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BRONCHIAL ASTHMA BRONCHITIS
Bronchial asthma is a disease characterized by widespread spasmodic narrowing of the air passages due to increased responsiveness of the tracheobronchial tree due to a variety of possible stimuli.
It is an episodic disease manifested primarily by dyspnoea, cough & wheezing.
Types of asthma
1. Atopic asthma (allergic, extrinsic)
It starts at an early age and is provoked by allergens. Atopic individuals have allergic ailments of skin nose and eyes. Patients with atopic asthma form IgE antibodies when they come in contact with the affecting allergens. It is also called early onset asthma. Family history of allergic disease is common. There might be two types of manifestations;
-An acute immediate response or
-A late phase reaction.
In atopic asthma drug hypersensitivity is absent.
2. Non atopic asthma (idiosyncratic, intrinsic)
This type of asthma develops later in adult life with negative personal & family history of allergy, the skin tests are negative and there are normal levels of serum IgE. A common association is after an upper respiratory tract infection by viruses. There may be presence of associated nasal polyp and chronic bronchitis. 10% patients are found to be hypersensitive to drugs. (Most commonly small dose of aspirin)
3. Mixed type
These are those patients who do not fit clearly into either of the categories and have mixed features of both the types.
INDUCING FACTORS
Genetic factors are important in determining why asthma occurs and it is common in relatives of atopic individuals.
Tobacco smoke, maternal smoking during pregnancy or infancy etc can cause asthma.
PROVOKING FACTORS
Infection: History of upper respiratory infection before an attack of asthma has been frequently reported (especially Rhino virus).
Allergy: Exposure to potential allergens like pollens, moulds, cockroaches etc. can provoke an attack of asthma.
Drugs: including beta blockers, cholinergic drugs etc can provoke bronchial asthma.
Food : Egg, milk and wheat cause may asthma in some cases, even food preserving agents may precipitate an asthmatic attack.
Exercise: Vigorous exercise particularly on a cold dry.
Environment: Possibilities of suffering with an attack are more on a cold dry day. Traffic pollution aggravates Asthma. Tobacco Smoke aggravates Asthma
Occupation: Exposure to chemicals like platinum, chrome nickel, reactive dyes of diazonium salt, pharmaceutical agents, wood dust, cotton dust are a common cause among industrial workers.
Gastric: Esophageal Reflux: Reflux of gastric contents in lower third of esophagus may provoke asthma.
SIGNS & SYMPTOMS
Dyspnoea
Wheezing
Stridor
Coughing
Tightness and itching of the chest
Inability for physical exertion.
There may be chronic respiratory impairment.
During very severe attacks, an asthmatic person may turn blue from lack of oxygen, and can experience chest pain or even loss of consciousness.
DIAGNOSIS
Asthma is defined simply as reversible airway obstruction. Reversibility occurs either spontaneously or with treatment. The basic measurement is peak flow rates and the following diagnostic criteria are generally used:
=20% difference on at least three days in a week for at least two weeks;
=20% improvement of peak flow following treatment, for example:
10 minutes of inhaled ß-agonist (e.g., salbutamol);
six week of inhaled corticosteroid (e.g., beclometasone);
14 days of 30mg prednisolone.
=20% decrease in peak flow following exposure to a trigger (e.g., exercise).
Pulmonary function test is advised in chronic cases.
TREATMENT
Identifying the triggering factors and avoiding them is recommended but it is not always possible.
Allopathic treatment is based on desensitization of the individual with the help of drugs or use of bronchodilators which are categorized depending on their acting durations such as short acting and long acting. These treatments do not cure the patient but give a temporary relief, only to leave the patient to be struck by another life-threatening attack which is almost unpredictable.
Homoeopathic treatments are individualized and directed to make sure that the patient is cured rather than a temporary relief & that too with the help of natural medications which are absolutely free from side-effects.
BRONCHITIS
ACUTE BRONCHITIS
It is an acute inflammatory condition of the large and medium bronchi. The same organisms which cause colds may cause bronchitis. It is a common complication of influenza and measles which leads to repetitive bouts of unproductive cough. Causes also include various environmental factors like pollution, pollens, smoking etc.
Signs & Symptoms
Cough is often dry at first but later it frequently becomes productive/ mucoid or even mucopurulent.
Acute coryza or symptoms of pharyngitis can be followed by cough which persists once the original symptoms have abated.
Streaks of blood for short periods may be present.
A fever with symptoms of rhinovirus infection is less common in adults than in children but is common if the infecting organism is an influenza virus, Mycoplasma pneumoniae or an adenovirus
Investigations
Investigations are not usually required as the blood count may be normal and chest radiograph is normal.
The C-reactive protein may be raised in case of bacterial infection.
Absolute eosinophilic count may be done to rule out allergic bronchitis.
CHRONIC BRONCHITIS
Persistent cough with expectoration on most days for at least three months of a year, for two or more consecutive years is defined as chronic bronchitis. It is most common in industrial areas with a high rainfall. In spite of its name chronic inflammation of the bronchi is not a prominent feature. The condition is more common in middle aged males than females. It has been observed that chronic bronchitis is frequently associated with emphysema.
With repeated acute exacerbations of the inflammation and increasing retention of secretion, spread of the chronic changes along the bronchial tree may take place which may lead to laryngotracheobronchitis.
THE CAUSES of chronic bronchitis are multiple and usually form an interactive complex,
Atmospheric pollution
Smoking
Repeated attacks of Acute Bronchitis
Occupational factors (exposure to organic or inorganic dusts)
SYMPTOMS
Persistent cough with copious expectoration of long duration.
Recurrent respiratory infections are common.
Dyspnoea is present on exertion (It is usually not present while at rest)
Cyanosis & edema may be present, and hence the patients suffering may be denoted as ‘blue bloaters’.
Features of right heart failure are common.
TREATMENTS
Antibiotics don't effectively treat most cases of bronchitis because the condition usually results from a viral infection.
Prevention is aimed to prevent acute exacerbations when suffering from chronic bronchitis.
Our treatments are homoeopathic, they are individualized in approach and we make sure that the cause has been taken care off.
What can I do myself?
You may take a nonprescription cough medicine, but make sure consult in case the symptoms persist.
It's best not to suppress a cough that brings up mucus, because coughing helps remove irritants from your lungs and air passages.
Avoid exposure to irritants and tobacco smoke.
Drinking plenty of water may help in some cases.
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