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Bronchial asthma: how to recognize and control a chronic respiratory disease
Individual manifestations of asthma: no one scenario is the same
Bronchial asthma affects people of all ages, but the course can be different for everyone. Some people have a mild cough after running, while others have nighttime attacks of shortness of breath. This is where the complexity lies: the disease has many forms, from mild to life-threatening.
Where does diagnosis begin: from suspicion to confirmation?
In medical practice, the diagnosis of asthma is a combination of clinical observations, instrumental methods and laboratory tests. A careful history is the first step. If the patient complains of episodes of difficulty breathing, wheezing, frequent coughing without other causes, this is a signal for further evaluation.
Next, apply:
Spirometry: estimates the volume of air that a person can inhale and exhale.
Bronchodilator tests: help determine the reversibility of obstruction.
Provocative tests (e.g., with methacholine): confirm bronchial hyperreactivity.
Nitric oxide (FeNO) measurement: marker of eosinophilic inflammation.
Allergy tests and IgE analyses: allow to identify the atopic nature of the disease.
Why symptoms are often ignored: the adaptation trap
Patients become accustomed to symptoms. For example, a persistent morning cough or shortness of breath when climbing stairs are perceived as «normal.» Such adaptation is dangerous because complications can appear suddenly — from asthmatic status to respiratory failure.
Treatment variability: there is no universal inhaler
Modern therapy for bronchial asthma is based on a stepwise approach, according to the international GINA strategy. Treatment should be dynamic - depending on how well the disease is controlled.
| Therapy step | Appointment | Example of drugs |
|---|---|---|
| Initial | Treatment on demand | Inhalers with a combination of ICS + LABA |
| Control | Regular daily treatment | Budesonide, Seretide, Symbicort |
| Reinforced | For severe persistent form | Biologics (omalizumab) |
The most common mistake is to stop treatment on your own after symptoms disappear. Asthma requires long-term control, even during remission.
Uncontrolled complications: not just the lungs
Chronic inflammation can lead to airway remodeling, which is irreversible changes in the airways. This means that treatment is less effective in the future. In addition, patients with uncontrolled asthma are more likely to have infections, have problems with sleep, concentration, and work capacity.
Educational component: the key to success
Effective treatment depends not only on medications, but also on the patient's level of awareness. Learning proper inhalation technique, recognizing triggers, and keeping a symptom diary all significantly reduce the risk of exacerbations.
Practical example
A 15-year-old boy who had been hospitalized repeatedly with pneumonia was finally diagnosed with asthma only after FeNO testing and spirometry. After starting basic therapy, the frequency of exacerbations decreased from 5 times a year to 1.
Asthma is a chronic but controllable disease. And the earlier the correct diagnosis is made, the better the chances of an active life without attacks and hospitalizations.
