BRONCHIAL ASTHMA

                            BRONCHIAL ASTHMA

What is Bronchial Asthma ?

  "Bronchial asthma is a disease characterized by an increased responsiveness of the airways to various stimuli .It manifests by widespread narrowing of the airways causing paroxysmal dyspnea ,wheezing or cough.The diffuse obstruction to the airflow is reversible in a large majority of cases,either spontaneously or in response to treatment .Bronchial reactivity is a necessary component of asthma".

What can be the risk factors of it?

 

+Viral infections:more frequently it triggers airway narrowing as viral infections interfere with integrity of mucous surfaces by opening up tight inter-epithelial cell junctions and induce shedding of epithelium.

+Weather change:sudden change in the weather might result in:-

(i)loss of heat and water from lower airways.

(ii)sudden release of airborne allergens in atmosphere resulting in severity of asthma. 

+Emotional factors:emotional stress operated through the vagus nerve ,initiates smooth muscle contractility of bronchi.

+Endocrine factors:some endocrine changes including puberty may increase symptoms of asthma. 

What could be the clinical

 The clinical features of asthma are variable.

(1)Acute asthma usually begins with cold and spasmodic coughing.

(2)Dyspnea with prolonges expiration and wheezing.

(3)Sweating profusely,cyanosis may develop and may get fatigued easily and feel restless.

(4)feeling of airhunger and wheezing sound while breathing out.

(5)Loss of appetite

(6)Complaints like tightnes of chest and chest hurting.

(7)In chronic cases chest becomes barrel shaped.

Which criteria tells us about diagnosis of asthma?

 A prolonged whistling sound heard at the mouth during expiration (that is wheezing),a recurrent attacks of wheezing indicate Bronchial Asthma .

Cough,which is associated with asthma generally worsens during exercise.Chronic spasmodic cough may associates with asthma.

INVESTIGATIONS

• Absolute eosinophil counts
• chest x-ray film
• allergy test: skin test and radioallergosorbent allergen specific IgE have limited usefulness.
• spirometry  

 Pharmotherapy

 Use of medications that relax smooth muscle and dilate the airways and that decrease inflammation and thereby prevent severness of disease

 The medications used for longterm treatment of asthma includes bronchodilators,steroids mast cellstabilizers ,leukotriene modifiers and theophylline.

Drugs such as salbutamol can be used as bronchodilators ,inhaled steroids like beclamethasone and montelukast like can be used in children above 12 years of age.

  

 Management

The effective long term management of asthma involves :

(i)identification and elimination of factors causing asthma such as passive smoking,allergic disorders,inadequate ventilation at home leading to dampness,cold air ,cold food ,smoke,dust and pets in family.

(ii)wet mopping of floor should be done in home because dry dusting increases exposure to house dust.

(iii)adolescents should be refrain from smoking

(iv)exposure to strong or pungent odors such as wet paint,disinfectants and smoke should be minimized.

Monitoring and modification of treatment

After starting of treatment patients should be seen every 4-12 weeks.on each visit a detailed history regarding frequency of symptoms,sleep disturbance,physical activity,need for bronchodilators. 

 
!SAY NO TO SMOKING!

                                                                                                                
                                                                 -BY DR. RAVI RANJAN
                                                          -BY  DR.TANYA SHARMA