Everyone knows that the cold season is a test for the respiratory system. Does this mean that in the spring, patients with weak lungs have nothing to fear?
Tells expert of the Alliance for the Fight against Respiratory Diseases at WHO, Professor of the Department of Pulmonology, Russian National Research Medical University, Doctor of Medicine Zaurbek Aisanov…
Zaurbek Aisanov: Neither spring nor summer, respiratory diseases do not pause, especially chronic ones. The cause of exacerbation of asthma and chronic obstructive pulmonary disease (COPD) – the most common diseases of the pulmonary system – may be factors that are not directly related to seasonality (environmental pollution, allergens, fungi, dust, pollen, mold, etc.). So exacerbations are likely in the warm season.
How do they go to the chronicles
Lydia Yudina, AIF: How does the disease become chronic? How many acute diseases do you need to endure for this?
– Acute viral diseases, bronchitis, pneumonia do not always lead to chronic respiratory pathology. Chronic diseases are more likely to develop due to a genetic predisposition. For example, manifestations of bronchial asthma may appear after contact with an allergen or the very first viral infection. Chronic obstructive pulmonary disease progresses gradually (usually under the influence of smoking). At first, it is asymptomatic, then coughing and shortness of breath occur, to which the patient adapts and perceives it as a variant of the norm, therefore, the doctor often turns to the doctor for the first time already at a far advanced stage of the disease.
– Does seeking help early help? After all, it is impossible to cure chronic diseases.
– Early diagnosis implies early initiation of treatment, which allows effective control of the disease from the outset. Thanks to this, a person lives an almost ordinary life, which does not differ from the life of healthy people.
Having identified the provoking factors that cause exacerbation of asthma, the patient can protect himself from them. In cases where it is impossible to avoid contact with the allergen (they can be pollen, house dust mites, etc.), allergen-specific immunotherapy (administration of increasing doses of the allergen) may be indicated. In COPD, smoking cessation and proper therapy can help slow the progression of the disease. The prognosis largely depends on the severity of pulmonary pathology – the more severe the disease, the shorter the life.
Not to mention the fact that a patient with bronchial asthma, without receiving treatment, may die from an attack of suffocation. And COPD, according to WHO, is the fourth leading cause of death in the world.
– Fortunately, the incidence of asthma in Russia is one of the lowest in developed countries.
– According to official statistics, Russia really does figure as a country with a low prevalence of bronchial asthma. However, according to data obtained in the course of epidemiological studies, the prevalence of the disease among children and adolescents in Russia is 9%, and among adults – 6.9% (that is, at the same level with global indicators).
The prevalence of chronic obstructive pulmonary disease is greatly underestimated both in the world and in Russia, largely due to the difficulties with diagnosis. According to the most optimistic estimates, one in ten people over 40 suffers from COPD.
– Why is it not always possible to make the correct diagnosis?
– There are no problems with diagnosing asthma. A person who has survived a choking attack immediately goes to a doctor and receives a confirmation of the diagnosis. The main symptoms of COPD are shortness of breath and cough with sputum discharge. However, they are not enough to make a diagnosis – spirometry is necessary (a study of the function of external respiration). For early detection of the disease, this study should be recommended for all smokers (since 80–90% of COPD is associated with smoking).
How to treat the disease
– Is there an effective treatment for these ailments?
– When I started working, patients with bronchial asthma were prescribed pills and intravenous injections of hormones. This therapy was not only ineffective, but could only be carried out in medical institutions and had many serious side effects. Asthma attacks at the time were the cause of frequent ambulance calls and hospitalizations. Most asthma patients today live their normal lives. Asthma is primarily an inflammatory disease. Therefore, it is necessary to take inhaled steroids to treat it. But these drugs do not bring immediate relief, so patients sometimes refuse to use them and abuse bronchodilator drugs. This not only provokes exacerbations, but can also cause death, including in patients with a mild course of the disease.
The result of treatment also depends on how closely the patient follows the instructions for use of the inhaler device. Often, patients are not taught the correct technique of use, and effective therapy is discredited by inappropriate use.
In severe bronchial asthma (observed in 6-10% of patients), standard treatment does not help. Targeted immunobiological therapy may be indicated for such patients.
With COPD, it is impossible to completely rid a person of symptoms. However, bronchodilator therapy can help prevent shortness of breath and, in some cases, stop the progression of the disease.
– Earlier the slogan “Help yourself” was popular. How relevant is it for chronic lung diseases? Do they improve their condition, for example, by eating well or being physically active?
– Nutrition is very important. Regular intake of nutrients is required to form and maintain lung tissue. It is known that among emaciated asthenic pulmonary patients, mortality is higher. Exercise for asthma is a complex topic. There is the so-called exercise asthma, in which the load can be a provocateur of asthma attacks. Elite sport is a serious risk factor. It is no coincidence that the prevalence of asthma among athletes (skiers, cyclists, swimmers) is higher than the average in the population.
Nevertheless, the load, selected by the doctor, taking into account the condition, age and phenotype of the disease, in asthma can improve both the condition and prognosis of patients. Adherence to a healthy lifestyle is an important adjunct to drug therapy, but not a replacement.