What to do with bronchial asthma?

What to do with bronchial asthma?
International Classification (ICD) J45.-

Basics

The term asthma stands for a chronic disease of the respiratory tract. If one suffers from asthma, then one suffers from episodic coughing attacks that can lead to respiratory distress and suffocation. The airways narrow and make it impossible for the patient to breathe in and out normally. Generally speaking, when you have asthma, you suffer from a very high level of inflammation in the airways, and the airways are hypersensitive to certain stimuli.

Bronchial asthma is one of the most common respiratory diseases in the world. Even children and teenagers can suffer from this disease. Research has shown that children are particularly prone to asthma if their parents have been diagnosed with allergies. The child is especially likely to develop asthma if the parent's allergy is related to the airways.

Asthma is a permanent disease that cannot be cured, but can be significantly alleviated. Thanks to numerous modern treatment methods, it is now possible to guarantee the sufferer an active and symptom-free life without being too restricted by the disease.

What changes in our body when we suffer from asthma?

Inhalation: When we breathe in, the chest expands and the lungs expand; negative pressure causes air to be sucked in.

The air we breathe enters our trachea through the mouth or nose, and from here it travels to the left or right lung, where it branches out into numerous smaller and smaller branches, reaching the smallest corners of the lung.

The bronchial system finally ends in the alveoli (= alveoli). This is where the gas exchange of the lungs takes place.

The heart pumps oxygen-poor blood into the lungs, which flows through the branching blood vessels to the alveoli, where it is separated from the inhaled air by a delicate membrane.

The blood releases carbon dioxide and in return takes in oxygen. Now the blood is oxygenated and can flow back to the heart to be distributed throughout our body.

In asthmatics, there is inflammation of the bronchial system. The small branches of the bronchial tree are affected by such inflammation. Due to a disturbance of this bronchial system, over irritation and attack occurs.

In this case, the inflamed mucous membrane swells, the cross-section of the tubular system becomes smaller, the air can flow through less easily, and the asthma sufferer finds it more difficult to exhale.

In addition, the muscles of asthmatics react particularly sensitively. The muscular ring contracts like a spasm. This restricts the obstructed air flow even more.

In addition, the asthmatic's inflamed bronchial system produces a viscous and thick secretion that cannot be easily removed from the lungs and therefore accumulates in the airways. To get rid of the mucus, asthma sufferers have to cough more.

These three factors lead to a narrowing of the airways (= obstruction). Breathing in is largely unhindered, but when breathing out, the obstruction becomes noticeable.

This is why air collects in the lungs during an asthma attack and cannot be exhaled again.

Causes

The causes of asthma have not yet been clearly identified. There can be numerous causes for an asthmatic disease. However, it has already been clearly established that a hereditary asthma disease is very likely. However, hereditary factors do not necessarily lead to the disease.

Research has also shown that allergies in the parents can have an effect on whether or not a child suffers from asthmatic disease. This means that the risk factor for asthmatic disease in children increases if you are a parent with asthma.

On top of that, being an allergy sufferer can make you more prone to develop asthma. Again, this does not mean that just because you are an allergy sufferer, you have to get asthma.

If you get asthma, a number of triggers can contribute to you having an asthmatic attack, these include

  • physical exertion
  • stress
  • cold
  • a reaction to medication such as aspirin or beta blockers
  • pollutants in the air we breathe
  • Irritants such as ozone
  • Psychological factors can also represent a trigger effect and negatively influence the course of the disease.
  • Allergy sufferers experience asthmatic attacks when confronted with the allergen, allergens being the substances that cause the allergy.

Symptoms

The following symptoms may occur with asthma disease:

  • Seizure-like shortness of breath and shortness of breath.
  • Coughing fits with the expectoration of viscous mucus
  • Whistling sounds during breathing
  • Tightness in the chest

The more severe the disease, the more severe the symptoms. However, the symptoms can occur together. In any case, you should be examined by a doctor immediately if you experience any of the above symptoms.

Should an asthma attack occur, then the following symptoms occur in addition to the shortness of breath, coughing and whistling breathing:

  • Choking
  • Gasping breathing
  • Exhaustion
  • Inability to speak
  • Blue colouring of the skin
  • Racing heart

If the asthma attack is not treated, it can progress to "status asthmatikus," a severely life-threatening asthma attack that lasts for hours to days.

Diagnosis

In most cases, the medical history (clarifying conversation with the doctor about the medical history) can provide the first indications of an asthma disease. Then it is important to find out whether it is bronchial asthma or another disease of the respiratory tract.

Asking about the frequency of the symptoms, about certain stimuli and situations of the attack or asking whether there are other asthmatics in the family can provide the first clues to the disease. Only then will a physical examination follow.

Should you or your children experience symptoms, it is advantageous to keep a so-called illness diary in order to be able to better limit the illness.

The easiest way to check the lung function is with a spirometry - here decisive information about the efficiency of the respiratory organs and their condition is given. The force and speed with which one exhales can be measured. In the case of inflamed bronchial tubes, i.e. in asthma patients, these values are reduced.

The maximum respiratory flow (peak flow) is also affected in an asthmatic.

If the asthma patient is symptom-free at the time of the examination, the spirometry may be normal. In this case, a so-called provocation test can be carried out. In this test, certain asthma-triggering substances are used to provoke a mild asthma attack.

If allergic asthma is suspected, the doctor will carry out an allergy test. Here it must be clarified to which allergens the patient reacts with an asthma attack.

Therapy

Treatment that can cure asthma is not possible in and of itself. In children, however, it is possible to treat asthma consistently, as long as the disease is detected early.

Nevertheless, there are a number of options available to asthma sufferers that can help them live relatively symptom-free. For the patient, this means that he or she can behave without restrictions while maintaining maximum physical performance.

This freedom from symptoms can be achieved by various forms of treatment. However, the optimal treatment always consists of several factors. The most important treatment for asthma is certainly drug therapy. A distinction is made between relievers and controllers for the treatment of asthma.

Treatment of asthma with reliever and controller medicines

Reliever medicines

Relievers (a term from the English language, which means to facilitate and alleviate) become active in their medicinal effect immediately after application. Thus, these can relieve acute symptoms by taking them when asthmatic symptoms occur.

Relievers are short-acting beta-2 sympathomimetics. These serve to relax the constricted and cramped bronchial muscles and thus serve to widen the airways.

In addition to short-acting beta-2-sympathomimetics, long-acting beta-sympathomimetics can also be used, always in combination with other drugs. These also lead to a dilation of the bronchial tubes and do not counteract the inflammatory reaction.

Controller drugs

Glucocorticoids are so-called controller drugs, which, as the name suggests, have an inherent controlling effect. They reduce and calm the inflammation of the bronchial tubes, so these controllers can prevent attacks and symptoms in the long term. It is absolutely important to use these controllers regularly.

Controllers are taken directly into the airways by inhalation, which allows them to work directly at their destination. These agents can also be used in tablet form. However, this occurs in more severe asthma cases.

Leukotriene antagonists are also controllers. These are an alternative to glucocorticoids in milder asthma cases, and are used especially in children.

Dosage and the combination of medications are adjusted to the severity of the disease. The treating physician sets up a plan to guide the intake of medication, following the principle of "as many medications as necessary, but as few as possible".

Regular check-ups are necessary for this reason.

Prevent

Measures to prevent an allergic reaction should be taken in addition to medication in any case. Here one can fall back on different behaviours and applications.

Allergen avoidance

Allergen avoidance is mainly used if you suffer from an allergic asthma disease. Allergens are allergy triggers such as pollen in the case of a pollen allergy or house dust in the case of a house dust allergy. If an asthma attack is caused by contact with these allergens, one should of course avoid these substances as much as possible. Here, a so-called hyposensitization against the allergen can also help. However, it is not only in the case of an allergic asthma attack that the causative agents should be avoided, even if non-allergic triggers cause the attack. Patients should firstly be aware of the factors and situations that cause symptoms or attacks, and secondly be able to avoid them. Allergen avoidance is not always easy, especially when environmental factors trigger asthma attacks. Cold wind, dry air, ozone pollution and house dust can be such agents that you cannot easily avoid.

Finally a non-smoker

Nicotine consumption naturally has an extremely negative effect on asthma. Therefore, always refrain from smoking cigarettes and cigars. The same applies not only to active smoking, but also to passive smoking. So avoid places where there is no non-smoking area.

Sport and physical activity

are a particularly important measure to alleviate symptoms and to be able to live seizure-free. Sporting activities contribute positively to the performance of the heart and lungs. Nevertheless, asthmatics should know their limits and not overdo it. In and of itself, there are hardly any restrictions with regard to a certain type of sport.

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