoms of bronchial asthma and how is the diagnosis made?

If you suspect asthma, pay attention to following symptoms:
Coughing during sleep or after physical activity.
Rheezing in the lungs, wheezing, difficulty breathing.
Shortness of breath after playing sports.
Complaints of tightness in the chest, lack of air.

Acute respiratory diseases (for example, bronchitis) can be accompanied by wheezing and even difficulty breathing, so it is sometimes difficult to make a correct diagnosis.

The doctor will need some time to examine and make a diagnosis. During this period, you may be asked to record any symptoms your baby experiences and monitor their progress. It will be necessary to indicate what in this or that case was a provocation for their occurrence.

During an attack clinical picture looks very characteristic. To identify significant allergens in the interictal period, do skin tests or determine specific antibodies (Ig E) in a blood test.

Treatment of bronchial asthma in children:

During an attack, it is necessary to relieve the narrowing of the bronchi as quickly as possible and alleviate the patient’s condition. In the interictal period, therapy is carried out to reduce the allergic mood of the body. If your child has been diagnosed with bronchial asthma, you need to try to determine what substances cause an allergic reaction in him and limit as much as possible, and if possible, completely eliminate contact with them.

Must be followed carefully medical appointments and try to cure possible foci of infection that exist in the baby’s body - primarily in the nasopharynx. You will have to wait with preventive vaccinations during an exacerbation period.

Preparations:

The doctor will prescribe medications for your child to use during an attack and will also prescribe a course of treatment between attacks. To relieve an attack of bronchial asthma, pharmaceuticals that relieve spasms are used smooth muscle bronchi and bring quick relief to the patient. The most commonly used are fenoterol (Berotec), salbutamol (Ventolin), and ipratropium bromide (Atrovent).

The list of drugs for the treatment of bronchial asthma in children is very extensive and the drug should be selected based on individual reaction child. In the presence of infectious process Antibiotics to which the patient does not have an allergic reaction are prescribed for the shortest possible course.

To prevent attacks, treatment with sodium cromoglycate (Intal) or nedocromil (Tyled) is indicated. They are used in the form of inhalations for a course of 1 to 2-4 months. These drugs prevent the implementation of allergic reactions in the tissues of the bronchi, thereby reducing their reactivity. In the youngest patients, it is possible to use ketotifen tablets. In severe cases, inhaled hormone therapy is indicated. Regular physical therapy exercises are very important. correct routine days with maximum exposure to fresh air.

Anti-asthmatic drugs:

Antiasthmatic drugs are often used in the form of inhalations. So remedy immediately reaches the bronchi.
Children sometimes find it difficult to use the inhaler (to synchronize inhalation with pressing). In this case, a special device is used - a spacer. This is a large plastic container. On one side it has a mouthpiece, which the child takes into his mouth, and on the other side there is a hole for an inhaler. You press the inhaler button once, the medicine is injected into the container, after which the child inhales it from the spacer at least 10 times.

The most effective, especially in children of the first years of life, is nebulizer therapy. A nebulizer is a special spray device that creates very small suspended particles, allowing them to penetrate most deeply into the bronchial tree. Inhalation medicinal mixture- through a mask or through a mouthpiece (in children over 3 years old).

An attack of bronchial asthma in children - help:

During an asthma attack, symptoms increase dramatically. The severity of an asthma attack in children varies, and the scope of treatment depends on this. In any case, parents should remain calm and provide moral support to the child.

It is good if the child is trained in biological methods feedback(BFB) and volitional breathing control (VBC), he can use these methods to relieve an attack. Give your child the medicine recommended by your doctor to relieve seizures. The patient should sit upright and breathe regularly and calmly. The drug begins to act within 3-8 minutes. If relief does not occur during this time, and your child is very scared or tired, call an ambulance.