Allergic Asthma: Symptoms, Causes, and Risks
Bronchial asthma is a common disease. About 10 to 15 percent of children and about seven percent of adults are affected. The most common asthma triggers are allergies. Doctors then speak of allergic asthma.
The most important facts in brief:
- Asthma leads to a chronic inflammation of the airways. This causes hypersensitivity of the bronchial tubes. Experts refer to this as a hyper responsive bronchial system.
- If the hypersensitive bronchial tubes are irritated, for example by contact with certain allergens; the mucous membrane in the bronchial system swells. Increased mucus production sets in and the bronchial tubes become tense.
- In allergic asthma, allergens such as pollen, house dust, or animal hair play a particularly frequent triggering role.
- The worst case, allergens cause an acute asthma attack. In this case, the bronchial musculature cramps strongly and exhalation becomes difficult. Typical characteristics are whistling breathing noises, coughing and severe shortness of breath.
Physicians differentiate between allergic asthma (extrinsic) and non-allergic (intrinsic) bronchial asthma. This differentiation is important for the treatment of the disease. In the non-allergic form, factors such as respiratory infections or physical exertion trigger the chronic inflammation of the airways.
Allergic asthma, together with allergic rhinitis (hay fever) and neurodermatitis, is one of the diseases of the atopic group. The term atopy refers to a hereditary predisposition to exaggerated defensive reactions on contact with allergens. The atopic diseases can occur simultaneously, alone or in succession.
In addition; there are also mixed forms of asthma in which a very clear assignment to one of the asthma classifications is not possible with certainty.
Triggers and Symptoms of Allergic Asthma
The body's immune system fights off harmful foreign substances. In allergies, however, there is a defective and exaggerated immune response to substances that are actually harmless. The triggering substances are also known as allergens.
What are the causes of allergic asthma
The cause of asthma is always a hereditary predisposition. When the body comes into contact with a certain allergen, the immune system overreacts: It is in an imbalance and triggers an allergic reaction, although the allergen is actually not harmful to the organism.
In principle, the body can have an allergic reaction to many substances. The following triggers are typical for allergic asthma:
Insecticides one of allergic asthma triggers
- Plant pollen
- House dust mite droppings
- Animal hair and bird feathers
- Insecticide
- Mold spores
- Flour or wood dust
- Certain foods
- Medication
If a pollen allergy (such as a birch allergy in the case of hay fever) is the cause of allergic asthma, doctors also speak of seasonal asthma because it only occurs during the pollen season. Allergic asthma due to house dust or animal hair allergies, on the other hand, can lead to symptoms all year round.
Symptoms: How does allergic asthma feel?
Swollen mucous membranes, allergic rhinitis, itching of the skin or conjunctiva, asthma or asthmatic cough, or even a circulatory collapse are possible symptoms of the faulty immune response.
In allergic bronchial asthma, chronic inflammation of the lower airways occurs, causing the mucous membranes to swell. In addition, the inflamed mucosa produces more mucus, which sufferers cannot cough up properly due to the swelling. It is also possible that the bronchial tubes cramp and the flow of air is obstructed. This becomes noticeable with whistling breathing (wheezing).
Breathing air hardly escapes from the cramped bronchial tubes, which in turn impedes inhalation. Patients feel this through shortness of breath as well as an unpleasant pressure when breathing.
Warning signal is a stridor:
A stridor is an audible, pulling or whistling breathing sound caused by a narrowing of the airways. If an asthma attack cannot be quickly broken by the patient's emergency medications, you should call an emergency physician.
Risks in pregnancy and in children
Pregnant women, infants and children are special risk groups for allergic bronchial asthma. Affected parents and pregnant women should therefore take special care and consult a doctor not only early but also regularly.
Allergic asthma in pregnancy
If you have asthma during pregnancy, seek advice from your doctor.
If you are pregnant and suffer from allergic asthma, you should inform your caring doctors about the asthma condition. During pregnancy; additional examinations by a lung doctor are necessary. Because untreated asthma is then associated with special risks - both for the growing child and for the expectant mother.
As a rule, pregnant women should attend check-ups every four to six weeks. Your doctor will know whether you can continue to use your asthma medication during pregnancy or whether a change in therapy is necessary.
However, do not discontinue the medication on your own. Inhaled medications enter the blood only in small amounts. The risk of harm to the baby from poorly controlled severe asthma outweighs the risk of asthma medication. Instead, always consult a medical professional. If an asthma attack occurs, pregnant women need care in the hospital to avoid hypoxia to the baby.
What are the effects of asthma on breastfeeding?
Asthma and allergies are diseases with a hereditary component. Therefore, children of asthmatics have about a threefold increased risk of developing asthma themselves later on. Breastfeeding does not protect against asthma, but it can reduce the risk and at the same time also lowers the likelihood that the child will develop allergies later on.
It is assumed that the antibodies (IgA); specific messenger substances (cytokines) and long-chain fatty acids contained in breast milk stimulate the infant's gut-associated immune system, which is also associated with the development of the gut microbiome.
Even when breastfeeding, talk to your doctor about your asthma therapy and ask if you can continue your medication as usual.
Allergic asthma in children
Allergic asthma in children
In childhood, allergic bronchial asthma can already become apparent . The problem is that young children are often not yet able to express or describe the symptoms correctly.
If the child repeatedly suffers from coughing or difficult, possibly whistling breathing, parents should have the symptoms clarified by a pediatrician. The specialist can check whether asthma is present. In addition; an allergy test will provide information about possible allergic triggers that should be avoided in the future.
If your child is already known to have allergic rhinitis, you should treat the allergy consistently. This is because it is possible for the symptoms to move from the upper to the lower respiratory tract due to a so-called floor change. An allergic rhinitis can develop into asthma in this way.
In general, allergic asthma in children has a good prognosis and the symptoms disappear in about 50 percent of children during puberty. Nevertheless, the bronchial system remains sensitive even in adulthood, so that about one third of patients later develop asthma symptoms again.
What does the diagnosis of allergic asthma include?
In order to diagnose allergic asthma, the doctor will first ask you detailed questions in an anamnesis interview. Often, triggers and possible allergens are already crystallized here.
This is followed by a physical examination:
- Listening to the lungs: Here, the physician pays particular attention to conspicuous breathing noises.
- Spirometry: The test of lung function includes measuring the amount of inhaled air and the exhaled air flow.
- Body plethysmography: This supplementary examination allows other lung volumes to be determined. For example, the doctor can determine how much air remains in the airways and how high the airway resistance is.
- Reversibility test: This is a test to see if lung function changes after the administration of airway dilation medications.
- Provocation test: The lungs are specifically irritated by specific substances to measure how this worsens lung function.
Finally, allergy tests are performed. Here, the prick test is helpful: the physician applies an allergen to the skin and observes the reaction. In addition; blood tests can be used to determine specific allergy antibodies.
Is exercise allowed in allergic asthma?
In general, there is nothing to be said against sports in allergic asthma, because physical training makes the patient more resilient and helps to increase the depth of breathing. Endurance sports such as
Exercise is allowed in allergic asthma
- To run,
- Swim,
- To go biking,
- Hiking or
- To dance.
However, asthmatics should also carry their emergency medication with them during sports so that they can take immediate countermeasures if their symptoms worsen.
Special caution applies to patients with so-called exertional asthma (also known as exercise-induced asthma): In these patients, symptoms only manifest themselves under strong physical exertion, such as during sports.
Treatment of allergic asthma
After diagnosis, the first question many sufferers probably ask themselves is: Is allergic asthma curable? Although it is a chronic disease, it can be treated well. Patients can contribute significantly to the improvement of symptoms by consistently avoiding the triggering allergen and by taking adequate allergy treatment. In addition; asthma treatment should be given to maintain normal lung function and avoid exacerbations.
What helps against allergic asthma?
To effectively treat allergic asthma, the following therapy components are essential:
- Avoid triggering allergens
- Treat allergy
- Drug treatment of asthma
In addition; supportive measures such as patient education and breathing training may be considered. Some patients have also had good experiences with homeopathy for allergic asthma.
Treatment for allergic asthma
In principle, two types of asthma medication are available for the treatment of allergic asthma: so-called controllers inhibit the inflammation in the airways in the long term, while relievers dilate the bronchial tubes.
As a rule of thumb, if asthma symptoms occur twice a week, the doctor should initiate long-term therapy. Exactly which agents he or she recommends depends on the severity of the symptoms, how well you have responded to previous therapy, and any pre-existing conditions.
Most medications for allergic asthma are for inhalation. The spray is nebulized via an inhaler and transported into the bronchial tubes with a deep breath. In this way, the body hardly absorbs the active ingredients into the blood, which can lead to significantly lower side effects.
If symptoms are pronounced, the doctor may also prescribe anti-inflammatory or bronchodilator medications in tablet form. In addition, if the asthma attack is severe, intravenous medications are often necessary.
Recently, a new form of treatment for severe allergic asthma has become available in the form of biologics. The prerequisite is that conventional therapy cannot sufficiently control asthma. The drugs intervene in asthma-triggering mechanisms.
What is the peak flow?
The peak flow meter is a small device that helps patients easily measure their lung function at home. It determines the highest possible flow rate at which you can breathe air into the device.
This value suggests constriction in the airways. If you note and observe the measured values, you can detect changes in lung function in good time. If the peak flow worsens, you should contact your doctor. He or she can make an adjustment to asthma therapy if necessary.
Treatment of allergies
Asthma patients should avoid contact with the triggering allergen if possible. For example, in the case of pollen allergies, it is worthwhile to pay attention to the pollen forecast and to move as little as possible outdoors on corresponding days.
Nevertheless, it is often not possible to avoid allergens completely. To alleviate allergy symptoms, various preparations are available that reduce the inflammatory reaction in the body or counteract the release of pro-inflammatory messenger substances.
In addition, hyposensitization is the only way to combat the cause of the allergy in the long term. In this therapy, also known as specific immunotherapy (SIT), the physician repeatedly administers tiny doses of the triggering allergic to the patient over a long period of time. Over time, the doses are increased. In this way, the immune system slowly becomes accustomed to the allergen and the allergic reaction diminishes or, at best, disappears completely. However, desensitization or hyposensitization is not possible for all allergens: the method is mainly successful for pollen allergies and insect venom allergies.
Allergic asthma and Corona
The current Corona pandemic is causing concern for many asthmatics. This is because Sars-CoV-2 can attack and permanently damage the lungs. However, study results currently indicate that asthmatics with controlled allergic asthma are not at increased risk for severe disease progression in the event of Corona infection. Therefore, in consultation with their physician, asthmatics should take care to continue asthma treatment as usual to avoid worsening lung function. It is even currently thought that asthma drug therapies, more specifically cortisone sprays, may have a protective effect.
Recommended Probiotics Products
With some probiotics preparations, sufferers have the opportunity to regulate their immune system and thus naturally reduce the allergic reaction. These probiotics should contain two highly active specific bacterial strains for dietary management of the atopic diseases atopic dermatitis and asthma. Patients can reduce their symptoms and achieve a better quality of life.
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- Schmoller, Tibor / Meyer Andreas: The asthma self-help book: So that you never run out of breath again. Stuttgart: Trias Verlag 22012, p. 57.
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