CREMONA – The weekly appointment is back with the section «The doctor answers». The protagonist of this episode is the doctor Monia Betti, pulmonologist of the Pneumology Unit of the Cremona Hospital.
«Asthma is a chronic inflammatory disease of the airwayscharacterized by periods of symptomaticity, with cough and wheezing of the wheezing type, and periods in which the patient is completely asymptomatic »explains Dr. Betti.
The characteristic of asthma is precisely the reversible broncho-obstruction which resolves after treatment with inhaled drugs or, in the most severe stages of asthma, with oral corticosteroid drugs (cortisone).
HOW DO YOU GET TO THE DIAGNOSIS?
«The diagnosis of asthma always starts from the correct anamnestic collection – specifies the specialist – soi evaluate the patient, listen to the type of symptomatology he reports, the collection of factors including comorbidities (such as gastroesophageal reflux, obesity, rhinitis, etc.). It is necessary and indispensable toexecution of spirometric testsa functional examination, which diagnoses asthma by evaluating an obstruction of the airways both at the baseline level and after the administration of bronchodilators ».
Since in certain periods the patient is asymptomatic, spirometry may be normal, the diagnostic evaluation must be completed by performing a methacholine test.
«We must then further characterize asthma by establishing whether it has an allergic origin or not, an assumption that it will have an implication in the therapeutic choice “explains Dr. Betti. «The asthmatic patient has a maintenance therapy consisting of inhaled corticosteroid drugs plus bronchodilators and an on-demand therapy during the exacerbation of asthma. In these cases, therefore, in addition to the usual therapy that can be maximized, for some patients it is necessary to introduce oral corticosteroids for a short period of time “.
An important point is to understand if the patient takes inhalation therapy correctly, “because patients often underestimate the disease and the effectiveness of the drugs”.
The video section dedicated to health – in collaboration with the Cremona ASST – deals with a specific topic every week with the help of a specialist. Information on the Pneumology Unit of the Cremona Hospital on the website (www.asst-cremona.it).
