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Asthma: When breathing becomes difficult

May 7, 2019

For many of those affected, asthma is a lifelong burden. It leads to inflammations with attacks of coughing, breathlessness, dyspnea and whistling breathing. There are many causes for the disease.

A child holding an asthma inhaler
Image: picture alliance/dpa/empics/P. Byrne

Asthmabegins with an inflammation in the lungs. The airways inside the lungs swell up, obstructing the airflow, which impedes gas exchange in the lungs. Especially exhaling becomes difficult for patients. Carbon-dioxide-enriched air in the lungs can no longer be properly discharged. The patients feel difficulty in breathing while the stimulus — the desire to get fresh oxygen into the lungs — becomes stronger and stronger. However, when they inhale, they cannot ventilate the lungs properly because the stale air in the lungs has not been completely released yet. This leads to dyspnea, a vicious circle which the patients can only break out of through conscious and calm exhalation excercises. 

Read more: Fast food 'increases' asthma risk in children

Graph: How asthma develops

What to do in the event of an asthma attack?

It's important to keep calm. The patient should sit upright and place their forearms on their thighs. When standing, they should adopt a broad-legged, forward-leaning "goalkeeper position." This helps them to use all the auxiliary breathing muscles in the shoulder, chest and back area.

Then they should exhale slowly through largely closed lips. This "lip brake" suppresses the inhalation impulse and thus helps to reduce shortness of breath. Then first responders should help those affected to take the right medication. Patients usually use inhalers to nebulize specific medication, often including cortison. The drugs expand the bronchia and make breathing easier.

Before inhalation, the patient should exhale completely and hold his breath for a while after inhalation. This way, the medication can take effect. If the situation worsens, first responders must call a paramedic.

How to prevent asthma attacks

What prognosis do asthma sufferers have?

The disease often develops in childhood, but is often recognized late. In children, asthma often can be cured completely. In adults, however, that is usually no longer possible.

But the disease can be treated well. With successful treatment and good prevention, asthmatics are fully able to do physical work and can even take part in competitive sports. In order for patients to achieve this, they can participate in special training courses.

However, if asthma remains untreated, the respiratory tract can be severely damaged. Asthma attacks can then become increasingly severe. Without medical treatment, the lack of oxygen can even lead to unconsciousness in rare cases. That means the patient's life is in danger. Under certain circumstances, they must be given artificial respiration with oxygen.  

Read more: Scientists want to learn more about human lungs by mimicking them in the lab

What are the causes

Doctors have not yet fully understood the reason why some people develop asthma and others do not. It is likely that genetic predisposition plays a role. But external influences are also decisive in the development of asthma. That's especially true for allergic or "extrinsic" asthma. It is caused by a multitude of possible pollutants in the air, ranging from chemicals and solvents in paints, adhesives and plastics to vapors and dusts produced in metal or wood workshops, animal hair, grain dust or food such as fish and shellfish or meat products.

Asthma can also be caused by a viral or bacterial infection. Often this leads to so-called "intrinsic asthma," which is accompanied by an increased immune defense of the body. The paranasal sinuses are almost always inflamed and nasal polyps can occur.

Medication can also trigger asthma. Another cause can be the reflux of gastric acid into the esophagus. Asthma can also develop into chronic obstructive bronchitis (COPD). Then the cough no longer occurs in form of a sudden asthma attack, but continues constantly. 

Read more: Detecting and treating asthma

Acupressure for asthma

What can people affected by asthma do?

First of all, it is important to find out, with the help of lung doctors and allergists, what type of asthma is involved. Allergy sufferers should avoid allergens that play a role in the development of asthma. Strong physical exertion can trigger an asthma attack, so at work and during sports, patients should increase their performance step by step and observe the reaction in their lungs carefully.

Even when they are not under physical stress, people affected should pay attention to their breathing, because emotional stress can also lead to breathlessness. The risk of an asthma attack also increases if patients suddenly inhale cold or foggy air. Cigarette smoke, strong car exhaust fumes or even ozone are also triggers. And asthmatics should avoid certain medications.

Above all, it is important to follow therapy instructions of the lung doctor to a tee, take prescribed medication regularly and do breathing exercises.

Deutsche Welle Fabian Schmidt App NEU
Fabian Schmidt Science editor focusing on technologies and inventions