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19.09.2019

The type of disease in which hypersensitivity to aspirin becomes the cause of complications is called aspirin asthma. Every decade the number of patients with severe chronic disease - bronchial asthma - is increasing. Asthma is caused by excessive sensitivity of the upper respiratory tract to external factors. Both viral infections and allergies to various substances can be provocateurs of bronchial asthma.

Definition and pathogenesis

Aspirin asthma is a special variant of bronchial asthma, in which anti-inflammatory nonsteroidal drugs are one of the main provoking factors. Aspirin asthma is isolated as a special form of bronchial asthma, similar to it in its symptoms. As with bronchial asthma, for many years patients suffer from bouts of shortness of breath and painful cough, sometimes developing into suffocation, which limits them in various life manifestations.

The peculiarity of aspirin asthma is that anti-inflammatory nonsteroidal drugs act as the main cause. Many patients mistakenly believe that aspirin alone can cause aspirin asthma. In fact, a large group of drugs such as analgin, askofen, baralgin, diclofenac, ibuprofen, sedalgin, citramone has a similar chemical structure. The yellow dye tartrazine and yellow-coated tablets such as no-shpu should be excluded.

As a result of taking such drugs in the human body, more molecules are formed that make the bronchi narrow, and there are not enough substances that promote expansion.

This type of asthma is characterized by a serious condition of patients. At an early stage of the disease, disorders of the immune and endocrine systems are found. Patients complain of nasal congestion and profuse discharge, which can continue all year round. When you take aspirin, your health worsens. The classic symptoms of the disease are intolerance to NSAIDs, rhinitis and nasal polyps. The last two signs may not be present in aspirin asthma.

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Features of diagnosis and treatment

The danger of aspirin asthma is that sometimes non-steroidal drugs are used for bronchial asthma. For example, in order to stop an attack of suffocation, baralgin can be administered, which contains the anti-inflammatory drug analgin. The use of such drugs can cause an even more severe attack of suffocation and lead to serious consequences, up to and including death.

The treatment of aspirin asthma is practically the same as the treatment of the usual form of this disease. Aspirin asthma has one main feature: non-steroidal anti-inflammatory drugs are contraindicated in patients. It is necessary to take paracetamol with caution. Timely diagnosis of intolerance to non-steroidal drugs is necessary. For diagnostic purposes, provocative tests with aspirin are usually used. Patients are given a small dose of the drug and the indicators of external respiration are recorded. This analysis should be done very carefully. In the center where the analysis is carried out, there must be an intensive care unit. There are three degrees of severity of the disease:

mild: rare day and night seizures that can go away on their own;
medium: nocturnal attacks more often than twice a month;
severe: frequent seizures, life-threatening. The patient often needs hospitalization.

It is impossible to completely cure aspirin asthma. But the ongoing therapy will help alleviate the patient's condition. For this, inhalations are often given to patients. People with aspirin asthma are prescribed inhaled corticosteroids, for example:

flunisolide;
budesonide;
fluticasone propionate.

Desintization with aspirin. In some cases, it is impossible to refuse aspirin for health reasons, for example, with rheumatic diseases. The phenomenon of patient insensitivity to repeated doses makes such treatment possible. At the beginning of the course, they give about 10 mg of aspirin, then increase the dose to 650 mg. Then the patients are given maintenance doses of aspirin for a long time. Surgery. In the treatment of aspirin asthma, a method such as removing polyps from the nasal cavity is sometimes used. As a result of the operation, nasal breathing and the general condition of the patient improve.

Treatment should only be carried out under the supervision of qualified professionals.

Aspirin bronchial asthma is not the case when you can self-medicate.

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Aspirin asthma in children

Bronchial asthma, combined with aspirin intolerance, is often familial. It is possible to observe families in which attacks of suffocation as a result of taking anti-inflammatory drugs occurred in four generations. Children in such families suffer from aspirin asthma.

Aspirin intolerance is observed in about 30% of children with bronchial asthma. Children may be disturbed by bouts of dry cough, shortness of breath, especially at night and in the morning. Corticosteroids are often used to treat the disease. For proper therapy, it is necessary to diagnose a type of bronchial asthma in a timely manner. Diagnosis of the disease in children has its own difficulties.

As for the last group, the provoking substances are contained in them in very small quantities, so it is hardly reasonable to exclude them completely from your diet, especially since there are many useful substances in them. However, it is worth knowing about their features and not overeating, especially for patients who have a severe form of this disease.

The commonly performed provocative test method is too dangerous to be applied to children. Another method is also used - high-performance liquid chromatography, with the help of which the amount of leukotrienes released by leukocytes under the influence of indomethacin is determined. It is carried out using the analysis of the patient's venous blood. In any case, parents should observe how the child reacts to the medications they are taking in order to note any deterioration. This will help the doctor make a correct diagnosis.

The dose of the drug is selected depending on the severity of the disease. The leading role in the delivery of the drug is played by inhalation devices - nebulizers. They ensure the maximum penetration of the drug into the respiratory tract. The patient can carry ultrasonic nebulizers with him.

Aspirin asthma is one of the types of bronchial asthma, it occurs when using drugs based on acetylsalicylic acid and other anti-inflammatory pain relievers. This form has its own diagnostic criteria, it is worth analyzing in which cases this disease occurs, what symptoms it usually manifests itself, what are the methods of treatment.

What it is?

Aspirin bronchial asthma is not the most common type of this pathology. It develops due to the effect of acetylsalicylic acid on the body, while it is rather difficult to predict a possible increased susceptibility to this substance.

According to statistics, the majority of cases are women aged 30 to 50 years. There is interesting data on the inherited predisposition to bronchial asthma. According to the studies, the predisposition to aspirin bronchial asthma is transmitted through the maternal line about 10 times more often than through the paternal one. Moreover, the mother passes the defective genes to her daughters more often than to her sons. In general, cases of the aspirin form account for more than 20 - 40 percent of all cases of asthma, different sources provide different information.

In children, this disease is usually less common, but such a possibility exists. In general, in most cases, the presence of this disease is determined only at the beginning of treatment with pain relievers and anti-inflammatory drugs.

For aspirin asthma, a triad of symptoms is characteristic, if it does not fully unfold, they speak of an incomplete triad. This triad is one of the main diagnostic criteria for this disease, if it is absent, it is impossible to talk about aspirin asthma in most cases. The following signs are usually referred to the triad:

the inflammatory process on the nasal mucosa, usually leads to the occurrence of various types of rhinitis;
attacks of difficult breathing, suffocation;
identification of intolerance to aspirin and other anti-inflammatory pain relieving nonsteroidal drugs.

Important! In some cases, the symptoms of this disease are disguised as allergic reactions.

The pathogenesis of this disease is a rather complex process, there are several theories why some people become too sensitive to acetylsalicylic acid. The formation of aspirin asthma is associated with metabolic processes in the body.

If the triad of aspirin asthma is absent, the cause of the symptoms may be different. In general, if signs of bronchial asthma appear, a full examination should be carried out, which will help to pinpoint the cause.

The main symptom of this disease is shortness of breath, a severe cough that turns into choking, like any type of asthma. The further, the more severe the symptoms become, especially if their main cause, the intake of acetylsalicylic acid, does not stop.

This disease in most cases begins to develop with an inflammatory process in the nasopharynx. It usually presents as rhinitis, very often with the formation of polyps on the nasal mucosa. Also, with this form of asthma, patients may note the following:

recently had to take pain relievers, anti-inflammatory nonsteroidal drugs, symptoms begin to worsen with taking aspirin and other drugs;
before asthma there was a period reminiscent of the common cold, pre-asthma;
sometimes all of the above symptoms are accompanied by the appearance of a rash on the skin, usually they are a rash like hives;
expiratory dyspnea usually occurs when exhaling becomes harder than inhaling.

If you experience these symptoms, you should definitely consult a doctor. It is worth noting that other types of asthma may be accompanied by these signs, therefore, a full diagnosis is required before starting treatment.

Important! If asthma is left untreated, asthma attacks can become too intense, leading to unconsciousness and even death.

Who heals

In the event of asthma attacks and signs of this disease, you can contact an otolaryngologist or directly to a pulmonologist. You may need to consult an allergist and other specialists.

Most varieties of this pathology cannot be completely cured, since they depend on the internal processes of the body, which are extremely difficult to influence. However, avoiding irritants, taking anti-inflammatory drugs, choosing the right treatment to stop attacks, you can lead the disease to permanent remission.

Aspirin Asthma Treatment

Treatment for this disease is usually complex, it includes several different methods. They must be combined in order to achieve the most pronounced result:

Diet. Some foods contain acetylsalicylic acid, so they are advised to be removed from the diet. These products usually include canned food, various semi-finished meat products, many citrus fruits, including tangerines, many varieties of nuts and berries, and some vegetables. Also, you can not drink beer, it is advised to avoid the use of products containing the dye tartrazine.
Desensitization in aspirin asthma. This method is used if, according to indications, anti-inflammatory drugs cannot be completely ruled out. This method is based on the fact that resistance to aspirin increases if higher doses are taken within 24 to 72 hours after an attack.
Various drugs. They help relieve the effects of seizures. Usually, various anti-rhinitis drugs are used; antagonists of leukotriene receptors are used to relieve asthma itself: zafirlukast and other drugs that reduce the production of leukotrienes.

If nasal polyps form, they may need to be surgically removed. In general, the treatment plan may vary depending on the indication. Asthma therapy can be carried out exclusively under the supervision of a physician.

Antibiotics for this disease are usually not prescribed, they can be used if any infection of the respiratory tract and nasopharynx develops due to rhinitis. The use of such drugs is not prohibited for this type of asthma.

How to bring down the temperature with aspirin asthma? During colds, it is difficult to do without pain relievers and anti-inflammatory drugs. If you need to bring down the temperature, you can do with simpler means: for example, cold compresses, taking liquids, plain water, in large quantities.

If during the disease it is impossible to do without anti-inflammatory drugs of this series, then it is advisable to turn to the method of desensitization. If there is evidence, they always try to implement it.

What painkillers are possible?

Since most pain medications for this disease are prohibited, it becomes difficult to find the right medicine. In most cases, desensitization is required if aspirin and similar drugs cannot be dispensed with.

Hormonal, steroid-based pain relievers are usually allowed. However, it should be borne in mind that such drugs can usually be used exclusively with a prescription. In general, people with aspirin asthma need to be careful when selecting medications for fever and pain. In some cases, when taking pain relievers, antihistamines are prescribed to help alleviate the symptoms of aspirin asthma.

Can lidocaine be injected?

Studies show that lidocaine does not worsen the condition of patients with aspirin-like asthma. Therefore, it can be used as a pain reliever. However, it is worth noting that the dosage must be strictly observed; before starting treatment, it is imperative to consult a doctor.

Aspirin asthma

Allergic reactions are common today, which may be due to unfavorable environmental conditions, increased use of sensitizing products, and the intake of medications.

Medicines are designed to alleviate the patient's condition, but sometimes NSAIDs lead to the development of aspirin bronchial asthma.

What it is

Aspirin asthma is one of the forms of an allergic reaction of the body in response to ingestion of non-steroidal anti-inflammatory drugs (NSAIDs), the most popular representative of which is acetylsalicylic acid (aspirin).

This drug can only be taken by adults and children over 15 years old, therefore, this pathology does not happen in childhood.

The disease accompanies about 30% of patients with bronchial asthma, therefore it is often called aspirin bronchial asthma. They have similar symptoms, but aspirin asthma is characterized by a more severe course.

It is more common among women aged 30-50 years. The disease is inherited, that is, it is of a family nature.

Video: First Aid

Allergens in aspirin asthma are drugs containing salicylates, for example: acetylsalicylic acid (ASA).

The medicine has anesthetic, anti-inflammatory, antipyretic, antiplatelet effect, therefore it is widely used in various diseases.

Aspirin is an irreversible inhibitor of the enzyme cyclooxygenase (COX), which is secreted by the cells of the body during pathological reactions. COX ensures the conversion of arachidonic acid into inflammatory mediators, which determine all the symptoms in various diseases.

Other drugs of the NSAID group are reversible inhibitors and are safer to use, therefore they do not emit other types of asthma.

Although, when diagnosing and preventing a disease, it is necessary to take into account the group of the drug that the patient is taking.

In the body, when taking ASA, COX is blocked and the following phenomena are noticeable:

the release of bradykinin, a mediator that dilates blood vessels, decreases and their permeability decreases;
the formation of macroergs (ATP) decreases;
the synthesis of hyaluronidase decreases;
the work of the thermoregulation center is regulated and the body temperature decreases;
the sensitivity of the pain centers decreases;
the aggregation (adhesion) of platelets decreases.

For what diseases do you take aspirin?

Aspirin is an almost universal remedy, which is why it is used to treat a wide range of diseases.

Today, the list of diseases is decreasing due to the side effects of this drug.

People suffering from allergic pathology need to take NSAIDs with caution for these diseases!

Preparations containing acetylsalicylic acid:

Be careful when taking the listed drugs!

Pathogenesis - the course of the disease, due to the mechanism of action of ASA. Once in the body, ASA actively and irreversibly blocks cyclooxygenase in healthy people.

In people with aspirin asthma, lipoxygenase is synthesized instead of COX, which promotes the conversion of arachidonic acid into leukotrienes.

Leukotrienes are biologically active substances involved in the pathogenesis of bronchial asthma, leading to bronchospasm, affecting vascular tone and permeability and playing an important role in the development of aspirin asthma.

There is a platelet theory that explains the pathogenesis of the disease through the effect of ASA on platelets.

Their degranulation (destruction) occurs, as a result, cytotoxic (destroying cells) and pro-inflammatory (promoting inflammation) mediators are released. It turns out the opposite effect of aspirin: it should have helped, but it only got worse!

In healthy people, the pathological effect of aspirin on platelets was not found, and in those suffering only platelets change their properties under the action of ASA, other cells are not involved in the process.

Aspirin asthma symptoms

The symptomatology of the disease directly depends on the effect produced by the tablets and on the dose of the drug.

The appearance of the first symptoms after 5-10 minutes from taking a tablet with acetylsalicylic acid.
Asthma attacks, bronchospasm appear due to the action of leukotrienes, it is difficult for the patient to breathe, additional muscles are included in the breathing process:

retractions of the jugular and supraclavicular fossae are noticeable;
retraction of the intercostal muscles is noted;
the patient rests his hands on the surface.

Whistling wheezing is heard.
Expiratory shortness of breath is characteristic, when it is more difficult to inhale than exhale. The same symptom occurs in bronchial asthma.
Cough.
Abundant discharge from the nasal cavity, which is typical for allergic reactions of any origin. Rhinitis is present throughout the year, exacerbated by taking aspirin.
Severe nasal congestion occurs with typical allergies.
The appearance of polyps in the nose, which does not appear instantly, but with a prolonged course.
Decreased sense of smell.
Headache.
Stomach ache.
Purulent sinusitis with prolonged course.
There may be skin manifestations:

rash;
rashes.

The patient does not necessarily show all the symptoms; only one or two nonspecific signs may appear, which complicates the diagnosis of the disease.

The long course of the disease leads to the development of bronchial asthma, therefore, when making a diagnosis of aspirin asthma, consult an allergist!

All symptoms appear suddenly, frightening the patient. The course is difficult, so it is imperative to call an ambulance. Often, patients with vivid symptoms end up in the intensive care unit.

Learn about idiopathic non-allergic urticaria here.

Diagnostics

A large role in the diagnosis is given to the collection of data about the patient, it is necessary to find out:

whether drugs of the NSAID group were taken;
Whether the patient suffers from bronchial asthma;
whether there have been such cases before;
the name of the drug that was taken before the attack;
whether there is an effect from taking theofedrine.

Theofedrine is a drug that is used to relieve an attack of bronchial asthma.

Clinical picture

What Doctors Say About Antihistamines

Doctor of Medical Sciences, Professor G.V. Emelyanov Medical practice: over 30 years.
Practical medical experience: over 30 years

According to the latest WHO data, it is allergic reactions in the human body that lead to the majority of fatal diseases. And it all starts with the fact that a person has an itchy nose, sneezing, runny nose, red spots on the skin, in some cases, suffocation.

7 million people die every year due to allergies, and the extent of the lesion is such that the allergic enzyme is present in almost every person.

Unfortunately, in Russia and the CIS countries, pharmacy corporations sell expensive drugs that only relieve symptoms, thereby putting people on this or that drug. That is why in these countries there is such a high percentage of diseases and so many people suffer from "non-working" drugs.

A patient suffering from bronchial and aspirin asthma notes that the effect of the drugs is initially there, the spasm passes, but after a couple of minutes it reappears. This effect is explained by the fact that theofedrine contains a preparation containing ASA.

Initially, theophedrine inhibits the synthesis of histamine and the spasm passes, but leukotrienes provide the development of a later spasm of the bronchi and their edema, so taking theofedrine does not relieve the attack.

To prove the presence of aspirin asthma, provocative tests with salicylic acid are carried out in specialized clinics.

The patient is given a small dose of the drug, and the doctor monitors changes in the respiratory system with the help of special equipment. Changes in the respiratory organs are recorded on the sensors, and a diagnosis is made.

According to surveys, fewer patients are detected than according to the tests carried out, therefore, in the presence of bronchial asthma, do not be lazy to carry out tests!

In patients with aspirin asthma, an increased content of leukotrienes in the urine, the contents of the bronchi and nasal cavity is noted, therefore, urine, nasal cavity and bronchial mucus are examined.

The diagnostic criterion may be the improvement of the patient's condition after taking antileukotriene drugs, persistence of symptoms when taking antihistamines.

Treatment can be urgent and systemic. An emergency must be carried out if the patient has a sudden attack, before the arrival of an ambulance.

When you go to the hospital, be sure to tell the healthcare professional what manipulations you performed so that they are not repeated again and worsen the patient's condition.

Rinse the stomach to rid the patient of the provoking factor. With the help of a special tube, about a liter of water is poured into the stomach, gradually raising the tube. Then the tube is lowered into a basin or bucket, but the level should not be lower than the level of the patient's body. This is done several times until the pill appears from the body.
Give activated charcoal or other adsorbent so that there is no acid in the intestines. Coal is given in the calculation of one tablet per ten kg of the patient's weight.
An antihistamine to relieve allergy symptoms.
With severe suffocation, you can inject adrenaline.

Remove the allergen and avoid contact with it
In the dispensary, specialists carry out desensitization, which is based on the formation of the body's resistance to acetylsalicylic acid and other NSAID drugs. After an attack for one to three days, the patient is given medication, gradually increasing the dose. This method is difficult for patients due to suffocation.
Treatment with leukotriene antagonists:

Zileuton.
"Zafirulkast".
Montelukasat.
"Pranlukast".

Glucocorticosteroid drugs instead of NSAIDs to relieve symptoms of inflammation. They are used systemically or inhaled.

Treatment is difficult, and must be selected correctly, since the use of any drugs of the NSAID group is unfavorable for the patient!

Prevention

To prevent asthma attacks, you should avoid taking drugs of the NSAID group.
If you have a disease of bronchial asthma, conduct a test for the tolerance of acetylsalicylic acid, even if there were no previous signs of allergy to the drug.
Check the body's sensitivity to amidopyrine, as it is often prescribed in the treatment of arrhythmias and bronchial asthma.
Follow a diet avoiding foods containing salicylates.

Salicylate products to avoid:

shaving products;
self-tanning;
tanning agent;
perfume;
conditioners;
ointments and creams to relieve joint pain;
mouthwash;
mint toothpastes.

With the development of a sharp and bright attack, the patient's prognosis is unfavorable in the absence of outside help.

If help is provided to the patient in a timely manner, then there is no reason for concern. Patients with aspirin asthma will have a favorable prognosis if they follow preventive measures, which requires a lot of effort.

For a positive prognosis, it is important:

periodic observation by an allergist;
periodic inspections;
delivery of tests for the detection of leukotrienes;
lack of contact with drugs of the NSAID group;
correct diet;
healthy recreation and lifestyle.

The diagnosis of aspirin asthma is not fatal, so do not panic, but treat the disease!

Diet is one of the main conditions for recovery and treatment of diseases. It is difficult to keep it because salicylates are found in a lot of food.

If the diet is not followed, the patient is expected to:

fatigue;
headache;
nasal discharge;
cough;
deterioration of smell;
the appearance of polyps in the nasal cavity;
the appearance of suffocation.

Prohibited foods for aspirin asthma:

Aspirin asthma is a rare pathological condition that can lead to human disability.

It is difficult to predict, therefore, everyone has the likelihood of developing this disease, although it is more common among patients with bronchial asthma!

For the treatment of allergic urticaria, see the page.

The types of urticaria in adults are described below.

Knowing emergency help for an attack can save someone's life, so remember the information and be healthy!

Aspirin asthma

To designate bronchial asthma, the attacks of which usually occur in response to the introduction of a non-hormonal (non-steroidal) anti-inflammatory agent into the patient's body, the term "aspirin bronchial asthma" is used. This name is due to the fact that it is aspirin (acetylsalicylic acid, salicylates) that is a typical representative of this group of drugs. This form of the disease can be either independent, isolated, or associated with other forms (with allergic asthma itself, for example).

Causes and mechanisms of development of the disease

The essence of the action of aspirin lies in the fact that the contact of acetylsalicylic acid with the cell membrane grossly interferes with the metabolism in it. The exchange of arachidonic acid and its derivatives (substances similar in structure to the latter) is affected. Cyclooxygenase is turned off from the work of the enzyme (a substance without which the reaction is impossible), as a result of which the production of substances (they are called prostaglandins), which expand the bronchi and have anti-inflammatory properties, usually occurs. At the same time, another pathway of transformations of arachidonic acid begins to work more strongly, the enzyme for which is the lipoxygenase substance.

The production of substances (they are called leukotrienes) is enhanced, which have an inflammatory effect and contribute to the narrowing of the bronchi. Symptoms of bronchial asthma occur in a patient just as a result of the hardening (weakening) of the first process and the strengthening of the second, their mismatch.

For a long time it was not entirely clear why the same mechanism of action of the drug in some people (even those suffering from bronchial asthma) does not lead to an attack, while in others it is invariably accompanied by it. Most likely, only three should be attributed to the main reasons:

The last two reasons, which are of paramount importance in the occurrence of the aspirin form of bronchial asthma, can be summarized as follows: at the heart of aspirin asthma is an imbalance between the metabolic products of arachidonic acid.

How to recognize aspirin asthma in a patient

First of all, the results of the survey indicate that the patient has aspirin asthma. Directly or indirectly (often without understanding this connection on their own), the patient will tell you that asthma symptoms appear after taking anti-inflammatory drugs (pain relievers or antipyretics), for example, he can name such drugs as Ibuprofen, Aspirin, Analgin, Citramon, Askofen, Pentalgin, Sedalgin.

In addition, the doctor needs to ask if symptoms of the disease occur in response to the consumption of lard and any canned foods (canning often occurs with the addition of acetylsalicylic acid).

Of particular importance is the question of whether the symptoms stop if the patient takes theofedrine (should have a bronchodilatory effect). If a patient has aspirin asthma, he will answer that this medicine is ineffective for him or at first reduces the symptoms, and after a few tens of minutes they increase again. This is due to the fact that, in addition to theophylline (it expands the bronchi), theofedrine contains the substances amidopyrine and phenacetin (anti-inflammatory drugs that act in an aspirin-like manner).

Sometimes provocative tests can be used to confirm the diagnosis of aspirin asthma: a special injection of aspirin into the patient's body, followed by observation, whether symptoms of the disease occur. It is important to remember that such research must be carried out only in a medical facility and (where there are medical personnel ready to provide urgent assistance to the patient if he is provoked by a severe attack of suffocation). Do it yourself at home STRICTLY PROHIBITED.

At present, there are also less dangerous laboratory tests for the patient, for which it is necessary and sufficient to take the patient's blood. It is they who are now preferred.

Before embarking on medication, the treatment of aspirin bronchial asthma should consist in the correct diet for the asthmatic. It is necessary to explain to the patient that the diet for aspirin asthma is of great importance. After all, its contribution to alleviating the disease is regulated by the patient himself. He and only he affects his own state, if the diet is followed (or not followed). This is an important psychological technique that stimulates the patient to take active actions aimed at his own treatment, and also increases confidence in drug treatment, which is also important for the effectiveness of treatment in general.

The diet for a patient suffering from aspirin bronchial asthma should exclude food, which usually contains salicylates in significant doses for the disease (when taken, symptoms will be caused). This is the following list:

Smoked and fried foods
Stock cubes and gelatin, canned foods
Mayonnaise, cheese, dairy products (including ice cream) with additives
Butter, to which vegetable fats are added, as well as margarine (including products with the addition of margarine)
Spices, various spices, potato starch (potatoes themselves, respectively)
Vegetables (you can only carrots, cabbage, 2 cloves of garlic per day and beets), as well as fruits, berries and dried fruits
Peanuts, honey, molasses and halva, preserves and jams
Juices, alcohol, carbonated drinks

Of course, this entire list will horrify the patient at first. Therefore, you also need to talk about what foods the diet allows you to consume without limiting yourself. These include:

Fish, sometimes boiled natural seafood, fish and poultry
Eggs (it is better to choose rustic ones)
Two tablespoons of sunflower oil throughout the day
Salt is proposed to be replaced by seaweed
Natural dairy products
Bread that was baked at the bakery
Still mineral water, coffee, tea, cocoa with sugar

It is good if an asthmatic person makes it a rule to read the composition of products (prescribed on the package) before eating them.

Treatment that accompanies the diet

Treatment of aspirin asthma, first of all, involves the rejection of anti-inflammatory drugs of aspirin action.

Paracetamol, Benzydamine or Guacetisal, which have a different mechanism of action, are recommended as pain relievers and antipyretics.

Further desensitization is often performed. This special treatment means that the patient is regularly given small, gradually increasing doses of aspirin. After a while, the patient's body stops giving asthma symptoms in response to aspirin. Such treatment is contraindicated in pregnancy, stomach or duodenal ulcers, as well as a tendency to bleeding.

In addition, treatment includes antileukotriene drugs: they prevent the leukotrienes from narrowing the bronchi. For example, Zafirlukast or Montelukast.

It is important for the patient to remember that without adherence to the diet, treatment will be ineffective.

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Causes of Asthma in Children

Aspirin asthma

The causative agent of aspirin asthma is non-steroidal anti-inflammatory drugs that help narrow the bronchi. NSAIDs also include aspirin, or acetylsalicylic acid, which is used as an analgesic, anti-inflammatory agent. Very often, aspirin asthma is combined with infectious bronchial asthma (9-22% of patients suffer from two types of asthma), but it can also exist in its pure form.

Aspirin asthma is not a congenital, but an acquired disease. Symptoms of aspirin asthma mainly appear after atopic bronchial asthma, so children do not get sick with it. In most cases, women in the age of 30-50 get sick.

Symptoms are severe nasal congestion and rhinitis, resulting in decreased sense of smell and headache. Further, polyps appear in the nose and sinuses, followed by attacks of suffocation and intolerance to NSAIDs.

The mechanism of development of aspirin asthma

The reason is the interference of aspirin in the metabolism of arachidonic acid, which is contained in the cell membrane. In a healthy state, this acid, under the influence of the enzyme cyclooxygenase, is converted into a compound that helps trigger the inflammatory response. And NSAIDs in this situation block the enzyme, preventing it from developing. In patients with aspirin asthma, the cyclooxygenase enzyme is defective and the body uses another, lipoxygenase, which converts arachidonic acid into leukotrienes, which promote bronchial edema and sputum production. As a result, symptoms of aspirin bronchial asthma begin to appear.

What to abstain from with aspirin asthma?

The patient should not take pyrazolone drugs: theofedrine, analgin, spazmalgon, baralgin, amidopyrine, tempalgin, reopirin, aspirin and other NSAIDs, as well as drugs that include: diclofenac, indomethacin, ibuprofen, sulindac, piroxicam, naproxen and .d.

If necessary, paracetamol, solpadein, tramadol (or tramal), phenacetin can be taken as a pain and heat reliever.

Along with the listed drugs, aspirin bronchial asthma can manifest itself from the presence of the yellow dye tartrazine in food (both in food and in drugs). In its chemical composition, it is similar to aspirin.

Patients should not eat confectionery products and yellow alcoholic beverages (contain tartrazine).

Salicylates are also harmful: natural (tomatoes, raspberries, oranges, black currants, plums, cucumbers, apricots, cherries), industrial (canned food and gastronomy). Natural salicylates contain small amounts of tartrazine and therefore rarely cause an attack. The production of histamine is dangerous for the patient, this process is provoked by citrus fruits, fish, fresh cabbage.

Take urgent measures

Sometimes a person is unaware of the presence of this ailment in himself and takes aspirin. If the first symptoms appear (after 5-10 minutes a runny nose, cough, breathing difficulties begin), you must:

rinse the stomach: drink 1 liter of boiled water, then press the root of the tongue to empty the stomach. If a pill has jumped out, then you do not need to perform the subsequent actions;
drink 10 tablets of activated carbon and an antihistamine tablet (tavegil, suprastin, claritin, etc.);
when the attack has passed, you need to make an appointment with an allergist.

How to identify aspirin bronchial asthma?

Special in vivo tests may be done to detect aspirin asthma. Under the supervision of an allergist with special equipment (in case of an attack), the patient is given aspirin (or another drug related to NSAIDs). A trial was conducted in which 100 people participated: a third of the subjects had no symptoms of aspirin asthma, the second third had bronchospasm, which sometimes was not even clinically recorded, and only the remaining third had a serious reaction to the drug.

In vitro tests are carried out, but in this case, there is no risk of an attack, because tests for the reaction are carried out with blood cells (you just need to donate blood).

The reaction to NSAIDs can occur anywhere in the respiratory system, and in some cases, the intestines, stomach and other mucous membranes can be affected. This negatively affects the immune system, which manifests itself in the form of severe and lingering inflammatory diseases.

Desensitization as the main method of treatment

Desensitization is one of the methods of treating aspirin asthma, based, like in vivo tests, on provocations, only in small doses for a certain time. Treatment must necessarily be carried out in a dispensary under the supervision of specialists using all the necessary equipment. For example, with an interval of 30 minutes, the patient is given an aspirin with a constant dose increase: 3, 30, 60, 100, 150, 325 and 650 mg. But this quick method is tough enough, which mostly ends in a choking attack. Therefore, it is better to increase the dose every other day.

Before desensitization, it is necessary to relieve the exacerbation of asthma and check for contraindications, which are: pregnancy, bleeding, stomach or duodenal ulcer.

Inhalations are carried out not only as a basic method, but also in the case of a peptic ulcer of the duodenum or stomach (in this case, injections of aspirin-lysine can also be used). Aldecin (USA) is very convenient to use, because it has a removable nosepiece, which is very important for polyposis rhinosinusopathy.

Surgery will further develop symptoms and complicate the disease.

If the patient does not tolerate desensitization well, hemosorption is performed for a week and desensitization again. If the symptoms of the manifestation of the disease are weak, then hemosorption can completely cure a patient suffering from aspirin bronchial asthma.

After recovery in a hospital, the patient is prescribed a supportive outpatient course of treatment, the essence of which is to regularly take aspirin for a year after meals, washed down with alkaline mineral water, under the strict supervision of a physician.

Leukotriene antagonists

Treatment with antileukotriene drugs is a treatment with leukotriene antagonists (from Greek it is translated as "enemy"). But along with inhalation hormonal agents, it is recommended to use tablets.

About 20 years ago, many companies began developing antileukotrienes in two directions: inhibitors (substances that suppress any reaction) of the synthesis of leukotrienes and substances that bind leukotriene receptors (like antihistamines). A huge number of compounds have been synthesized, but only four of them are active: zileutone (first direction); zafirlukaste, montelukaste and pranlukaste (in the second direction). But as it turned out in practice, aspirin asthma was not completely cured, only the number of additional drugs and the number of attacks decreased.

Leukotriene drugs are still in development. They belong to a group of drugs that help control aspirin bronchial asthma and are concomitant in the treatment of patients.

Hemisorption and laser blood irradiation

Complex and severe aspirin bronchial asthma is treated with a combination of hemosorption and intravenous laser blood irradiation.

The essence of hemosorption is to remove toxic or pathological substances from the body through the influence of the sorbent outside the body.

Laser irradiation of blood (photohemotherapy, intravascular laser irradiation of blood, ILBI) is a method of efferent therapy (extracorporeal detoxification, gravitational surgery of blood), which consists of a dosed effect with low-intensity lasers.

ILBI method affects the processes of subcellular and cellular levels, therefore, the normal functioning of tissues and organs is restored. It is important that foreign substances are not introduced into the body to influence any particular link in the development of the disease, but only the body's self-regulation system is being adjusted. Therefore, this method is very effective, versatile and safe.

ILBI is done every day (or every other day), the course is determined by the doctor and averages from 3 to 10 procedures. The procedure takes 15-20 minutes. Laser blood irradiation is painless.

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Non-steroidal anti-inflammatory drugs have a complex effect on inflammation and pain. Their use is often accompanied by various side effects, one of which is the reactive narrowing of the bronchi after the use of acetylsalicylic acid. This phenomenon is called "aspirin asthma" because of the clinical picture characteristic of asthma.

Aspirin asthma is represented by the Fernand-Vidal triad, which includes:

the development of polyposis rhinosinusitis;
the phenomenon of asthma attacks;
intolerance to non-steroidal anti-inflammatory drugs (NSAIDs).

Causes of the disease

Aspirin

The main provoking factors for the development of aspirin-dependent asphyxiation are substances and drugs containing salicylates (aspirin and other NSAIDs). However, the mechanisms of the effect of aspirin on the respiratory system are not fully understood. The modern pathogenesis of aspirin bronchial asthma is based on two theories of its occurrence.

Some researchers believe that the onset of intolerance to salicylate is manifested due to a violation of metabolic processes with arachidonic acid, which is involved in the development of inflammatory reactions. Salicylates inhibit the mechanisms of creation of cyclooxygenase, thereby suppressing the metabolic reaction with arachidonic acid and triggering other mechanisms of inflammation. A large amount of leukotrienes appears, which cause edema and bronchospasm.

Another theory speaks of the occurrence of an imbalance of prostaglandins in the body due to the use of NSAIDs, specifically, an increase in the amount of prostaglandin F, which causes bronchospasm, leading to suffocation. Some medical communities associate excess accumulation of prostaglandins with a hereditary predisposition.

In addition, natural salicylates are found in some foods, and their constant use causes asthma symptoms. Women are more likely to develop aspirin asthma. It rarely develops in children and adult men.

The main signs

Clinically, the course of aspirin-dependent asthma is divided into 2 periods. Patients often do not associate the initial stage with taking medications, and when the disease begins to progress, showing symptoms of suffocation, they turn to a doctor.

Initial period

Early manifestations do not relate to the respiratory system, but often affect the functional characteristics of the endocrine and immune systems. Every sixth sick person suffers from a thyroid gland pathology. In women, menstrual disorders, early menopause are observed.

Many patients note a decrease in the functions of the immune system, which manifests itself in complaints of frequent ARVI. The nervous system is often involved in the process. Neurological disorders are characterized by:

Melancholic depression

a strong emotional reaction to stress;
feeling of inner tension;
constant anxiety;
manifestations of melancholic depression.

Later, the first symptoms of involvement of the respiratory system appear. Rhinitis develops, the treatment of which does not lead to recovery.

Acute period

The height of the disease begins with the onset of asthma attacks or conditions close to bronchospasm. The disease manifests itself during hormonal changes, which corresponds to age:

Most patients talk about the connection of an attack of suffocation with some factors, which include:

inhalation of strong odors;
physical activity;
change in the temperature of the inhaled air in the evening and in the morning.

The asthma attack of aspirin origin is symptomatically different from ordinary asthma. Within 60 minutes after consuming aspirin and substances containing salicylates, the patient develops characteristic breathing difficulties, which are accompanied by:

the outflow of a large amount of mucus from the sinuses;
lacrimation;
redness of the face and neck.

In addition, some patients have other manifestations that accompany an attack of aspirin asthma:

Low blood pressure

decrease in pressure;
increased secretion of saliva;
vomit;
pain in the stomach.

Unlike regular asthma, aspirin asthma quickly loses its attachment to the seasonality of attacks. Patients feel constant chest congestion. Conventional bronchodilators do not help them improve their condition. Severe series of attacks occur more than four times a year and are caused by various factors: from taking NSAIDs to inhaling hypothermic air and emotional distress. Many women have a connection between exacerbations and the second stage of the menstrual cycle.

Diagnosis of the disease

Provocative test

In the diagnostic measures of aspirin suffocation syndrome, there are no differences from ordinary asthma. Patient research begins with anamnesis and physical examination. Very often, complaints of nasal congestion and choking may be absent.

Further, the diagnosis includes laboratory and instrumental studies. The most reliable way to detect aspirin asthma is an aspirin challenge test. It is very dangerous and must be performed by a medical specialist in a center with an anti-shock ward or an intensive care unit.

Additional methods are a blood test, which reveals eosinophilia, and tomography of the sinuses, polyps are found on it. To establish the degree of suffocation, functional breathing disorders are examined, their degree is established.

Aspirin Asthma Treatment

The basic principles of therapy for aspirin bronchial asthma (BA) were formed by pulmonologists in the guidelines at the global conference on asthmatics. According to these principles, it is necessary:

Control asthma symptoms.
Take measures to prevent exacerbations, including the development of status asthmaticus.
Maintain a close to normal functional state of the respiratory system.
To achieve normal physical activity of the patient.
Eliminate negative drug provoking factors.
Prevent irreversible airway obstruction.
Prevent death from suffocation.

To achieve these goals, it is necessary to carry out special therapy. The exclusion of drugs of the NSAID group and products containing natural acetylsalicylic acid is paramount. Further, the administration of drugs (Epithalamin, Epifamin) and activities aimed at increasing melatonin in the body, which helps the asthmatic to sleep normally, are prescribed.

The drug Epifamin

Antioxidants are prescribed - substances that reduce oxidative processes in the body. In addition, various methods improve microcirculation in the bronchopulmonary system. Anti-inflammatory therapy is prescribed to stabilize cell membranes and reduce leukotrienes. Immunomodulators are included in the treatment to increase the body's defenses.

Sometimes desensitization of acetylsalicylic acid is used. The patient, under the supervision of doctors, begins taking aspirin with small doses. This treatment leads to a decrease in sensitivity to salicylates.

In recent years, leukotriene receptor blockers have been effectively used, with the help of which patients with aspirin asthma can even take salicylates without consequences. The main drugs in this group are Montelukast, Zafirlukast.

Forecast

The prognosis is favorable with rational therapy, but a complete cure for the disease is impossible. Asthma is a lifelong disease, therefore, complex therapy and the elimination of salicylates from the diet do not lead to recovery, but reduce the number of exacerbations and attacks, helping to achieve remission.

Prevention

Preventive measures are aimed at reducing the number of attacks and improving the general condition of the patient. Necessary:

exclude aspirin and all NSAIDs;
follow a diet, excluding canned food, most fruits, beer, substances and products containing tartrazine;
exclude smoking and alcohol consumption.

Complications

Irregular therapy, diet refusal and home treatment with folk remedies can lead to status asthmaticus. In this state, asthma attacks develop for almost no reason, often and are not relieved by drugs, which can lead to death.

Asthmatic status

To avoid serious complications, the patient must understand that asthma must be treated for life.

Bronchial asthma refers to chronic diseases of the respiratory tract of an allergic nature and is characterized by a paroxysmal course. Any substance can provoke an attack, including non-steroidal anti-inflammatory drugs (NSAIDs) - acetylsalicylic acid, or aspirin.

Aspirin asthma manifests itself not only with the use of drugs, but also with the use of products that contain natural salicylates. According to statistics, among people suffering from bronchial asthma, one in five has hypersensitivity to aspirin and other NSAIDs. This disease is not congenital, more often women over the age of 30 suffer from it. Aspirin bronchial asthma is characterized by pronounced clinical manifestations, accompanied by a general serious condition of the patient.

When aspirin acts on the walls of the bronchi, the metabolism of archidonic acids changes, which leads to an imbalance between the substances that stimulate bronchial spasm and the substances that dilate the bronchi. As a result, the bronchi narrow, their walls begin to produce a large amount of thick viscous secretion, which complicates the breathing process. Aspirin asthma is provoked not only by the action of acetylsalicylic acid, but also by other drugs of the NSAID group, for example, Ibuprofen, Ksefokam, Ketorolac, etc.

Symptoms

Aspirin bronchial asthma is characterized by severe persistent attacks and manifests itself as the Fernand-Vidal triad, which includes the development of polypous rhinosinusitis, asthma attacks of varying severity and intolerance to drugs from the NSAID group.

In the early stages of development, the disease can cause hormonal imbalance, which can be manifested by a violation of the menstrual cycle in women, early onset of menopause, and miscarriage. Aspirin asthma also manifests itself in the form of malfunctions of the thyroid gland.

The main symptom of aspirin bronchial asthma is asthma attacks, which have certain characteristic features:

It is more difficult for the patient to breathe out the air than to inhale it.
During an attack, a person cannot perform active physical movements, since there is not enough oxygen and dizziness suddenly sets in.
With an attack, the patient usually takes a sitting position, with the torso tilted forward, resting his hands on a table or other furniture.
In the distance, dry wheezing rales are heard, intensifying on exhalation.
The attack often accompanies a cough, but mucous secretions are difficult to clear from the respiratory tract. This unproductive cough can also be a symptom of bronchial asthma.

Often, the disease begins with a prolonged profuse rhinitis, which practically does not respond to therapeutic measures. Often, rhinitis turns into polypous rhinosinusitis, which combines the following signs:

The formation of polyps on the nasal mucosa, resembling pea-shaped polyps up to 4 mm in size, are often painless.
Difficulty in nasal breathing and a lot of mucus in the nose.
A certain degree of reduction in the sense of smell.
Cough, ear congestion, fever are possible.
With the transition of inflammation to the sinuses, pain appears in the glabella or face.

Symptoms such as choking and drug intolerance can occur at the same time, with a short time interval. For example, a reaction to a drug may appear in 30-60 minutes, while suffocation develops much faster.

Symptoms of hypersensitivity to a group of NSAID drugs can be:

Redness of the face.
Acute coryza with itching and thin discharge.
Itching of the skin of the face and upper half of the body.
The appearance of urticaria - a very itchy pink rash all over the body, protruding over the surrounding tissues.
The development of allergic conjunctivitis, accompanied by lacrimation, redness of the eyes, a feeling of sand under the eyelids.
With a severe degree of intolerance, an allergic reaction of the type of angioedema (Quincke's edema) begins, in which the tissues of the face (mainly the nasolabial triangle) and tongue swell sharply, which can lead to suffocation. Swelling in the genital area or, less often, on the body is possible.
Anaphylactic shock is the most severe manifestation of drug intolerance. At the same time, blood pressure sharply decreases, reddening of the skin of the face and trunk, turning into blue, rapid breathing and pulse are noted, pain in the abdomen, loss of consciousness are possible. This condition requires urgent medical attention.

With timely access to a doctor and conscientious observance of his recommendations, patients manage to minimize such manifestations and live a full life.

Required examinations

To diagnose asthma, the doctor collects anamnesis (for an accurate diagnosis, the patient must describe the manifestations of the disease as fully and clearly as possible) and the patient's complaints; X-ray of the lungs to exclude other pathologies of the respiratory system and detect increased tissue airiness (emphysema); measurement of indicators of external respiration. If necessary, an allergy test is carried out for aspirin or other drugs.

Treatment

After a complete examination and diagnosis, the doctor prescribes treatment, which is currently based on inhaled corticosteroids (Diprospan, Budesonide, Beklazon Eco), bronchodilators (Salbutamol, Fenoterol, Atrovent) and antagonists leukotriene receptors (Montelukast, Akolat, Singular, etc.). The dosage of the drug is strictly selected and controlled by the attending physician. With good tolerance, desensitization is carried out - they have a certain effect on the pathogenesis of the disease and develop the body's immunity to new doses of aspirin.

With abundant growth of polyps in the nasal cavity, they are proposed to be surgically removed, after which it becomes easier to breathe through the nose.

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Diet

Treatment of bronchial aspirin asthma includes not only medication, but also adherence to a certain regimen and diet, which allows you to strengthen the body's defenses.

Diet for bronchial asthma implies the following:

Refusal from all products containing E102 dye, which gives food a yellow tint. These include sodas, juices, instant soups, convenience foods, and more.
Avoiding the use of strong allergens such as citrus fruits, exotic fruits, mushrooms, honey.
Salt restriction.
Complete exclusion of smoked meats, salted dishes, vinegar and foods with preservatives.
Limiting dishes with flavors and flavorings.
Drinking plenty of fluids.

Thus, every person who is faced with this disease can live a full life and play sports. To do this, he must be extremely careful about his health, strictly follow the diet and daily regimen, and also follow the instructions of a specialist.