How is asthma diagnosed? Asthma provocateurs

Bronchial asthma is spreading among the masses; today almost 300 million adults and children suffer from it in the world. It is asthma that is considered the most common chronic disease of childhood; the life histories of almost 15% of young Russians are marked with this unpleasant diagnosis, and sick children outnumber adults.

An unusual feature of bronchial asthma: the maximum proportion of the disease is diagnosed in childhood, mainly in boys; by adolescence, the ratio of sick boys and girls evens out, and in adults, asthma is predominantly suffered by women.

In Russia, ten out of a hundred adults suffer from asthma, and in total there are about 7 million; every year a little more than 40 thousand do not survive another severe attack of the disease. The highest incidence rate affected the Scots. Dampness and cold promote asthma, which even Hippocrates knew, who came up with the idea of calling the resulting paroxysmal suffocation asthma.

It is noted that cleanliness also leads to an increase in the frequency of allergies, and asthma as its clinical apogee. A funny clinical case occurred in the Middle Ages: an Italian doctor cured a bishop of asthma without any drugs, prescribing him a diet with exercises and, most importantly, replacing his old feather bed.

City dwellers suffer from bronchial asthma more often than villagers, because in an overly clean civilization and polluted urbanization, the human body is not accustomed to respond adequately to the effects of various natural allergens, but various air pollutants - harmful particles from man-made production - are constantly floating and flying in the air. It has been noted that the severity of asthma is directly related to the social and nervous status of the patient; the more nervous his life, the more complex his illness.

Asthma provocateurs

There are many reasons for the occurrence of asthma; today experts define it as a “heterogeneous” disease, literally, heterogeneous or multi-causal. But it is known for sure that the majority of cases of asthma occur against the background of chronic inflammation of the mucous membranes of the respiratory tract, but not all diseases can be explained only by this. In asthma, the body reacts inappropriately to certain stimuli, when the response to the presence of a non-natural factor is greater than it should be.

Allergens that fill the external environment most often play the role of triggering the disease. As a rule, these are natural allergens, such as house dust, animal hair, chitinous scales of insects, and fungal spores. To initiate the process, a microscopic dose of the allergen is enough, not even a gram is required. By the way, scientific research confirms that the less often a child encounters such allergens, that is, the cleaner the world around him, the greater the likelihood of developing asthma upon his first encounter with a previously inaccessible component of the external environment. Thus, cockroaches were expelled from apartments and the next generations of people who had never encountered domestic cockroaches began to react more frequently to their allergens.

Contributes to the formation of asthma, but does not cause it, gas pollution, occupational hazardous substances, tobacco smoke, food. Triggers are considered to be a cold, damp climate, significant physical, and in fact almost sports in an untrained person, loads. In themselves, all of them are not allergens, but they help allergens harm by also narrowing the lumen of the bronchi. There is even exercise asthma, which manifests itself during physical activity, usually associated with inadequate treatment.

Many of us have reasons for asthma that are related to work, or rather, to the environment at work. This form is called asthma in the workplace. There are hundreds of substances that can cause disease; house dust is not at all like library dust, or street dust, or office dust. In case of work-related asthma, the development of an attack is caused by “work” office dust, which does not match the composition of home dust. The same thing happens in some industry, where the dust contains particles of paints and chemicals that are not found in apartments. And it turns out that there is always a reason for asthma.

Diagnostics

To diagnose asthmatic manifestations, it is necessary to conduct a thorough examination of the body. The medical clinic in Mytishchi has equipment and reagents to perform allergy tests at any time of the year, regardless of the intensity of the disease.

Allergy tests are a diagnostic method for identifying the allergen to which the patient’s body reacts.

To determine the allergic status, it is necessary to conduct laboratory tests - tests for sensitivity to various allergens - fungal, pollen and household.

A study of respiratory function - spirography - allows you to estimate tidal volumes.

The doctor will prescribe a number of laboratory tests:

General and biochemical blood test;
Antibody test;
Examination of stool for the presence of helminths;
CT

Internal attitude towards asthma

But for the development of asthma, an internal predisposition is also needed. It is assumed that there is a genetic predisposition, because with at least one parent with asthma, in half the cases the child runs the risk of inheriting the disease. But the specific genes responsible for the onset of the disease have not yet been found. Excess weight contributes to the development of asthma, in which the abdominal fat pushes the diaphragm into the chest cavity, due to which the breathing volume decreases, the lower parts of the lungs are “compressed” and bacteria that are carried with the air multiply in heat and humidity.

An interesting feature of the relationship between the disease and gender. In childhood, boys are more susceptible to asthma, but not because of the “male” chromosome or sex hormones, but simply their bronchial lumen is slightly smaller, therefore, when inflamed, the bronchi are easily blocked by edematous mucosa, forming a favorable environment for maintaining bacterial inflammation. In adults, asthma is a female disease, and here it is apparently linked to the production of sex hormones, because attacks often coincide with menstruation.

How does asthma occur?

Bronchial asthma is based on inflammation of the airways, and inflammation can be caused by bacteria, viruses, protozoa - anyone. But very often the first attack of the disease occurs precisely after an infection, and since every person suffers a viral infection - a cold - on average six times a year, the reason for the development of asthma arises quite often. The attack of suffocation itself occurs directly due to a sharp narrowing of the lumen of the bronchi, as a rule, against the background of an already existing inflammatory narrowing.

The mucous membrane in a state of inflammation is saturated with excess fluid and immune cells gather in large numbers, releasing biologically active substances at the slightest provocation. A tiny allergen that has flown in with the air flow falls on the loose, swollen mucosa, and immediately crowds of immune cells rush towards it, throwing out products that should kill the allergen, but the allergen is not a living organism, it cannot be killed. The mucous membrane swells even more, narrowing the lumen, and air can pass through the bronchus only with the application of force. Choking begins, all normal people are afraid of death from lack of air, and the release of “fear hormones” intensifies the attack even more.

Asthma attacks are most often triggered by stress, emotional experiences, after mental stress and overwork. Asthma is a psychosomatic disease; it not only occurs against a background of emotions, the attack is aggravated by emotion, and the fear of encountering an allergen and developing an attack does not pass without leaving a mark on the psyche. In patients under 40 years of age, in nine out of ten cases the cause of the disease is a long-standing allergy. Older people may also develop asthma because emphysema and pulmonary diseases create a favorable environment.

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Bronchial asthma

Bronchial asthma is a chronic inflammatory disease of the airways. It is characterized by increased sensitivity of tissues to various irritants. In response to an irritant, a muscle spasm occurs in the bronchi, their lumen narrows, and increased mucus production begins. This makes breathing difficult, causing severe shortness of breath and coughing. The disease occurs in 5% of the population - according to WHO, in 2021, 235 million people in the world suffered from bronchial asthma. The most dangerous thing is that the prevalence of the pathology continues to grow.

Reasons for development

Bronchial asthma can appear due to external influences or internal processes in the body.

Hormonal imbalances

Pathologies of the thyroid gland (hypothyroidism, thyrotoxicosis) can become an indirect factor in the development of asthma. Due to a lack or excess of hormones, the bronchial mucosa swells, the trachea is compressed, and bronchial obstruction (insufficient ventilation of the lungs) increases. Also, disturbances in the functioning of the thyroid gland worsen the course of existing asthma. It has been proven that in patients with asthma with parallel goiter formation, asthma attacks occur more often, and periods of remission are much shorter.
Obesity is another factor influencing the development of the disease. The hormone leptin is synthesized in adipose tissue, which normally promotes weight loss. But in overweight people, leptin is produced excessively and provokes an inflammatory process in the bronchi. The higher the level of the substance, the longer the inflammation lasts, the more difficult the treatment will be.

Respiratory system diseases, infections

The risk of developing asthma increases with chronic bronchitis, tonsillitis, pneumonia, and viral respiratory infections. Irritated, swollen mucous membranes with frequent relapses simply do not have time to recover.

Genetic predisposition

Researchers have so far identified a small number of genes responsible for the development of bronchial asthma. If one of the parents suffers from asthma, the probability of the disease in the child is 20–30%, and if both parents are sick - already 75%.

Adverse environmental factors

This implies the constant presence in the air of substances that can cause irritation of the respiratory tract: tobacco smoke, pollen and molds, house dust, aggressive chemical compounds.

Main symptoms of the disease

Bronchial asthma does not begin abruptly; all symptoms develop gradually and, if left untreated, develop into a chronic form. You should be wary of:

lack of air, turning into shortness of breath,
attacks of suffocation,
wheezing when breathing,
dry cough with sputum.

Types of bronchial asthma

Allergic (exogenous). Manifested by sensitivity to allergens of animal and plant origin, and chemical vapors. The body then produces antibodies to allergens.
Non-allergic (endogenous). Symptoms develop without contact with allergens. Often the disease occurs due to stress, disorders in the immune system, heavy physical activity, and taking certain medications.
Mixed. There are signs of both types of bronchial asthma.

Severity

Experts note mild, moderate and severe forms of asthma. Depending on the frequency of attacks, four stages are distinguished:

1st stage. Characterized by 1 daytime attack per week and 2 nighttime attacks per month;
2nd stage. Daytime attacks occur several times a week, night attacks - more than 2 times a month;
3rd stage. Attacks almost daily, at night - more than once a week;
4th stage. Daytime attacks become constant, possibly several times during the day and at night.

All these signs are present both at rest and during physical activity.
In severe forms of the disease, complications may develop:

spontaneous pneumothorax - reflux of air from the environment into the pleural cavity, because the integrity of the lung is compromised;
cor pulmonale - an increase in size of the right ventricle of the heart. This provokes the appearance of edema, swelling of the neck veins;
Pulmonary atelectasis - occurs when the bronchi are blocked. It is expressed in the “deflation” of the entire lung or part of it, which makes gas exchange impossible.

It is very important to consult a doctor in a timely manner, undergo a course of treatment and prevent complications.

What can cause an attack

If asthma is allergic, the first symptoms appear within minutes upon any contact with allergens. Allergens can be both food and household. Most often the reaction is caused by:

nuts,
milk,
eggs,
seafood,
honey.

Also, attacks of bronchial asthma occur due to inhalation of pollen, perfumes, contact with animal fur, after physical exertion, and from exposure to cold air.
If asthma is non-allergic, attacks may begin due to exacerbation of chronic ENT diseases.

Medications are also common triggers. A striking example is aspirin-induced asthma against the background of increased sensitivity to acetylsalicylic acid and NSAIDs in general. Adrenergic blockers, which are necessary for the treatment of cardiovascular diseases, can also provoke an attack.

What to do during an attack

To stop an asthma attack before seeing a doctor, do the following:

try to calm down - panic increases symptoms;
Take a sitting position - it will make breathing easier;
inhale the aerosol medicine in an increased dose - bronchospasm will prevent the entire dose from being delivered in the standard volume;
After 15–20 minutes, you are allowed to inhale another dose of the medicine.

If it doesn't get better, you need to call an ambulance. You cannot get to the clinic on your own so that another asthma attack does not catch you on the way.

Diagnostics

Tell your pulmonologist about all your symptoms, frequency of attacks, living and working conditions. The diagnosis of bronchial asthma will need to be confirmed by instrumental and laboratory tests.

Spirometry

The test determines how much air a person can exhale in total. The patient inhales so that the lungs fill as much as possible, and then exhales the entire possible volume into the tube of the device - a spirometer. The obtained indicators of inhaled, retained and exhaled air are compared with normal ones, and a conclusion is made about the vital volume of the lungs.

Peak flowmetry

The measurement is similar to spirometry. The difference is that you need to make forced (intensified, fast) inhalation and exhalation. This method determines the peak expiratory flow (PEF), which decreases in bronchial asthma. Peak flowmetry allows you to find out how much the airways are narrowed and evaluate the effectiveness of treatment.

Radiography

Required if there is a suspicion of tuberculosis, tumor formations, thickening of the walls of organs. Not only the chest organs, but also the sinuses are examined to exclude alternative diagnoses.

Laboratory research

Helps assess the severity of the inflammatory process. This includes a general and biochemical blood test, urine test, determination of sugar levels, tests for hepatitis, HIV and syphilis. In case of asthma, it is mandatory to take samples of respiratory tract secretions for flora and sensitivity to antibiotics. Additionally, the doctor may prescribe tests with allergens to determine the amount of antibodies.

Treatment

Based on the type of bronchial asthma, its severity and duration, the doctor selects the optimal treatment.

Drug therapy

Medicines for the treatment of asthma are divided into 2 groups.
Some have a bronchodilator effect and stop an acute attack. Others are used in basic therapy, eliminating the very cause of the disease - chronic inflammation in the respiratory tract. Basic medications are taken for a long time, since the effect develops after 2–4 weeks of use. In both groups, drugs in inhalation form - aerosols - are common. These are the most effective and safe remedies for bronchial asthma. The active substance in high concentrations is delivered in seconds exactly where it is needed - to the bronchi.

Aerosols

Beta-agonists (salbutamol and salmeterol) are the most common medications for quickly relieving symptoms during an attack. Glucocorticoids (beclomethasone, budesonide, fluticasone) are not suitable for stopping an attack, as their effect is cumulative. Used in the complex treatment of asthma. M-anticholinergics (ipratropium bromide). The main effect is to relieve bronchospasm; they are used both in complex treatment and in the prevention of attacks.

Non-inhaled drugs

Leukotriene receptor antagonists (montelukast, zileuton, zafirlukast) are tablets for eliminating attacks that occur from physical activity.
Methylxanthines (aminophylline, theophylline) - emergency injections. Relaxes the smooth muscles of internal organs and relieves bronchospasm.

Only a doctor can select emergency and basic therapy, because all drugs have contraindications. Thus, many of them cannot be used for bronchial asthma in combination with epilepsy.

Allergen-specific immunotherapy (ASIT)

The identified allergen is injected into the patient's body in microscopic doses.
Each time the dose is increased slightly. As a result, tolerance to the irritant is developed, and the immune response becomes more adequate. Manifestations of bronchial asthma are weakened, and the risk of complications is reduced. Therapy lasts 3–5 years, so you need to be prepared for long-term treatment and not expect quick results.

Complementary therapy

Alternative medicine methods can also improve the condition of bronchial asthma.

Psychotherapy

This treatment will help the patient keep emotions under control during conflict situations so that excessive emotional reactivity does not provoke an attack.

Acupuncture

The needles mechanically irritate active points on the body, in response the body produces prostaglandins. These substances, in turn, increase the sensitivity of the bronchi to bronchodilators (i.e., drugs that relieve spasms).

Massotherapy

With frequent attacks, the respiratory muscles experience increased stress. Massage relieves muscle fatigue, facilitates mucus discharge, and evens out breathing. The procedure is prescribed both during the period of exacerbation and in the remission stage in order to consolidate the result of treatment.

Breathing exercises

The purpose of the method is to teach a person to control the breathing apparatus, as well as to master the shallow type of breathing in order to stop an incipient attack. Simple exercises improve the mobility of the chest, clear the airways, and help maintain normal tone of the bronchial muscles. The most popular gymnastics are Strelnikova and Buteyko. One example of exercises using the Buteyko method is in the picture.

Seizure prevention

It is believed that there are no effective measures against exacerbation of bronchial asthma. But nonspecific prevention will make attacks less frequent and shorter. What you can do yourself:

remove carpets, soft toys, thick curtains from the room - they accumulate dust;
do light wet cleaning 2-3 times a day;
do not have pets;
do not use perfumes or aerosol deodorants;
stop smoking;
make a detailed list of allergenic foods and avoid eating them;
harden the body at low temperatures.

Gradually getting used to the cold is a good prevention of respiratory tract inflammation.
However, hardening only prevents the disease; During an exacerbation of bronchial asthma, you should not overcool. To achieve better results, preventive measures should be carried out regularly, and not occasionally. And remember that they cannot replace the treatment regimen prescribed by a pulmonologist.

Living with bronchial asthma

A diagnosis of bronchial asthma is not a death sentence; there are many ways to relieve symptoms and maintain a sufficient level of quality of life. To keep the disease under control, it is recommended:

visit a pulmonologist regularly - not only during exacerbations, but also for preventive examinations. After all, you may not attach importance to any symptoms and start the disease;
get a peak flow meter in order to notice changes in respiratory function in time and consult a doctor;
study the disease independently using reliable medical sources;
control your lifestyle, create a comfortable environment for yourself.

Medical will help you cope with bronchial asthma and make life more comfortable. By contacting us, you receive:

accurate diagnostics - all equipment is verified, the indicators correspond to real ones;
consultation with an experienced pulmonologist - we treat all types of bronchial asthma in patients of any age;
optimal course of treatment - we take into account your medical history and concomitant diseases;
information about prevention - we will tell you how to reduce the frequency of attacks.

To schedule a consultation, call 8 (831) 262-63-15 or request a call back, and we will contact you.

What is asthma like?

As we realized more recently, bronchial asthma arises from many causes. But the prevailing cause for the majority is allergies; this variant of the disease is called “allergic”. It develops from childhood and is always associated with dermatitis, allergic rhinitis or food allergies that precede asthma and subsequently accompany asthma. In such patients, eosinophils are extremely actively involved in inflammation, which can be seen under a microscope and in a blood test. This type of asthma responds well to treatment.

Bronchial asthma of a non-allergic nature, on the contrary, reacts poorly to medications. There is also a bronchial AS, so its somewhat unusual nature is noted. It is typical for adult women who are not prone to allergies. There is a variant of asthma in obesity, when the best cure for the disease is to reduce the patient’s weight.

Experts use the division of the disease according to the frequency of attacks, so if attacks do not occur every week, exacerbations of the disease are brief, and nighttime suffocation occurs no more than twice a month, then this type of asthma is called intermittent, that is, intermittent.

When attacks of suffocation bother you weekly and even get you out of bed at night more than twice a month, then the option is assumed to be mild persistent, that is, constant or chronic, but still mild. And the severe persistent form is characterized by daily symptoms, frequent exacerbations, when attacks of suffocation develop day and night, sharply limiting the patient’s activity. Between the mild and severe persistent variants there is moderate asthma, which does not allow itself to be forgotten almost every day; at night attacks occur no more than once a week.

From the patients:

late appeal,
self-medication, especially uncontrolled use of bronchodilators, which is one of the main causes of mortality in asthma,
underestimation of the severity of the condition,
fear of treatment with corticosteroid drugs,
failure to appear for follow-up examinations with a doctor, reluctance to participate in educational programs.

As you can see, the guilt of doctors and patients coincides on many points.

Asthma can occur at any age, most often after a respiratory tract infection. In most cases, the development of asthma attacks is preceded for several years by allergic rhinitis, conjunctivitis, and nonproductive cough. The frequency of attacks depends on the severity of the disease, but I would like to especially emphasize that asthma of any severity requires examination and treatment. Like any chronic disease, asthma requires adequate treatment during exacerbation and prevention during remission.

Medical standards for diagnosis and treatment of patients with bronchial asthma.

Asthma attack

An asthma attack does not begin suddenly at all, as is commonly believed, but is preceded by certain symptoms and sensations, the onset of which already alarms the patient. During foreplay, itching in the nasopharynx or itching in the nose, a series of sneezing begins, the skin turns red in spots, the eyes itch, and this can continue for quite a long time. Incipient suffocation is indicated by a paroxysmal cough and slight shortness of breath. If therapeutic measures are taken at this moment, the attack can stop in its infancy.

The attack itself is manifested by an acute lack of air, compression in the chest, when you can only take a very short breath, and exhalation is very slow and somehow difficult. As you exhale, loud wheezing sounds develop inside the chest and can be heard over a considerable distance. The patient sits down, leaning on the edge of the chair, frightened and confused, the veins on his neck are swollen, his lips turn blue on his pale face. The patient is literally coughing, but the sputum comes out with difficulty in small mucous clots.

The duration of an attack can vary: from several minutes to hours and even days. The severity of symptoms also varies. In some patients, it does not come to the point of suffocation; the attack resolves on its own. More often, an attack occurs at night and in the morning, because during sleep the nervous system reduces the lumen of the bronchi, reducing the flow of oxygen to deepen sleep. After awakening, the bronchi remain in a constricted state for some time, therefore, by nature, a certain natural background in itself is predisposing for the occurrence of an attack.

How is the diagnosis made?

The diagnosis of asthma is made by the patient describing the attack. If the picture meets certain clinical criteria, then a diagnosis of bronchial asthma is made. If there are doubts, then additional studies are carried out, spirometry with various drugs that narrow the bronchi to exclude other pulmonary diseases such as COPD - chronic obstructive pulmonary disease.

What are the signs that suggest asthma?

During an attack of true asthma there should always be wheezing with coughing, shortness of breath and a feeling of heaviness in the chest. If all this begins at night and early in the morning, then there is less doubt. That is, clinical signs of an asthma attack are necessary, even if not all at once, but there must be a set of symptoms.
Symptoms do not appear on their own, but in strict connection with something specific: contact with an allergen or when going out into frosty air, during physical activity, or something else specific.
The patient must have an allergy; for diagnosis it is better that there was obvious allergic rhinitis or skin lesions.
Family history remembers a relative having asthma.
The attack occurs when taking aspirin or hypertension medication.
There may also be an increased number of eosinophils in the blood test, and on spirometry, not all indicators fit into the norm, although this sign is not necessary outside of an attack, just like wheezing in the lungs.

The disease is not considered similar to bronchial asthma if the symptoms occur exclusively during a cold, a cough with sputum occurs without wheezing or shortness of breath, during an attack you feel dizzy and unpleasant tingling of the skin or goosebumps occur, the voice changes - hoarseness. Long-term smoking of more than a pack daily and severe heart disease are not beneficial for asthma. In this situation, an in-depth examination will be able to clarify the picture and come to the correct diagnosis.

Examination:

1. Mandatory laboratory tests:

Clinical blood test (once every 10 days);
Biochemical blood test (bilirubin, ALT, AST, urea, glucose);
RW, HIV;
General sputum analysis;
Bacteriological examination of sputum for flora and sensitivity to antibiotics;
General urine analysis.

2. Additional laboratory tests:

Determination of protein fractions;
Determination of the level of IgA, IgM, IgG in blood serum;
Blood test: cortisol, ACTH (for patients receiving systemic GCS);
Urine analysis for 17- content (for patients receiving systemic corticosteroids).

3. Allergological examination is mandatory:

Skin tests with allergens;
Determination of the level of total IgE;
Determination of the level of specific IgE.

4. Additional allergy examination:

Provocative tests with allergens (conjunctival, nasal, inhalation);
Determination of the level of specific IgG;
Test for inhibition of natural leukocyte emigration.

5. Mandatory instrumental studies:

X-ray of the chest organs;
X-ray of the paranasal sinuses;
ECG 1 time (if pathological - repeat);
FVD study 2 times.

6. Additional instrumental studies:

Diagnostic bronchoscopy;
Bronchomotor tests (assessment of respiratory function after exposure to bronchodilators, bronchoconstrictors, physical activity).

7. Mandatory consultations with specialists:

Allergist;
Pulmonologist;
ENT

8. Additional consultations with specialists - according to indications.

Research in recent years has confirmed the undeniable connection between the severe course of bronchial asthma and the presence of chronic, frequently recurrent infectious and inflammatory diseases, sluggish, difficult to treat, caused by intracellular microorganisms (chlamydia, mycoplasma), viruses (cytomegalovirus, Epstein-Barr virus, herpes virus), bacteria, fungi , helminths. In connection with the need to sanitize foci of chronic infection and correct the immune status (in the presence of clinical signs of impaired immunity), it is necessary:

study of immune status with control after therapy;
virological examination;
diagnosis of parasitic infestations (feces analysis for worm eggs, detection of antibodies to helminths).

How is asthma treated?

The goal of treatment of bronchial asthma is, firstly, the rapid relief of the onset of an attack, and secondly, the prevention of a new attack, which is referred to as disease control, preferably long-term control. Treatment of asthma is stepwise, where each step includes various drug options, starting with a simple and minimally harmful drug, gradually moving in therapy to a more complex combination of drugs and toxic ones. Without medications, asthma cannot be cured and this is a given for now.

Today, medications have appeared that are sufficiently effective that they even allow numerous asthmatics of Norwegian ski teams to take prizes in all competitions. Both Norwegian skiers and the whole world today use convenient portable inhalation devices to prevent and prevent asthma attacks at the first stage of therapy.

The inhaler contains a medicine that expands the lumen of the bronchus and hormonal components that relieve an allergic reaction, that is, the entire medicinal filling acts specifically on the mechanism of development of the pathological process. Inhalers come in powder and aerosol forms, and the valve allows you to accurately dose the drug. This is a convenient and safe device, even a child can use it, but most importantly, the drug is delivered exactly where the problem is happening.

Tablets and injections are used later, when asthma is more severe and does not respond well to treatment. Injection solutions and tablets also dilate the bronchi and relieve the allergic component, and of course, stop the inflammatory reaction, but like any medicine they also have toxic side effects, which inhalation forms are practically free of.

When a patient is first diagnosed with asthma or is just suspected, treatment begins immediately. If there is almost no reaction to the use of inhalation agents, then the examination is continued to find out the true cause - another disease.

When a patient complains of symptoms, but they seem to be similar to asthma, but still not characteristic of it, that is, the likelihood of asthma according to the diagnostic criteria is low, they can also prescribe inhalation agents, and if there is no result, then with full confidence asthma swept away.

If the patient has fifty-fifty, that is, the same amount of “for” asthma, then treatment is also started. In this situation, they are guided by the principle: if it helps - asthma, if it doesn’t help - not asthma.

In severe asthma, during an exacerbation, hospitalization is required, because asthma can lead to death, and after discharge, such patients should be closely monitored for a year. Treatment in the hospital is also offered if outpatient therapy is ineffective; the psychological aspect is also taken into account - it is not so scary in front of doctors, which is important for a psychosomatic illness.

Asthma in young mothers

Asthma in pregnant and lactating women cannot affect the female body, but no one can say in advance how hormonal changes will affect asthma itself. The course of the disease can either improve or worsen. Although inhaled hormonal drugs have virtually no side effects and do not fundamentally affect the development of the fetus, treatment of a pregnant woman should only be carried out under medical supervision. During childbirth, despite severe stress, asthma attacks are very rare, however, during surgical delivery and simply pain relief during labor, they try to avoid anesthesia, giving preference to any option of local anesthesia. Breastfeeding is not prohibited for asthmatics.

The material was prepared by Ekaterina Anatolyevna Tafintseva, a general practitioner, head of the hospital at the international clinic Medica24.