It is a Heterogeneous disease.

It is usually characterized by chronic inflammatory disease of airway.

It is characterized by history of dyspnea, cough, chest pain, chest tightness, wheezing, breathlessness.

Classification

• Intrinsic asthma 
• Non atopic
• Idiosyncratic
• Late onset asthma
• Family history present
• 
  

Extrinsic asthma

• Atopic individuals
• Allergic
• Early onset of asthma
• Family history present
• History of allergy present

Risk factor

1. Endogenous factor 

              Genetic predisposition

             Type 1st hypersensitivity reaction

      2. Airway hyper responsible

      3. Gender- common in boys

      4. Age- begin before the age of 25 years.

      5. Obesity

      6. Early viral infection

Environmental Factor

• Allergens
• Occupational sensitiser
• Respiratory infection.

Triggers

Inhaled allergens

Upper respiratory tract viral infection

Air pollution

Passive smoking

Drugs

Physical factor

Exercise

Emotional stress

Irritants (spray/fumes)

Clinical Features

1. Episodic asthma
2. Occur as episodes with asymptomatic between asthmatic attack.
3. Frequency and duration of attack vary.
4. Present with sudden onset of paroxysms of wheezing/dyspnea.
5. May develop spontaneously
6. Triggered by- allergens, exercise, viral infection.

Severe acute asthma

Status asthmaticus

Not severe form of asthma

Severe acute paroxysms persists for days,weeks.

Severe dyspnea unproductive cough.

Triggered by- sweating, central cyanosis, tachycardia.

Severe air flow obstruction leading to severe cyanosis even death.

Chronic asthma

Chest tightness

Wheeze at night

Breathlessness on exertion

It is characterized by episodes of spontaneous cough wheeze worse during night.

Chronic productive cough.

Chronic productive cough and mucoid sputum

Punctuated by recurrent attack of purulent expectoration from infection.

Prone to repeated attack of severe acute asthma.

Investigation

• LFT
• Exercise test
• X-ray of chest
• Blood and sputum test
• Pulmonary function test
• Serum IgE level- elevated
• ECG
• Blood gas analysis
• Skin test- by pricking test hypersensitivity reaction to various antigen can be obtained.

Differential Diagnosis

• COPD
• Bronchiectasis 
• Reactive airway viral syndrome
• Gastro-oesophageal reflux disease
• Congestive heart failure
• Upper airway obstruction
• Cardiac asthma

Complication

1. Right heart failure
2. Bronchiectasis
3. Bronchitis
4. Emphysema of lung

Management

• Bed rest
• Proper imposition on a back or sitting up in a chair 
• O² inhalation
• Salbutamol
• Steroid
• Antibiotics-amoxycillin 500mg
• Corticosteroid
• Antimicrobial therapy
• Plenty of fluids (dehydration)
• Vantilation
• Breathing exercise
• Psychiatric treatment may be required
• Precipitating factor should be treated.

Homoeopathic Medicine For Bronchial Asthma

• Antimonium tart
• Puls
• Bryonia
• Hepar sulp
• Kali bi

The selection of homoeopathic remedies based on symptom similarities and doses according to the Susceptibility of patient.

Don't take homoeopathic medicine without any prescription / without any advise of physician.