What you need to diagnose asthma in a child. Is the diagnosis final and not subject to appeal? Eliminate Risk Factors for Asthma

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

Cough and oxygen starvation

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

symptoms of which are bouts of shortness of breath, coughing, and sometimes suffocation.

But in children, this disease proceeds somewhat differently than in adults.

The 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 asthma attack. Clinically, we see a paroxysmal cough. The child coughs constantly - day, evening, night. In addition to problems with the lungs, bronchial asthma also negatively affects other internal organs.

- It happens that when a teenager is brought to an appointment with an allergist, it turns out that he has been suffering from bronchial asthma for three, five, or even seven years. First of all, the central nervous system, the heart suffers from chronic hypoxia, since these organs have a very high need for oxygen. The child may lag behind in development, in 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 has acute respiratory infections with obstructive syndrome more than three times a year, he has allergies in his family, and atopic dermatitis was observed at an early age, 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 from contact with it. To identify the allergen, all kinds of diagnostics are used - these are samples, a blood test 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 the animal is an allergen for a particular child. If you suspect an allergy, it is initially wrong to remove all animals from the house, - the allergist-immunologist believes. — There is an interesting theory that finds its confirmation in clinical studies. It turns out that the earlier the child begins to contact with animals, the faster he becomes sensitive to allergens, and in the future the child's body does not react to them.

Sometimes, on the contrary, the treatment does not bring positive results, because the parents “forgot” to mention that they keep two fluffy cats of a rare breed at home. Before getting a pet or trying to get rid of it, I would advise you to find out if the child is allergic to it or not.

The boy grew up and ... got better?

If the diagnosis is confirmed, it must be understood that bronchial asthma is a chronic disease. It is impossible to completely recover from it, but it is quite possible to transfer the disease into remission, which can last a lifetime, Olga Tarbaeva believes.

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

“Children's organism gratefully perceives the treatment, it can rebuild,” Olga Leonidovna is convinced. - Many of my patients - asthmatic guys - go in for professional sports, some even competed at world championships. This once again proves that bronchial asthma is not a sentence.

In addition, according to the specialist, there is a mild form of bronchial asthma. In young children, especially in the Far North, the provoking factor for its appearance is a cold - a 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. When a boy grows, the production of the hormone testosterone increases, which reduces allergic inflammation, explains Olga Tarbaeva. - But you can’t rely only on the fact that the boy will “outgrow”. It is necessary to take certain measures to remove allergic inflammation and restore the structure of the lungs.

In addition to drug therapy, there are additional treatments that are also very important. These are sports, if the doctor allows.

“Sports for bronchial asthma is a method of treatment,” emphasizes the allergist-immunologist. - If the child is ready for increased physical activity, you need to start training his lungs. Any sport that stresses the respiratory system is good for a child with asthma. Spa treatment will also bring great benefits. An integrated approach is important here. This is climatotherapy, when we take a child from the Far North, this is swimming, breathing exercises, and massage. Together, this gives a very good effect.

"Likbez" for parents

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

- Treatment for bronchial asthma is long and specific. And both the child himself and all family members should participate in it, Olga Tarbaeva believes. - First, you should not hide his diagnosis from the child. Knowing him, the child should listen to himself, tell adults - parents, teachers, when and why he became ill. He needs to know what medications he is taking. For more effective treatment, feedback is needed between the doctor, the little patient and his parents. It is impossible to consult “for all occasions” within the framework of one medical appointment.

To do this, the FlamingoMed Family Medicine Clinic holds asthma schools for parents of young patients, for adolescents who are ready to receive information on how to live with this diagnosis. I have been teaching asthma schools for 14 years. Such an "educational program" 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 refers to the increased sensitivity of the bronchi to the effects of allergens. Most often, these are household and industrial dust, fungal spores, plant pollen, pet hair particles, microorganisms, food allergens, etc. At present, an increase in cases of bronchial asthma in the EU countries has been proven due to the frequent use of synthetic detergents.

Last but not least is heredity. It has been proven that in the presence of atopic (exogenous, allergic) only in one parent, the probability of a disease 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, edema and bronchospasm occur. Clinically, we see a typical asthma attack, which is expressed in the difficulty of exhalation. The breath of an asthmatic is wheezing, the face becomes bluish, there is swelling of the veins of the neck, etc. During auscultation, the doctor listens to a large number of dry rales. They are often well heard by the ear and resemble a combination of different pitches of the sounds of an accordion playing. The duration of the attack is different. Typical lasts 1/2-1 hour. After shortness of breath decreases, coughing begins and a small amount of vitreous viscous sputum is separated.

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

Diagnosis of bronchial asthma

The diagnosis of bronchial asthma is made mainly on the basis of the patient's complaints, 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), Kurschman spirals (representing the interweaving of small bronchi),

After the very first serious attack, recorded by the ambulance doctors, the person ends up in a specialized hospital or pulmonology department. This is where the main diagnosis comes in. The primary diagnosis of bronchial asthma cannot be made at once at the appointment of a local therapist or even a pulmonologist at a polyclinic. 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 deeper methods of examination. Bronchial reactivity is being studied. It includes determining the function of external respiration with pharmacological tests using histamine or bronchodilators. In most patients, skin prick tests can identify the precipitating factor.

Is the diagnosis 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, they are not accepted to serve in the army, the police, etc. Moreover, patients with bronchial asthma cannot undergo some physiotherapy, 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, receives medicines almost daily, then the question of how to remove the diagnosis of bronchial asthma is not in principle. In a number of cases (although very rarely), bronchial asthma was exposed to 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 of attacks there are no more - the diagnosis is incorrect.

Often the diagnosis of bronchial asthma is removed in old age, because. Previously, he exhibited almost exclusively on the basis of the clinic. In this case, people most often have a clinic similar to asthma. In a more modern survey, it is currently not confirmed.

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

How to remove the diagnosis of bronchial asthma? Method one

For starters, you should simply contact the clinic at the place of residence. If there is a pulmonologist there, then immediately go to him, and if there is no specialist, then to the therapist. Depending on the capabilities of the clinic, a number of examinations can be done at the place of residence.

Upon receipt of specific results of the examination, the specialist makes a conclusion about the confirmation of the diagnosis of asthma. In case of doubtful results of tests and examinations, the pulmonologist offers hospitalization in a hospital. This is where the need for further investigation will be decided. You should warn 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 careful as possible and listen to honey. staff. The results of the study of the function of external respiration can be misinterpreted if the patient before the examination, during the examination, behaved inattentively and did not listen to the doctor's recommendations.

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

We make a diagnosis. Option two

Many advise "get rid" of the diagnosis of bronchial asthma in a cardinal 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 filing 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, indeed, everything will be fine if the doctor has never seen you and generally works on the first day. In most cases, there is always a question about the availability of previous medical records. You still have to provide some information about yourself. In the case of passing medical commissions, such a scheme is practically unacceptable. When you are employed, especially in hazardous industries, you will be required to undergo a series of additional examinations in which certain deviations will be revealed. Again, exhausting tests and visits to specialists will follow until a diagnosis is established.

The third way to remove the diagnosis

Some believe that one of the simplest options is a financial solution to the issue, and if it is simpler, then a bribe. Of the positive aspects - no burden of examinations. What about the negative ones? If in the case of the loss of an outpatient card, you can get off with a “light fright” and a quarrel with the doctor, then even an attempt to give a bribe is already a criminal liability. In addition, no one will give you a guarantee that during the passage of repeated commissions, the diagnosis of bronchial asthma will not be established later.

Which scheme to choose is up to you. Naturally, it is worth remembering that bronchial asthma is a fairly serious disease that requires constant monitoring by a specialist, correction of treatment, adherence to a certain lifestyle,. Is it worth removing the diagnosis for the sake of employment, and then being left without qualified medical care and supervision? In some cases, this can lead to aggravation of the disease and even. If nothing really bothers you, then go in the most correct and official way: undergo the 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 the Bryansk State University named after Academician I. G. Petrovsky and now writes news sections in several local medical newspapers.

Asthma- diseases of the respiratory system 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, the main signs of which are attacks of shortness of breath, coughing, and sometimes suffocation.

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

The symptoms of bronchial asthma are manifested as a result of the negative impact on the cells and cellular elements (eosinophils, mast cells, macrophages, dendritic cells, T-lymphocytes, etc.) of the body of the respiratory tract of 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 in them, which subsequently disrupts normal air exchange, and the main clinical manifestations appear - wheezing, coughing, feeling chest congestion, shortness of breath, difficulty breathing, etc.

Asthma attacks are most often activated at night and in the early morning.

The cause of bronchial asthma is a combination of external and internal factors. External factors - allergens (house dust, gas, chemical fumes, odors, dry air, stress, etc.). Internal factors - disturbances in the functioning of the immune, endocrine and respiratory systems, 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 is from 4 to 10% of the population on Earth. The highest percentage of which are residents of the UK, New Zealand, Cuba, which is primarily due to the local flora, as well as the high concentration of allergens carried to these territories by ocean air masses. On the territory of Russia, the percentage of morbidity in adults is up to 7%, in children - up to 10%.

An increase in the incidence of asthma has been observed since the mid-1980s. Among the reasons, there is a deterioration in the environmental situation - air pollution with oil 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. Nevertheless, 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, plant pollen, dust mites and their excrement. All of these dust particles, especially dust mites, are known allergens that, when they enter the bronchial tree, provoke attacks of bronchial asthma.

Bad environmental situation. 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 was noted among workers in the chemical industry, craftsmen working with building materials (especially plaster, drywall, paint, varnish), workers in poorly ventilated and polluted premises (offices, warehouses), masters of beauty salons (working with nails, painting hair).

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

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

Respiratory diseases. Diseases such as chronic bronchitis, as well as their causative agents - infection, contribute to the development of inflammatory processes in the mucous membranes and disruption of the smooth muscle components of the respiratory system, 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 drugs from a number of non-steroidal anti-inflammatory drugs (NSAIDs) are noted among such drugs.

Stress. Frequent stressful situations, as well as the inability to overcome and adequately respond to various problems lead to. Stress contributes to the weakening of the immune system, which makes it harder for the body to cope with allergens and other pathological factors that can lead to the development of bronchial asthma.

Food. It is noted that with good nutrition, mainly food of 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. Food additives can also trigger asthma attacks, such as sulfites, which are preservatives used by many manufacturers in wine and beer.

Internal causes of bronchial asthma

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

Disorders in the autonomic nervous system (ANS), immune and endocrine systems.

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 usually get worse at night and early in the morning.

The first signs of bronchial asthma

Shortness of breath, especially after exercise;
, 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, 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 seek medical help, because. even if the symptoms of the disease either appear or disappear on their own, each time, this can lead to a complex chronic course with exacerbations. In addition, timely assistance will warn against pathological changes in the respiratory tract, which are sometimes almost impossible to turn into a completely healthy state.

The main symptoms of bronchial asthma

, malaise;
Violation of the rhythm of the heart () - the pulse during the illness is in the range of up to 90 beats / min., And during an attack, it increases to 130 beats / min .;
Wheezing on respiration, whistling;
Feeling of congestion in the chest, suffocation;
Pain in the lower part of the chest (with prolonged attacks)

Symptoms in severe disease

Acrocyanosis and diffuse cyanosis of the skin;
Enlargement of the heart;
Signs of emphysema - an increase in the chest, weakening of breathing;
Pathological changes in the structure of the nail plate - the nails crack;
Drowsiness
The development of secondary diseases -,.

Bronchial asthma is classified as follows:

By etiology:

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

By severity

Each of the degrees has its own characteristics.

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

Stage 2: Mild persistent asthma. Attacks of the disease occur more than 1 time per week, but not more than 1 time per day. Night attacks - 2-3 per month. Exacerbations were revealed more clearly - the patient's sleep is disturbed, physical activity is inhibited. FEV1 or PSV, as in the first degree - more than 80%. The spread of PSV is from 20 to 30%.

Stage 3: Moderately persistent asthma. The patient is haunted by almost daily bouts of illness. Nocturnal seizures are also observed more than 1 per week. The patient has disturbed sleep, physical activity. FEV1 or PSV - 60-80% of normal breathing, spread of PSV - 30% or more.

Stage 4: Severe persistent asthma. The patient is haunted by daily asthma attacks, several nightly attacks a week. Physical activity is limited, accompanied by insomnia. FEV1 or PSV - about 60% of normal breathing, the spread of PSV - 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 consider 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 ingestion of the contents of the stomach into the respiratory tract (lumen of the bronchial tree). In addition to asthma, the inhalation of acidic stomach contents sometimes leads to the development of diseases such as bronchitis, pneumonia, pulmonary fibrosis, and sleep apnea.

Aspirin bronchial asthma. The disease develops against the background of taking drugs such as Aspirin, as well as other drugs from a number of 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. Especially attacks are activated after work in cold air. It is mainly accompanied by a cough, which passes on its own in 30-45 minutes.

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

Nocturnal asthma. This form of asthma is only the 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 - the recumbent position of the body, a more active effect on the body of allergens at night.

Cough variant of asthma. It is characterized by a special clinical course of the disease - only present. 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 the following examination methods and features:

History and complaints of the patient;
Physical examination;
Conducting spirometry (examination of the function of external respiration) - FEV1 (forced expiratory volume in 1 second), PSV (peak expiratory flow rate), FVC (forced vital capacity of the lungs);
Breath tests with bronchodilators;
Examination for the presence in sputum (bronchial secretion) and blood of eosinophils, Charcot-Leiden crystals and Kurshman spirals;
Setting the allergological status (skin, conjunctival, inhalation and nasal tests, determination of general and specific IgE, radioallergosorbent test);
(x-ray) of the chest;
Daily pH-metry in case of suspected reflux nature of bronchial asthma;
8 minute run test.

How to treat asthma? The treatment of bronchial asthma is painstaking and lengthy work, which includes the following therapies:

Drug treatment, including basic therapy aimed at supporting and anti-inflammatory treatment, as well as symptomatic therapy aimed at stopping the symptoms accompanying asthma;
Exclusion from the patient's life of factors for the development of the disease (allergens, etc.);
Diet
General strengthening of the body.

It is very important in the treatment of asthma not to use only symptomatic agents (short-term relief of the course of the disease), for example, beta-adrenergic agonists (Ventolina, Salbutamol), because. the body gets used to them, and over time, the effectiveness of these funds is reduced, and sometimes even absent, while the pathological processes continue to develop, and further treatment, as well as a positive prognosis for complete recovery, become more complicated.

1. Drug treatment of asthma. Asthma medications

Basic therapy of bronchial asthma affects the mechanism of the disease, it allows you to control it. Basic therapy drugs include: glucocorticosteroids (including inhaled), 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 drugs include bronchodilators: β2-agonists and xanthines.

Consider asthma medications in more detail ...

Basic therapy of bronchial asthma

Glucocorticosteroids. They are used in the treatment of mild and moderate asthma, as well as the prevention of 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 decrease in pathological processes in the lumen of the bronchi and edema. In addition, glucocorticosteroids slow down the development of the disease. To minimize side effects, glucocorticosteroids are used as inhalation. With exacerbations of the disease, they do not find effectiveness in their application.

Glucocorticosteroids for asthma: "Acolat", "Singular".

Antagonists of leukotriene receptors (leukotrienes). They are used for all degrees of severity of asthma, as well as in the treatment of chronic obstructive bronchitis. Efficacy in the treatment of aspirin bronchial asthma has been noted. 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, puffiness and secretion production by the walls of the bronchial tree are stopped. The disadvantage of drugs from a number of leukotriene receptor antagonists is the lack of their 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. Also, the disadvantage is the high price of these funds.

Leukotriene receptor antagonists in asthma: zafirlukast (Acolat), montelukast (Singulair), pranlukast.

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

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

monoclonal antibodies. It is used in the treatment of 3 (medium) and 4 (severe) stages of bronchial asthma, with allergic asthma. The principle of action lies in the specific impact and blocking of certain cells and their mediators in the event of a disease. The disadvantage is the age limit - from 12 years. With exacerbations of the disease is not used.

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 the allergen from the Th2 type to the Th1 type. At the same time, the allergic reaction is inhibited, the hypersensitivity of the tissues of the bronchial lumen to the allergen decreases. The essence of ASIT treatment is the gradual introduction of a small dose of allergens at certain intervals. The dose is gradually increased, thereby developing the resistance of the immune system to possible allergic agents, for example, dust mites, often found in house dust. Among the introduced allergens, the most popular are mites, tree pollen and fungi.

Symptomatic therapy of bronchial asthma

β2-adrenergic agonists (beta-agonists) short-acting. They are the most effective group of drugs (bronchodilators) for relieving exacerbations and attacks of bronchial asthma, and without limiting the age group of patients. The fastest effect (from 30 to 120 minutes) and with fewer side effects is observed in the inhaled form of beta-agonists. Well protects against bronchospasm against the background of physical activity.

Short-acting β2-agonists in asthma: salbutamol (Ventolin, Salamol Steri-Neb), terbutaline (Brikanil), fenoterol (Berotek).

β2-agonists (beta-agonists) long-acting. Used to relieve asthma attacks and exacerbations, as well as their frequency. When using drugs based on the substance salmeterol, for the treatment of asthma with respiratory complications, there have been cases of death. More safe are preparations based on formoterol.

Long-acting β2-agonists in asthma: salmeterol (Serevent), formoterol (Oxys, 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 xanthines, which 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 hormone dosage in severe asthma in children.

Xanthines for asthma: "Teopek", "Teotard", "Theophylline", "Eufillin".

Inhalers for bronchial asthma

Asthma inhalers are small (pocket) inhalers that can quickly deliver the active asthma drug to the right place in the respiratory system. Thus, the agent 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 an attack. Among the inhalers for asthma, the following remedies can be distinguished:

Inhaled glucocorticosteroids (IGCS): non-halogenated (budesonide ("Benacort", "Budenit Steri-Neb"), ciclesonide ("Alvesco")), chlorinated (beclomethasone dipropionate ("Becotid", "Beclason Eco"), mometasone furoate ("Asmanex")), fluorinated ( Azmocort, triamcenolone acetonide, flunisolide, fluticasone propionate).

b2-agonists: short action ("Ventolin", "Salbutamol"), long action ("Berotek", "Serevent").

Anticholinergics: Atrovent, Spiriva.

Cromons:"Intal", "Tayled".

Combined drugs: Berodual, Seretide, Symbicort. They have a very fast stopping asthma attacks effect.

Other medicines for the treatment of bronchial asthma

Expectorants. They help to reduce the viscosity of sputum, loosen mucous plugs, and also 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). Children under 5 years of age should not take antibiotics. Antibiotics are selected based on the diagnosis, depending on the type of pathogen.

Among the antibiotics can be noted: "", "" (with mycoplasmal infection), penicillin and cephalosporin (with).

2. Non-drug treatment of bronchial asthma

Eliminate Risk Factors for Asthma

Without a doubt, the elimination of factors that contribute to the risk of development, as well as exacerbation of asthma attacks, is one of the fundamental steps in the treatment of this disease. We have already considered the risk factors for the development of bronchial asthma at the beginning of the article, in the Causes of bronchial asthma paragraph, so here we will only list them briefly.

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 drugs (Aspirin and other NSAIDs), contaminated air conditioner filters, fumes from household chemicals (cleaners and detergents) and cosmetics (hairspray, perfume), work with building materials (gypsum, drywall, plaster, paint, varnishes), etc.

Speleotherapy and halotherapy

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

halotherapy- in fact, it is an analogue of speleotherapy, the only difference is that halotherapy implies treatment only with "salty" air.

Some resorts, as well as some health care facilities, have special rooms that are completely lined with salt. Sessions in salt caves relieve inflammation of the mucous membranes, inactivate pathogens, increase the production of hormones by the endocrine system, decrease 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 asthma medication.

Diet for asthma

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

What not to eat with asthma: fish products, seafood, caviar, fatty meats (poultry, pork), smoked meats, fatty foods, eggs, legumes, nuts, chocolate, honey, tomatoes, tomato-based sauces, food with yeast, citrus fruits (oranges, tangerines, pomelo , grapefruit), strawberry, raspberry, currant, apricot, peach, melon, alcohol.

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

What can you eat with asthma: cereals (with butter), soups (hateful), chicken, low-fat sausages and sausages (doctor's), rye bread, bran bread, oatmeal or biscuit cookies, vegetable and fruit salads, compotes, mineral water, tea, coffee (if it contains have caffeine).

Diet- 4-5 times / day, without overeating. It is better to cook food for a couple, but you can also boil, stew, bake. Eat only warm.

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

Forecast

The prognosis in the treatment of bronchial asthma is positive, but largely depends on the degree at which the disease is detected, thorough diagnosis, the patient's exact compliance with all the prescriptions of the attending physician, as well as restrictions on factors that can provoke attacks of this disease. The longer the patient is self-treated, the less favorable the treatment prognosis.

Important! Before using folk remedies for the treatment of bronchial asthma, be sure to consult your doctor.

Treatment of asthma with water (method of Dr. Batmanghelidzh). The essence of the treatment is to drink water according to the following scheme: 2 glasses 30 minutes before a meal, and 1 glass 2.5 hours after a meal. In addition, water must be drunk during the day to quench thirst. Water can be alternated, first salted (½ tsp sea salt per 2 liters of water), then melted, boiled water cannot be used. Efficiency is increased by placing a few crystals of sea salt under the tongue after drinking water, as well as with the additional intake of vitamin complexes. To relieve attacks, you can put a pinch of salt under the tongue, then drink a glass of water. During treatment, the use of alcoholic and caffeinated drinks is not allowed. The drug treatment is preserved.

Ginger. Grate about 4-5 cm of dried ginger root and cover it with cold water. Next, heat the mixture in a water bath until it begins to boil, then cover the mixture with a lid and boil the product for about 20 minutes. Next, set aside the container with the product, with a tightly closed lid, and let it brew until it cools down. Take a decoction of ginger root in a warm form, 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, and add a pinch of salt to 30 g of juice, and drink the remedy. Before going to bed, a mixture of 1 tbsp also has a beneficial effect. tablespoons of ginger juice and honey, which can be washed down with herbal tea or warm water.

Ginger essential oil can be used as inhalation.

Oats. Sort and clean 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 remedy for 2 hours over low heat. After boiling, you should have about 2 liters of the product left. Next, add 1 teaspoon and 1 teaspoon of butter to 150 ml of decoction. You need to drink the remedy on an empty stomach, in a hot form. You can store the product in the refrigerator. The course of treatment is 1 year or more.

Salt lamp. As already mentioned, a little earlier, in the paragraph “Non-drug treatment of bronchial asthma”, inhalation of salt air has proven itself well in the fight against this disease. To do this, you can visit special salt caves. You can also place a salt lamp in the patient's room, which can be purchased at home improvement stores. If financial resources allow you, you can equip a salt room in your country house, for this you can search the network for schemes, as well as rock salt sellers. Halotherapy contributes not only to the treatment of asthma, but also to many other diseases, and also strengthens the body in general.

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, a large concentration of vehicles;

- Give up smoking (including passive), alcoholic beverages;

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

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

- If a large amount of dust is often collected in the house, install an air purifier;

— Ventilate the room where you live/work more often;

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

- Do not let respiratory diseases take their course;

- Take medications only after consulting a doctor;

-Move more, temper yourself;

- Put a salt lamp in your house, this is both a benefit and an excellent piece of furniture;

- Try to relax at least once a year in ecologically clean places - on the sea, in the mountains, forests.

Which doctor should be consulted 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. External factors include psycho-emotional stress, excessive physical activity, unfavorable climate, as well as exposure to chemical irritants and allergens. Internal factors include disorders of the immune and endocrine systems, as well as bronchial hyperreactivity.

Many patients have a familial predisposition to the disease.

Now 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 in asthma is characterized by high specificity. The cause of the pathological process is the impact of the allergic component in combination with immune disorders, which causes the paroxysmal course of the disease.

Note: burdened family history - in every third person with asthma. With a hereditary predisposition, the elements that provoke asthma attacks are very difficult to trace; the disease is atopic.

In addition to the main (allergic) component, there are a number of 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, which worsens the patency of the airways;
insufficient formation of mucous bronchial secretions (cough with asthma is usually unproductive);
predominant damage to the bronchi of small diameter;
changes in the lung tissue due to hypoventilation.

Important:one of the leading factors leading to asthma is called 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

There are 4 stages in the development of asthma:

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

In the early stages, seizures develop relatively rarely and can be quickly stopped. As exacerbations progress, they become less sensitive to drug therapy.

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

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

The following clinical and pathogenetic forms are classified as special forms:

aspirin (due to the intake of salicylates);
reflux-induced (against the background of gastroesophageal "reverse reflux");
night;
professional;
exercise asthma.

Atopic (allergic) bronchial asthma- this is the most common form of pathology, due to the increased sensitivity of the organs of the respiratory system to various allergens. The protective reaction of the 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 the genetic predisposition to allergies.

Symptoms of bronchial asthma

Choking or shortness of breath at rest or with exertion. Inhalation of plant pollen, a sharp change in ambient temperature, etc. can provoke the appearance of such symptoms. An important distinguishing feature of asthma attacks at an early stage of the disease is the suddenness of their development.
Superficial breathing of the expiratory type (with an extended exhalation). Patients are worried that they cannot breathe out completely.
Dry hacking cough that develops in parallel with shortness of breath. It is not possible to cough for a long time; only at the end of the attack is there a discharge of a small amount of mucous bronchial secretion (sputum).
Dry wheezing when breathing. In some cases, they can be determined 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 a sitting position with his legs down and hold his hands on the support.

Important:only individual signs from among those mentioned above can indicate a pathological increase in bronchial reactivity. As a rule, at first the attacks are short-lived and do not develop again for a long time. In this case, we are talking about the "period of imaginary well-being." Gradually, the symptoms will be more pronounced and often manifested. Early contact with a doctor 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 characteristic symptoms associated with bronchial asthma are distinguished:

and dizziness. Symptoms can be observed in 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) observed during an attack. Heart rate - up to 120-130 per minute. In patients with moderate and severe asthma, a small tachycardia (up to 90 bpm) also occurs between attacks;
blue extremities (acrocyanosis) and diffuse cyanosis of the skin. The appearance of this clinical sign is due to a pronounced progressive 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");
symptoms of emphysema. Changes are characteristic of a long and (or) severe course of the disease. The patient's chest width increases and the supraclavicular regions protrude. When percussion is determined by the expansion of the boundaries of the lungs, and when listening - weakening of breathing;
symptoms of cor pulmonale. In severe asthma, a stable increase in pressure in the pulmonary circulation develops, which leads to an increase in the right ventricle and atrium. Auscultation in the projection of the pulmonary valve can reveal the accent of the second tone;
susceptibility to allergic reactions and allergic diseases.

Important:static status is a prolonged suffocation that is not stopped by traditional drug therapy. The condition is accompanied by a violation of consciousness, up to a complete loss. Asthmatic status can be fatal.

Diagnosis of asthma

The diagnosis of "bronchial asthma" is made on the basis of the presence of symptoms characteristic of this disease. A certain difficulty may be the differential diagnosis of 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 recovers normal health. Bronchitis is not characterized by sudden nocturnal attacks at rest. Shortness of breath is a "classic" symptom of an asthma attack, regardless of the severity of the course, and with bronchitis it develops only with a long-term obstructive form or a very severe exacerbation.

Cough accompanies bronchitis both during an 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, and hyperthermia is unusual for asthma.

Note: differential diagnosis is important in the initial stages of 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 of the stages of development requires making adjustments to the plan of therapeutic measures. A peak flow meter should be used to evaluate asthma over time and the degree of disease control.

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

Basic (basic) therapy involves maintenance treatment aimed at reducing the inflammatory response. Symptomatic therapy is the measures taken to relieve seizures.

Experts note that the appointment of hormonal drugs (glucocorticosteroids) allows you to control the pathological process. Medicines of this group not only relieve symptoms during an attack, but are also able to influence the main links of pathogenesis, blocking the release of allergy and inflammation mediators. 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 funds are prescribed for mild and moderate compensated course of the process. In emergency cases, they are ineffective in tablets, but inhalations with these pharmacological drugs help to stop the patient's asthmatic status;
leukotriene antagonists (prescribed for bronchial obstruction);
methylxanthines. For basic therapy, tablet forms are used, and injections are needed to stop attacks (Eufillin in high dosages);
monoclonal antibodies. Injections are indicated with an established allergic component. For the removal of seizures are not used;
cromons. Inhalations of this group of drugs are indicated for the basic treatment of mild forms. The attack is not removed;
b2-agonists. Long-acting inhalers are used for maintenance treatment, and short-acting agents (Salbutamol, Ventolin) are used to stop an attack;
anticholinergics. In special inhalers, they are indicated for emergency care for bronchial asthma during an attack.

Combined inhalation agents can be prescribed both for emergency care (Symbicort drug) 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 so-called. "forerunners".
Predictive 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 decreases if the child is given a sitting or upright position. Breathing becomes intermittent with shortened frequent breaths.

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

Boys are more likely to develop bronchial asthma in childhood, because the diameter of the bronchial lumen is narrower in them than in girls.

Obesity in children increases the risk of developing asthma, as the diaphragm in this case is higher and ventilation of the lungs is difficult.

Modern medications do not completely cure bronchial asthma in children, but drugs help relieve an attack and minimize allergic and inflammatory reactions. The specifics of therapy lies in the fact that they are shown as the main method of administering medicinal substances.

About bronchial asthma in children is described in detail in this video review:

Asthma during pregnancy

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

The control of the disease allows you to minimize the possible risk to the unborn child. Basic therapy should not be interrupted. Of course, you can not refuse the funds needed for emergency care for bronchial asthma. Loss of control threatens with preeclampsia (with placental damage), hypermesis (pronounced toxicosis), complications during childbirth and premature birth. It is not excluded intrauterine growth retardation.

Most of the 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 lung function. In severe form after the 32nd week of pregnancy, an ultrasound of the fetus is certainly required.

Prevention of bronchial asthma

Unfortunately, at present, sufficiently effective measures for the prevention of bronchial asthma have not been developed. Persons with a hereditary predisposition can be advised to minimize contact with allergen substances, if possible, exclude hypothermia of the body and pay increased attention to changes in well-being.

Children are encouraged to breastfeed for at least 1 year. If it is necessary to transfer the baby to artificial feeding, the mixture should be selected after consulting with the pediatrician. It is undesirable 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 stuffing.

Hardening and rational nutrition will help strengthen the body's defenses, 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 for diagnosing and preventing 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, and as a result, difficulty breathing occurs. Attacks of suffocation often develop at night or in the early hours of the morning and begin with a painful cough with sputum that is difficult to discharge. There is shortness of breath, which is characterized by difficulty exhaling. A variety of dry and moist rales are heard in the lungs. The patient's lips turn blue, he takes a forced posture, trying to alleviate his condition, auxiliary muscles are involved in inhalation. Such symptoms are characterized by a developed attack of bronchial asthma.

Causes of asthma:

The predominant form of bronchial asthma in children is atopic asthma. Allergen most often becomes house dust, plant pollen, animal hair.
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. In addition, viral diseases dramatically increase the sensitivity of the bronchi to a variety of stimuli. A certain role in the development of the disease belongs to hereditary predisposition.

How to help a child?

Ventilate rooms more often, make sure that there are no weeping spots in the room, as mold spores and various fungi are also irritants. Encourage your child to do moderate exercise, this will help him grow strong, keep fit and resist stress. It is necessary that the child adheres to a healthy diet, and also does not consume foods that most often cause allergies.
For example, nuts, wheat, dairy products. Do not stress your child: emotional distress can aggravate symptoms.

Don't smoke around your child, because even if your child doesn't have asthma symptoms, they can occur when one or both parents smoke. Keeping pets or birds in the home can make asthma worse. Don't let your home become a dust mites haven. Do wet cleaning and vacuuming at least 2 times a week. Wash your baby's bedding and soft toys often. Knock out carpets and wash curtains, which are also very often a flare shelter.

What are the symptoms of asthma and how is it diagnosed?

If you suspect asthma, look out for the following symptoms:
Violent cough during sleep or after exercise.
Wheezing in the lungs, wheezing, difficulty exhaling.
Shortness of breath after sports.
Complaints of tightness in the chest, lack of air.

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

The doctor will need some time for examination and diagnosis. During this period, you may be asked to write down the symptoms your baby develops and monitor their progress. It will be necessary to indicate what in one case or another was a provocation for their occurrence.

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

Treatment of bronchial asthma in children:

During an attack, it is necessary to remove the narrowing of the bronchi as soon 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 asthma, you need to try to determine which substances cause an allergic reaction in him, and limit as much as possible, and if possible completely eliminate contact with them.

It is necessary to carefully follow medical prescriptions and try to cure possible foci of infection that exist in the baby's body - primarily in the nasopharynx. With preventive vaccinations during the period of exacerbation, you will have to wait.

Preparations:

The doctor will prescribe medications for your child to use during an attack, as well as prescribe a course of treatment for the period between attacks. To stop an attack of bronchial asthma, pharmaceutical agents are used that relieve spasm of the smooth muscles of the bronchi and bring quick relief to the patient. The most commonly used are fenoterol (Berotek), salbutamol (Ventolin), ipratropium bromide (Atrovent).

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

To prevent seizures, treatment with cromoglycate (Intal) or nedocromil (Thyled) sodium 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 smallest patients, it is possible to use ketotifen tablets. In severe cases, inhaled hormone therapy is indicated. It is very important to constantly engage in physiotherapy exercises, the correct daily routine with maximum stay in the fresh air.

Anti-asthma drugs:

Anti-asthmatic drugs are often used in the form of inhalations. So the remedy immediately reaches the bronchi.
It is sometimes difficult for children to use the inhaler (synchronize inspiration with pressure). In this case, a special device is used - a spacer. It's a big plastic container. On the one hand, he has a mouthpiece, which the child takes in his mouth, and on the other hand, 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, nebulizer therapy. A nebulizer is a special spray device that creates very fine suspension particles, allowing them to penetrate the bronchial tree most deeply. Inhalation of the therapeutic mixture - through a mask or through a mouthpiece (in children older than 3 years).

Asthma attack in children - help:

During an asthma attack, the symptoms increase dramatically. The severity of an asthma attack in children is different, and the volume of therapeutic measures depends on this. In any case, parents should remain calm and provide moral support to the child.

Well, if a child is trained in biofeedback (BFB) and volitional breath control (VUD), he can use these methods to relieve an attack. Give your child the drug recommended by the doctor to relieve seizures. The patient should sit upright and breathe measuredly and calmly. The drug begins to act within 3-8 minutes. If during this time there is no relief, and your child is very scared or tired, call an ambulance.