تشخيص الربو وعلاجه – مقال انظر حولك

Asthma diagnosis and treatment. Asthma is a chronic lung disease that causes bouts of difficulty breathing. When you have asthma, your airways are very sensitive and may react to a number of different triggers, such as smoke, pollen, or infection. Read in this article the diagnosis and treatment of asthma.

Types of asthma

Asthma causes narrowing and inflammation of the airways, which leads to obstruction of airflow. Asthma can be treated with medications that control the condition in the long term, in addition to inhalers to treat attacks.

Asthma has an enormous societal impact. More than 26 million people in the United States — including about 6 million children — have asthma. There are actually several different types of asthma, and understanding the specific medication you have can help you get the most effective treatment, including: Types of asthma are the following:

• Allergic asthmarelates to the development of asthma symptoms after exposure to allergens such as animal dander, dust mites, cockroaches, and mold.
• Exercise-induced asthma (EIA)Affecting one in five people, EIA is characterized by bronchoconstriction and asthma symptoms that develop during or after exercise.
• Occupational asthmaThis common respiratory condition results from exposure to asthma triggers in the workplace.
• Miscellaneous asthma from coughWhile coughing is a common symptom of asthma, it is generally the most important or only symptom in this type of asthma.
• Nocturnal asthmaSymptoms appear at night and interfere with sleep.
• You must know what type of asthma you suffer from, in order to treat it appropriately.

Asthma symptoms

• The classic symptoms of asthma are wheezing, chest tightness, shortness of breath, and cough.
• Asthma is not a static disease. Symptoms will wax and go over time and will be different from the symptoms of others.
• If your asthma symptoms become severe, it is a medical emergency that can lead to respiratory distress and even death.
• Signs of a serious asthma attack include severe wheezing, very rapid breathing, difficulty speaking due to shortness of breath, bluish skin, profuse sweating, and a feeling of impending doom.
• You need to go to the emergency room if you experience any of these symptoms.

Causes of asthma

• Asthma has increased dramatically over the past several decades.
• While the exact cause of asthma is unknown, many believe that the following factors work together to cause asthma or pose risk factors for the condition:
• Atopy (a hereditary tendency to develop allergies).
• Family history of asthma.
• Suffering from some respiratory infections in early childhood.
• Exposure to certain allergens and airborne viral infections during early childhood (as the immune system develops).
• Other allergens, such as animal dander.
• Allergic rhinitis.
• Exposure to cigarette smoke.
• Obesity and obesity.
• Airway hyperreactivity (exaggerated airway response to various stimuli).
• Your asthma triggers will be individual, some common ones include smoke, pollen, pet dander, mold, dust mites, infections, foods, exercise and medications.
• Identifying and avoiding triggers is a key component of asthma control.

Asthma diagnosis and treatment

• Asthma is not always easy to diagnose. In order for your doctor to diagnose asthma, you must have symptoms consistent with asthma.
• Your doctor will generally take a detailed history and perform a physical examination. He or she may order other tests to help make a diagnosis, such as a lung function test, chest X-ray, or certain blood tests.
• Although you may receive a diagnosis of asthma at any age, most people will be diagnosed in childhood.
• The classic signs of asthma — wheezing, chest tightness, shortness of breath, and cough — can make diagnosis difficult because they are general and non-specific.
• Your doctor uses a combination of medical history review, physical examination, and testing to reach a diagnosis and rule out other conditions that may mimic asthma.

1- Home test

• While you cannot diagnose yourself or your child with the condition, it is very helpful to be aware of the signs and symptoms of asthma and keep a record of who has them.
• Note any factors you think may be involved – for example, you feel short of breath every time you are exposed to dust. This diary may be of great value to your doctor.
• As part of the diagnosis, or for ongoing tests, your doctor may ask you to do spirometry at home — a lung function test that measures how much air you breathe in and out (and how quickly you do it).

2- Physical examination

• In addition to checking for signs of shortness of breath and response to allergens, your doctor will ask you questions about your symptoms and your medical history to try to piece together pieces of the diagnostic puzzle.
• Your doctor listens carefully for wheezing that is typical of asthma but not specific to asthma.
• Characteristically, it will be a high-pitched, almost instrument-like sound when exhaled.
• While this sign does not appear all the time in people with asthma, and does not indicate the severity of the condition if you have it, detecting its presence is helpful in the diagnosis process.
• The doctor will also check for rhinitis, a pale swelling in the nasal cavities that indicates allergic rhinitis that can worsen asthma symptoms.
• The details you can share about your symptoms are important here, as some asthma indicators are not indicators that can be noticed at your appointment.

Questions your doctor will ask

Your doctor will ask you about:

• Shortness of breath, which some may alternatively describe as tightness in the chest.
• Cough. The cough associated with asthma is characteristically dry and unproductive and is often worse at night.
• Conditions that trigger symptoms This is where a symptom diary plays an important role.
• Usually in the case of asthma, symptoms will wax and wane over time.
• Your doctor will likely ask you to explain how quickly symptoms appear, whether there is any predictability, and what brings relief.
• You may also be asked to think of specific triggers for your symptoms, such as exposure to allergens such as dust, pets or smoke, or changes in the weather, such as cold air.
• Asthma is more common in people with a family history of asthma or atopic disease, so your doctor will also want to know if any of your relatives have hay fever, allergic rhinitis, or a skin condition.
• A history of any of these conditions in a patient with symptoms consistent with asthma increases the likelihood of developing asthma.

3- Laboratories and tests

If it is clear that your symptoms are due to asthma, your doctor may perform a test to help confirm the diagnosis or to get a more detailed report explaining what the problems are and how to solve them.

4- Lung function tests

• These are quick, non-invasive tests that give your doctor an idea of ​​how well your lungs are working. They are:
• Peak expiratory flow rateIt is a measurement of how difficult it is to exhale. This is measured with a simple device, a peak flow meter.
• Normal peak expiratory flow rate is usually 80% of your expectation or greater.
• You and your doctor will develop a plan for what to do if your PEFR is less than 80% of normal. (You may or may not be required to take these readings at home as well as at your doctor’s office.)
• Spirometry: Although spirometry devices are available at home, your doctor will also perform this test in the office with more advanced equipment.
• This test allows your doctor to better determine how severe your airflow obstruction is and whether you could benefit from asthma treatment.

5- Bronchiectasis tests

• These tests measure the lungs’ response either to fast-acting asthma medications or to intentional disruption of normal airflow.
• This is usually considered if you have symptoms suggestive of asthma, but have a normal spirometry test.
• Bronchodilator responseOne of the characteristics of asthma is improvement after treatment with a bronchodilator, which is a fast-acting medication.
• In general, your doctor will repeat spirometry 10 to 15 minutes after bronchodilator treatment. Increases in airflow of 12% are considered positive and help diagnose asthma.
• Bronchoalveolar identification challenge test: Unlike looking to improve lung function with a bronchodilator, a bronchodilator test attempts to elicit airflow obstruction after inhaling an irritant. This test is usually only performed if you develop atypical symptoms.

Radiological diagnosis of asthma

• Chest X-rays are usually normal in asthma patients.
• But your doctor may order one if you’re experiencing wheezing for the first time.
• If asthma goes undiagnosed for a long time, a chest X-ray may show hyperexpansion (hyperinflation of the lungs).

Differential diagnoses of asthma

• Asthma can sometimes be very difficult, as you may experience all the possible symptoms or none at all.
• Furthermore, wheezing can be accompanied by a number of other diseases as well, which your doctor takes into consideration as he works to make a diagnosis.
• Gastroesophageal reflux disease (GERD)Gastroesophageal reflux may lead to wheezing and coughing, and is also commonly responsible for nocturnal asthma symptoms. Patients typically experience a painful burning sensation as well as a sour or bitter taste in the back of the mouth.
• Congestive heart failure: It is a condition in which the heart pump fails and is unable to provide adequate blood supply. In addition to some symptoms similar to asthma, patients suffer from swelling in the legs and difficulty breathing while lying down.
• chronic obstructive pulmonary disease (chronic obstructive pulmonary disease)COPD): COPD usually develops after the age of 40 and is primarily caused by damage caused by smoking. It has initial symptoms similar to asthma, such as wheezing, coughing, chest tightness, and shortness of breath.
• One difference between COPD symptoms and asthma is that COPD is often accompanied by a typical morning cough, while asthma symptoms can occur at any time of the day.
• This often only occurs when exposed to triggers. While breathing returns to normal with treatment for asthma, COPD leads to a continuing deterioration in lung function.
• Pulmonary embolism (P.E)Pulmonary embolism sometimes causes wheezing, a classic asthma symptom, but shortness of breath and chest pain are more common.
• cystic fibrosis (CF)Cystic fibrosis patients suffer from wheezing, in addition to shortness of breath and coughing. However, this chronic disease is also associated with poor growth and a number of other problems in early childhood.

Treatment of asthma

• Asthma treatment focuses on both prevention and control of symptoms, as well as reducing inflammation.
• Your asthma management plan is at the center of it all. Think of it as a roadmap for excellent asthma control and reduced asthma symptoms.
• Your plan, which should be reviewed periodically with your doctor, covers the key areas you need to pay attention to to avoid asthma problems.
• Monitoring: By monitoring the frequency and severity of symptoms, you are better able to take appropriate action or determine if you are doing something wrong.
• Avoid triggers: An asthma diary may help if your asthma symptoms are getting worse, as it can help you identify patterns of symptoms that occur with different exposures – the information you need so you can work to avoid them.
• Treatment with medicationsYour asthma treatment will combine regular use of control medications and periodic use of relievers when symptoms worsen.
• It is essential that you understand which medication to use, when and how to take it, and how often you need to take it.
• Non-compliance with a treatment regimen is a common reason why asthma patients fail to achieve optimal asthma control.

Coping with asthma

• Living with asthma can be difficult, and you’ll likely find yourself angry, frustrated, or sad because you can’t do some of the things you enjoyed before you (or your child’s) diagnosis.
• But if you pay attention to the details of successful asthma management, you or your child can live an active, healthy life.
• It all comes down to learning what you need to better control your asthma.
• Medication reminders can help you stay compliant, and strategies like using dust mite-resistant pillowcases can go a long way in alleviating irritants.
• Do not underestimate the value of social support. You can learn a lot about living with asthma from those who walk the same path with you.

Studying our journey with asthma diagnosis and treatment, and tracking your asthma symptoms will help you correctly diagnose and treat asthma, after knowing its type, and the irritants that lead to the symptoms.