Asthma: Causes, symptoms and treatment

Genetic predisposition and environmental factors such as allergens (allergic asthma), infections (infectious asthma) and chemical substances (occupational asthma) play a role in the development of asthma. With intrinsic asthma, physical exertion or stress (exercise-induced asthma) can trigger an asthma attack. The airways of people with asthma are constantly on the verge of becoming inflamed and so respond much more severely to these irritants than the airways of healthy people.

Asthma typically presents in children in the form of whistling (wheezing) or humming breath sounds. Many other symptoms do not appear until adolescence or adulthood:

• Shortness of breath
• Severe, generally dry cough
• Chest tightness
• Difficulty breathing out
• Blue tinged fingernails and lips due to a lack of oxygen

It is very important, especially in children, that asthma is diagnosed early so that treatment can be started as early as possible to avoid long-term damage. This is why any child with a wheeze or humming sound when they breathe should always see a doctor, who will then carry out various tests/examinations to make a diagnosis:

• Medical history: Detailed discussion between the doctor and patient/parents and a physical examination.
• Pulmonary function test: Special devices (spirometer or body plethysmograph) are used to create a lung function curve which doctors can use to make a diagnosis.
• An allergy test can clarify if the patient has an allergy and which allergens trigger the asthma.

The risk factors may vary depending on the type of asthma. Tobacco smoke (active and passive) increases the risk of all types of asthma. The following risk factors can play a role:

• Allergies in the family
• Low birth weight
• Skin diseases in childhood: neurodermitis, cradle cap, eczema
• Parents who smoke in the home (second-hand smoke)
• Active smoking
• Excess hygiene
• Frequent infections as a child that triggered acute bronchitis or bronchiolitis, for example
• Not being breastfed or only being breastfed briefly

It is important to treat asthma as early and as quickly as possible to avoid damage. The aim of the treatment is for the patient to have no symptoms (asymptomatic). If there are no symptoms, the asthma is considered to be “well managed”.

Drug treatment tends to be inhalative, as the active ingredient should reach the lungs directly. Basic drug treatment for asthma in children and adults can essentially be classified as follows:

• Long-term drugs (controllers) are inhaled as a long-term treatment; these suppress airway infections – the underlying problem with asthma.
• Emergency drugs (relievers) are inhaled as needed and alleviate asthma attacks. This means that they act fast, by expanding the bronchi and relaxing the respiratory muscles.

The goal of the long-term medication is, in consultation with the doctors treating the patient, to find out the exact dosage at which the patient has no symptoms. NB: Do not change the dosage yourself – only do so in consultation with your doctor.

A central pillar of asthma control is to inhale properly, as that is the only way the necessary dose can reach the lungs. With metered-dose aerosols – also called puffers in laypersons' terms – you need to coordinate releasing the spray with breathing in. This is often impossible for younger children, and can also be a challenge for adults. It is therefore recommended that patients use a holding chamber (e.g. VORTEX) when using a metered dose aerosol. Read here to find out more about “the proper inhalation technique for asthma spray”.

Firstly, it is important to avoid anything that has a negative effect on the asthma. First and foremost, you must strictly avoid cigarette smoke (passive and active).

People with asthma benefit from exercise and sport. It is important not to lose confidence. Do not compare yourself or your child to other people without asthma. Speak to your doctor about particular types of sport that suit you or your child.

Looking after your airways if you have asthma: Inhaling saline solutions

Depending on the salt content, inhaling saline solutions with a suitable inhalation device can help moisten the airways or release mucus. Interactions between drug therapies for asthma and the inhalation of saline solutions are not to be expected.