According to the WHO, bronchial asthma is one of the most common
non-communicable diseases. So, in the world they suffer from 3.8% of the
population. In Russia, the prevalence of bronchial asthma among adults is 6.9%,
among children and adolescents it reaches 10% 1 . The incidence of
bronchial asthma is constantly growing: it is expected that by 2025 the number
of cases will increase by more than 100 million 2 .
About the disease
Bronchial asthma is an inflammation of the airways, which is manifested by shortness of breath, wheezing, chest congestion, cough. During an attack, a person begins to suffocate, and if bronchospasm is not removed (a pronounced narrowing of the bronchi that prevents the passage of air), this can lead to sad consequences, even fatal.
The diagnosis of “bronchial asthma” can only be made by a doctor on the basis of complaints and anamnesis (information about the development of the disease) of the patient, the results of functional examination methods, a specific allergological examination and the exclusion of other diseases. When collecting an anamnesis from a patient, the doctor finds out the causes and duration of symptoms, the presence of allergic reactions in the patient and his close relatives, the causal features of the occurrence of signs of the disease and its exacerbations.
Increased frequency of attacks indicates an exacerbation of bronchial asthma. It can develop both in patients with an already diagnosed disease, and be its first manifestation. To exacerbate bronchial asthma can lead to various factors, or triggers that contribute to inflammation of the airways, provoking acute bronchospasm. These factors are different for different people, but the main ones include: respiratory tract infections (mainly viruses, most often rhinoviruses ), allergens, aeropollutants (various chemicals that, when accumulated in the atmosphere in high concentrations, can cause deterioration in human and animal health ), physical activity, meteorological factors, taking certain medications, emotional reactions, exacerbation of rhinosinusitis , gastroesophageal reflux, pregnancy, and inadequate therapy.
Consequences of bronchial asthma
No one is immune from bronchial asthma: people with different income
levels and social status suffer from it. Therefore, WHO recognizes asthma as a
problem in all countries, regardless of the level of development. However,
according to this organization, 80% of asthma deaths occur in low- and
middle-income countries 3 . This is partly due to the fact that the
disease is not diagnosed in time, treated incorrectly, and therefore not
For example, according to a study published in 2002 in the journal Respiratory Medicine 4 , most patients fail to recognize the symptoms of an impending attack in time, avoid long-term use of drugs to control the disease, and, accordingly, do not receive the full amount of necessary treatment.
Uncontrolled bronchial asthma, in turn, affects a person’s lifestyle and ability to work and, as a result, becomes not only a medical, but also an economic problem both on the scale of one family and on the scale of the whole country.
Is there a solution to the problem?
Unfortunately, bronchial asthma cannot be completely cured, however, if
it is taken under control and the risk of exacerbations is reduced, it is
possible to significantly improve the patient’s quality of life. This is the
main task of modern therapy. Bronchial asthma is considered controlled if:
- symptoms occur no more than 2 times a week;
- there are no night awakenings due to bronchial asthma;
- the need for drugs to relieve symptoms no more than 2 times a week;
- no physical activity restrictions 1 .
Fortunately, disease control can be achieved in most patients with bronchial asthma. Only 20–30% of patients may be resistant to conventional therapy due to the complexity of the asthma phenotype* (severe atopic asthma, obese asthma, smoker’s asthma, late onset asthma, asthma with fixed bronchial obstruction) .
Factors such as improper inhalation technique, poor adherence to treatment, smoking, concomitant diseases, and incorrect diagnosis can also complicate the course and therapy of bronchial asthma.
Nevertheless, all patients with bronchial asthma should strive to effectively control it, that is, accurately follow all the doctor’s instructions, follow the prescribed therapy, and also try to limit the influence of factors that cause attacks. At the same time, self-education is important: the more the patient knows about his disease, the higher the chance, if not to win, then to successfully manage it.