Asthma

Asthma is a disease that causes a temporary or permanent narrowing of the airways. Asthma attacks usually cause wheezing, coughing, and breathlessness. With inadequate treatment, physical fitness is impacted because the lungs are no longer able to absorb as much oxygen. 

Asthma does not automatically worsen over time and can be treated effectively. With medication and supportive measures, such as regular exercise, most people with asthma can enjoy largely symptom-free lives. Over time, people with asthma learn which treatments work best for them and what they can do to avoid asthma attacks. 

In children, asthma symptoms usually consist of coughing and whistling or wheezing sounds when breathing. Teenagers and adults also experience the following additional symptoms: 

• breathlessness, often as part of an attack 
• shortness of breath during exercise 
• noisy breathing (out) (whistling, wheezing, rattling) 
• chest tightness 
• coughing/feeling an urge to cough

Asthma symptoms typically occur in the form of sudden attacks. An asthma attack may begin with slightly impaired breathing but may progress to severe respiratory distress. People with asthma often suffer attacks at night, leaving them tired and worn-out the next day. 

Asthma is likely to have a certain hereditary component, as it occurs more frequently in some families than others. Risk factors for asthma include: 

• atopic eczema, hay fever, or other allergies in the family  
• below-average birth weight  
• sex (more boys than girls have asthma) 
• having parents who smoke  

In people with asthma, the immune system overreacts very slightly. In order for symptoms to occur, however, an additional irritant or trigger is required. The immune system only overreacts if certain triggers make their way to the mucous membranes lining the bronchial tubes. 

A distinction is made between allergic asthma and non-allergic asthma, based on the trigger in each case. However, this distinction is not always clear-cut. 

Allergic asthma is also known as “extrinsic” asthma because the external trigger is breathed into the airways with the air. Typical triggers include: 

• tobacco smoke from active and passive smoking 
• plant pollen 
• animals 
• dust mite droppings 
• food ingredients 
• cold air 
• perfume 
• exhaust fumes 
• certain chemicals 

For more detailed information about diagnosing and treating allergic asthma, visit allergieinformationsdienst.de. 

Non-allergic asthma, also known as “intrinsic” asthma, is caused not by foreign bodies that are inhaled from the environment but by irritants from within the body itself. These include: 

• bacterial and viral inflammation of the airways 
• accelerated breathing induced by physical or emotional stress  
• acetylsalicylic acid (ASA) and other painkillers that are classed as NSAIDs (non-steroidal anti-inflammatory drugs), which trigger analgesic-induced asthma 

Regardless of the trigger, the effect on the lungs and breathing is very similar: 

• Immune system cells are activated in the mucous membrane of the bronchioles 
• The muscles surrounding the airways cramp up
• The mucous membranes in the airways become inflamed and swollen
• A particularly thick mucus often forms 

An asthma attack occurs when the tensed muscles, the swollen mucous membranes, and the sticky mucus cause excessive constriction of the airways. 

People can get asthma at any age. In most cases, however, the symptoms begin during childhood or adolescence. In Germany, around 4 percent of children and 6 percent of adults have asthma. Asthma is the most common chronic disease among children. 

The progression of asthma may differ greatly between individuals. Some children or teenagers experience hardly any problems once they reach adulthood and can live almost normal lives. In other cases, however, the symptoms may persist or worsen. It is important to identify the irritants that trigger an attack and to avoid these.  

The outlook for people with asthma also depends to a large degree on timely treatment and on how the disease is managed by individuals themselves. It is important that medication be taken consistently and that supportive measures (such as exercise) be undertaken also, in addition to the use of special breathing techniques.  

Asthma frequently occurs in individuals who have previously had problems with allergies, such as hay fever, conjunctivitis, or atopic eczema. The symptoms of asthma may vary depending on the season or other factors. They may recede into the background at times or temporarily disappear altogether.

Respiratory complaints can be caused by various health conditions. Therefore, a number of different tests are required in order to arrive at a definitive diagnosis of asthma. The following are essential elements of the diagnostic process: 

• An in-depth discussion with the doctor, in which the doctor asks about the patient’s medical history, lifestyle, and the precise nature of the symptoms. 
• A physical examination, looking at the patient’s general health and the functioning of the lungs, heart, and circulatory system. 
• Lung function tests (spirometry, peak flow measurement) to check lung capacity. Spirometry measures how much air is inhaled and exhaled. A peak flow meter measures the speed of airflow as air is exhaled.  

If the results are not definitive, further testing of the airways or allergy tests will follow. 

For more detailed information about the symptoms and diagnosis of asthma, visit gesundheitsinformation.de.

The primary goal of treatment depends on the needs of the individual patient. The primary goal is usually to minimize the frequency and severity of the symptoms. The goal is to make daily life as normal as possible.

Effective medications with minimal side-effects are available for the long-term treatment of asthma and prevention of asthma attacks. These are even suitable for use during pregnancy. The doctor and patient will discuss and agree on the most suitable medication. 

Two main groups of medication are used to treat asthma: 

• fast-acting medication to be taken as needed (relievers) 
• slow-acting medication to be taken on a regular basis (controllers) 

For those with mild asthma, it may be sufficient to use relievers only. These are only to be taken when acute symptoms occur. 

However, more severe asthma requires ongoing treatment with controllers, as the airways are always slightly inflamed. Taking medication on a regular basis is the only way to control the asthma and prevent attacks. 

To keep the symptoms under control, sport and exercise as well as special breathing techniques also help. These measures can all serve to support treatment with medication. 

It may also be a good idea to get vaccinated against flu or pneumococci bacteria. 

Asthma is a condition that can impact many areas of life. Asthma attacks at night can lead to fatigue and difficulty with concentration during the day. Physical fitness may also be reduced. 

It takes time to learn how to manage chronic asthma. This applies to sufferers and their families alike. The better educated everyone involved is about the topic, the better they can support one another. 

Reliable support from a doctor, the best-possible treatment, and asthma training will all help a person with asthma to become an expert in managing the condition. Asthma training is offered by pulmonary specialists and by some rehabilitation clinics, for example. 

The aim of asthma training is to teach participants: 

• how the condition arises and how it can be treated 
• how to detect the early symptoms of an asthma attack 
• how to avoid triggers  
• what to do in an emergency 

Detailed information for people with asthma, their family and loved ones is available from the asthma patient line. 

Another option is to join an asthma support group. These meet regularly to allow people with asthma or their families and loved ones to share information and experiences and to support one another. 

You can find self-help groups through the database provided on the website of the National Contact and Information Point for Encouraging and Supporting Self-Help Groups (NAKOS).