Asthma

Asthma occurs due to chronic inflammation of the airways. Typical symptoms include dry cough, shortness of breath and difficulty breathing.

Man jogging in the autumn forest

Asthma – also allergic asthma or bronchial asthma – results from hypersensitivity of the airways. Triggers are various stimuli such as allergens but also include cold conditions or physical exertion. Although there is no cure, it can be managed successfully.

Causes and triggers

The diagnosis of asthma is generally more precise these days. A distinction is drawn between:

  • allergic asthma , when a trigger (allergen) is identified
  • congenital asthma, e.g. in the case of extremely premature births (lungs not sufficiently developed) or genetic defects
  • acquired asthma, e.g. in smokers or certain occupations (dust lung disease).

Asthma is mainly caused by allergens – especially any spread through the air, such as pollen –, house dust mites, fur animals and fungal spores. Certain foods may also induce asthma.

In adults, exposure to substances at work may also cause allergic asthma, for example, flour dust in bakers and flowers in florists. Respiratory tract infections in infants or later in adults may also lead to asthma.

Where an asthmatic inflammatory reaction is already present, many non-specific enhancers, or triggers, may cause or enhance asthma attacks.

So-called triggers are:

  • changes in temperature
  • the weather, e.g. fog, cold air
  • bacterial and viral infections, e.g. colds
  • respiratory tract infections
  • dust, e.g. in cellars, on books, when cleaning rooms or making beds
  • strong smells, perfumes, flower scents
  • smoke (cigarettes and cigars)
  • air pollutants (ozone, exhaust fumes)
  • stress and emotion
  • physical exertion, e.g. sport, sexual intercourse
  • medication, e.g. pain-killers

Symptoms

  • persistent dry cough or tickling in the throat, possibly coughing up of clear phlegm after physical exertion, when exposed to cold, after infection or immoderate laughter
  • night-time coughing
  • wheezing
  • difficulty in breathing
  • tightness in the chest

What symptoms occur and their severity vary from one person to another. Individual symptoms sometimes first appear during or after severe physical exertion This is then a case of exertion-asthma (exertion-induced asthma). 

Diagnosis

Not every narrowing of the airways is actually asthma. Finding the diagnosis can be quite protracted and demands patience from those concerned. Symptoms lasting throughout the year are indicative of chronic asthma. In seasonal asthma, the asthmatic symptoms are confined to the pollen season. The diagnosis is made by a lung specialist (chest physician or pneumologist) or an allergy specialist.

Treatment

Optimum lung function and a symptom-free life are the ultimate goals of good asthma therapy. First and foremost, contact with the allergen is to be avoided or reduced. Therefore the first imperative is to identify the allergen or the trigger, if possible, to eliminate it and thus avoid asthma attacks. Further treatment may include individually tailored medicines which open up the airways and inhibit inflammation. It is important that patients have good inhalation technique.

After thorough investigation, specific immunotherapy is often recommended for allergic asthma. It is regarded as a causal treatment. It involves building up an immune response so that, to a large extent, contact with the allergen no longer triggers a reaction.

Tips & tricks

A good breathing technique can help cope better and in a relaxed manner with physical exertion and acute shortness of breath.

There is no perfect climate for all forms of asthma. On the other hand, dry mountain air low in allergens and dust, for example, can be beneficial for sufferers who have a reaction to pollen, house dust mites and other air contaminants. Irritants such as cigarette smoke, industrial gases and scents should be avoided where possible.

Strong feelings such as anger, fear, joy and stress can enhance asthma symptoms. It is therefore worthwhile developing strategies to manage such everyday situations. Breathing exercises and relaxation techniques are to be particularly recommended.

Facts and figures

In Switzerland 12% of all children and 6% of adults are affected. If untreated, pollen allergy can lead to asthma in 30% of cases. This is known as progression.

Editors: aha! Swiss Allergy Centre in co-operation with the Scientific Advisory Board. For prevalence figures, see source references.