In addition to the article on hay fever, we would like to tie in with this article on allergic diseases with this article on bronchial asthma. The most striking symptom of this disease is shortness of breath. From this alone it can be seen that the functions of the respiratory system are disturbed to a considerable extent by bronchial asthma.
Anatomy & function of the respiratory organs
As we know, the respiratory system consists of the supplying airways (nasal cavity, pharynx, larynx, trachea, bronchi) and the two lungs. The deeper sections of the airways are the bronchi, which branch out from the relatively large-caliber trachea. This tube-like cavity system narrows more and more until finally the smallest branches of the bronchi, the bronchioles, open into the alveoli. The wall of the bronchi essentially consists of three layers, the mucous membrane, the muscle layer and a cartilage-bearing fibrous layer. For histiocytosis 101, please visit photionary.com.
While the larger bronchi are anatomically similar to the trachea, the medium-sized bronchi are characterized by their abundance of mucous glands. The small bronchi are poorer in glands, but have a strongly developed muscle layer. The muscle fibers run partly transversely, partly crossing, helically. With this arrangement, the bronchial width can be narrowed to a quarter of the original width during contraction. A change in the bronchial cross section can be caused by various influences. In addition to physical stimulus qualities, chemical agents should also be mentioned here. Ammonia causes a spasm, carbonic acid a relaxation of the bronchial muscles.
Even more important is the nervous regulation of the bronchial width via the vegetative nervous system, which controls and coordinates all unconscious functions of the body, for example the activities of the digestive organs, the endocrine glands or the circulatory system, independently of our will and also reveals close, mutual relationships with mental processes. Stimulating one of the “restraints” of this vegetative nervous system, the parasympathetic nervous system, causes the bronchial spasm to spasm, while stimulating the antagonist, the sympathetic nervous system, causes the bronchial tubes to expand.
Causes
The question of what causes bronchial asthma is not that easy to answer. Today, the majority of doctors and researchers who deal intensively with this disease, based on extensive studies, are of the opinion that bronchial asthma is mostly a so-called allergic overreaction. This means that the cause is to be found in an allergy, an altered ability to react that the organism has after contact with foreign substances (allergens or antigens) when exposed to the same stimulus again.
In bronchial asthma we find most frequently a sensitization by bacteria, for example in the course of an infection, primarily of the respiratory organs ( whooping cough, bronchitis, pneumonia, etc.). This usually leads to breathing difficulties following such an illness, which eventually take on the typical character of asthma. But other allergens, such as certain types of dust, mold spores or animal dander, can also trigger asthma attacks in a sensitized organism.
Here are some examples: A patient reports typical asthmatic symptoms that have been occurring with some regularity for more than two years when she goes to bed. Exact investigations reveal hypersensitivity to bed feathers. The patient is instructed to remove all bed feathers from pillows and comforters and replace them with synthetic fiber fillings. Since then no more asthma attacks have been observed.
A young patient, who is a baker by trade, has been suffering for about three years from strong sneezing, a thin runny nose and asthmatic conditions as soon as he inhales flour dust, but only from wheat flour. The detailed examination can uncover a wheat flour allergy, which was to be expected according to the information given by the patient. The recommended change of occupation was carried out with the success that the patient was symptom-free for over a year.
For the further course of an allergosis, in this case bronchial asthma, it is important whether it is a monovalent allergy, ie sensitization to just one substance, or a polyvalent allergy, sensitization to different substances. As a rule, in most allergy sufferers, a polyvalence develops over time, which means that asthma attacks can be triggered by contact with very different substances.
Last but not least, the importance of psychological influences for the development of asthmatic symptoms should be pointed out. Even if we agree with many doctors that psychological asthma in the absence of allergens at the time of the acute asthma attack only exists if the person concerned has had an organic, allergic asthma attack at some point before, we can as the disease progresses, it is also affected by emotional factors such as fear, fright, worries or similar, seizures are triggered. The fact that real asthma attacks can be triggered solely by imaginings and hypnosis, or by watching films in which the asthma-triggering allergen is present – i.e. via the central nervous system – is explained by Pavlov’s findings on the conditioned reflexes.
Here is an example:
A woman with asthma reacted immediately to cigar smoke (not cigarette smoke) with an asthmatic attack. One day she was in the cinema. In one scene, an actor lit a cigar. That sight was enough to trigger an attack.
It is also assumed that the predisposition to asthma can be inherited and thus promote the tendency to allergic diseases and thus also to bronchial asthma.
Symptoms & course of the disease
The first symptoms of the onset of asthma are often mild. Only in the case of allergic asthma do clear symptoms appear shortly after contact with the triggering substance. Early signs that clearly indicate asthma are mostly associated with the first asthma attack. The affected person usually feels shortness of breath as well as pain and a feeling of tightness in the chest.
These symptoms often occur at night. There can be a long period of freedom from symptoms between the irregular asthma attacks. When an asthma attack begins, typical symptoms such as a dry, hacking cough, difficulty breathing when speaking and whistling noises when exhaling can occur. Shortness of breath develops with an increase in breathing and heart rate.
Breathing out becomes harder and takes longer than usual. Other features of asthma are mucus formation due to swelling of the mucous membranes and problems with coughing up. During an asthma attack, the symptoms increase. A longer, difficult course with significant symptoms can be life-threatening. Asthma can also have a mental and nervous effect through restlessness and fear of suffocation and death.
In individual cases, asthma can also cause chronic symptoms over a long period of time. During a severe asthma attack, breathing is very rapid and superficial. Speaking longer sentences is no longer possible. Due to the lack of oxygen, bluish discoloration occurs on the lips. In rare cases, the most severe seizures can lead to unconsciousness within minutes.
Complications
If the disease is left untreated, symptoms such as shortness of breath and shortness of breath usually steadily worsen, asthma attacks increase and become not only more frequent but also more severe. However, the condition of bronchial asthma patients can deteriorate continuously if they are treated adequately. In these cases, a series of serious complications, including the patient’s death, can be expected, even if the latter is rarely the case nowadays.
In the case of an acute asthma attack, gas exchange in the lungs is often disrupted, so that the person affected is only inadequately supplied with oxygen. The cause is a narrowing of the small airways, due to which the air can no longer leave the lungs. This is not only accompanied by an acute lack of oxygen, but can also lead to overinflation and the resulting damage to the lungs.
The alveoli in the lungs are particularly at risk. Pulmonary emphysema can also develop in severe attacks. Then the patient often has to be cared for with the help of an oxygen cylinder. The processes in the lungs can also put a strain on the heart. In the case of severe courses of the disease, there is therefore a risk that the patient will develop what is known as right heart failure, which additionally reduces physical resilience.
When should you go to the doctor?
In the case of bronchial asthma, the person affected should definitely consult a doctor to treat these symptoms properly. As a rule, this disease cannot heal on its own, so treatment by a doctor is always necessary. This is the only way to properly reduce and treat the symptoms and complaints. If left untreated, bronchial asthma can, in the worst case, lead to the death of the affected person. A doctor should be contacted if the person concerned suffers from severe breathing difficulties. Coughing and shortness of breath occur.
In many cases, the disease also increases the patient’s respiratory rate. As a result, the patient is only slightly resilient and can therefore only participate in everyday life to a limited extent. Disorders of consciousness can also indicate bronchial asthma if they occur over a longer period of time and do not go away on their own. If the person concerned loses consciousness as a result of the illness, an ambulance should be called immediately. The disease can be diagnosed by a general practitioner or by an internist. However, the exact treatment depends on the severity of the symptoms, so that no general prediction can be made.
Treatment & Therapy
When treating bronchial asthma, a distinction must be made between measures that are aimed at the cause of the disease and that alone include a possibility of healing, and measures that are intended to improve the symptoms purely symptomatically. The aim of every therapy, apart from the aim of complete healing, is to reduce the strength, frequency and readiness of seizures, and to prevent secondary diseases.
There is a chance of healing or the absence of the attacks if the causative allergen can be found and eliminated or if a specific desensitization is possible, i.e. the organism can be rebalanced to the point where it does not react to the allergen in question by feeding slowly increasing amounts of the same allergen. Eliminating allergens can be done by staying in a low-allergen climate (mountain or sea climate), by creating an artificial climate (climate chambers with filtered air and pressure regulation) and by sanitizing the apartment (removal of bed feathers, animal skins, mold and other allergens active substances) can be achieved.
As the name suggests, symptomatic therapy aims to eliminate the symptoms caused by the antigen-antibody reaction, such as bronchial spasm, swelling of the bronchial mucosa and increased secretion of the bronchial mucous glands. A large number of different medications with different principles of action are available for this purpose.
Great importance is attached to the elimination of chronic infections, for example chronic sinusitis or chronic bronchitis. Under certain circumstances, conservative therapy will have to be combined with surgical measures. If we consider what was said above about the importance of the autonomic nervous system for bronchial asthma, then it becomes understandable that psychotherapy can also bring about an improvement in the symptoms in appropriate cases.
Last but not least, the spa treatment in proven spa facilities (brine baths and mountain air spas) must be considered. The physical treatment with massages carried out during these cures in addition to brine inhalations and brine baths ; Breathing exercises and hardening measures should also continue to be used in the home town.
From the large number of therapeutic options, it is already clear that there is no absolutely safe remedy for bronchial asthma. It is important to find out which allergen is causing the disease as early as possible. If, despite this, no specific cause to be combated can be found, complex therapy must be carried out using all available means. Ongoing outpatient monitoring and, when necessary, intensive inpatient treatment can largely preserve or help most asthmatics regain their ability to work.
Aftercare
Like COPD, bronchial asthma is a chronic lung disease. For this reason, consistent follow-up care is necessary in order to medically monitor the course of the disease. Relief of symptoms is the long-term goal of follow-up care. The respective condition of the patient is decisive for the treatment procedure.
The individual course of the disease ranges from severe cases to almost no symptoms at all. In the case of severe asthma, the consistent use of medication is essential. If the symptoms are weak, the medicine can be taken in lower doses under the supervision of a lung specialist.
The asthmatic should avoid breathing dry air. Instead, a humidity of about 50 to 60 percent is recommended. Nicotine consumption should also be given up, and smoking is not allowed in the immediate vicinity of the affected person. Stress also has a negative effect on the patient’s condition.
In self-help groups, those affected have the opportunity to exchange ideas and receive useful advice for dealing with asthma on a daily basis. As part of the follow-up care, patients receive emergency medication for unexpected asthma attacks. The specialist explains to those affected about the correct behavior in the event of a seizure.
