bronchial asthma

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a condition marked by recurrent attacks of dyspnea, with airway inflammation and wheezing due to spasmodic constriction of the bronchi; it is also known as bronchial asthma. Attacks vary greatly from occasional periods of wheezing and slight dyspnea to severe attacks that almost cause suffocation. An acute attack that lasts for several days is called status asthmaticus; this is a medical emergency that can be fatal. adj., adj asthmat´ic.
Causes. Asthma can be classified into three types according to causative factors. Allergic or atopic asthma (sometimes called extrinsic asthma) is due to an allergy to antigens; usually the offending allergens are suspended in the air in the form of pollen, dust, smoke, automobile exhaust, or animal dander. More than half of the cases of asthma in children and young adults are of this type. Intrinsic asthma is usually secondary to chronic or recurrent infections of the bronchi, sinuses, or tonsils and adenoids. There is evidence that this type develops from a hypersensitivity to the bacteria or, more commonly, viruses causing the infection. Attacks can be precipitated by infections, emotional factors, and exposure to nonspecific irritants. The third type of asthma, mixed, is due to a combination of extrinsic and intrinsic factors.

There is an inherited tendency toward the development of extrinsic asthma. It is related to a hypersensitivity reaction of the immune response. The patient often gives a family medical history that includes allergies of one kind or another and a personal history of allergic disorders. Secondary factors affecting the severity of an attack or triggering its onset include events that produce emotional stress, environmental changes in humidity and temperature, and exposure to noxious fumes or other airborne allergens.
Symptoms. Typically, an attack of asthma is characterized by dyspnea and a wheezing type of respiration. The patient usually assumes a classic sitting position, leaning forward so as to use all the accessory muscles of respiration. The skin is usually pale and moist with perspiration, but in a severe attack there may be cyanosis of the lips and nailbeds. In the early stages of the attack coughing may be dry; but as the attack progresses the cough becomes more productive of a thick, tenacious, mucoid sputum.
 An asthma attack with respiratory distress. From Frazier et al., 2000.
Treatment. The treatment of extrinsic asthma begins with attempts to determine the allergens causing the attacks. The cooperation of the patient is needed to relate onset of attacks with specific environmental substances and emotional factors that trigger or intensify symptoms. The patient with nonallergic asthma should avoid infections, nonspecific irritants, such as cigarette smoke, and other factors that provoke attacks.

Drugs given for the treatment of asthma are primarily used for the relief of symptoms. There is no cure for asthma but the disease can be controlled with an individualized regimen of drug therapy coupled with rest, relaxation, and avoidance of causative factors. Bronchodilators such as epinephrine and aminophylline may be used to enlarge the bronchioles, thus relieving respiratory embarrassment. Other drugs that thin the secretions and help in their ejection (expectorants) may also be prescribed.

The patient with status asthmaticus is very seriously ill and must receive special attention and medication to avoid excessive strain on the heart and severe respiratory difficulties that can be fatal.
Patient Care. Because asthma is a chronic condition with an irregular pattern of remissions and exacerbations, education of the patient is essential to successful treatment. The plan of care must be highly individualized to meet the needs of the patient and must be designed to encourage active participation in the prescribed program and in self care. Most patients welcome the opportunity to learn more about their disorder and ways in which they can exert some control over the environmental and emotional events that are likely to precipitate an attack.

Exercises that improve posture are helpful in maintaining good air exchange. Special deep breathing exercises can be taught to the patient so that elasticity and full expansion of lung and bronchial tissues are maintained. (See also lung and chronic obstructive pulmonary disease.) Some asthmatic patients have developed a protective breathing pattern that is shallow and ineffective because of a fear that deep breathing will bring on an attack of coughing and wheezing. They will need help in breaking this pattern and learning to breathe deeply and fully expand the bronchi and lungs.

The patient should be encouraged to drink large quantities of fluids unless otherwise contraindicated. The extra fluids are needed to replace those lost during respiratory distress. The increased intake of fluids also can help thin the bronchial secretions so that they are more easily removed by coughing and deep breathing.

The patient should be warned of the hazards of extremes in eating, exercise, and emotional events such as prolonged laughing or crying. The key words are modification and moderation to avoid overtaxing and overstimulating the body systems. Relaxation techniques can be very helpful, especially if the patient can find a method that effectively reduces tension.

Asthmatic patients fare better if they feel that they do have some control over their disease and are not necessarily helpless victims of a debilitating incurable illness. There is no cure for asthma but there are ways in which one can adjust to the illness and minimize its effects.
allergic asthma (atopic asthma) that due to an atopic allergy; see asthma.
bronchial asthma asthma.
cardiac asthma a term applied to breathing difficulties due to pulmonary edema in heart disease, such as left ventricular failure.
extrinsic asthma
asthma caused by some factor in the environment, usually atopic in nature.
intrinsic asthma that due to a chronic or recurrent infection; see asthma.
occupational asthma extrinsic asthma due to an allergen present in the workplace.

bron·chi·al asth·ma

an acute or chronic disorder characterized by widespread and largely reversible reduction in the caliber of bronchi and bronchioles, due in varying degrees to smooth muscle spasm, mucosal edema, and excessive mucus in the lumens of airways. Cardinal symptoms are dyspnea, wheezing, and cough. Attacks or exacerbations may be induced by airborne allergens (for example, molds, pollens, animal dander, dust mite and cockroach antigens), inhaled irritants (for example, cold air, cigarette smoke, ozone), physical exercise, respiratory infection, psychological stress, or other factors. The signs and symptoms of bronchial asthma are caused by the local release of spasmogens and inflammatory mediators (for example, histamines, leukotrienes, prostaglandins) and other substances from mast cells, eosinophils, lymphocytes, neutrophils, and epithelial cells. Airway caliber may be abruptly and drastically reduced during a paroxysm or after diagnostic challenge with methacholine or histamine, and may quickly return to normal after administration of a bronchodilator (for example, inhaled β-adrenergic agonist or subcutaneous epinephrine).

Asthma is a common disorder, with a prevalence of about 5% in the U.S., and a leading cause of illness and disability in people between 2 and 17 years of age. It is responsible for 14.5 million outpatient visits and 5,000 deaths yearly in this country. The prevalence of asthma has been increasing during the past 25 years, particularly in children under age 5. Asthma first occurring in childhood is more likely to be allergic in origin and to show seasonal variation. Chronic sinusitis and gastroesophageal reflux disease are statistically correlated with asthma. A subset of people with allergic asthma also have nasal polyps and sensitivity to aspirin and other nonsteroidal antiinflammatory drugs (Samter triad). Occupational exposure to airborne irritants or allergens causes at least 10% of chronic asthma in adults. Current views of the pathophysiology of asthma emphasize its inflammatory component and the risk of gradual, irreversible airway remodeling due to subepithelial fibrosis in poorly controlled asthma. Interleukin 13 has been implicated as a mediator of such fibrosis, and the presence of antibody to Chlamydia pneumoniae has been linked statistically to accelerated deterioration of lung function in patients with asthma. Current recommendations for treatment of chronic or severe asthma call for use of antiinflammatory drugs (particularly inhaled corticosteroids). Other treatments include β2-adrenergic bronchodilators (albuterol, terbutaline, salmeterol), xanthines (theophylline, oxtriphylline, dyphylline), mast cell stabilizers (cromolyn, nedocromil), and antileukotrienes (montelukast, zafirlukast, zileuton). Self-monitoring of peak respiratory flow rate with a simple portable device helps patients adjust drug doses for optimal effect. Avoidance of allergens, irritants, and other known triggers is essential to good control.

bronchial asthma

Asthma that is caused by spasmodic contraction of the muscular walls of the bronchial tubes.

bron·chi·al asth·ma

(brong'kē-ăl az'mă)
A condition of the lungs with extensive narrowing of the airways, varying over short periods either spontaneously or as a result of treatment, due in varying degrees to contraction (spasm) of smooth muscle, edema of the mucosa, chronic or recurrent local inflammation of the submucosa with eventual fibrosis, and excessive mucus in the lumen of the bronchi and bronchioles; these changes are caused by the local release of spasmogens and vasoactive substances (e.g., histamine, or certain leukotrienes or prostaglandins) in the course of an allergic process.

bronchial asthma

A tautological term; all ASTHMA is bronchial.

bron·chi·al asth·ma

(brong'kē-ăl az'mă)
An acute or chronic disorder characterized by widespread and largely reversible reduction in the caliber of bronchi and bronchioles, due in varying degrees to smooth muscle spasm, mucosal edema, and excessive mucus in the lumens of airways. Cardinal symptoms are dyspnea, wheezing, and cough.

Patient discussion about bronchial asthma

Q. about asthma?

A. a general question get's a general answer:

Q. ASTHMA how does it effect every day life?

A. Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath, and coughing. The coughing often occurs at night or early in the morning.

Some experts believe that asthma has similar explanation with what happened to allergic reaction.
Asthma can't be cured. Even when you feel fine, you still have the disease and it can flare up at any time. The best way to avoid asthma attack is by staying away from its triggers.

But with today's knowledge and treatments, most people who have asthma are able to manage the disease. They have few, if any, symptoms. They can live normal, active lives and sleep through the night without interruption from asthma.

Q. what do i do with asthma i have asthma

A. i think the best way is avoidance of irritants. but that means sometime moving to a cleaner environment- different city, different state... not easy to do. other things is reassuring that your home is "asthma proof"- a good vacuum cleaner, dusting at least every week.

More discussions about bronchial asthma
References in periodicals archive ?
This will allow the evaluation of their role in the development of bronchial asthma in a large number of well-defined patients.
Blood gas tension in bronchial asthma. Lancet 1967; 1:644-6.
Comparisons were made on X-ray findings between (1) the bronchial asthma and normal groups, (2) the bronchitis and normal groups, and (3) the bronchial asthma and bronchitis groups.
The study was a randomized controlled trial conducted in Bengaluru including 60 patients with mild-moderate bronchial asthma. Subjects were selected from the diagnosed cases of bronchial asthma attending Victoria Hospital Outpatient Department for treatment, based on inclusion and exclusion criteria.
Patients with a current, active infection of the respiratory system, infection of the lower respiratory tract 4 weeks prior to the study, chronic diseases other than bronchial asthma, prematurity aspiration of a foreign body in the airways in their history, and pulmonary inflammation or bronchiolitis during the first year of life were excluded from the study.
Pranayam for three consecutive months without disrupting their medical treatment, while 40 patients of bronchial asthma taking only medical treatment were included in the control group.
Other co-morbidities included diabetes mellitus and long standing bronchial asthma on treatment with long acting bronchodilator and steroid inhalers.
The first 50 bronchial asthma patients followed general clinics at Kakiah PHC center, Makkah Al-Mukarramah were also recruited as a comparison group.
A study conducted by Sandor and Martin on CAM for bronchial asthma acknowledged its use by; 59%, 41%, 26.5% and 27.2% of the patients in United Kingdom, United States, Germany and Singapore9.
Research-based pharmaceutical and healthcare company GlaxoSmithKline plc (LSE: GSK) (NYSE: GSK) and biopharmaceutical company Theravance Inc (Nasdaq: THRX) announced on Friday the approval by the Japanese Ministry of Health, Labour and Welfare (MHLW) of RELVAR ELLIPTA for the treatment of bronchial asthma, in cases where concurrent use of inhaled corticosteroid and long-acting inhaled beta2 agonist is required.
Objective: The study was carried out to evaluate the role of serum eosinophil cationic protein (ECP) as a biological marker for the diagnosis and to assess the severity of bronchial asthma. Methodology: This observational cross-sectional study was conducted among 70 bronchial asthma patients and 45 disease controls (tuberculosis-15, chronic obstructive pulmonary disease-15, interstitial lung disease-15) enrolled from patients attending the outpatient department of the National Institute of Disease of the Chest and Hospital (NIDCH), Dhaka, Bangladesh during July 2010 to June 2011.
Almost 80% of those were remedies to cure cardiovascular disease, 17% - type 2 diabetes, 3% - bronchial asthma. Patients receive medicines in pharmacies free of charge or with insignificant payment.