Bronchial asthma - causes, symptoms and therapy

Bronchial Asthma - An Overview

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

• definition: Bronchial asthma is a chronic disease of the bronchial tubes that relieves certain stimuli.
• frequency: Asthma is a common disease. About one in ten children and every twentieth adult suffers from it.
• symptomsTypical symptoms include persistent coughing with coughing fits, shortness of breath, shortness of breath and chest tightness.
• causes: Due to certain conditions (for example, allergy, viral infection), the bronchial system of the asthmatic is in constant readiness to defend itself and reacts strongly to certain stimuli such as pollen, animal hair, exhaust fumes, chemicals or dust.
• Asthma Types: The disease occurs in an allergic (extrinsic) and a non-allergic (intrinsic) form as well as in a hybrid form of both.
• therapy: Bronchial asthma is not curable but can be treated well. A therapy usually consists of a drug treatment and a training of those affected. Through targeted conversion of the lifestyle asthmatics can live largely free of complaints. Naturopathy can support this process.

contents

• Bronchial Asthma - An Overview
• definition
• frequency
• Asthma bronchial symptoms
• risk factors
• causes
• Status asthmaticus
• diagnostics
• Asthma types
• trigger
• therapy
• Naturopathy
• home remedies
• Current state of research

definition

Bronchial asthma, or bronchial asthma, is a seizure-type chronic respiratory disease characterized by increased bronchial sensitivity to various stimuli (bronchial hyperresponsiveness). Typically, asthma manifests itself in spurts characterized by tightness of the chest, shortness of breath, wheezing, coughing, and shortness of breath. The seizures often occur at night or in the early morning.

frequency

Worldwide, the incidence of asthma is estimated at around 100 million people affected. In Germany, the disease occurs in about eight to ten percent of children and about five to seven percent of adults. This affects around 8 million people in Germany. Especially in childhood, bronchial asthma is one of the most common chronic diseases. On average, every eighth child under the age of ten and one in ten children under the age of 15 develop this disease.

While children are more likely to be affected by boys, their proportions increase with age, until they eventually outnumber women in adulthood. According to the 12-month prevalence 2017 of asthma bronchiale, published by the Robert Koch Institute (RKI), 7.1 percent of women and 5.4 percent of men in Germany currently suffer from the chronic disease.

Bronchial asthma is a chronic disease in which the bronchi are hypersensitive to various stimuli. (Image: PIC4U / fotolia.com)

In Germany, there were significantly fewer asthma cases in the eastern federal states shortly after reunification than in the west of the country. Today, the occurrence in East and West is almost balanced. The most probable reason for this is the approximation of living conditions and the type of diet as well as the increase in air pollutants.

Asthma bronchial symptoms

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

• Cough with glassy mucus ejection,
• constant coughing,
• a whistling sound when exhaling (wheezing),
• an oppressive or tight feeling in the chest,
• tough mucus,
• sudden respiratory distress,
• shortness of breath,
• Asthma attacks in which several symptoms occur suddenly and violently.

Tightness in the chest and constant coughing are typical asthma symptoms. (Image: highwaystarz / fotolia.com)

risk factors

The incidence of bronchial asthma has increased over the last few years. Therefore, one should recognize the warning signs of asthma. If the parents already suffer from so-called atopic diseases, which include, for example, allergies and atopic dermatitis, the risk for a child to develop bronchial asthma also increases. In addition, children who have been breastfed for less than six months show a higher susceptibility compared to breastfed babies. Also in certain occupations such as bakers (through flour dust) or hairdresser (by chemicals) the occurrence of asthma is favored. In summary, the following factors are considered a risk to develop asthma:

• Excessive hygiene: Germs are important for the development of an intact immune system, lasting exaggerated hygiene measures promote the formation of allergies and asthma.
• geneticsSeveral allergic persons in one family indicate that the rest of the family is also at greater risk.
• Certain childhood diseasesWhen a child develops certain diseases, the risk of getting bronchial asthma is higher. These diseases include allergies, atopic dermatitis, cradle cap, itchy rash. (Eczema)
• birth weight: Underweight babies have a slightly higher risk of developing asthma.
• Parents are smokers: Children of smoking parents are more likely to suffer from asthma than non-smoker parents. In particular, a smoking mother increases the risk for her child.
• virus infections: Frequent infections with viruses are associated with an increased risk of non-allergic asthma.
• Early weaningBreastmilk 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.
• drugs: Heartburn drugs increase the risk of childhood asthma when taken during pregnancy.

What happens with asthma? (Picture: rob3000 / fotolia.com)

causes

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

Environmental factors particularly affect people who are often exposed to certain substances such as adhesives, lacquers, flour dust, wood dust, latex, animal hair, pollens, insecticides or chemicals. In addition, an association with insufficient immune system formation due to excessive hygiene measures is suspected.

Contrary to the exact causes of causation, physicians know explicitly which processes take place in the body of allergy sufferers. In the bronchial system of those affected there is an intensified inflammatory reaction to which the body reacts with a constant readiness to defend itself. This situation can be suddenly increased by certain influences and triggers. The bronchi of those affected react overly sensitive to certain, mostly harmless, stimuli with intense defense reactions. These reactions include:

• spasmodic constriction of the bronchi,
• Swelling of the mucous membranes in the bronchial walls,
• violent tough mucus formation,
• Coughing fits with glassy mucus.

How asthma develops. (Picture: bilderzwerg / fotolia.com)

Tense feelings, whistling noises and shortness of breath
The diameter of the bronchi narrows and the breathing air can only make it difficult to enter and exit. This process is called obstruction in medicine and is responsible for the typical whistling sounds and tightness in the chest. As a result of the obstruction, the respiratory muscles can become overloaded. The narrowing complicates in particular the exhalation. Thus, with each breath, a little more air than usual can remain in the lungs, gradually inflating the lungs, making inhalation difficult. As a result, asthma sufferers may experience a shortness of breath.

Shy appearance
Asthma causes inconvenient symptoms in those affected. Although the inflammatory readiness is always present, but it requires a specific trigger (trigger), which causes the typical asthma symptoms. This can lead to an asthma attack, which can become a medical emergency in the worst case.

Status asthmaticus

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

• severe shortness of breath (dyspnoea),
• panting, accelerated breathing,
• paleness,
• Blue discoloration of the fingers, toes and lips (cyanosis) due to the undersupply of the body with oxygen (hypoxia),
• Disturbances of consciousness,
• increased heart rate,
• Dilation of the pupil,
• unrest,
• incontinence.

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

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

The status asthmaticus can reach life-threatening levels and requires immediate medical attention. (Image: auremar / fotolia.com)

Mortality from asthma
In Germany, 4 to 8 people per 100,000 people die each year as a result of the disease. This results in a number of about 3200 to 6400 deaths per year. Often, fatal asthma attacks occur in winter. Most deaths would be avoidable, but many patients underestimate their condition and do not reliably follow the doctor's instructions.

diagnostics

Anyone who goes to the doctor with an asthma suspicion is in most cases first asked about their own family history (anamnesis). This is often followed by a general physical examination. Through a lung function test, the doctor can determine whether the breathing is disturbed and there is a narrowing of the bronchi.

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

spirometry
Another breath measurement method is spirometry. When performing the user blows in a mouthpiece that is connected to a so-called spirometer. This measures the power of inhalation and exhalation as well as the amount of air. Based on these data, a possible limited lung function can be determined. Through regular measurements, the doctor can document the course of the disease.

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

• provocation test: The patient inhales certain substances while the doctor checks to see if the bronchi narrow.
• stress test: This test verifies that physical exertion shows asthma symptoms.
• drug trial: Before and after the administration of certain medicines used for asthma, such as salbutamol or fenoterol, the doctor checks the lung function to determine possible changes.
• Whole-body plethysmographyIn 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 any effort, which makes this test especially suitable for children and old people. In addition, this is the only test method to measure the remaining amount of air in the lungs after exhalation (residual volume).
• allergy testIn an allergy test, the suspected substances are applied or injected onto the skin and the reaction is checked (prick test). In addition, a blood analysis is suitable as an allergy test in which the special antibodies are detected (RAST test).

If it is an allergic asthma, the doctor can prove this by the so-called prick test. (Image: Andre / fotolia.com)

Asthma types

First and foremost, a distinction is made between allergic (extrinsic) and non-allergic (intrinsic) asthma. But there is also a hybrid of both. 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. Thus, a purely allergic cause from the age of 20 can only be detected in less than a fifth of cases.

Allergic form
The extrinsic asthma form is triggered by allergenic substances. In the course of so-called allergic early reactions, there is an increased formation of antibodies of the immunoglobulin-E (IgE) type. These antibodies usually occur in small amounts in the blood. This process is followed by the allergic late reaction, ie the typical symptoms of bronchial asthma. The allergic form also includes the seasonal asthma, which is related to the pollen of certain allergenic pollen.

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

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

In 30 to 50 percent of adult asthmatics, allergy as the cause of the disease is undetectable. The course of the disease of the intrinsic form is characterized by smaller variations in severity, but often takes a more severe course from the beginning.

The non-allergic type of asthma often occurs as a result of viral infections of the respiratory tract. (Image: psdesign1 / fotolia.com)

Mixed forms of asthma
Many sufferers develop a hybrid between the intrinsic and extrinsic forms. 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 similar. These triggers cause no allergic reactions in the body, but trigger only the asthmatic symptoms.

exercise-induced asthma
Exercise-induced asthma or stress-related asthma causes asthma symptoms at the beginning and after physical exertion. This form affects most asthmatic children and about every third asthmatic adult. Typical of this type is that the seizures are caused only during sports activities, especially when they are exercised in cold air. The inflammation of the bronchi is promoted by the cooling and drying of the bronchial mucous membranes during accelerated respiration in cold air.

Gastroesophageal reflux
Another form of the disease is asthma with gastroesophageal reflux. In this form gastric juice enters the esophagus and triggers a reflex-like cramping of the bronchi. Some medications or agents, such as theophylline or beta-2-sympathomimetics used in asthma therapy, may exacerbate this effect as they may paralyze esophageal motions.

Brittle-onset form
It is a very rare form of the disease, characterized by recurrent severe asthma attacks to the life-threatening status asthmaticus. The seizures occur suddenly, with no signs of worsening.

Transition to COPD
About 20 to 30 percent of asthma cases develop into chronic obstructive pulmonary disease (COPD) during the course of the disease. These cases are characterized by the fact that sufferers not only during a seizure but constantly suffering from cough with sputum.

trigger

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

Allergens are common causes of asthma attacks. (Image: freshidea / fotolia.com)

Allergic triggers
These include substances that cause allergic reactions, such as:

• Tree and grass pollen,
• House dust (see dust mite asthma),
• 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 due to virus infections,
• bacterial infections,
• certain substances to which the person is exposed over a long period of time (often for professional reasons).

General triggers
These include nonspecific stimuli to which all asthmatics can respond, such as:

• certain air conditions (cold or humid-warm air, fog),
• Air pollution (exhaust gases, soot particles, dust raised),
• cigarette smoke,
• fragrances,
• Infections of the upper and lower respiratory tract,
• physical exertion,
• mental stress or stress.

Asthma cases have been on the increase in recent years. Experts suggest that this is related to increasing air pollution and prolonged pollen migration from global warming. (Image: Ralf Geithe / fotolia.com)

therapy

According to current knowledge, bronchial asthma is not curable. In most cases, however, therapies can achieve a high degree of freedom from symptoms. One of the most common therapy methods is drug treatment. The drugs are said to relieve the symptoms and reduce the onset of asthma attacks. Disease sufferers must learn through experience how and when to use the drugs to maximize their efficacy with the lowest possible drug use.

Medicines for bronchial asthma
Medications in the form of sprays, tablets, inhalations and injections are used to combat asthma in order to prevent seizures or to interrupt discomfort caused by antispasmodic, anti-inflammatory, respiratory and allergy-inhibiting agents. These include in particular:

• Glucocorticosteroids (cortisone) with the active ingredients beclomethasone, budesonide, flunisolide, fluticasone or mometasone for inhalation
• Beta-2-sympathomimetics such as salmeterol or short-acting beta-2-sympathomimetics such as salbutamol
• Anticholinergics (should inhibit convulsive contractions of the bronchial muscles)
• Disodium cromoglicinic acid (DNCG)
• ketotifen
• Leukotrienehemmer such as montelukast and zafirlukast
• Nedocromil (anti-inflammatory)
• Omalizumab (blocks antibodies of the type immunoglobulin E)
• Theophylline (relaxes the bronchial muscles, is rarely used today)

Many asthma medications can be taken in the form of sprays or inhalations. (Image: beltado / fotolia.com)

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

patient education
Through targeted training of asthmatics, they should learn how to better deal with the disease. In addition to important background information on the disease, the participants learn to better interpret the body's signs, to use breathing techniques, to respond properly in emergency situations and to better recognize and avoid the individual triggers. The training courses are offered by many pulmonary specialists, rehabilitation clinics, hospitals and self-help groups.

Naturopathy

Asthma is a serious, even life-threatening, disease that should be treated with medically prescribed therapies. In support of this, naturopathy can be used to control asthma in a natural way. The naturopathic therapies should stimulate the self-healing powers and mitigate the excessive reactions.

Preparations of coltsfoot, St. John's Wort and Rauwolfia are suitable for releasing bronchial spasms, coughing and calming. Regular exercises from tai chi or qi gong have proven to be effective methods of relaxation, ideally involving breathing. Yoga also relieves symptoms of bronchial asthma. Targeted respiratory therapy such as autogenic training can reduce respiratory distress.

hypnosis
Body and psyche can benefit from therapeutic hypnosis. In addition to the relaxing and immunoregulatory aspects, conflicts can be uncovered that have contributed to, or are currently exacerbating, the onset of asthmatic complaints. Some asthmatics report an improvement in lung function through the imagination of cells and tissues in the context of hypnosis.

home remedies

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

Other natural remedies
Naturopathic treatments have not yet been scientifically researched, but have shown good results in supportive therapy of bronchial asthma. These methods include:

• acupuncture
• homeopathy
• Isopathy
• Autohemotherapy
• Physical procedures with steam and air baths as well as upper body massages
• bioresonanz

Current state of research

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

• One third of asthma patients do not suffer from asthma at all. This was stated by scientists from the University of Ottawa, who concluded that many people can live without medication for asthma without any problems.
• Insomnia increases the risk of developing asthma. A research team from the Norwegian University of Science and Technology found that insomnia can massively increase the risk of adult asthma.
• More and more aggressive pollen in German cities. Experts report that pollen season is significantly longer and more intense as a result of global warming, with corresponding consequences for the risk of asthma.
• According to immunologists from the University of Zurich, the farm protects children from allergies and asthma.

(jvs, vb; updated March 19, 2018)
Specialist supervision: Barbara Schindewolf-Lensch (doctor)

Sources and links

• 12-month prevalence of bronchial asthma published by the Robert Koch Institute (RKI),
• Journal of Asthma by the German Lung Foundation,
• Pulmonologists in the network,
• Guideline Asthma of the German Society for Pulmonology and Respiratory Medicine and the German Respiratory League,
• World Health Organization WHO asthma reports.
• as well as articles linked in the text.