BRONCHIAL ASTHMA

BRONCHIAL ASTHMA
It is defined as the brochoconstriction caused by obstruction in airways due to inflammation and clinically presented as wheeze,cough,chest tightness and dyspnoea.

Or

It is pathologically defined as a syndrome of variable airflow or airway obstruction characterized by bronchial inflammation with prominent eosinophill infilteration. Chronic obstructive pulmonary disease (COPD) is a syndrome characterized and defined by a single physiological parameter :
limitation of expiratory airflow.

ETIOLOGY

1.Allergic/atopic/early onset asthma
---rhinitis, urticaria, eczema, (+)skin tests, ↑IgE,

(+) response to provocation tests with aeroallergens.

2.Idiosyncratic/non-atopic/late onset asthma
--- no allergic diseases, (-)skin tests, normal IgE, symptoms.

3.Mixed group
---usually onset later in life

PATHOGENESIS AND PATHOPHYSIOLOGY

Both asthma and COPD are characterized by airflow obstruction and chronic persistent airway

inflammation, and many patients with asthma have characteristics of COPD, an overlap that often makes it difficult to establish anaccurate diagnosis. The characteristic physiologic abnormality in asthma is eosinophilic inflammation; indeed, an increase in activated and degranulating eosinophils has been demonstrated in bronchial biopsies and bronchoalveolar lavage of asthma patients.

TRIGGERS OF ACUTE ASTHMATIC EPISODES

1.Allergens - pollen

2.Pharmacol stimuli such as aspirin, NSAIDS, β- adrenergic blockers, preservatives,col agent 3.Environment pollutionozone, SO2, NO2

4. Occupationalexposure

5.viral respiratory infection

6. Exercise

7.Emotional stress

8.Foggy weather

9.Night or early morning

10. non specific irritant perfume,paint.

11.Cold air

CLINICAL FEATURE

• Episodic wheeze, chest tightness, shortness of breath, cough

• Symptoms worsen in the presence of allergens, irritants, or exercise

• Symptoms worsen at night, awakening the patient

• History of allergic rhinitis or atopic dermatitis

• Family history of asthma, allergy, sinusitis, or rhinitis Similarly, certain physical examination findings can help in the diagnosis of asthma:

• Sounds of wheezing during normal breathing or a prolonged phase of forced exhalation

• Increased nasal secretions, mucosal swelling, sinusitis, rhinitis, or nasal polyps

• Atopic dermatitis, eczema, or other signs of allergic dermatitites

MANIFESTATIONS OF RESPIRATORY FAILURE

1.
Hypoxemia
: cyanosis- very late sign, not dependable

2.
Hypercapnia
: sweating, tachycardia,widened pulse pressure

3.
Acidosis
: tachypnea

4.
Blood gases
the only accurate assessment of ventilatory status

DIFFERENTIAL DIAGNOSIS

1.bronchiectasis.

2. Acute LV failure - pulmonary oedema.

3. Pulmonary embolism.

4. Endobronchial disease.

5. Chronic bronchitis.

6. Eosinophilic pneumonia.

7. emphysema

INVESTIGATION OF ASTHMA

1.CBP with ESR; increase eosinophill,increase ESR in chronic attack.

2.Chest X - ray indicates a hyperventilated chest

3.When a patient has a acute attack, examination of arterial blood gases would point out the severity of the disease.

4.A Pulmonary Function Testing may indicate an obstructive pattern of airway disease.

5.SKIN TEST may confirm allergens.

6.PROVOCATION CHALLENGE TEST

7.IgE Specific test.

8.SPUTUM EXAMINATION charcot layden crystal.

9.Bronchoscopy.

HOMOEOPATHIC REMEDIES FOR ASTHMA

There are numerous homeopathic medicines that are used for different conditions but every medicine no matter how effective that might be, is not likely to cure every asthmatic condition. The medicine must always be chosen according to particular conditions of an individual. There are over eighty homeopathic medicines that are used for treatment of different conditions of asthma but following are few of those that are commonly used. Asthma is a serious disease which needs proper attention of a professional homeopath. Homeopathic remedies can help to control symptoms in chronic asthma. Several homeopathic remedies are valuable for treatment of asthma. In an acute attack of asthma it is recommended that you seek the care of a professional.

Antimonium tartaricum

Arsenicum alb

Blatta Orientalis

Drosera

Ipecac

Kali Carbonicum

Pothos
Phosporus -
Spongia

Bryonia alba

Natrum sulph

Nux Vomica

Spongia

Lobelia

Sambucus nigra

Chamommila

Kali bichromicum

Bromium

Araelia racemosa

Coca

Cocuss cacti

Dulcamara

Grindelia

Carbo veg

Passiflora

Dr. Shweta Bairagi