Asthma is an increasingly frequent respiratory disease.

Asthma

Asthma is an increasingly frequent respiratory disease.

Bronchial Hyperreactivity

The bronchi of these patients are hyper reactive: they contract too much when starting factors are present; that involves a reduction in their gauge. The air passes badly, it does not arrive well at the level of the cells, oxygen can arrive in insufficient quantity and the organization will be more or less in hypoxia i.e. in lack of oxygen.

The allergy often at the origin of asthma

The allergies are the independent factors which support the appearance of the asthma attacks.

Of course pollens are allergisants: all the year ago of it. The also confined atmospheres are favourable with the appearance of crises, just like the nonventilated, dusty, wet parts. The agents allergens are the acarina, the dejections of cockroaches, the moulds. The hairs of animals (cats, dogs, horses) are also very allergisants.

The tobacco is a factor supporting asthma

The tobacco is a worsening factor of asthma, as well for the asthmatic smoker itself as for the asthmatic ones which lives with him undergoing a passive smoking then.

It seems that pollution is also a supporting factor.

Grounds atopic favourable with the appearance of an asthma

Asthma often appears in the young child before 5 years; this child often has a ground atopic, it makes cutaneous allergies, eczema… and in the family one often finds a relative with a hay cold, an eczema, asthma, an allergic conjunctivitis.

Bronchiolites with repetition in the infant can also be a main door towards the asthmatic disease where there exists certainly a atopic component but the infection by the VRS (Respiratory Virus Syncitial) involves the increase in the bronchial hyperreactivity.

The asthma of effort is a asthmatic equivalent: 3 factors can be responsible about it: the cold, the effort, hyperventilation (typically the ski touring where all the factors are joined together) at a subject having a bronchial hyperreactivity.

Tests of sensitivity

It is sometimes difficult to highlight the allergen responsible for the asthma attacks, it is possible to seek the allergen by tests of sensitivity: they are small punctures on the front armlevers.

To know the allergen, it is to be able to avoid it.

Manifestations of asthma

The asthmatic disease is moderate with severe according to the number and the severity of the crises.

An asthma attack appears variablement by a hard breathing, a whistle in the chest with the expiry (sibilants), an oppression, a cough.

The crisis can be of short duration with the disappearance of all the signs after the crisis; it can not be suppressed completely, of the signs persist in particular the night with always a respiratory gene, a cough.

The crises are more or less frequent from 1 to 4 per month with several per week.

Sometimes of other signs can appear like a more or less intense tiredness, the short breath, a hypoxia with a cyanosite (bluish color) of the ear lobes, lips, nails, a tachycardia: they sign an aggravation of the crisis.

The chronic irritation of the bronchi

In the long term, if asthma or is not badly treated, if the crises too frequent, are badly suppressed, the bronchi irritated permanently, the disease will evolve to a chronic ignition of the bronchi and a chronic respiratory insufficiency settles.

The chronic respiratory insufficiency is a severe handicap with constant breathlessness, impossibility of going, of getting dressed, need for permanent oxygen…

A basic treatment followed good avoids this exit in the majority of the cases.

Treatment of the asthma attack

When the crisis is light, the asthmatic patient uses thedilating ones in dosing aerosol, a puff of drug in general makes pass the crisis. It is possible to renew the treatment.

If the crisis does not pass at the end of several puffs, the doctor will be consulted and will propose a subcutaneous puncture of broncho dilating.

When the crises are severe, it is necessary to go to the hospital.

In the event of asthma of effort, the patient will take a puff of broncho dilating before practicing the sports activity to avoid the appearance of a crisis.

Basic treatment

It is extremely important. It makes it possible to space the crises and to decrease their severity; in the long term, it makes it possible to avoid the passage to the chronic disease. The effects are not felt immediately, it is all the difficulty of the observance of this treatment.

It should be followed, speak with your doctor if you have evil to take your drugs, if you do not feel not justified.

It is obviously necessary to avoid the starting factors or to control them. Above all, and it is not always easy, to avoid the allergens (dust, pollens, drugs…). To do the housework to eliminate the acarina: no fitteds carpet, not of carpet, or to shake them vigorously the every day, to avoid the dust traps (racks, curtains…). There exist also products anti-acarina of bombs aerosol to be pulverized.

To privilege the synthetic one for the bed linen: no pillows nor feather beds in feather.

To air the bed linens (mattress, pillow, cloths…) the every day.

To avoid the animals which give allergies: to avoid having these animals at the house or to at least to prohibit them the access to the room of the asthmatic person, to often wash them, wash clothing the every day.

To avoid the drugs which give an allergy among these patients.

Sometimes it is impossible to escape certain allergens, it is possible to make a desensitizing if there is no counter-indication but it is constraining and not always easy in the child.

He is imperative not to smoke and flee the smoked out atmospheres.

Medicamentous treatment

In the ordinance of a asthmatic patient of thedilating ones which decreases broncho-constriction are associated with drugs antiallergic (antihistamines), sometimes of corticoids are prescribed over one defined period, they will decrease an ignition associated with broncho-constriction.

In the basic treatment, cures with the mountain where the air healthy, is ventilated, are interesting. Moreover, within this framework, an active therapeutic education is undertaken, the contact with the other asthmatic ones is useful.

Therapeutic education

The asthmatic patient must learn how to manage his disease and his asthma attacks: he will find council near his attending physician, during a hospitalization or in specialized health care centres.
He will learn how to know the preambles of the crisis (i.e. the harbingers): the nose which runs, the eyes which cry, the throat which scrapes…

He will learn how to inhale his broncho-dilating drugs correctly, to adapt the treatment according to the respiratory state.

He will learn how to recognize the severity of a crisis, to know when to call the doctor or when to go directly to the urgencies.

He will go regularly every at least 6 months in his attending physician to make an assessment; doctor and patient will discuss together the crises and the way in which they are apprehended by the patient, of the possible difficulties of determining the severity of a crisis, sorrow to follow the basic treatment.

The doctor will evaluate the expiratory flow of point with an apparatus (the debimeter of point or peak flow) i.e. will measure the breath, and will compare it with preceding measurements.

To retain

Asthma is generally a disease of the bronchi which contract too much, in the presence of an allergen like the acarina, the hairs of animals, pollens,… they involve a gene to breathe. The tobacco is a worsening factor of the asthmatic disease. Sometimes the crises are serious and require the hospitalization.

The asthmatic patients must take their disease in hand, to include/understand well the process of the disease, they will avoid the starting allergens and other factors, they will have to observe the basic treatment which from day to day does not appear very effective but in the long run avoids the development of a chronic asthma, knowledge to treat their crises well, to recognize their benignity or their severity, know when to call a doctor. It is with them of going regularly in the doctor to take stock of the evolution of the disease.