Bronchial asthma how to treat thoroughly?

The article was written by Dr. Nguyen Van Dinh - Head of Respiratory - Asthma - Allergy - Clinical Immunology Unit, Vinmec Times City International General Hospital.
When you are diagnosed with asthma, you will need to follow it closely to keep the disease under control. Vinmec Asthma, Allergy and Clinical Immunology Clinic has developed a treatment protocol and care guide to help patients achieve optimal and long-term treatment effects. Moreover, you will truly become your own doctor with the support of your doctor to be able to control your own asthma.

1. How was your asthma diagnosed?


Diagnosis of asthma does not simply give you a single information "You have asthma", but doctors will tell you about the severity of the disease, the nature of your asthma, What causes asthma and its comorbidities. If you have a confirmed diagnosis, your doctor will prescribe medication and instruct you on how to use it because asthma medications are intended for local use in the lungs in inhaled form. Specific steps include:

Ventilation function test

Asthma is characterized by bronchospasm, so lung function testing will reveal obstruction. If an obstruction is found, your doctor will give you a special test to see if your lungs are responding to your asthma medications. If yes, then you are definitively diagnosed with bronchial asthma. Otherwise, your doctor will diagnose your asthma based on your clinical manifestations. In many cases, even though the patient has bronchial asthma, these indicators are still within normal values ​​if the patient is not having bronchospasm. However, based on the clinical symptoms and risk factors, the patient was still diagnosed as bronchial asthma. Some difficult cases require stimulation testing to diagnose or rule out.

Measure exhaled NO (FeNO).


NO synthesis is increased in response to inflammation, so NO can be used as a marker to assess acute or chronic inflammation, especially in asthma.
High FeNO values ​​in patients with allergic rhinitis or other high-risk factors for asthma will facilitate early asthma treatment decisions and provide greater benefit to the patient. - FeNO also helps to assess the response to the drug if the value decreases after taking the drug, especially with inhaled or systemic corticosteroids. FeNo also helps to assess the patient's adherence to treatment

2. Causes of Asthma


Although bronchial asthma can be allergic or non-allergic, 80% of asthma patients are allergic. Determining the cause of asthma is very important in the prevention and specific treatment. At Vinmec Times City Hospital, doctors determine the causes with skin tests and blood tests to determine IgE antibody levels specific to common asthma causes.
Housebugs Mold Dog and cat hair Cockroaches Pollen Medicines: Aspirin, anti-inflammatory painkillers Food: Milk, eggs, nuts (peanuts, cashews, almonds, chestnuts...)
Hen phế quản điều trị như thế nào để điều trị triệt để?
Bọ nhà (House dust mites) là nguyên nhân gây hen phổ biến nhất

3. Health assessments to be performed prior to asthma treatment


Asthma is an allergic disease, so there are many diseases at the same time such as allergic rhinitis, eczema (atopic eczema) and conjunctivitis. In addition to gastroesophageal reflux disease, obesity makes asthma treatment more difficult. Of these diseases, allergic rhinitis is the most common. Allergic rhinitis and bronchial asthma are considered mutually exclusive because they are a common pathology of the upper to lower respiratory tract due to the similar structure of the mucous membranes covering the nose, sinuses and bronchi.
Viêm mũi dị ứng và hen phế quản thường sẽ song hành cùng nhau
Viêm mũi dị ứng và hen phế quản thường song hành cùng nhau

The mechanisms and causes of allergic reactions that cause rhinosinusitis and bronchial asthma are the same. Therefore, when having bronchial asthma, patients need to be screened for allergic rhinitis (80% of asthma patients have rhinitis) for diagnosis and treatment. The benefit of treating rhinitis in asthmatic patients is better asthma control. If allergic rhinitis is missed or is not controlled, it can make asthma worse or make asthma attacks more difficult to control. In contrast, patients with allergic rhinitis should be screened for asthma (40% of allergic rhinitis patients have asthma). Early detection and treatment of asthma will help to improve the progression to severity and long-term complications of asthma, especially in children. Another problem that needs to be raised is that many children have allergic rhinitis and have episodes of wheezing, even wheezing, but still only diagnosed and bronchospasm, so long-term and preventive treatment is not available. , causing recurrent disease. More specifically, many mothers of children who have been diagnosed with asthma and respond well to asthma medications are still worried and do not want to admit their children have asthma, so there are mistakes in disease control. Current asthma medications are mainly used topically, with very low concentrations in micrograms (1/1000 grams), so they are basically safe. Many mothers worry about the side effects of asthma medications on growth and other effects. However, uncontrolled asthma affects physical and mental development much more than medication. Therefore, the benefits of early asthma control are overwhelming.

4. What will the doctor do to effectively treat asthma?


From these visits, your doctor can give you a comprehensive assessment of your asthma and will create a plan to help you, along with your doctor, manage the disease.
Your doctor will explain to you about medicines for asthma. Which drug is the main treatment drug for prevention and anti-inflammatory? What medication is used to relieve asthma? What are the possible side effects? And how to minimize these effects. Teach you how to use inhaler, inhaler, basic steps to make sure you know the right way. Many cases of asthma attacks become severe because of the wrong medication and/or the wrong way. Your doctor will guide you to self-monitor and assess your asthma at home with a simple but very effective set of questions. Based on the scores you provide, your doctor will know your asthma history for the past 28 days and plan to treat you better.

Conclude


In summary, bronchial asthma is a complicated allergic disease that needs to be detected early and comprehensively in order to have a suitable and complete treatment plan to avoid dangerous complications and unnecessary complications. due to lack of comprehensive control. If you have symptoms of bronchial asthma, you should see a specialist doctor for examination and treatment. Wishing you all good health.

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