Bronchial asthma is essentially a disorder of the immune system, affecting the lungs and airways. Asthma is classified into types. But it is often not possible to distinguish between the two.

- Extrinsic asthma- is stimulated by Known substances that trigger an allergic reaction.
- Intrinsic asthma- there is no specific stimulating factor.

Differential Diagnosis of Asthma

1- Systemic vasculitis
2- Psychiatric disorders.
3- Upper and lower airway disorders.

Anatomy of the Lower Respiratory Tract

The trachea (windpipe) extends down through the neck into the chest where it divides into the right and left bronchi. The right bronchus enters the right lung and the left bronchus enters the left lung. Within the lungs the bronchi progressively divide into smaller and smaller branches so that air can reach all parts of the lungs.

Etiology of Asthma

A number of different factors can trigger an asthmatic attack i.e. antigens, infection, air pollutants, emotional states, exercise, and exposure to cold. Exposure to these factors triggers a series of events leading to an attack. One of the steps, involved in this phenomenon, is the release of naturally occurring chemical transmitters from cells called mast cells that are found in the wall of the bronchi.

Through such chemicals and nerve impulses, muscle tissue in the wall of the bronchi contracts and the bronchi are made narrow. The narrowing of the bronchi restricts the flow of air and produces difficulty in breathing. This is made worse because mucus frequently clogs the bronchi also.

Mechanism of Asthma

Asthma is one disease, but it has two main underlying components. These components occur deep within the airways of the lungs:

* Inflammation. The airways of the lungs are often swollen and irritated if one has asthma, and become more swollen and irritated when an attack begins. In some people with asthma, the mucus glands in the airways produce excessive, thick mucus, further obstructing the airways.
* Constriction. The muscles around the airways in the lungs squeeze together or tighten. This tightening is often called ‘broncho-constriction’, and it can make it hard to breathe the air in or out of the lungs, the condition called as dyspnea.
Inflammation and constriction together cause narrowing of the airways, which develop wheezing, chest tightness, or shortness of breath.

With asthma, airways may be inflamed even when the patient is not having symptoms.

Sign and symptoms of Asthma

The main complaints are episodic wheezing, feeling of tightness in chest, dyspnea and cough. The frequency of asthma is highly variable. Some patients may have very frequent, brief attacks of asthma; other may suffer nearly continuous symptoms. Asthma is often worse at night mostly around 3- 4 am.

Complications of Asthma

These include airway infection, dehydration, exhaustion etc. rarely pneumo-thorax may occur. In very severe cases, acute respiratory failure may occur.

Treatment of Bronchial Asthma

RESPIRATION – ASTHMATIC -
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? Dr. Rajneesh Kumar Sharma
Homoeo Cure & Research Centre P. Ltd.
N.H. 74, Moradabad Road,
Kashipur- Zip- 244713
Uttaranchal (INDIA)
Ph. 05947- 260327, 274338, 277418, 275535
Fax – 91 5947 274338, Cell – 98 371 47000
E. Mail- drrajneeshhom@yahoo.co.in
drrajneeshhom@hotmail.com

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