Asthma – Symptoms And Treatment

allergic asthma 

The asthma is an inflammatory disease of the airways . It is a chronic disease that appears in seizures during which the person experiences difficulty breathing , breathlessness, and wheezing. Between seizures, breathing is normal in most asthmatics . 6.7% of the population and 9% of children are affected by asthma in France, ie more than 4 million people. Although deaths from asthma in France have declined, this disease still causes 1 000 deaths per year among people under 65 years of age.

  • Our video
  • Definition
  • Statistics
  • causes
  • sYMPTOMS
  • Recognizing symptoms
  • Idea received wrong: my lungs radio is normal: I am therefore not asthmatic
  • Diagnostic
    • Advanced flow meter
    • Measuring his breath
    • EFR
  • Treatment
    • Bronchodilator drugs
    • Long-acting bronchodilators
    • Aerosol dispensers
    • Inhaled corticosteroids
    • Corticosteroids in the form of tablets
    • antileukotrienes
    • Anti IgE
    • Other treatments
    • Respiratory physiotherapy
    • Inhalation chamber
    • Spa treatments
    • Allergy treatment
  • Prevention
  • See also: Asthma

 

Our video

Definition

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Asthma is a chronic bronchial inflammatory disease associating several processes including bronchial hyperreactivity, local inflammation and thickening of the bronchial walls accompanied by mucus formation and bronchoconstriction , that is to say a decrease Of the diameter of the bronchi. In the event of an asthma attack , the bronchi contract, and then develop an edema decreasing their diameter. The bronchi become obstructed and prevent the air from circulating.

Statistics

In 20 years, the number of cases of allergies and asthma is increasing in France, but also around the world. Asthma is the first chronic disease of the child and still results in one thousand deaths a year according to the National Institute for Health Surveillance , INVS. Asthma causes 600,000 days of hospitalization . The estimated cost of asthma is one billion euros in healthcare costs. Barely one in three asthmatics receives treatment in France, or only about one million people, and 4 out of 10 people take it correctly. Asthma is a classic cause of school absenteeism. It is estimated that, A potential asthmatic is born in France every ten minutes. Asthma is considered the most common chronic condition of the child. About 3 people die each day from a severe asthma attack. The results of AIRE ** (Asthma Insight and Reality in Europe) study, the largest study ever conducted on asthma in Europe, revealed that only 5% of European asthmatics would be treated according to international guidelines in force.

causes

Allergy is one of the main causes of asthma. These include allergies to pollen , dust, dust mites , animal hair, mold , and so on. In addition, tobacco is an aggravating factor.

sYMPTOMS

This inflammation of the bronchi prevents the passage of air and causes the symptoms of the asthma attack . The discomfort experienced during the symptoms is caused by the difficulty of passing air through the airways . The airway inflammation is prolonged even in the absence of events, which can push asthmatics to interrupt their treatment. Chronic inflammation causes bronchial remodeling that aggravates asthmatic disease if no background treatment is implemented. Asthmatics have difficulty breathing and exhaling the air in their lungs . A typical cough and whistling accompanied this discomfort.

The diagnosis of a typical and characteristic asthma attack is quite simple to perform. A large majority of asthmatics do not have this type of wheezing and live years with asthma progressing slowly but surely. Many people have been embarrassed for years by less impressive manifestations without the diagnosis being made. Episodes of dry cough that have been evolving for several weeks, even months or years, occurring mostly in the evening, during the night when exertion can also be signs of asthma. Repeated episodes of bronchitis may also show asthma. A shortness of breath , feeling of losing his breath are elements suggestive of asthma. Some adults or children show great fatigue as a result of this disease.

A frequent, persistent cough several weeks after a nasopharyngitis . Many people have for years manifestations of this type that are not diagnosed as being related to asthma. The disease, untreated, worsens gradually and can, years later evolved towards respiratory insufficiency with consequences sometimes severe and more difficult to control.

The Asthma is an insidious disease that can evolve slowly without the patient realizing it. Many people thus live years with a breath “a little short” which gradually worsens without any other manifestation. These people who have been limited in their daily lives for years do not imagine for a moment that they are asthmatic. Even their practitioner finds it difficult to make this diagnosis because they do not exhibit whistles so characteristic of the disease. Unfortunately, it happens that one day, often between the ages of 50 and 60, the symptoms worsen brutally, even tragically. Asthma can be compared to an iceberg whose visible part represents the typical crisis and its whistling and the submerged, invisible part with more pernicious symptoms,

Recognizing symptoms

Knowing how to recognize the signs of diagnosing asthma is probably the most important advice that patients need to know. Tracking the manifestations of this disease can help thousands of people who can then consult a doctor who is well versed in the diagnosis and treatment of this disease. Simple questions should be routinely asked of all asthmatics during a consultation. The answers obtained make it possible to evaluate the patient’s discomfort and to adapt his treatment. An embarrassment is felt during certain activities such as playing a sport or running after a bus, for example, at home or at work. A shortness of breath occurs during the rise of 2 or 3 stages, during walking or at rest. The asthmatic person is awakened at night or earlier than usual by coughing, shortness of breath, tightness, whistling and pain in the chest. The bronchodilator inhaler is used frequently. A tiredness is common for minor efforts. An embarrassment can be perceived on the telephone, situation often intriguing the interlocutors “it’s weird, you have breathless? “. Presence of one or more bronchitis which have been prolonged by coughing for several weeks. Some practitioners do not always think of the diagnosis of asthma, often very difficult, when the patient does not present a typical crisis with his whistling. They can sometimes tell the patient that he has no asthma. The diagnosis of this disease is sometimes difficult and requires regular practice. Feel free to lobby your doctor if you think you are embarrassed and ask to see a specialist or perform PFT , pulmonary function tests , only test the accurate diagnosis of asthma. A newborn with at least three episodes of respiratory wheezing, a respiratory gene , several wheezing bronchitis or “asthmatiform” bronchitis before the age of two years should be considered an asthmatic child.

The only discomfort described by some asthmatics is fatigue, which is aggravated by the sometimes minimal efforts of everyday life. Walking, climbing stairs, Shopping sometimes represent an insurmountable effort that patients do not imagine being caused by asthma. Some asthmatics live for decades with fatigue caused by an obstruction, most often quite severe, of their bronchi. When a physician makes this diagnosis, sometimes by chance or after an episode of superinfection or worsening of the disease, these patients are surprised to see the dramatic improvement in their “shape” and fatigue with the treatments proposed. Most often severe, of their bronchi. When a physician makes this diagnosis, sometimes by chance or after an episode of superinfection or worsening of the disease, these patients are surprised to see the dramatic improvement in their “shape” and fatigue with the treatments proposed. Most often severe, of their bronchi. When a physician makes this diagnosis, sometimes by chance or after an episode of superinfection or worsening of the disease, these patients are surprised to see the dramatic improvement in their “shape” and fatigue with the treatments proposed.

Idea received wrong: my lungs radio is normal: I am therefore not asthmatic

The fact of having a normal lung radio does not mean that the person does not have asthma: this idea is false. Indeed, the great majority of patients with asthma presents no abnormality when a thoracic radio , it is the radio of the lungs, is carried out. The chest X-ray was systematically performed at the balance sheet of asthma because it eliminates another diagnosis or to highlight some of the complications of the disease. The discovery of a normal radio does not encourage asthmatics to follow a treatment because they imagine that a normal radio is equivalent to the absence of asthma.

Diagnostic

The great majority of asthma patients is nothing wrong when a radio chest, chest x-ray is performed. Chest X-ray is routinely performed on an asthma test because it can eliminate another diagnosis or sometimes reveal complications of the disease. The discovery of a normal radio does not encourage asthmatics to follow a treatment because they imagine that a normal radio is equivalent to the absence of asthma.

The diagnosis of asthma can be made when the symptoms are characteristic. In addition to a crisis, it is nevertheless possible to determine the origin and severity of asthma by carrying out a series of analyzes:

  • Respiratory functional exploration to determine respiratory capacity;
  • The bronchial provocation test (comparison of the volume of exhaled air before and after being brought into contact with an allergen );
  • The test of reversibility of the obstruction following the inhalation of a product dilating the bronchi.

Advanced flow meter

The peak flow meter is a small device that measures the peak expiratory flow rate: this is the maximum velocity at which air can circulate during forced exhalation after it has inflated to the maximum of its lungs.

These small appliances are reimbursed by the health insurance fund. The use of peak flow meter consists in comparing the figure obtained with a theoretical value, which varies according to the age, the size and the sex of the patient.

Some patients must monitor their breath daily with this device: measurements are usually taken at dawn in the morning and at bedtime at night. A measurement may be necessary at any time of day if discomfort arises.

A number less than a theoretical value means a limitation of the air flow and indicates a respiratory discomfort.

Depending on the value observed, measures should be taken according to the doctor’s advice: use of bronchodilators, increased doses of treatments, need to take corticosteroid medications.

You have to call your doctor to get a notice or call 15, if the number found is too low. This measure allows the respiratory function of the patient to be monitored, and to react quickly in case of discomfort.

The peak expiratory flow rate, DEP, is expressed in liters per minute. DEP varies with age: it is lower in children than in adults and is higher in young adults than in elderly adults. The DEP is proportional to the size. Man has a higher expiratory flow rate than a woman of equal height and age. DEP is an essential indicator of the severity of asthma.

The goal of treating asthma is to get the best expiratory flow stably.

Measuring his breath

  • Put the cursor at the bottom of the graduated scale, level 0 and stand.
  • Take the camera horizontally.
  • Inflate the chest to the maximum, mouth open.
  • Insert the mouthpiece into the mouth and tighten it into the lips
  • Blow in one fell swoop, as hard and fast as possible.
  • Repeat the process three times and note the highest value.

The feeling of not being embarrassed does not mean that asthmatic disease is not present. Many asthmatics find peak expiratory flow rates, DEP, anomalously low, while they do not feel embarrassed and do not “whistle”
Each practitioner should be able to systematically perform this measurement which takes a few seconds; This would make it possible to screen more people with apparently symptomless asthma. For more information, please visit http://www.automesure.com/

EFR

EFR, functional respiratory exploration, the only way to check and control asthma. It allows to measure parameters allowing to appreciate the respiratory function and the degree of the asthma. It should be performed at least once a year, even in patients who are not experiencing any discomfort. There is indeed a difference between the perception of respiratory discomfort and the reality of bronchial obstruction. Nearly 20% of asthmatics do not perceive a bronchial obstruction greater than 50%.

The EFR helps to diagnose asthma, assess its severity and the effectiveness of treatments. If the EFR is normal and doubt persists, a non-specific bronchial provocation test may be proposed. TheEFR is a painless examination that is reimbursed by the health insurance fund.
Measurement of blood gases makes it possible to measure the level of oxygen and carbon dioxide in the arteries . During a severe crisis, the oxygen level decreases and that of the carbon dioxide increases due to a reduction in the diameter of the bronchi preventing oxygen to reach the blood vessels. The goals of managing childhood asthma, the most common chronic disease, should allow the child to lead a normal life with normalized lung function. However, according to the AIRE study, 40% of children with asthma have never had an EFR. EFR in Children Measurement of blood gases makes it possible to measure the level of oxygen and carbon dioxide in the arteries . During a severe crisis, the oxygen level decreases and that of the carbon dioxide increases due to a reduction in the diameter of the bronchi preventing oxygen to reach the blood vessels. The goals of managing childhood asthma, the most common chronic disease, should allow the child to lead a normal life with normalized lung function. However, according to the AIRE study, 40% of children with asthma have never had an EFR. EFR in Children Measurement of blood gases makes it possible to measure the level of oxygen and carbon dioxide in the arteries . During a severe crisis, the oxygen level decreases and that of the carbon dioxide increases due to a reduction in the diameter of the bronchi preventing oxygen to reach the blood vessels. The goals of managing childhood asthma, the most common chronic disease, should allow the child to lead a normal life with normalized lung function. However, according to the AIRE study, 40% of children with asthma have never had an EFR. EFR in Children Oxygen and carbon dioxide in the arteries . During a severe crisis, the oxygen level decreases and that of the carbon dioxide increases due to a reduction in the diameter of the bronchi preventing oxygen to reach the blood vessels. The goals of managing childhood asthma, the most common chronic disease, should allow the child to lead a normal life with normalized lung function. However, according to the AIRE study, 40% of children with asthma have never had an EFR. EFR in Children Oxygen and carbon dioxide in the arteries . During a severe crisis, the oxygen level decreases and that of the carbon dioxide increases due to a reduction in the diameter of the bronchi preventing oxygen to reach the blood vessels. The goals of managing childhood asthma, the most common chronic disease, should allow the child to lead a normal life with normalized lung function. However, according to the AIRE study, 40% of children with asthma have never had an EFR. EFR in Children Oxygen to reach the blood vessels. The goals of managing childhood asthma, the most common chronic disease, should allow the child to lead a normal life with normalized lung function. However, according to the AIRE study, 40% of children with asthma have never had an EFR. EFR in Children Oxygen to reach the blood vessels. The goals of managing childhood asthma, the most common chronic disease, should allow the child to lead a normal life with normalized lung function. However, according to the AIRE study, 40% of children with asthma have never had an EFR. EFR in Children

  • Children are able from 6 or 7 years old to perform the same examination as in adults
  • Between the age of 3 and 6 years, bronchial obstruction is measured by measurement of airway resistances.
  • Before two and a half years, this examination is performed in certain pediatric departments: a drug is delivered to the baby baby in order to fall asleep.

Treatment

Asthma is a chronic disease that mostly requires a long-term treatment (chronic treatment) associated with regular monitoring, even if the patient feels no manifestation. This disease, which affects more than 4 million people in France (6.7% of the population and 9% of children), can be compared to diabetes or high blood pressure , chronic diseases requiring long – term treatment short. Unfortunately a large majority of asthmatics do not take any background treatment and are at risk of their illness worsening.

Bronchodilator drugs

Short-acting and rapid-acting bronchodilators are prescribed to relieve an asthma attack or cough episodes, minor equivalents of asthma. They act against bronchial constriction and allow them to expand. In most cases, the patient feels an improvement after a few minutes, helping him to breathe better. Their duration of action is four to six hours. Bronchodilators are also used before exertion to prevent discomfort in people with exercise-induced asthma. Their duration of action is four to six hours.

Bronchodilator drugs sometimes cause tachycardia , accelerated heartbeat , Which generally decline rapidly. The opinion of a cardiac physician is sometimes necessary if these manifestations worsen or if there are cardiac abnormalities. Many people are afraid to take this type of product because “they are bad for the heart ” and because “in any case they are useless”. Physicians are sometimes forced to deploy a lot of energy to convince patients to use this type of product.

Some tips for using fast-acting bronchodilator medications such as checking that the product is not empty and that its validity date is not exceeded. It is recommended to have several bottles at hand, at home or in the workplace, for example, A crisis that can occur in any circumstance. The dose of the bronchodilator used depends on each person and the severity of the asthma. Caution, these medicines are used for short periods. The consumption of more than 4 puffs per week of rapid-acting bronchodilators (ie 1 vial of 200 doses per year) indicates that asthma is not balanced and that it is necessary to consult. The need to increase the doses of the product, sometimes up to 12 or 15 puffs each day, due to the ineffectiveness of inhaled doses, indicates an aggravation of the asthma for which it is necessary in this case To consult urgently. For more information: Recommendations of the High Authority for Health for the follow-up of asthmatics (2004)

Long-acting bronchodilators

Long-acting bronchodilator drugs are increasingly routinely prescribed in daily background treatment, unlike rapid-acting bronchodilators, which are used in case of discomfort. They can only be prescribed in certain asthmatic patients who are also receiving anti-inflammatorytreatment .

Aerosol dispensers

The use of metered dose inhalers allows the drug to directly reach the airways. They require learning from the doctor. These dosing aerosols are sometimes misused, which reduces the effectiveness of the drugs. This is most often an incorrect synchronization between the pressure on the vial and the inhalation of the puff). The pressure on the bottle is not always performed at the right time in relation to the inspiration and the puff immediately emerges. The breathing is not sufficiently retained after inhalation: it is indeed asked to count to 10 before expiring. Begin the first inhalations of the medication in front of an ice – Absence of fog indicating the incorrect use of the medication. There are other devices that facilitate the penetration of the products and avoid bad hand-lung synchronization of the aerosol: dry powder inhalation systems including turbuhaler (the asthmatic person rotates the small device and deeply inspires a Once he heard a little noise), the diskaler, the diskus …

Inhaled corticosteroids

The steroids inhaled are anti-inflammatory drugs in bronchial referred. A large majority of asthmatics have an asthma that requires anti-inflammatory background treatment, prescribed many months, even several years. This background treatment allows treatment of chronic inflammation and helps prevent the worsening of asthmatic disease. It should be prescribed as soon as the asthma becomes persistent and the embarrassed person has to take more than 4 puffs of bronchodilators per week. The corticosteroids control the inflammation of the bronchi as well as the course of the disease towards an aggravation, reducing the number the number and intensity of the seizures. These drugs, Usually use with a metered dose or dry powder aerosol .

The dosage and duration of treatment vary according to the intensity of the discomfort and the numbers obtained during the respiratory examination (EFR). This treatment is adapted to each asthmatic. Discontinuation of anti-inflammatory treatment is rarely possible for a few months without seizures returning within a variable period of time. Only the doctor following the asthmatic patient may decide to discontinue this treatment. These medications do not cause any improvement after a few minutes after taking them, unlike bronchodilator drugs. Some patients then think that these treatments are useless and interrupt them.

The side effects of these medicines should not be confused with those of corticosteroids taken in the form of tablets , syrup or injections. They can be manifested by a change in the voice accompanied by hoarseness or a mycosis of the mouth . It is advisable to rinse your mouth after using corticosteroids to avoid the appearance of side effects. Hoarseness or mycosis of the mouth. It is advisable to rinse your mouth after using corticosteroids to avoid the appearance of side effects. Hoarseness or mycosis of the mouth . It is advisable to rinse your mouth after using corticosteroids to avoid the appearance of side effects.

Corticosteroids in the form of tablets

In severe attacks or when asthma worsens during bronchitis, for example, corticosteroid medications in the form of tablets are prescribed. In this case, it is associated with long-acting inhaled corticosteroid and bronchodilator therapy. People with this treatment usually have severe asthma and should be monitored very closely. This treatment is usually prescribed for a few days. In some situations, this treatment is prescribed for longer: In this case, side effects can occur: increased appetite , temporary weight gain , a change in mood …

antileukotrienes

Antileukotrienes, used in the form of tablets, act by blocking the action of leukotrienes, mediators of inflammation of the respiratory tract. They are useful in the prevention of exercise asthma and also in the background treatment of asthma incompletely controlled by inhaled corticosteroids.

Anti IgE

A new class of drugs, Anti-IgE, are prescribed in severe allergic asthma.

Other treatments

The antibiotics are prescribed in bronchial superinfection.

Respiratory physiotherapy

The chest physiotherapy is a method that can help people with asthma, especially babies and toddlers. It allows, during the attacks, to eliminate the secretions blocked in the bronchi, thus fighting against the bronchial congestion. It also helps to learn how to better control one’s breath, to place one’s breath, to relax during the appearance of an embarrassment, the crisis causing anxiety that aggravates asthma and finally to learn how to use medications in forms Of metered aerosols.

Inhalation chamber

The use of an inhalation chamber is intended for infants. This inhalation chamber is a reservoir allowing easier inhalation of the product. A puff is delivered through the mouthpiece of the inhalation chamber. The child can then inhale the product by performing 5 to 10 inspiratory movements. The inhalation rooms of a large volume are intended for infants and babies while the smaller ones are offered to the bigger children, from 4 to 5 years approximately. They are covered by health insurance .

Shake well before dispensing. Deliver only one dose at a time and wait 5 to 10 breaths before giving the second dose. Do not forget to regularly clean the mask and the tank. When the child is very agitated, two people are advised: put the child on the knees of one of the 2 people, reassure him and avoid getting too angry, put a hand on the mask in order to maintain and maintain it The head of the child. Have him drink after inhalation and pass a damp cloth over his face. Do not give the aerosol directly to the mouth. Have him drink after inhalation and pass a damp cloth over his face. Do not give the aerosol directly to the mouth. Have him drink after inhalation and pass a damp cloth over his face. Do not give the aerosol directly to the mouth.

Spa treatments

A stay in a spa can help asthmatics, even if no scientific study really makes their effectiveness. The psychological effect provided by the cure is of course very beneficial because asthmatics are taken care of daily and receive care allowing them to relax and be less embarrassed. This stay under favorable climatic conditions allows to be supervised, to practice certain sports activities, to receive a more targeted education. The physical and psychological support of the patient allows him to better adhere to the treatment and to become aware of the need to be followed regularly. However, a stay in a spa can not solve the problem of the ” Asthma by eliminating the disease. In the vast majority of cases, treatment must be prosecuted. An asthmatic who returns from a spa cure may very well be the victim of a relapse during the next few days because of the contact with the mites, for example, less present in the cure cities. Be aware that a cure will not remove asthma.

Allergy treatment

When one or more allergies are involved in the mechanism of asthma, a treatment of these allergies must be implemented. It is necessary to treat any allergic rhinitis in order to avoid the onset of asthma. It is also necessary to carry out the preventive measures in case of confirmed allergy to mites, pollens or animals for example. A desensitization may be considered.

The figures are overwhelming: more than half of asthmatics do not respect the prescriptions recommended by doctors. The asthmatic person has a great deal of difficulty accepting the idea of ​​being affected by a chronic illness with which she will have to learn to live and be followed for a very long time. Duration is a difficult concept to grasp for a patient who will tend to “escape” and interrupt his treatment as soon as he feels better. The absence of manifestations does not encourage the patients to continue their substantive treatment. According to a study by the Asthma association of 4,000 asthmatics, only 65% ​​of them lead a normal life, and nearly half have a sleep disrupted by respiratory discomfort .

The rate of follow-up of the consultations depends on the severity of the asthma, its allergic nature and the patient’s ability to comply with the proposed therapeutic measures. Several months are sometimes necessary to convince the asthmatics to take their treatments of background even if ‘ They do not feel embarrassed or do not make a crisis. The physician should use a lot of energy and should not be afraid to repeat himself so that his patient does not stop treatment when he feels better. Unlike people taking medication for years against high blood pressure, hypercholesterolemia or diabetes for example, a majority of asthmatics do not accept to take its treatments for so long.

Prevention

There is no treatment to cure asthma definitively. Nevertheless, crises are likely to become scarce and to diminish in some cases. To do this, it is essential to stop tobacco consumption and to prevent passive smoking . In addition, it is necessary as much as possible to avoid to come in contact with the allergen in case of allergic asthma . For example, it is possible to use anti-mite linen in case of allergy to these parasites , avoid contact with cats in case of animal hair allergy, etc. The education of the patient or his parents is essential and reduces the occurrence of serious seizures. Schools of asthma exist to educate families.

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