An attack of suffocation is accompanied by bronchial asthma. Bronchial asthma - symptoms and treatment in adults, signs

– a dangerous chronic disease of the respiratory tract, which has multiple causes.

This means that it is impossible to name one specific reason why the disease will appear. There is a whole complex of factors that combine with each other and provoke the development of bronchial asthma.

The inner surface of the respiratory organs is covered with a mucous membrane.

When any irritant hits the mucous membrane (solid particles, viruses, bacteria, etc.), it begins to actively produce mucus, which narrows the air gaps and creates an impenetrable barrier for any type of pathogen into the lungs.

As a result, a cough appears (everyone is familiar with the situation when small crumbs get into the respiratory tract and a cough suddenly appears).

In people suffering from bronchial asthma, such a cough occurs not only when a person chokes. The inner surface of their bronchi can even react to fine house dust.

In this case, bronchial spasm, swelling of the mucous membrane, and increased production of bronchial secretions appear. As a result, the lumens of the bronchial branches become clogged, and this ultimately leads to suffocation.

The most important symptom of the disease is an attack of suffocation of bronchial asthma. In rare cases, suffocation occurs suddenly.

The disease, as it were, “warns” the patient about an upcoming attack, which can be divided into three stages:

precursor stage;
high stage;
stage of reverse development.

Harbingers

During the warning period, the patient will experience the following symptoms:

An intense watery runny nose appears.
Itching of the mucous membranes of the eyes.
Paroxysmal cough with heavy expectoration.
Dyspnea.
Sometimes the chin, cervical region and back between the shoulder blades itch unbearably.
My head starts to hurt badly.
The patient feels tired.
Some patients begin to feel sick during the warning signs.
There is a frequent urge to go to the toilet.

The precursor stage can begin several minutes, hours, and sometimes 2-3 days before the onset of the attack.

High period

The period of the height of an attack of suffocation is accompanied by the following symptoms:

Sudden onset of shortness of breath and chest tightness.
The chest swells greatly, as if taking a deep breath.
The patient begins to quickly inhale air and exhale 3-4 times slower. In this case, whistling sounds are characteristic.
Some patients inhale and exhale air rapidly, without stopping. Other patients with bronchial asthma, on the contrary, breathe slowly - 10-12 breaths per minute.
The patient takes a characteristic position: sitting, he leans forward and rests his elbows on his knees.
The muscles of the shoulders, back, and abdominal cavity are involved in the breathing process. The patient's face and the veins in the neck take on a puffy appearance. The skin of the face becomes blue. Cold sweat appears.
Wheezing and coughing appear during an attack.
In some cases, sputum may be released, after which the patient's condition improves. The separated mucus is viscous, and some white dense inclusions in the form of threads and balls may be found in it. This is nothing more than frozen mucus that filled the bronchioles.
Sometimes the temperature can rise to 37-37.5 °C.
Sometimes blood pressure rises.

Reverse Development

The period of reverse development can end quickly, or it can last more than one day. With the rapid completion of the reverse period, tension is relieved and all signs of suffocation go away. The patient develops an appetite and wants to drink a lot.

He also gets sleepy. A long period of reverse development is characterized by the fact that the patient still experiences difficulty breathing for several days, he remains weak, drowsy and often depressed.

Based on severity, asthma can be divided into mild, moderate and severe.

A mild form of the disease involves attacks several times a month during the day, and no more than 2 times a month at night. Moreover, attacks can go away on their own, without the use of medications.
With moderate bronchial asthma, daytime attacks occur 1-2 times a week, and nighttime attacks occur more than 2 times a month. Between attacks, breathing is extremely difficult.
In severe stages of the disease, numerous attacks occur both day and night. In this case, suffocation is so serious that it threatens the patient’s life.

Why does the disease develop?

To date, there is no description of a clear mechanism for the occurrence of bronchial asthma, since the causes of its occurrence are diverse, have different roots and varying degrees of influence in each specific case.

One thing is clear that internal and external factors play a role in the development of the disease.

External factors

External reasons make up a fairly extensive list.

These include:

Allergens: plant pollen, microscopic fungi, house dust, animal hair, food and drug allergens, household chemicals, etc.
Various infections: bacteria, viruses, fungi.
A production factor where irritants of a chemical and mechanical nature may be present.
Climatic and weather conditions.
Poor nutrition.
Unfavorable environmental conditions.
Psychological reasons.
Physical overload.
Passive or active smoking. Cigarette smoke contains toxins that corrode the bronchial epithelium.

However, external causes accompany millions of people on the planet, and bronchial asthma affects 8% of the population.

Consequently, all these external factors gain strength if there is an internal predisposition of a person.

Internal prerequisites for the occurrence of the disease

Internal causes of asthma include the following.

Immune system disorder. Human immunity is designed to protect the body from pathogenic microflora. To do this, lymphoid tissue produces certain protective cells that destroy pathogens and remove them. If for some reason the immune system fails to cope with its function, then viruses, bacteria, fungi freely settle on organs and systems and begin to multiply intensively. As a result, various diseases develop, including ailments of the respiratory system (tracheitis, bronchitis, pneumonia). With weakened immunity, these diseases become chronic and can give rise to the development of bronchial asthma.
Defects of the endocrine system. Numerous studies have shown that there is a relationship between endocrine mechanisms and allergies. There is evidence that in asthmatics the central mechanism of regulation of the endocrine glands is disrupted.
Hypersensitivity and reactivity of the bronchi. When performing a methacholine test, the bronchi of patients with bronchial asthma show sensitivity 200-1000 times greater than the bronchi of a healthy person. A huge role in the development of the disease is played by the constant high reactivity of the bronchi, which is formed during prolonged infection or allergies, as well as during prolonged exposure to various irritants.
Heredity. Bronchial asthma in more than 30% of patients has hereditary roots. That is, if ancestors suffered from this disease, then it is quite possible for a person to develop the disease if certain factors listed above occur.

What types are there?

The combination of various reasons that ultimately lead to the appearance of such a serious disease can indicate a type of bronchial asthma. Below are some of them.

Allergic type, or atopic

This is the most common variant of the disease, which is caused by non-infectious irritants against the background of some internal factors, for example, heredity.

According to statistics, 25% of people develop atopic asthma if one of their parents suffered from it. If both parents were asthmatics, then the probability of the disease is already 40%.

The best known and most common allergen is house dust, as it can be found in any home. It is dust that causes asthma attacks in 30-40% of patients.

Plant pollen, animal hair, feathers and bird down have a similar effect.

Bronchospasms can be triggered by strong odors, for example, the smell of paint, perfume, air freshener, washing powder and other household chemicals. It is not uncommon for food allergies to occur.

The most allergenic are eggs, fish, citrus fruits, chocolate, milk, strawberries, and vegetable oils.

Medicines can also act as provocateurs of bronchospasm. Among the leaders of such drugs are acetylsalicylic acid, analgin, penicillin, tetracycline, etc.

By the way, there is even a type of bronchial asthma called Aspirin asthma, which causes the patient to have asthma attacks when taking aspirin.

The unfavorable environmental situation in large and industrial cities is characterized by the fact that the atmosphere is polluted with various chemical components.

For patients with bronchial asthma, inhaling such air can aggravate their condition.

In modern homes there are many objects that emit harmful chemical components (pollutants).

They can come from various heating appliances, stoves, pressed coatings, etc. These include tobacco smoke.

Infectious-allergic type

Clinical observations show that many chronic respiratory diseases can “develop” into bronchial asthma.

In 50% of cases of chronic tonsillitis, chronic bronchitis, pneumonia, etc., bronchial asthma develops.

And the culprits of these diseases are pathogenic microflora - viruses, bacteria, fungi. That is, the root of bronchial asthma in this case belongs to infection.

Infectious-allergic asthma is characterized by protracted and complex attacks of breathlessness, which are difficult to relieve with adrenergic stimulants. Between attacks the patient experiences heavy breathing.

More often attacks occur at night.

"Psychological" form

Sometimes prolonged emotional and psychological overload causes rapid heartbeat and increased blood circulation.

In people with an asthmatic predisposition, this can cause swelling of the bronchial mucosa and narrowing of their lumen, i.e., an asthmatic attack may occur.

In clinical practice, there are cases where the first asthma attack occurred due to stress.

Often the roots of “psychological” asthma lie in the suppression of emotions. For example, children may suppress their crying.

On the one hand, crying is an opportunity to attract the attention of parents. But at the same time, the child may develop a feeling of fear of being punished for crying and fear of refusal.

The child finds himself in a state of contradiction between the hope of gaining the trust of his parents and the fear of this. Such psychological reasons lead to breathing defects, i.e., bronchial asthma.

According to statistics, psychological factors in the development of bronchial asthma occur in 30% of cases.

Exercise-induced asthma

Physical stress is accompanied by increased breathing even in the healthiest person. Breathing becomes deeper.

However, people with bronchoasthmatic syndrome are at risk due to the high risk of suffocation.

During physical activity, breathing quickens, intense ventilation occurs, and therefore cooling and drying occurs in the bronchial mucosa.

These factors are enough for the hypersensitive bronchi of an asthmatic to react with spasm.

Typically, an attack begins 2-5 minutes after exercise, and its duration varies between 15-60 minutes. Asthma of “physical effort” is observed in 70% of adults and 90% of children suffering from bronchial asthma.

From all of the above, we can conclude that bronchial asthma is a multifactorial disease that is based on internal and external causes.

We wish you that such a dangerous disease as bronchial asthma never bothers you or your family.

It is a disease with a chronic course, which is based on allergic inflammation and high sensitivity of the bronchi to pathogens coming from the environment. This disease has become more widespread in recent years.

According to WHO(World Health Organization) asthma is considered one of the leaders among diseases that lead to mortality and chronicity. According to statistics, about 300 million people on Earth suffer from bronchial asthma. In this regard, the issue of bronchial asthma has recently become a key issue in all countries. pulmonology.

Risk factors and mechanism of development of bronchial asthma

It is one of the most common nonspecific diseases of the lung tissue. Bronchial asthma often manifests itself at an early age due to the peculiarity of the anatomical structure of the bronchial tree in children. In this case, the symptoms will be similar to those of other diseases, for example, acute bronchitis.

Hypersensitivity is the second link in the chain of development of bronchial asthma. It is caused by genes located on chromosome 5. The bronchi have increased sensitivity to agents coming from the environment, that is, in ordinary bronchi there are no changes when dust enters, for example, in healthy people the bronchi do not react in the form of asthma. As a result, the reaction of small caliber bronchi (bronchioles) is manifested by narrowing of the lumen (spasm) and attacks of suffocation. Characteristic shortness of breath during exhalation.

Bronchial asthma occurs in both men and women and there are no clear statistics. Much depends on:

Genetic predisposition. That is, the presence of bronchial asthma in close relatives increases the risk by 15-20%.

The influence of harmful toxic substances(cigarette smoke, smoke from a fire, etc.). Of course, these factors have a small percentage in the development of bronchial asthma, but they can aggravate the situation.
The disease is more common in boys in the early years, then gradually the percentage of men and women becomes equal. In total, about 6-8% of the population suffers from bronchial asthma.

Occurrence of bronchial asthma also depends on the climatic conditions of the country. Countries with higher humidity, due to constant rain or ocean air flow (Great Britain, Italy). Recently, the role of ecology has increased. It has been proven that in countries with high air pollution, bronchial asthma is much more common.

These data suggest how to properly take care of your microclimate in the house and what undesirable factors should be removed.

Causes of bronchial asthma

There are several theories about the mechanisms of bronchial asthma. It should be noted that in some cases, the outbreak of this disease is directly related to the environment, and pollution is a very important factor.

Hereditary factors are of key importance in the formation of an allergic and inflammatory reaction. There are:

Atopic appearance bronchial asthma. In this case, the incidence of the disease increases in persons whose parents suffered from bronchial asthma. Thus, the most common external pathogens are: dust, pollen, various insect bites, chemical fumes, paint odors and others. Atopy is caused by genes located on chromosome 11 and which are responsible for the synthesis of immunoglobulins E (IgE). IgE is an active antibody that reacts to the penetration of the agent and thereby develops a bronchial reaction
Increased synthesis immunoglobulins E. This condition increases the risk of bronchial reaction, which manifests itself in the form of spasm and bronchial obstruction.
Chronic inflammation of the bronchi (chronic bronchitis)

Each factor is of great importance; if you combine one or more factors together, the risk of disease increases by 50-70 percent.
External factors(risk factors):

Occupational hazards. In this case we mean various exhaust gases, industrial dust, detergents and others.
Household allergens (dust)
Food allergens
Various medicines, vaccines
Pets, namely wool, a specific smell can cause an allergic reaction of the bronchi
Household chemicals and others

They also directly highlight factors that contribute to the action of causative factors, thereby increasing the risk of asthma attacks. These factors include:

Respiratory tract infections
Weight loss, poor nutrition
Other allergic manifestations (skin rashes)
Active and passive smoking also affects the bronchial epithelium. In addition to tobacco, cigarettes contain caustic toxins for the respiratory tract. When smoking, the protective layer is erased. Long-term smokers are at greater risk of respiratory tract disease. In case of bronchial asthma, the risk increases asthmatic statuses. Status asthmaticus is characterized by a sudden attack of suffocation resulting from swelling of the bronchioles. An attack of suffocation is difficult to control and in some cases can lead to death.

As a result of the action of factors, some changes occur in the bronchi:

Spasm of the muscular layer of the bronchi (smooth muscles)
Swelling, redness are signs of inflammation.
Infiltration by cellular elements and filling the lumen of the bronchi with secretion, which over time completely clogs the bronchus.

As a result of the fact that the cause of bronchial asthma can be various factors, there are also forms non-atopic bronchial asthma

Types of bronchial asthma

Aspirin-induced bronchial asthma. Choking attacks occur after taking aspirin tablets or other drugs from the group of non-steroidal anti-inflammatory drugs (ibuprofen, paracetamol and others).

Exercise-induced bronchial asthma. As a result of sports activities, after ten minutes, bronchospasm occurs, which determines the general condition.

Bronchial asthma caused by gastroesophageal reflux. Gastroesophageal reflux is a process in which the contents of the stomach flow back into the esophagus, irritating the mucous membrane due to its acidity. It occurs due to incompetence of the connection between the stomach and esophagus, diaphragmatic hernia, trauma and other reasons can cause this condition. As a result of this process, the airways are irritated and a cough may occur, which is not characteristic of bronchial asthma.

Bronchial asthma for unknown reasons. As a rule, this type is typical for adults. Occurs in complete health, even in the absence of allergies.

Signs and symptoms of bronchial asthma

An attack of bronchial asthma. Before the attack begins, they isolate period of harbingers, which manifests itself as irritability, anxiety, sometimes weakness, less often drowsiness and apathy. Lasting about two or three days.
External manifestations

facial redness
tachycardia
pupil dilation
Possible nausea and vomiting

An asthma attack differs from the warning period in that it occurs at night (not a strict rule), patients are very restless and nervous. More muscle groups are involved in the act of breathing, including the abdominal muscles, pectoral muscles, and neck muscles. Characterized by widening of the intercostal spaces, retraction of the supraclavicular and subclavian spaces, which indicates difficulty breathing. The temperature usually remains normal. Characteristic noisy breathing, namely, when exhaling, a sound resembling a quiet whistle (wheezing) is heard. An asthma attack lasts about 40 minutes, in rare cases up to several hours, or even less often days. A condition in which an attack lasts for several days is called status asthmaticus(status asthmaticus).

The basic rule for a bronchial attack is that the attack lasts about six hours and there is no effect after 3 injections of adrenaline with an interval of 20 minutes.
The following stages of an asthmatic attack are distinguished:

First stage characterized by a milder course, since the patient’s condition is relatively compensated. The attack occurs gradually; some patients get used to the discomfort during breathing, as a result of which they do not consult a doctor. Breathing is weak and noisy. During auscultation, the expected wheezing is not heard, which is characteristic of bronchial asthma.
Second stage manifests itself as a serious condition . Impaired breathing can gradually lead to respiratory failure. The pulse is frequent, the pressure is reduced, the general condition is much worse than in the first stage. For this stage it is possible to develop hypoxic coma. Coma is caused by obstruction of the lumen of small bronchi and bronchioles by viscous secretions.
Third stage An asthmatic attack is characterized by complete decompensation and a high risk of death. Characterized by progressive hypoxia (lack of oxygen), manifested by loss of consciousness, disappearance of physiological reflexes, tachycardia, shortness of breath, both during exhalation and during inhalation. Auscultation: no wheezing can be heard above the lungs, breathing is altered.

Post-attack period characterized by weakness, blood pressure is reduced, breathing gradually normalizes. Normal breathing is established in the lungs. During forced exhalation, wheezing may be heard in the lungs, therefore, the patency of the airways is not fully restored.
In order to understand at what stage the process is, instrumental diagnostics and spirography and forced expiration tests (Tiffno test), peak flowmetry and other standard studies are necessary.

Diagnosis of bronchial asthma

The diagnosis of bronchial asthma is made taking into account the symptoms and manifestations of an attack of bronchial asthma and paraclinical examination, which includes laboratory and instrumental studies.
Instrumental diagnosis of bronchial asthma
The main difficulty in making a diagnosis of bronchial asthma is the differential diagnosis between allergic and infectious forms of respiratory tract disease. Since infection can be a trigger in the development of asthma, but it can also be a separate form of bronchitis.

For diagnosis, both symptoms and objective examination, as well as pulmonary function tests (PRF), are important. Take into account the volume of forced expiration per second and this volume after taking bronchodilators, which relax the muscular wall of the bronchi, helping to expand the lumen of the bronchi and improve breathing. For a good result and correct interpretation, the patient must take a deep breath, then quickly exhale into a special apparatus spirograph. For diagnosis and confirmation of recovery, spirography is also carried out in remission.

Nowadays it is more often used peak flowmetry. Peak flow meter very easy to use at home, measures peak expiratory flow (PEF).

Patients are assigned to measure PEF daily and keep a chart, so the doctor can assess the condition of the bronchi and how the chart changes during the week and what the changes depend on, and discusses it with the patient. Thus, you can understand the power of allergens, evaluate the effectiveness of treatment, and prevent the occurrence of status asthmaticus.
There is a parameter of daily bronchial lability (DBL) based on peak flow measurements.
SLB = PEF in the evening - PEF in the morning / 0.5 x (PEF in the evening + PEF in the morning) X 100%

If this indicator increases by more than 20-25%, then bronchial asthma is considered uncompensated.

Provocative tests are also carried out: with physical activity, with inhalations of hyper- and hypoosmatic solutions.
One of the main tests is the determination of immunological changes, namely the measurement of the total level of IgE and specific immunoglobulins E, an increase in which will indicate the allergic component of asthma
Specific diagnosis of allergens is carried out using skin prick or prick tests. The test is carried out with suspected allergens that can cause asthma in the patient. The test is considered positive when, when an allergen is applied, a reaction in the form of a blister occurs on the skin. This reaction is caused by the interaction of the antigen with the fixed antibody.
For differential diagnosis with lung pathology, chest radiography is performed. During the interictal period, no changes are detected. It is possible to expand the chest and increase the transparency of the lungs during an exacerbation of asthma.

Treatment of bronchial asthma

Relief of acute asthma attacks:
B2-adrenergic agonists. This group includes the following drugs: Salbutamol, Terbutaline, Fenoterol (short-acting drugs) and Salmeterol, Formeterol (long-acting drugs). This group of drugs has several effects:

relaxes the smooth muscles of the bronchi
reduce vascular permeability, therefore, swelling of the mucous membrane decreases
improve bronchial cleansing
block the occurrence of bronchospasm
increase contractility of the diaphragm

One of the dosage regimens for these drugs:
Short-acting drugs
Salbutamol 100 mg 4 times a day
Terbutaline 250 mcg 4 times a day
Fenoterol 100 mcg 4 times a day
Long-acting drugs
Salmeterol 100 mcg – daily dose
Formeterol (Foradil) 24 mcg - daily dose
For children suffering from asthma, these drugs are used together with nebulizers. The nebulizer creates a flow of oxygen-air mixture of at least 4 g/l. This inhalation device is convenient because you do not need to control breathing and inhalation.

Allergic cough is an unpleasant disease, since the cough reflex is also accompanied by a lack of air, caused by severe shortness of breath. If a cough of allergic origin does not last long, doctors diagnose respiratory allergosis, but if it lasts chronically, asthma. But asthma is not always associated with allergies; this disease is provoked by various factors - both allergens and various chemicals, dust with different compositions, weather intolerable to the body, physical activity, and stressful situations. Although asthma can be triggered by infections, it is essentially an inflammation of the bronchi of a non-infectious nature. In order for the treatment of bronchial asthma in adults to be effective, you need to recognize the symptoms in time and consult a specialist. But since asthma in many cases resolves individually, each asthmatic must study the disease and his body’s reaction to it, and must also be able to independently deal with asthmatic attacks.

Features of the disease

Bronchial asthma is a disease that affects the air ducts of the bronchial tree through an inflammatory process, which leads to bronchial obstruction (also called broncho-obstructive syndrome) and lack of air, a person feels suffocated. Asthma is closely related to immunity, which in turn is related to the health of the body as a whole. As the number of unfavorable factors increases, the number of people with asthma also increases. The number of allergens is increasing, although the main allergen is household dust, which is found in every home and which is completely impossible to avoid. Asthma is treatable, especially in early childhood, but sometimes it appears in such severe forms that it cannot be completely cured for a long time.

The bronchi become inflamed in various diseases, but in asthma, the inflammatory process begins against the background of an unbalanced immune system, in which the body overreacts to allergens. It is because of this connection (weakened immunity and allergies) that asthma occurs in attacks, as a combination of circumstances is necessary - weakness of the body and an external or internal factor that provokes an inflammatory process in the bronchi, mainly this factor is of an allergic nature. In severe forms of asthma, the immune system is so unbalanced that attacks can occur several times a day for no apparent reason, or rather, there are reasons, but for a healthy person they are insignificant and do not cause him harm.

In addition to allergens, the bronchi are exposed to other factors:

The smooth muscles of the walls of the bronchial tree become too active and react to numerous factors, responding to irritation with spasm;
Sometimes asthma occurs due to allergies that affect the entire body.
External factors can influence the body in such a way that mediators of the inflammatory process are formed inside the body, foci of allergy directly affect the bronchi, and the allergic reaction may not manifest itself throughout the body.
Swelling of the bronchial mucosa during the inflammatory and allergic process leads to a narrowing of the air-permeable organs of the bronchial tree, this is the main cause of asthmatic attacks.
During attacks, little mucus is coughed up, which causes difficulty in getting air into the lungs.
During an attack, large bronchi, which are reinforced with cartilage, do not suffer as much, but smaller bronchi, which do not have such a design feature, stick together, become clogged, and it is at their level that asthma manifests itself in visible shortness of breath.
In addition to situational attacks, chronic lack of oxygen leads to pathological changes in the lungs, both at the volume level (an increase leads to emphysema) and at the tissue level (pneumosclerosis).

Such a complex disease as bronchial asthma, the symptoms and treatment of which in adults constitute a complex medical problem, has five stages (degrees, stages) of disease development. Sometimes the last stage is often not included in the list, being combined with the fourth, thus highlighting four more stages. But it is better to distinguish five stages; this classification allows treatment more effectively:

Mild asthma (episodic, intermittent) - attacks can occur several times a month, can pass without medication, and the person feels healthy between attacks. It is often diagnosed as respiratory allergy, especially in children, with the hope that the disease will go away as the child grows up.
The second type is a mild degree of persistent (translated as stubborn) asthma. Attacks do not occur every day, but two or more times a week; attacks at night are also more common.
Moderate form of persistent asthma - attacks occur every day.
Persistent asthma, severe form - attacks more than once a day, spirographic tests show that the bronchi work at almost half of their potential capacity.
An extremely severe form of persistent asthma - attacks can occur several times a day, even seemingly without cause, but the cause may be some minor factor against the background of a tired, extremely sensitive bronchial system.

Bronchial asthma in adults is a chronic disease that develops even when there are no acute attacks, since the inflammatory process in the bronchi may be present even without obvious signs, but this inflammation can suddenly worsen in the form of bronchial obstruction, which is accompanied by a lack of air, even feeling suffocation. If treated at the initial stage of the disease, then attacks can be successfully managed with the help of modern medications. However, if treatment is not carried out comprehensively, including diet, conditioning of the body and climatotherapy, then the body may become insensitive to mild medications; stronger ones must be used, although attacks will occur more often. The basis for successful treatment of asthma is comprehensive treatment; one cannot limit oneself to suppressing symptoms only; one must work for the future.

Onset of the disease

Asthma is curable - all patients, even in severe stages, need to know this. You just need to understand that the severity of the cure depends on the severity of the disease. After all, asthma in its chronic form, which lasts a long time, depletes the body, the bronchi overreact to irritants and attacks occur more often, are stronger and last longer. To make treatment easier and have the opportunity to recover, you need to recognize asthma at the initial stage, for this you need to know the first symptoms in adults:

shortness of breath, which can develop into sudden suffocation, arises from certain factors that need to be detected by analyzing the situation - this can be dirty air both in the room and on the street, at work, as well as the flowering of indoor plants, or seasonal flowering of trees and herbs , smoke, certain foods;
with shortness of breath there is an obsessive cough, which is dry, there is no sputum or there is very little of it and she coughs up at the end of the attack in the form of glassy mucus;
breathing is shallow, exhalation takes longer due to the fact that it is difficult;
wheezing, wheezing breathing, possibly with a dry crackling sound, these sounds can be heard without special devices for listening to the chest (without a stethoscope);
orthopnea - a position in which patients grab the edge of a bed, chair, or lean on a table in a special way in order to facilitate exhalation with a comfortable position;
if attacks occur at night, this should already alert you, because such manifestations of excessive bronchial reaction can subside on their own (therefore, you can ignore them), but the problem as a whole can grow, and it is at this initial stage that it can be effectively treated without strong drugs.

In any case, even if you successfully cope with attacks, you need to contact specialists for examination and recommendations, because external signs are a reflection of internal problems that are not so easy to see, especially for people who have not encountered this. But there is a situation when inexperienced doctors try to heal the problem, and not eliminate it, so either look for doctors you trust, or go to any doctor and study the problem yourself, and soon you will know which doctor’s recommendations you must follow and which ones you shouldn’t . Just definitely don’t use traditional methods, which consist of consuming goat’s milk, various herbs, to which you may be allergic; various untested methods can lead not to recovery, but to stronger medications.

Chronic disorders

When asthma just begins, it does not cause persistent pathological changes, but with a long course of the disease, both additional symptoms and permanent irreversible changes in the body appear:

The patient feels severely weakened, respiratory failure limits movement and generally makes it difficult to engage in any type of activity. The patient feels free only between attacks, and only if the asthma is mild.
In severe asthma, the patient's skin becomes bluish (acrocyanosis) due to the fact that the skin does not receive oxygen for a long period, this is a consequence of respiratory failure.
During an attack, the heart beats at a speed of up to 130 beats per minute. With progressive asthma, tachycardia is also observed, but to a lesser extent, the heart rate is about 90 beats per minute, with the norm being 60 - 80 beats per minute.
Fingers may swell like lenses, thickening in the nail area.
If asthma lasts a long time and is associated with constant and severe attacks, the patient’s respiratory efforts lead to the chest becoming unnaturally voluminous (emphysema), swelling is also observed above the collarbone, the lungs increase in volume, breathing is weakened, which is confirmed by auscultation (diagnosis with a stethoscope or phonendoscope ).
Cor pulmonale is a defect in the heart muscle in which the pressure in the pulmonary circulation is high, causing the right chambers of the heart to enlarge.
Lack of air can cause pain and dizziness.
Over time, insufficiently treated asthma leads to various allergic diseases that affect the skin (dermatitis, psoriasis), as well as the upper respiratory organs (rhinitis).

Causes

The reasons that lead to the disease can be divided into two parts - some lead to a state of the body in which allergic diseases develop more easily and provoke inflammation more easily, other reasons are directly responsible for the onset of an attack. Each patient has his own causes of attacks, and he must know them and use this knowledge for recovery:

genetic predisposition;
professional factors - unfavorable working conditions, possibly for a long period of time, possibly due to exposure to hazardous substances or dust;
long-term course of bronchitis or pulmonary, bronchial infection;
poor ecology, which manifests itself in polluted air and possibly water;
smoking - the harm of nicotine, which affects the breath, has long been proven;
household and industrial dust, and dust in everyday life is more dangerous, since a person spends more time in this environment and it is this reason that is responsible for almost half of the cases of asthmatic attacks;
medications, especially those that have a negative effect on the liver and respiratory organs, a form of asthma is possible, which stops when you stop taking certain medications.

Medications

Unfortunately, treating asthma requires a lot of potent drugs, including hormonal drugs, all of which have side effects. In addition, treatment often lasts for years, and it is the drugs, not just the disease, that can cause permanent changes in the body. For example, even a soft silicone mask from a nebulizer can cause facial deformation, especially in children. In the treatment of asthma, you need step-by-step, caution and constant comparison of efforts and results, thus choosing the most effective path. Sometimes drugs individually give a weak effect, but their combination solves the treatment problem.

Medicines have a dual effect - basic therapy affects the inflammatory process, symptomatic therapy is designed to combat attacks. Tablets and injections.

Glucosteroids are used in basic therapy for mild to moderate forms. Their action leads to a reduction in doses of hormonal drugs. They are ineffective during attacks, since their effect is too extended over time.
Leukotriene antagonists are used to relieve obstruction in cases of severe or chronic disease. A common drug for emergency relief of an attack.
Monoclonal antibodies are used when allergies are a major factor in asthma, this dosage form is the basis of Xolair injections. Not used during attacks.
In basic therapy, xanthines are used in the form of tablets, for example Theophylline; during attacks, an injection of aminophylline is administered.

In asthma, the effectiveness of inhaled medication has been proven. Recently, nebulizers have been widely used, which spray the drug using air compression or ultrasound. Medicines taken using stationary and pocket inhalers, as well as nebulizers, include:

b-2 andrometics, for basic therapy they do inhalations with Berotec, Servent, for attacks - with salbutamol (pocket inhaler), salbutamol in the form of a nebulizer is called Ventolin.
Cromones are effective only in the initial stages and in mild cases, but the weak effect of the drug does not allow relieving attacks.
Anticholinergics are the main drugs of basic therapy - Atrovent, Spiriva, properties that help prevent suffocation during attacks.
Glucocorticosteroids are used in basic therapy (the main medicine is flixotide), with the help of a nebulider and the same flixotide, attacks are relieved.
In basic therapy, combined drugs are used, among the most popular are Berodual; if it is necessary to quickly stop an attack, Symbicort is administered through a nebulizer.

Modern methods

It often happens that asthmatics unknowingly use only adrenergic agonists in the form of salbutamol (these nebulizer medications are called ventolin). Symptoms are relieved because these medications act quickly. With this approach, the problem not only remains, but also gets worse, because the body becomes addicted, and in the future, even increasing the dose may not have a therapeutic effect.

When treating asthma, it is not enough to relieve symptoms; you also need to use drugs and proven medical methods that act on the respiratory system and the body as a whole so that asthma can be treated. Treatment in this case may not imply complete recovery, but perhaps the absence of symptoms, since in the chronic form many irreversible changes occur (emphysema, for example).

In modern medicine, hormonal glucocorticoids are used, which not only quickly alleviate a person’s condition, but also act on the bronchi so that pathological processes are not so acute, and the body is given a break. Glucocorticoids stop the movement of leukocytes and eosinophils into the bronchi, which prevents an allergic reaction and minimizes the inflammatory process.

Also, hormonal drugs reduce swelling of the mucous membrane, the mucus thins out and drains more easily, which avoids blockage of the bronchial tubes. These drugs have many side effects, but an experienced doctor can select a safe dose; in addition, administration in the form of inhalations allows for targeted action, and harm to other organs is minimized.

The most recent direction in the treatment of the disease is the use of antagonists of two substances - monoclonal antibodies and leukotriene receptors. Despite many studies, tests and statements about the effectiveness of drugs based on the above antagonists, their therapeutic effect is controversial and is the subject of debate. But the theory claims that these drugs put a barrier between cells and inflammatory mediators. These drugs are quite expensive, they do not act on their own, but only reduce the amount of glucocorticoids required for treatment, so their use is not mandatory.

It is better to turn to proven non-drug methods for preventing asthmatic attacks, which include diet, climate therapy, and a healthy lifestyle.

Definition of disease. Causes of the disease

Bronchial asthma(BA) is a disease characterized by chronic inflammation of the airways, respiratory symptoms (wheezing, shortness of breath, chest congestion and cough) that vary in time and intensity and occur together with variable airway obstruction.

AD occupies a leading position in prevalence among the population. If you believe the statistics, over 15 years the number of people suffering from this pathology has doubled.

According to WHO estimates, today approximately 235 million people suffer from asthma, and by 2025 it is predicted to increase to 400 million people in the world. Thus, phase 3 studies (ISSAC) also revealed an increase in the global incidence of asthma in children aged 6-7 years (11.1-11.6%), among adolescents 13-14 years old (13.2-13.7%) .

The appearance and development of asthma is influenced by a number of reasons.

Internal reasons:

1. gender (in early childhood, boys are predominantly affected; after 12 years, girls);

2. hereditary tendency to atopy;

3. hereditary tendency to bronchial hyperreactivity;

4. overweight.

External conditions:

1. allergens:

non-infectious allergens: household, pollen, epidermal; fungal allergens;
infectious allergens (viral, bacterial);

2. respiratory tract infections.

If you notice similar symptoms, consult your doctor. Do not self-medicate - it is dangerous for your health!

Symptoms of bronchial asthma

Characteristic symptoms of asthma that most patients complain of include:

cough and chest heaviness;
expiratory shortness of breath;
wheezing.

Manifestations of asthma vary in severity, frequency of occurrence and depend on contact with various allergens and other trigger factors. They also depend on the selected anti-asthmatic treatment, the number and severity of concomitant diseases. Most often, asthma symptoms occur at night or in the early morning hours, as well as after physical exertion, which leads to a decrease in the physical activity of patients. Inflammatory changes in the bronchial tree and airway hyperresponsiveness are the main pathophysiological signs of asthma.

Mechanisms causing the main symptoms of asthma

The pathogenesis of bronchial asthma can be clearly represented in the form of a diagram:

Classification and stages of development of bronchial asthma

Today there are a huge number of classifications of AD. Below are the main ones, they help in understanding the reasons and are necessary for statistics. In addition, a modern approach to considering the problem of asthma is given, such as identifying asthma phenotypes.

In Russia, the following classification of asthma is used:

Classification of asthma (ICD-10)

Priority attention is now paid to personalized medicine, which currently does not have the ability to create an individual drug and methods for examining or preventing the development of a disease for a specific patient, but it has been proposed to distinguish separate categories. These subgroups of patients are called asthma phenotypes, characterized by features in the causes, development, methods of examination and therapy.

Currently there are the following phenotypic forms of asthma:

Allergic asthma. This type is not difficult to diagnose - the onset of the disease occurs in childhood and is associated with a burdened allergic history. As a rule, relatives also have respiratory or skin manifestations of allergies. In people with this type of asthma, immune inflammation has been recorded in the bronchial tree. Treatment of patients with this type of asthma with local corticosteroids (GCS) is effective.
Non-allergic asthma. This type of asthma affects mainly adults; there is no history of allergy pathology, and allergies are not hereditary. The nature of inflammatory changes in the bronchi of this category can be neutrophilic-eosinophilic, paucranulocytic, or a combination of these forms. ICS do not work well in the treatment of this type of asthma.
Asthma with persistent airway constriction. There is a group of patients who begin to experience irreversible changes in the bronchi; as a rule, these are people with uncontrolled asthma symptoms. Changes in the bronchial tree are characterized by restructuring of the bronchial wall. Therapy for these patients is complex and requires close attention.
Asthma with delayed onset. Most patients, mostly female, develop asthma at an advanced age. These categories of patients require the appointment of increased concentrations of ICS or become almost resistant to basic therapy.
Asthma combined with excess weight. This type takes into account that the category of people with excess weight and asthma suffer from more severe attacks of suffocation and coughing, shortness of breath constantly occurs, and changes in the bronchi are characterized by moderate allergic inflammation. Treatment of these patients begins with the correction of endocrinological abnormalities and diet therapy.

Complications of bronchial asthma

If you do not diagnose bronchial asthma in time and do not select therapy that will control the course of the disease, complications may develop:

cor pulmonale, up to acute heart failure;
emphysema and pneumosclerosis of the lungs, respiratory failure;
pulmonary atelectasis;
interstitial, subcutaneous emphysema;
spontaneous pneumothorax;
endocrine disorders;
neurological disorders.

Diagnosis of bronchial asthma

Bronchial asthma is a clinical diagnosis that is established by a doctor, taking into account the complaints, anamnestic characteristics of the patient, functional diagnostic methods taking into account the degree of reversibility of bronchial obstruction, a special examination for the presence of allergopathology and differential diagnosis with other diseases with similar complaints. The onset of the disease most often occurs at the age of 6 years, less often after 12 years. But it can also appear at a later age. Patients complain of episodes of difficulty breathing at night, in the early morning hours, or associate the complaints with emotional and sometimes physical overload. These symptoms are combined with difficulty breathing, difficulty breathing, “whistles” in the chest, and recurrent cough with a small amount of sputum. These symptoms can be relieved on their own or with the use of bronchodilator medications. It is necessary to associate the appearance of signs of asthma after interaction with allergenic substances, the seasonality of the onset of symptoms, the connection with clinical signs of a runny nose, and the presence of a history of atopic diseases or asthmatic problems.

If you suspect a diagnosis of asthma, you should ask the following questions:

Are you worried about wheezing attacks in your lungs?
Do you cough at night?
How do you tolerate physical activity?
Do you worry about heaviness behind the sternum, coughing after being in dusty rooms, contact with animal hair, in the spring and summer?
Have you noticed that you are more often sick for longer than two weeks, and the illness is often accompanied by a cough and shortness of breath?

Specific methods of diagnosis

1. Assessment of lung function and the degree of recurrence of bronchial constriction

2. Allergy examination. This involves conducting allergy tests on the skin, provocative tests with certain types of allergens, and laboratory tests to identify specific IgE antibodies. The most common are skin tests, as these are simple methods of implementation, reliably accurate and safe for patients.

2.1. There are the following types of skin allergy tests according to execution technique:

scarification allergy tests;
prick tests;
intradermal tests;
patch tests

To conduct skin tests, data from the patient's medical history is required, indicating an unambiguous connection between complaints and contact with that allergen or their group in the pathogenesis of the disease, an IgE-dependent type of allergic reaction.

Skin testing is not performed in the following cases:

2.2. Provocative inhalation test. Experts from the Respiratory Society from Europe recommend conducting this study. Before the study, spirometry is performed, and if the FEV1 level does not decrease below 70% of normal, the patient is allowed to undergo provocation. A nebulizer is used, with which it is possible to dispense certain doses of the allergen in a stream, and the patient makes several inhalations with certain dilutions of allergens under the constant supervision of an allergist. After each inhalation, the results are assessed three times after 10 minutes. The test is regarded as positive when FEV1 decreases by 20% or more from the initial values.

2.3. Laboratory diagnostic methods. Diagnostics in the laboratory is a non-main method. It is carried out if another study is needed to confirm the diagnosis. The main indications for prescribing laboratory diagnostics are:

age up to 3 years;
history of severe allergic reactions to skin examination;
the underlying disease is severe, with virtually no periods of remission;
differential diagnosis between IgE-mediated and non-IgE-mediated types of allergic reactions;
exacerbation of skin diseases or structural features of the skin;
requires constant use of antihistamines and glucocorticosteroids;
polyvalent allergy;
when performing skin testing, false results are obtained;
patient's refusal to undergo skin tests;
skin test results do not match clinical data.

The following methods are used in laboratories for determining total and specific IgE - radioisotope, chemiluminescent and enzyme immunoassays.

The newest approach to diagnosing allergic diseases at the moment is molecular allergy examination. It helps to make a more accurate diagnosis and calculate the prognosis of the course of the disease. For diagnosis, it is important to consider the following nuances:

the difference between true sensitization and cross-reactions in patients with polyallergy (when there is a wide spectrum of sensitization);
reducing the risk of severe systemic reactions during allergy testing, which improves patient compliance;
accurate determination of allergen subtypes for allergen-specific immunotherapy (ASIT);
The most common technology is the Immuna Solid phase Allergen Chip (ISAC). This is the most comprehensive platform that includes more than 100 allergenic molecules in a single study.

Treatment of bronchial asthma

Today, unfortunately, modern medicine cannot cure a patient from bronchial asthma, but all efforts come down to creating therapy that preserves the patient’s quality of life. Ideally, with controlled asthma, there should be no symptoms of the disease, spirometry values should remain normal, and there should be no signs of pathological changes in the lower parts of the lungs.

Pharmacotherapy for asthma can be divided into 2 groups:

Drugs for situational use
Regular use drugs

Drugs to relieve attacks are as follows:

short-acting β-agonists;
anticholinergic drugs;
combination drugs;
theophylline.

Maintenance therapy medications include:

inhaled and systemic glucocorticosteroids;
combinations of long-acting β2-agonists and corticosteroids;
long-acting theophyllines;
antileukotriene drugs;
antibodies to immunoglobulin E.

For the treatment of asthma, both medications and methods of introducing these substances into the body and respiratory tract are important. Drugs can be prescribed orally, parenterally, or inhaled.

The following groups of drug delivery through the respiratory tract are distinguished:

aerosol inhalers;
powder inhalers;
nebulizers.

The most modern and researched method of treating allergic asthma with proven effectiveness is ASIT (allergen-specific immunotherapy). ASIT is currently the only therapy that changes the development of the disease by acting on the mechanisms of asthma pathogenesis. If ASIT is carried out in time, this treatment can stop the transition of allergic rhinitis to asthma, as well as stop the transition from a mild form to a more severe one. And also the advantages of ASIT are the ability to prevent new sensitizations from appearing.

ASIT for asthma is performed in patients with:

mild or moderate form of the disease (FEV1 figures must be at least 70% of normal);
if asthma symptoms are not completely controlled by a hypoallergenic lifestyle and drug therapy;
if the patient has rhinoconjunctival symptoms;
if the patient refuses permanent formcotherapy;
if during pharmacotherapy there are undesirable effects that interfere with the patient.

Today we can offer patients the following types of ASIT:

injection of allergens
sublingual administration of allergens

Forecast. Prevention

In modern conditions, there is no evidence that environmental, climatic factors, or nutritional disorders can worsen the course of asthma, and eliminating these triggers will help reduce the severity of the disease and reduce the amount of pharmacotherapy. Further clinical observations in this vein are required.

Primary prevention is distinguished. It includes:

elimination of allergens during pregnancy and in the first years of a child’s life (hypoallergenic living and hypoallergenic diet);
lactation;
milk formulas;
nutritional supplements during pregnancy (there are several hypotheses about the protective effect of fish oil, selenium, vitamin E);
quitting smoking during pregnancy.

Secondary prevention includes:

avoid pollutants (increased concentrations of ozone, ozone oxides, suspended particles, acid aerosols);
fight against house dust mites;
do not have pets;
smoking cessation in the family.

204 10/03/2019 7 min.

An increasing number of adults are suffering from bronchial asthma. Doctors attribute this surge to the deteriorating environmental situation. The number of patients is rapidly increasing, even despite timely diagnosis and innovative treatment methods. According to statistics, more than 160 million people suffer from asthma in the world. What is the insidiousness of this disease? How to treat asthma?

Definition of disease

Bronchial asthma is a chronic inflammatory disease of the airways that causes hyperactivity of the bronchi. As a result, increased sensitivity of the bronchi to various environmental influences develops, manifested in the form of asthmatic spasm.

Due to excess mucus production, edema and spasm, the bronchial wall thickens and the lumen narrows. As a result of this narrowing, there is no sufficient gas exchange with the environment, which leads to repeated attacks of suffocation, wheezing, shortness of breath and coughing.

The attacks go away on their own or under the influence of medications.

Causes

Bronchial asthma occurs due to hypersensitivity to irritants. This disease can develop due to a hereditary predisposition or be associated with environmental factors (allergic factors, frequent respiratory tract infections).

An asthma attack is usually triggered by the following factors:

Allergens: dust, animal hair, food, mites, pollen, spores;
Viral and bacterial infections: , ;
Environmental irritants: tobacco smoke, exhaust fumes, sprays, perfumes;
Medicines: Acetylsalicylic acid or non-steroidal anti-inflammatory drugs;
Stress: anxiety, fear;

Symptoms

Early signs of asthma include symptoms such as:

The first signal of increased sensitivity of the bronchi can be only some of the above symptoms. They can appear for a very short time, most often at night, go away on their own and do not bother the patient again for a long time. However, over time, symptoms progress. It is very important not to miss this period of imaginary well-being and contact specialists in time.

Bronchial asthma in the initial stages of its development does not cause general disorders in the body. But over time, they inevitably arise, manifesting themselves in the form of the following symptoms:

Possible complications

Complications of bronchial asthma are classified into several types:

Respiratory: pneumonia, spontaneous pneumothorax, acute respiratory failure. Asthmatics are susceptible to frequent pneumonia; this is due to damage to the lung tissue and weakened immunity. Spontaneous pneumothorax is accompanied by rupture of the lung tissue, which leads to air entering the pleural cavity, where it accumulates and compresses the organs. This complication requires immediate surgical intervention. Acute respiratory failure is manifested by insufficient oxygen supply and requires emergency medical care, including drugs to dilate the bronchi and artificial pulmonary ventilation.

Chronic respiratory: hyperinflation of the lungs, pneumosclerosis, emphysema,. Chronic respiratory complications are less aggressive in nature, but appear more often. They affect asthmatics who suffer from the disease for several years. Lung hyperinflation is accompanied by dysfunction of the lung tissues and cannot be completely cured. Pneumosclerosis occurs most often in asthmatics who have had bronchitis or pneumonia. Signs of pneumosclerosis are a constant dry cough and shortness of breath, lethargy, weight loss and dull pain in the chest area. Emphysema is irreversible and cannot be treated, so it is only possible to relieve its symptoms. Obstructive bronchitis is more common than other chronic complications and is characterized by swelling and thickening of the walls of the bronchial tree. The disease has an irreversible process.
Cardiac complications: heart failure, myocardial dystrophy, hypotension, arrhythmia, myocardial infarction. The consequences are due to the fact that at the time of the attack, oxygen starvation occurs throughout the body and high pressure is observed in the chest. Oxygen starvation can lead to dystrophy of the heart muscle (myocardium). An increase in blood pressure in the thoracic region due to damage to the pulmonary vessels leads to the formation of a pulmonary heart. The cor pulmonale does not pump blood well, resulting in hypotension.
Gastrointestinal complications: are the result of exposure to medications that are used in the treatment of bronchial asthma. The drugs affect the gastrointestinal mucosa and provoke the appearance of duodenal or gastric ulcers. Gastrointestinal complications in advanced form can lead to internal bleeding.
Brain: neuropsychiatric disorders, respiratory encephalopathy, fainting, bettolepsy. Oxygen starvation of the brain leads to disruption of the normal functioning of higher nervous activity. The patient becomes irritable or, conversely, apathetic. Depressive states and asthenia are often observed; Respiratory encephalopathy (dementia) may develop.

One of the most serious complications is status asthmaticus, which is life-threatening. Accompanied by swelling of the bronchioles, in which sputum accumulates. The patient experiences increasing suffocation and oxygen starvation. If he is not provided with medical assistance as soon as possible, death may occur.

Treatment

An asthma attack usually occurs violently. The patient must immediately lean on the back of the chair, pull himself together and normalize his breathing. You need to exhale all the air in your lungs. Be sure to open the window to ensure air flow. In addition, the patient must immediately take short-acting medications (Salbutamol, Terbutaline, Fenoterol) by taking a couple of inhalations. These medications can be called “first aid” for an asthmatic. If the condition improves, it is necessary to perform 2 more inhalations.

By medication

Bronchial asthma requires taking medications, the action of which is aimed not only at relieving asthma attacks, but also at treating the disease. Such drugs dilate the bronchi and reduce inflammation.

Doctors have developed step-by-step therapy that helps control the course of the disease:

Folk remedies

Drug treatment of asthma can be supplemented with the use of traditional medicine. For example, rye pollen helps treat this disease well. It needs to be collected during flowering before sunrise and stocked up for the whole year. Pollen is infused in alcohol or strong moonshine. A glass of pollen is filled with 0.5 liters of alcohol and infused for 20 days in a dark place. Take 1 teaspoon 30 minutes before meals in the morning and evening.

In the treatment of asthma. Its root must be ground in a coffee grinder, then 400 g of powder is infused in 1 liter of alcohol for 2 weeks, shaking occasionally, and then filtered. The tincture is taken 2 times a day, 1 teaspoon. The product strengthens the bronchi, improves digestion and supports the kidneys.

Treatment with propolis is also useful for asthma. Pour 20 g of propolis into 80 g of alcohol, leave for a week, then strain. Take 20 drops with water or milk half an hour before meals 3 times a day. The course of treatment should be continued for 3 months. Propolis is also used mixed with honey for inhalation.

Instead of tea, traditional medicine advises drinking a decoction of nettle leaves (1 teaspoon per glass of water). If you have difficulty breathing, hawthorn infusion is useful (1 tablespoon of fruit per glass of water). This infusion should be drunk 3 times a day.

Infusions, herbal decoctions, medicinal teas have an additional therapeutic effect, but before use it is better to consult not only a doctor, but also an experienced herbalist.

Prevention

For preventive purposes, one should actively and systematically engage in physical education and swimming. In order to cope with the disease, you need to inflate balloons.

An effective measure is.

It is very important to walk a lot outdoors and, if possible, avoid contact with allergens such as pollen, dust, and animal hair. Inflammation of the respiratory tract should be avoided and treatment should be carried out promptly.

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conclusions

Bronchial asthma is a very insidious disease. If you treat it irresponsibly, then irreversible consequences will not take long to appear; even death during an attack is possible. Adults need to learn to live with this disease, react correctly to attacks and always have medications on hand. Asthma is not something to joke about. You must always be on alert and respond in a timely manner.

Also read what you can do if your child has asthma without suspicion.