According to experts, about 7 million people in Russia suffer from this disease (this is 1 in 20!)
Since the number of cases is constantly growing, the world community is making tremendous efforts to, if not defeat asthma, then at least curb it. WHO has developed a large international project “Global Initiative on Bronchial Asthma”.
In our country, a national asthma control program is being created, which provides for six main directions, the first of which is the education of the patients themselves. There are five asthma schools in Moscow, organized by the Institute of Pulmonology. Much attention is paid to educational work with asthma patients in St. Petersburg, Moscow region, Izhevsk, Perm, Saratov and other cities of Russia.
Bronchial asthma is a chronic inflammation and narrowing of the lumen of the bronchi, leading to difficulty breathing, shortness of breath, coughing, and in severe cases, even death. This disease was first described by Hippocrates in the 4th century BC (Greek asthma – heavy short breathing, suffocation). In childhood, boys are more likely to suffer from asthma, in adolescence, the ratio of boys and girls is leveled, women suffer from asthma a little more often than men, and among older people with asthma, the stronger sex again prevails …
It is not easy for a healthy person who breathes, so to speak, deeply to imagine what people suffering from this ailment may experience – an attack always appears suddenly, sometimes starting with a cough or sneezing, gradually causing a feeling of lack of air and even suffocation; inhalation and exhalation become frequent and convulsive, the lungs heavy and as if covered with wet cement. The feeling is as if some unknown force from the inside squeezes the throat and chest, and makes with the last bit of strength to catch grains of oxygen in tiny sips … Time drags on forever, you feel its every hard and rough second, but an attack can last minutes and even hours.
Asthmatics have to deal with such sensations constantly. If you do not take any measures, then in severe cases, asthma can literally suffocate a person.
In order to understand what causes asthma, it is easiest to imagine the respiratory system as an inverted tree. Inhaled air moves along the trunk – the trachea, which is divided into two large branches – the bronchi (right and left). The bronchi, in turn, are divided into even smaller branches, the smallest of which are called bronchioles. There can be up to 8 thousand bronchioles in our lungs. And at the tips of these twigs, like leaves, there are alveoli – tiny air sacs with the help of which air enters the blood.
The respiratory system is a real “tree of life” for humans. With its fruits – oxygen, nitrogen, etc. released from the air, it supplies the whole body through the circulatory system.
With asthma, the “tree” begins to ache, more and more growths appear on it, the bronchial branches begin to narrow from inflammation, and a lot of mucus appears inside them; all together this blocks the access of air to the alveoli. That is, asthma is nothing more than a sharp narrowing of the bronchial patency. And this very narrowing is caused by allergic mechanisms.
This is the main difference between asthma and respiratory tract infections, such as bronchitis or tonsillitis, in the development of which only a bacterial or viral factor is involved.
Respiratory tract infections are not directly involved in the development of asthma, but can be a catalyst. This is how it appears infectious allergic asthma… This type of asthma is more common in older and older people and is rare in children. If the infection has become protracted, then under the influence of chronic inflammation, the structure of the bronchi changes; the muscle layer thickens, the walls of the bronchi grow with connective tissue, and the bronchi themselves begin to react extremely sharply to any irritation (smoke, cold air, stress), sharply narrowing their lumen and making breathing difficult. In the future, the allergic one joins the infectious mechanism; this is caused by the loss of local regulation of immune responses from the body’s control.
Infectious-allergic asthma can develop, for example, against the background of chronic bronchitis or chronic obstructive pulmonary disease (COPD).
Atopic asthma has only an allergic nature, and its attacks directly depend on a person’s contacts with allergens. Frequent allergens include plant pollen, house dust, animal hair, detergents, food. An attack of atopic asthma can instantly occur even with slight contact with such allergens. Out of the reach of allergens, a person suffering from this type of asthma will feel practically healthy.
Atopic asthma can often be joined by other allergic diseases – urticaria, food allergies, atopic dermatitis, eczema, etc. This type of asthma is most often found in children.
With a prolonged course and the absence of treatment, atopic asthma leads to strong changes in the respiratory tract, and infection is also possible.
In general, neglected asthma, without proper treatment and supervision, is very dangerous. Gradually, with each attack, the narrowing of the bronchi will become more and more intense, and ultimately can lead to their complete blockage, and this is already a real suffocation.
And finally, the third type of asthma, quite specific – drug asthma. For example, with “aspirin asthma” long-term intake of aspirin (acetylsalicylic acid) leads to the accumulation of substances in the body that cause a strong and prolonged narrowing of the bronchial lumen. As a rule, to get rid of such asthma, it is enough to simply stop taking the harmful drug.
Asthma, like many other allergic reactions, can be inherited.
If one of your parents has asthma, the chances are about 25 percent that they could pass it on to you. If both parents are asthmatic, then, as you might guess, in this case, the probability of its transmission increases to almost 50 percent. And living in a family where there are smokers, be it a mother or a father, doubles his chances of getting asthma compared to children of non-smoking parents. Also, a baby born premature is 4 times more likely to get sick than full-term babies.
The same favorable background for the appearance of asthma is created by the already mentioned types of allergies and recent infections. In children, asthma often develops after a respiratory viral infection, especially when exposed to respiratory syncytial virus (RSV). Adults often experience exacerbation of asthma following bronchitis or pneumonia.
Reveal and conquer
Unfortunately, it can be difficult to identify asthma at first. This is compounded by the fact that it is similar to many other lung conditions. For example, sometimes you may be diagnosed with chronic bronchitis instead of asthma. The fact is that the intensity of the manifestation of asthma symptoms varies from person to person, and depending on the duration and severity of the disease. For example, in some people, asthma is only characterized by a cough. They have no wheezing and normal lung function. However, there is a smoldering, persistent inflammation that damages the bronchi.
There are several simple signs by which you can determine the possible presence of asthma:
* Shortness of breath at any time of the day or night;
* Cough with phlegm (especially if the phlegm has changed color or is stained with blood);
* Persistent cough;
* Chest tightness or pain.
All these symptoms should alert both you and your doctor, the trip to which should not be postponed.
An experienced doctor at the appointment will definitely ask if you have experienced similar symptoms before. Asthma will become one of the main “suspects” if you report that you have had bronchitis or even pneumonia several times over the past year.
The doctor will listen to you breathing with a stethoscope, or he may direct you for a chest x-ray or CT scan.
One of the main ways to detect asthma is spirometry, that is, measuring the volume of exhaled air (FEV). You should check before and after using an inhaled bronchodilator such as albuterol. If your FEV score improves by at least 12 percent after using a bronchodilator, then you almost certainly have asthma. If the test fails to make a definitive diagnosis, you may be asked to take methacholine (provocoline). In people with asthma, this substance causes wheezing, in healthy people this does not happen.
Finally, an allergen test takes place. This requires a skin prick test or blood test to see if you are allergic to pollen, dust mites, or other allergens.
In modern medicine, asthma is no longer a sentence; many methods of treating it or minimizing its symptoms have been developed. And no matter how insidious it is, the main thing is to identify it in time and begin full-fledged treatment.