Bronchial asthma

Definition

Bronchial asthma is a chronic disease of the respiratory tract, which in some cases leads to shortness of breath and coughing. In asthma, there is a repeated and sudden narrowing (obstruction) of the airways. If the asthma persists for a longer period of time, it can also lead to a structural reorganisation of the airways.

What are the typical symptoms of asthma?

  • Seizure-like shortness of breath
  • Dry cough
  • Chesty cough
  • Dry noises when exhaling (so-called “stridor”)
  • Asphyxiation fear
  • Chest tightness
  • Shortness of breath
  • Especially nocturnal symptoms

Asthma often leads to acute attacks of shortness of breath. One has the feeling of not being able to breathe properly because the airways become cramped. This occurs mainly at night or in the early morning.

There are also dry noises, especially when breathing out, which additionally lead to anxiety and thus increase the shortness of breath. During these attacks it is therefore very important to try to remain calm and to normalize breathing evenly and in a focused manner. The underlying cause of asthma is inflammation.

This leads to an accumulation of many cells of the immune system in the lungs. In the course of this inflammatory reaction, there is also an increased formation of mucus secretion, which accumulates in the bronchi. It is therefore important to take additional expectorant medication during treatment and to cough up the mucus selectively.

Asthma often leads to coughing, often in attacks and in response to certain stimuli. As asthma is often triggered by various triggers, the body reacts to these with a sometimes violent cough. These triggers include pollen, animal hair, dust mites or physical exertion. As the disease progresses, a chronic cough often develops, which becomes omnipresent in everyday life.

These therapy options are available

  • Avoidance of the triggering trigger factor in allergic asthma
  • Hyposensitization (preferably at an early age)
  • Inhaled glucocorticoids (e.g. budesonide)
  • Inhaled beta-sympathomimetics (e.g. sabutamol)
  • Leukotriene receptor antagonists (e.g. montelukast)
  • Theophylline
  • Tiotropium bromide
  • Biologicals

Almost two years ago, a new scheme was established in the therapy of asthma.

This is a so-called step-by-step scheme, which is used for long-term drug therapy. The aim is to start with as low a medication as possible and to increase this depending on the success of the therapy and the absence of attacks. Initially, only acute seizures are treated with so-called beta-sympathomimetics.

If these are not sufficient and an increasingly chronic cough becomes established, the next step is to switch to long-term therapy. This means that from now on a daily drug therapy is recommended. The first drug used here is cortisone in inhaled form as a spray.

The onset of action cannot be observed immediately. The full effect develops only after about 2 weeks. It is therefore not only purely therapeutic but also protective to prevent further progression of the disease.

Cortisone should be inhaled twice a day, the dosage depends on the respective preparation. The drug therapy of asthma is very varied and is structured in a step-by-step scheme in which different drugs are combined with each other depending on the severity of the disease. One group is formed by beta-sympathomimetics, which have a dilating effect on the airways and relax the muscles of the bronchi.

These are available both in a short-acting form for acute attacks and in a longer acting form to increase asthma control. Cortisone also plays an important role as an anti-inflammatory drug. It is important to note that therapeutic cortisone levels must be built up over a period of several weeks in order for it to have sufficient effect.

Other drugs include the respiratory dilating theophylline, which is not suitable in an emergency, and leukotriene receptor antagonists, such as montelukast. If all these drugs are no longer sufficiently effective, so-called biologicals are used. These act very specifically in the body and specifically inhibit messenger substances that promote inflammation.

They also have an anti-allergic effect. Examples of these are omalizumab or mepolizumab. Many asthma sufferers regularly take homeopathic remedies to improve their symptoms.

There are different preparations depending on the type of symptoms. For coughing attacks that are spasmodic, Lobelia inflata in the form of five globules can be taken three times a day. This stops the cough and also reduces excessive breathing, i.e. hyperventilation.

If there is increased coughing with sputum, which usually looks whitish and occurs mainly at night, potassium iodatum can also help as five globules three times a day. In cases of sudden respiratory distress with hoarseness, Sambucus nigra with five globules three times daily is recommended. If one gets the feeling of suffocation, Spongia with five globules three times daily helps.

This preparation can also be effective in case of a whistling breath. Another homeopathic remedy that can be taken generally for asthma (whether allergic or chronic), but also for COPD, is Ammi visnaga. This preparation should also be taken in the form of five globules three times a day.

In asthma, breathing exercises can be supportive and reduce the situations in which there is acute shortness of breath. An important element is the lip brake, in which the lips are placed on top of each other and the air is expelled through a small opening when breathing out. The carriage seat, in which the arms are placed on the thighs while seated, provides additional relief for the respiratory muscles.

As the asthma disease often causes attack-like coughing attacks, it is important to control them and to transport as much mucus as possible from the lungs. For this purpose, a so-called bronchial toilet should be carried out every morning, as the mucus accumulates during sleep, especially at night when breathing shallowly. For this purpose, the patient first takes a deep breath.

Afterwards a slight clearing of the throat is followed by a slight clearing of the throat and about half of the air is exhaled again. Now the remaining air can be used to cough up the mucus easily. The whole process should be repeated several times and integrated into the daily routine. To further strengthen the respiratory muscles, stretching exercises for the intercostal muscles and strengthening the diaphragm are recommended.