What is Asthma?
Asthma is a chronic condition where the airways narrow, making breathing difficult. Asthma often begins in childhood and can be easily treated with medication.
In Brief
- About 4% of children and 6% of adults in Germany have asthma. Experts classify asthma as allergic or non-allergic based on its triggers.
- Asthma is typically characterized by episodic symptoms, often occurring at night.
- Asthma does not necessarily worsen over time.
- With good treatment, it is usually possible to live largely symptom-free.
- Therapy includes medication and supportive measures such as regular exercise.
- Note: The information in this article cannot replace a doctor’s examination and should not be used for self-diagnosis or treatment.
What is Asthma?
Asthma is a condition where the airways temporarily or permanently narrow. Asthma attacks often lead to wheezing, coughing, and shortness of breath. Untreated asthma can limit physical performance due to insufficient oxygen reaching the lungs. Asthma does not worsen on its own and can be treated. With medication and supportive measures such as regular exercise, it is usually possible to live largely symptom-free. Over time, you will learn which treatments work best for you and how to prevent asthma attacks on your own.
What are the Symptoms of Asthma?
In children, usually only a cough and mild wheezing or whistling breath are seen. In adolescents and adults, other symptoms may appear:
- Shortness of breath (often in attacks)
- Shortness of breath during exertion
- Wheezing, whistling, or buzzing sounds during exhalation
- Chest tightness
- Coughing and/or throat irritation Asthma symptoms typically occur in episodes. Breathing may initially become only slightly more difficult but can sometimes lead to severe shortness of breath. People with asthma often experience attacks at night and feel tired and exhausted during the day.
What Triggers Asthma?
Certain familial risks are believed to play a role as asthma is more likely to occur in some families than others. Some factors that can cause asthma include:
- Family history of atopic dermatitis, hay fever, or other allergic diseases
- Below-average birth weight
- Gender: asthma is more common in boys than in girls
- Parental smoking
What are the Causes of Asthma?
In people with asthma, the immune system easily overreacts. An additional trigger is necessary for symptoms to start: the immune system overreacts only when certain stimuli hit the bronchial mucosa. Asthma is divided into allergic and non-allergic based on triggers. However, a clear distinction is not always possible. Allergic asthma, also called “extrinsic,” involves triggers that enter the airways from outside, such as:
- Tobacco smoke (active and passive smoking)
- Plant pollen
- Animals
- Dust mite feces
- Food components
- Cold air
- Perfumes
- Exhaust fumes
- Certain chemicals Non-allergic asthma, also known as “intrinsic,” involves triggers that originate from within the body, such as:
- Bacterial and viral respiratory infections
- Rapid breathing due to physical or emotional stress
- Analgesic asthma caused by acetylsalicylic acid (ASA) and other nonsteroidal anti-inflammatory drugs (NSAIDs) The effects on the lungs and breathing are quite similar regardless of the trigger:
- Activation of immune system cells in the bronchial mucosa
- Constriction of muscles around the airways
- Inflammation and swelling of the mucosa in the airways
- Often, particularly thick mucus forms An asthma attack occurs when spasms, swollen mucous membranes, and thick mucus severely narrow the airways.
How Common is Asthma?
Asthma can occur at any age. However, symptoms typically appear in childhood or adolescence. In Germany, about 4% of children and 6% of adults have asthma. In children, asthma is the most common chronic disease.
What is the Course of Asthma?
The course of asthma can vary greatly. Some children or adolescents may experience almost no issues in adulthood and can lead nearly normal lives. However, symptoms can remain the same or worsen. It is important to know and avoid triggering stimuli. The progression of asthma also largely depends on timely treatment and how well the disease is managed. Regular medication use and supportive measures such as exercise and specific breathing techniques are important. Asthma often occurs in individuals who already have allergic issues (e.g., hay fever, allergic conjunctivitis, or atopic dermatitis). Symptoms may vary depending on the season or other factors, remain in the background, or sometimes disappear completely.
How is Asthma Diagnosed?
Respiratory complaints can be due to various diseases. Therefore, multiple examinations are required to definitively diagnose asthma. Key points include:
- Detailed medical interview (anamnesis): The doctor investigates medical history, living environment, and specific complaints.
- Physical examination: The general health status, lung, heart, and circulation functions are checked.
- Lung function tests (spirometry, peak-flow measurement): These tests assess lung performance. Spirometry measures the amount of air you inhale and exhale. A peak-flow meter measures the speed of airflow during exhalation.
- If results are inconclusive, further respiratory tests or allergy tests may be conducted.
How is Asthma Treated?
The primary goal of treatment depends on the patient’s individual needs. Usually, the main aim is to minimize the frequency and severity of symptoms. Treatment should enable a largely normal daily life. There are effective medications with few side effects available to treat and prevent asthma attacks. These can also be used by pregnant women. Medication intake should be coordinated with a doctor. Two main groups of medications are used to treat asthma:
- Fast-acting relievers
- Long-acting controllers Reliever medications, taken as needed, are usually sufficient for individuals with mild asthma. They are only taken when acute symptoms arise. For severe asthma, long-term medication is necessary to treat the chronically inflamed airways. Only regular use of these medications can control asthma and prevent attacks. Sports and exercise, along with specific breathing techniques, can help manage symptoms and support medication treatment. Additionally, vaccinations against influenza or pneumococci may be beneficial.
What is Life Like with Asthma?
Asthma can affect many areas of life. Especially nighttime asthma attacks can lead to fatigue and concentration problems during the day. Physical fitness may also decrease. Learning to cope with chronic asthma takes time. This is often true for family members as well. The more informed everyone involved is, the better they can support each other.
Where Can People with Asthma Get Support?
With reliable medical support and the best possible treatment, asthma education can help you manage the disease. Asthma education programs are offered by pulmonologists and some rehabilitation clinics, among others. Asthma education should cover:
- How the disease develops and can be treated
- How to recognize early symptoms of an asthma attack
- Ways to avoid triggers
- How to act in an emergency
