Let’s Talk about What Kinds of Bronchial Asthma Exist
It is identified: allergic and non-allergic forms of asthma, each of which has distinctive features. When there is an allergic and non-allergic component, a mixed form of asthma is diagnosed. The most commonly used is the classification of bronchial asthma in terms of severity. It is used for the selection of asthma treatment all over the world.
Degree 1: Intermittent asthma
- Symptoms appear less than 1 time per week;
- Slow exacerbations;
- Night symptoms less than twice a month;
- The volume of forced expiration in 1 sec. (FEV1) or peak expiratory flow (PSV) ≥ 80% of the due (what and how to measure this, we will talk later);
- The difference of PSV or FEV1 is <20%.
Degree 2: Light persistent asthma
- Symptoms more often 1 time per week, but less often 1 time per day;
- An exacerbation can reduce physical activity and disturb sleep;
- Night symptoms – more than twice a month;
- FEV1 or PSV ≥ 80% from the norm;
- A difference of PSV or FEV1 is 20-30%.
Degree 3: Persistent asthma of moderate severity
- Daily symptoms;
- Obstructions can lead to a restriction of physical activity and sleep disturbance;
- Night symptoms more often than 1 time a week;
- Daily use of short-acting inhaled β2-agonists;
- FEV1 or PSV 60-80% of the norm;
- A difference is between PSV and FEV1> 30%.
Degree 4: Severe persistent asthma
- Daily symptoms;
- Child exacerbations;
- Pure nighttime symptoms;
- Limitation of physical activity;
- FEV1 or PSV ≤ 60% of the norm;
- A difference between is PSV or FEV1> 30%.
A degree of severity and degree of an exacerbation are not the same! Patients with any degree of severity of asthma can have mild, moderate or severe exacerbations.
In some patients with mild asthma, severe and life-threatening exacerbations are observed, while without exacerbation they have long asymptomatic periods with normal pulmonary function.
The severity of asthma in patients receiving treatment is assessed based on the amount of therapy necessary to control the symptoms and exacerbations (dose and amount of drugs).
The severity of asthma in patients amitting treatment is assessed on the basis of the amount of therapy (dose and quantity of drugs) required to control symptoms and exacerbations.
Depending on the period of the disorder:
Shortening – episodes of increasing dyspnea, coughing, wheezing or the chest pain, or a combination of these symptoms.
Important: the presence of symptoms in patients with asthma may be the disease’s manifestation, rather than exacerbation.
If the patient has additional (in excess of existing) demand for short-acting bronchodilators (for example, Beroduale) added to the existing symptoms, the number of day and night symptoms increases, there is severe shortness of breath, is asthma exacerbation, which also needs to be classified according to the degree of severity.
Remission is a complete absence of symptoms on the background of the withdrawal of the basic anti-inflammatory therapy. It should be noted that in children in the period of puberty, spontaneous remission of the disease often occurs.
Control is the absence of disease manifestations when using a suitable basic anti-inflammatory therapy. Achieving control is the main goal of asthma treatment! We will try to learn this aspect within these two weeks.