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Bronchial asthma - causes, symptoms and therapy

Bronchial asthma - causes, symptoms and therapy


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Bronchial asthma - an overview

People who frequently cough or have symptoms such as chest tightness or tightness, shortness of breath with a whistling sound when breathing and sudden shortness of breath may experience chronic bronchial asthma. In the following, symptoms, diagnosis, causes and therapies of the disease - including naturopathic approaches - are explained in more detail.

  • definition: Bronchial asthma is a chronic bronchial disorder in which relapsing attacks are triggered by certain stimuli.
  • frequency: Asthma is a common disease. Around every tenth child and every twentieth adult suffers from it.
  • Symptoms: Typical symptoms include constant coughing with coughing fits, shortness of breath, shortness of breath and feelings of tightness in the chest.
  • causes: Due to certain circumstances (e.g. allergy, viral infection), the bronchial system of asthmatics is constantly on the defensive and reacts violently to certain stimuli such as pollen, animal hair, exhaust gases, chemicals or dust.
  • Asthma types: The disease occurs in an allergic (extrinsic) and a non-allergic (intrinsic) form, as well as a mixture of the two.
  • therapy: Bronchial asthma is not curable, but can be treated well. Therapy usually consists of drug treatment and training for those affected. Through a targeted change in lifestyle, asthmatics can live largely free of symptoms. Naturopathy can support this process.

Definition

Bronchial asthma, also called bronchial asthma, is a seizure-like chronic illness of the respiratory tract with an increased sensitivity of the bronchial tubes to various stimuli (bronchial hyperreactivity). Typically, asthma manifests itself in flare-ups characterized by chest tightness, shortness of breath with whistling noises, coughing and shortness of breath. The seizures often occur at night or in the early morning.

Frequency

The frequency of asthma is estimated to be around 100 million people worldwide. In Germany, the disease occurs in approximately eight to ten percent of children and approximately five to seven percent of adults. This affects around 8 million people in Germany. Bronchial asthma is one of the most common chronic diseases, especially in childhood. On average, every eighth child under the age of ten and every tenth child under the age of 15 develop this disease.

While boys are more often affected in children, the proportions become more and more equal with increasing age until finally the proportion of women predominates in adulthood. According to the 12-month prevalence of bronchial asthma published by the Robert Koch Institute (RKI) in 2017, 7.1 percent of women and 5.4 percent of men in Germany are currently suffering from the chronic disease.

Shortly after reunification, Germany had significantly fewer asthma cases in the eastern federal states than in the western part of the country. Today the occurrence in the east and west is almost balanced. The most likely reason for this is assumed to be the harmonization of living conditions and the type of diet as well as the increase in air pollutants.

Bronchial asthma symptoms

It is characteristic of bronchial asthma that the muscles in the bronchial wall cramp, the bronchial mucosa swells and tough mucus is produced. This results in the typical symptoms such as:

  • Cough with glassy phlegm,
  • constant cough,
  • a whistling sound when breathing out (wheezing),
  • a feeling of tightness or tightness in the chest,
  • tough slime,
  • sudden breathlessness,
  • Shortness of breath,
  • Asthma attacks in which several symptoms appear suddenly and violently.

Risk factors

The incidence of bronchial asthma has increased over the past few years. Therefore, one should recognize the warning signs of asthma. If the parents already suffer from so-called atopic diseases, including allergies and neurodermatitis, the risk for a child to develop bronchial asthma increases. In addition, children who have been breastfed for less than six months are more susceptible than breastfed babies. Asthma is also favored in certain professions such as bakers (through flour dust) or hairdressers (through chemicals). In summary, the following factors are considered a risk of developing asthma:

  • Excessive hygiene: Germs are important for the development of an intact immune system, permanent excessive hygiene measures promote the formation of allergies and asthma.
  • genetics: Several allergy sufferers in a family indicate that the rest of the family is also at higher risk.
  • Certain childhood diseases: If a child develops certain diseases, the risk of developing bronchial asthma is higher. These diseases include allergies, neurodermatitis, cradle cap, itchy rash. (Eczema)
  • Birth weight: Underweight babies have a slightly increased risk of developing asthma.
  • Parents are smokers: Children of parents who smoke are more likely to suffer from asthma than children of non-parents who smoke. A smoking mother in particular increases the risk for her child.
  • Viral infections: Common virus infections are associated with an increased risk of non-allergic asthma.
  • Early weaning: Breast milk is important for a baby to develop a strong immune system.
  • Existing allergies: The presence of other allergies such as hay fever also increases the likelihood of asthma.
  • Medication: Medications for heartburn increase the risk of asthma in children if they are taken during pregnancy.

Causes

The exact reasons why people develop asthma are not yet sufficiently understood in medicine. The genes and environmental factors play a major role in the development of the disease. People from families with an increased allergy are at increased risk of developing bronchial asthma and allergic to certain triggers.

Environmental factors particularly affect people who are often exposed to certain substances in their profession such as adhesives, paints, flour dust, wood dust, latex, animal hair, pollen, insecticides or chemicals. In addition, a connection with an insufficient training of the immune system is suspected due to excessive hygiene measures.

Contrary to the exact reasons for the cause, doctors know explicitly what happens in the body of allergy sufferers. In the bronchial system of those affected, there is an increased inflammatory reaction to which the body reacts with a constant readiness to defend itself. This situation can be suddenly exacerbated by certain influences and triggers. The bronchial tubes of the affected people react hypersensitively to certain, mostly harmless, stimuli with intensive defense reactions. These reactions include:

  • cramp-like narrowing of the bronchi,
  • Swelling of the mucous membranes in the bronchial walls,
  • violent tough mucus formation,
  • Coughing fits with glassy mucus.

Feelings of oppression, whistling noises and shortness of breath
The diameter of the bronchi narrows and it is difficult to breathe in and out. This process is called obstruction in medicine and is responsible for the typical whistling sounds and the feeling of tightness in the chest. As a result of the obstruction, the respiratory muscles can become overloaded. The narrowing particularly complicates the exhalation. As a result, a little more air than usual can remain in the lungs with each breath, gradually inflating the lungs, making it more difficult to inhale. This can cause breathlessness in asthmatics.

Relapsing appearance
Asthma causes inconsistent symptoms in those affected. Inflammation is always present, but it requires a certain trigger that triggers the typical asthma symptoms. This can lead to an asthma attack, which in the worst case can become a medical emergency.

Status asthmaticus

In rare cases, the life-threatening status of asthmaticus can occur. In this state, severe symptoms of illness persist for up to 24 hours. To make matters worse, the usual asthmaticus therapeutic measures are only partially effective. Typical signs are:

  • severe shortness of breath (dyspnea),
  • panting, accelerated breathing,
  • Paleness,
  • Blue coloring of the fingers, toes and lips (cyanosis) due to insufficient supply of oxygen to the body (hypoxia),
  • Impaired consciousness,
  • increased heart rate,
  • Pupil dilation,
  • Restlessness,
  • Incontinence.

The asthmaticus status is life-threatening and requires immediate medical care. A blood gas analysis, in which the amount of oxygen in the blood is determined, determines the severity of the condition. In addition to oxygen supply, medication is also used in medical treatment. These include, for example:

  • Beta-2 sympathomimetics for bronchodilation,
  • Aminophylline and theophylline to relieve muscle spasms in the bronchi,
  • Corticosteroids to inhibit inflammatory reactions
  • Parasympatholytics to calm muscle contraction and reduce mucus production.

Asthma mortality
In Germany, 4 to 8 people per 100,000 inhabitants die each year from the consequences of the disease. This results in a number of approximately 3200 to 6400 deaths per year. Deadly asthma attacks often take place in winter. Most deaths would be avoidable, but many patients underestimate their condition and do not reliably follow medical instructions.

Diagnosis

If you go to the doctor with suspected asthma, in most cases you will first be asked about your own and family history (medical history). This is often followed by a general physical exam. The doctor can use a pulmonary function test to determine whether breathing is disturbed and whether the bronchi are constricted.

Peak flow meter
A so-called peak flow meter is often used here, not a device that can measure the strength of exhalation. These measurements can also be taken at regular intervals at home, for example to determine the success of treatment or deterioration.

Spirometry
Another breath measurement method is spirometry. When performing, the user blows into a mouthpiece that is connected to a so-called spirometer. This measures the power of inhaling and exhaling as well as the amount of air. Based on this data, a possible restricted lung function can be determined. The doctor can document the course of the disease through regular measurements.

More tests
Other ways to diagnose asthma or the form of asthma are:

  • Provocation test: Here, the patient inhales certain substances while the doctor checks whether the bronchi constrict as a result.
  • Stress test: This test checks whether symptoms of asthma appear during physical exertion.
  • Drug test: Before and after taking certain medications used for asthma, such as salbutamol or fenoterol, the doctor checks the lung function to determine possible changes.
  • Whole body plethysmography: In the large lung function test, the patient sits in a glass cabin in which he breathes into a device. The test person can breathe normally without exertion, which is why this test is particularly suitable for children and the elderly. In addition, this is the only test method to measure the remaining air content in the lungs after exhalation (residual volume).
  • Allergy test: In an allergy test, the suspected substances are applied or injected onto the skin and the reaction to them is checked (prick test). A blood analysis is also suitable as an allergy test, in which the special antibodies are detected (RAST test).

Asthma species

The disease is primarily differentiated between allergic (extrinsic) and non-allergic (intrinsic) asthma. But there is also a mixture of the two. While asthma is predominantly allergic in children, 20 to 30 percent of adults with asthma also develop a non-allergic (intrinsic) form of the disease. A purely allergic cause from the age of 20 can only be proven in less than a fifth of cases.

Allergic form
The extrinsic form of asthma is triggered by allergenic substances. In the course of so-called allergic early reactions there is an increased formation of antibodies of the type immunoglobulin-E (IgE). These antibodies are normally only found in small amounts in the blood. This process is followed by the allergic late reaction, i.e. the typical symptoms of bronchial asthma. The allergic form also includes seasonal asthma, which is associated with the pollen count of certain allergenic pollen.

Not allergic form
The intrinsic form of asthma often only occurs in people over the age of 40. Contrary to the allergic form, there is less of an increase in immunoglobulin E antibodies in intrinsic asthma. It is therefore not triggered by an allergen. In many cases, this form occurs as a result of a respiratory viral infection and is exacerbated by these infections.

The defense reactions that take place in the body are basically the same as in allergic asthma. However, this form almost always results in chronic inflammation of the sinuses, which can also lead to polyps in the nose (nasal polyposis), which makes nasal breathing considerably more difficult.

In 30 to 50 percent of adult asthmatics, an allergy as a trigger of the disease is not detectable. The course of the disease of the intrinsic form is characterized by smaller fluctuations in the severity, but often takes a more severe course from the beginning.

Mixed forms of asthma
For many sufferers, a mixed form develops between the intrinsic and extrinsic form. In most cases, the disease begins with allergic asthma. In the course of the disease, for example as a result of repeated respiratory infections, non-allergic factors are added and lead to asthmatic reactions to certain triggers, such as smoke, haze, smoke, cold air or the like. However, these triggers do not cause allergic reactions in the body, but only trigger the asthmatic symptoms.

Stress asthma
With asthma or exertional asthma, asthmatic symptoms occur at the beginning and after physical exertion. This form affects most asthmatic children and about one in three adults with asthma. It is typical of this type that the seizures are only caused during sporting activities, especially if they are carried out in cold air. The inflammation of the bronchi is promoted by the cooling and drying of the bronchial mucous membranes with accelerated breathing in cold air.

Gastroesophageal reflux
Another form of the disease is asthma with gastroesophageal reflux. In this form, gastric juice gets into the esophagus and triggers a reflex-like cramping of the bronchi. Some drugs or active ingredients such as theophylline or beta-2 sympathomimetics used in asthma therapy can intensify this effect because they can paralyze the movement of the esophagus.

Brittle gradient shape
It is a very rare form of the disease, which is characterized by recurrent severe asthma attacks up to the life-threatening asthmatic status. The seizures occur suddenly, with no signs of previous worsening.

Transition to COPD
Around 20 to 30 percent of asthma cases progress to chronic obstructive bronchitis (COPD) in the course of the disease. These cases are characterized by the fact that the affected person not only suffers from a cough with expectoration not only during a seizure but also.

Trigger

Asthma can be triggered by different stimuli. A distinction is made between allergenic and non-allergenic triggers and general triggers for all forms. The individual triggers can be different for those affected.

Allergic triggers
This includes substances that trigger allergic reactions, such as:

  • Tree and grass pollen,
  • House dust (see asthma from house dust mites),
  • Animal hair or bird feathers,
  • Mold spores,
  • certain foods such as shellfish, fish, hazelnuts, strawberries,
  • certain medications such as acetylsalicylic acid (ASA) or diclofenac.

Non-allergic triggers
Intrinsic triggers include:

  • Respiratory diseases caused by viral infections,
  • bacterial infections,
  • certain substances to which the person concerned is exposed over a long period of time (often due to work).

General triggers
These include non-specific stimuli to which all asthmatics can respond, such as:

  • certain air conditions (cold or humid-warm air, fog),
  • Air pollution (exhaust gases, soot particles, whirled up dust),
  • Cigarette smoke,
  • Fragrances,
  • Upper and lower respiratory tract infections,
  • physical exertion,
  • mental stress or stress.

Therapy

According to current knowledge, bronchial asthma is not curable. In most cases, therapies can be largely free of symptoms. Medicinal treatment is one of the most common therapeutic methods. The drugs are said to alleviate the symptoms and reduce asthma attacks. Sufferers must learn from operational experience how and when they use the medication in order to achieve the greatest possible effect with the lowest possible medication consumption.

Medicines for bronchial asthma
Medications in the form of sprays, tablets, inhalations and injections are used against asthma to prevent seizures or to interrupt symptoms that have already started due to antispasmodic, anti-inflammatory, breathing-expanding and allergy-inhibiting substances. These include in particular:

  • Glucocorticosteroids (cortisone) with the active substances beclometasone, budesonide, flunisolide, fluticasone or mometasone for inhalation
  • Beta-2 sympathomimetics such as salmeterol or in the event of short-acting beta-2 sympathomimetics such as salbutamol
  • Anticholinergics (should inhibit the spasmodic contraction of the bronchial muscles)
  • Disodium cromoglicic acid (DNCG)
  • Ketotifen
  • Leukotriene inhibitors such as montelukast and zafirlukast
  • Nedocromil (anti-inflammatory)
  • Omalizumab (blocks immunoglobulin E antibodies)
  • Theophylline (relaxes the bronchial muscles; is rarely used today)

Non-drug therapies
In addition to the drugs, non-drug therapies are recommended. These consist of avoiding the triggers, patient training to make everyday life largely symptom-free, and regular checks by the doctor.

Patient training
Through targeted training of asthmatics, they should learn how to deal better with the disease. In addition to important background information on the clinical picture, the participants learn how to better interpret the body's own signs, how to use breathing techniques, how to react correctly in emergency situations and how to better recognize and avoid individual triggers. The training is offered by many lung specialists, rehabilitation clinics, hospitals and self-help groups.

Naturopathy

Asthma is a serious, and in the worst case, life-threatening illness that should be treated by medically prescribed therapies. Naturopathy can be used to support asthma in a natural way. The naturopathic therapies should stimulate the self-healing powers and alleviate the excessive reactions.

Preparations made from coltsfoot, St. John's wort and rauwolfia are suitable for relieving bronchial spasms, cough secretions and for calming down. Regular exercises from Tai Chi or Qi Gong have proven to be effective relaxation methods, ideally including breathing. Yoga also relieves symptoms of bronchial asthma. Targeted breathing therapy such as autogenic training can reduce breathlessness.

hypnosis
Body and mind can benefit from therapeutic hypnosis. In addition to the relaxing and immune-regulating aspects, conflicts can be uncovered that contributed to the development of asthmatic complaints or that are currently intensifying them. Some asthmatics report an improvement in lung function through the imagination of cells and tissues as part of hypnosis.

Home remedies

Natural home remedies for cough can relieve the symptoms. However, if the home remedies become worse, self-treatment should be stopped immediately and a doctor consulted.

Other naturopathic treatments
Natural healing methods have not yet been researched scientifically, but experience has shown that they have shown good results in supportive therapy for bronchial asthma. These procedures include:

  • acupuncture
  • homeopathy
  • Isopathy
  • Autologous blood therapy
  • Physical procedures with steam and air baths as well as upper body massages
  • Bioresonance

Current state of research

There are numerous studies on bronchial asthma. Here are some examples and expert assessments from recent years:

  • A third of asthma patients do not have asthma at all. Scientists at the University of Ottawa found this and summed up that many sufferers can live without asthma medication without any problems.
  • Insomnia increases the risk of developing asthma. A team of researchers from the Norwegian University of Science and Technology found that insomnia can massively increase the risk of asthma in adults.
  • More and more aggressive pollen in German cities. Experts report that global warming makes the pollen season much longer and more intensive, with corresponding consequences on the risk of asthma.
  • According to immunologists from the University of Zurich, the farm protects children from allergies and asthma.

(jvs, vb)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate editor (FH) Volker Blasek, Barbara Schindewolf-Lensch

Swell:

  • German Society for Pneumology and Respiratory Medicine e.V .: Bronchial asthma (accessed: July 24, 2019), lungenaerzte-im-netz.de
  • Helmholtz Zentrum München - German Research Center for Health and the Environment (GmbH): Bronchial asthma (accessed: July 24, 2019), lungeninformationsdienst.de
  • NVL program from BÄK, KBV, AWMF: S3 guideline for national care guidelines for asthma, as of November 2018, awmf.org
  • Atemwegliga e.V .: Asthma (accessed: July 24, 2019), atemwaysliga.de
  • Institute for Quality and Efficiency in Health Care (IQWiG): Asthma (accessed: July 24, 2019), gesundheitsinformation.de
  • Professional Association of Pediatricians e. V .: Bronchial asthma (access: July 24, 2019), kinderaerzte-im-netz.de
  • Walter de Gruyter GmbH: Bronchial asthma (access: July 24, 2019), pschyrembel.de
  • Mayo CLinic: Asthma (accessed: July 24, 2019), mayoclinic.org
  • National Heart, Lung, and Blood Institute (NHLBI): Asthma (accessed: July 24, 2019), nhlbi.nih.gov
  • World Health Organization (WHO): Asthma (accessed: July 24, 2019), who.int
  • Robert Koch Institute (RKI): 12-month prevalence of bronchial asthma, Journal of Health Monitoring, 2017, rki.de
  • German Society for Pneumology and Respiratory Medicine e.V. and German Respiratory League e.V .: S2k guidelines for the diagnosis and therapy of patients with asthma, as of: 2017, thieme-connect.de

ICD codes for this disease: J45, J46ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.


Video: Bronchial Asthma. Diagnosis and Management (May 2022).