Allergic asthma symptoms in adults
Allergic asthma or asthma (bronchial asthma) is a chronic lung disease. It often starts in childhood. Asthmatics suffer from seizure-related shortness of breath and coughing.
The asthma or bronchial asthma is a chronic, so persistent inflammation and constriction of the bronchi. In addition to chronic inflammation, the bronchi in asthmatics have hypersensitivity (hyperreactivity) to certain physical stimuli (eg cold) or substances.
The bronchi are part of the lower respiratory tract. Through them, the inhaled air flows into the alveoli, where the oxygen exchange takes place. The bronchi begin below the trachea and branch out like a tree in the two lungs.
Non-allergic and allergic asthma
Medically one distinguishes between allergic and non-allergic asthma. Non-allergic asthma is also referred to as intrinsic asthma or endogenous asthma. It often develops only in the course of life – often as a mixed form with allergic component. By contrast, bronchial asthma in children is predominantly caused by an allergy.
Allergic asthma is common in children. Often, patients additionally suffer from a different allergy. Asthma can be triggered by various substances such as animal hair or food.
Allergic asthma is more common than non-allergic asthma. Especially children and adolescents are affected by this form of asthma. In many cases, they also suffer from other so-called atopic diseases. “Atopic” means that the disease is triggered by an excessive immune response. Those affected are usually genetically predisposed. Atopic diseases include, among others:
- Allergic asthma
- Hay fever
An allergy is an overreaction of the body’s defense system. The immune system is directed against so-called allergens. These substances often occur in nature, can consist of vegetable or animal proteins and are usually harmless.
In asthmatics, however, such allergens trigger an excessive inflammatory response in the respiratory tract. This leads to a constriction of the bronchial musculature, at the same time the mucous membrane lining the respiratory tract swells. This creates the asthma attack typical of allergic asthma.
Allergic asthma symptoms
Allergic asthma is similar to non-allergic asthma. Typically, however, the patients have complaints especially when they have recently been exposed to certain allergens. Allergic bronchial asthma is triggered by:
- Dust (dust mites)
- Animal hair (or the saliva attached to it)
How to heal and prevent allergic asthma?
In addition to the acute treatment of asthma attack and the long-term therapy, which are also used in non-allergic asthma, there are other possibilities of treatment for allergic asthma. Here is the avoidance of triggers in the foreground:
- Dust mite allergy: Do not use down comforters but synthetic material in blankets and mattresses. Remove long-haired carpets from your home and lay smooth floors such as laminate. If you do not want to do without rug, you should preferably lay shamrock carpets.
- Animal hair allergy: Asthma is made worse by keeping pets if you have a related allergy. Therefore no animals should live with you. Depending on how severe your allergic asthma is, you may need to avoid visiting friends with pets.
- Pollen allergy: Avoid walks in the flowering season and vacation in environment such as at the lake. In the early morning hours, the air is often less polluted. Also avoid outdoor activities in the period around a thunderstorm.
Allergic asthma can be cured by hyposensitization (subcutaneous immunotherapy, SCIT). The patient should gradually get used to the allergen and build up a tolerance until his immune system no longer responds to it. This is only possible under special conditions. It is only used in adults who are under 55 years old and have had symptoms for less than 5 years.
In addition, allergic asthma caused by drugs must be so well controlled that they currently do not suffer from asthma attacks. Furthermore, the hyposensitization can only be successful if the person has only one asthma allergy and not several.
Asthma is now one of the most significant chronic diseases. In particular, childhood asthma is common: about ten percent of all children suffer from bronchial asthma, boys more often than girls. After puberty, the disease disappears in about every second child but again.
By contrast, only about five percent of adults have asthma symptoms and women are more likely to be asthmatic than men.
Typical asthma symptoms include nocturnal cough and shortness of breath. Such symptoms can persist while other asthma symptoms start suddenly and increase to an asthma attack.
Asthma is usually characterized by a change from largely symptom-poor phases and sudden, repetitive asthma attacks. Among other things, there are signs of asthma:
- Cough, which occurs especially at night
- Shortness of breath (dyspnoea)
- Shortness of breath
- Tightness in the chest
- A dry, whistling sound when exhaling- audible with the naked ear
- Tedious, long exhalation
Asthma attack symptoms
Shortness of breath, even without physical stress
- Shortness of breath, even without physical stress
- Agonizing cough with occasionally less viscous, clear or yellowish mucus
- Restlessness and anxiety
How the asthma attack works
An asthma attack starts with a dry cough and tightness in the chest. It makes exhaling more difficult, and patients feel they can not breathe and they do not have enough room to breathe. Most are then excited or feel anxiety as an indication. The number of their breaths per minute (respiratory rate) increases and they use their respiratory muscles. This is called a group of upper body muscles that can support the lung’s work of breathing.
This can be achieved, for example, by supporting the arms on the thighs or on a table. In addition, there is audible wheezing and wheezing while exhaling as part of the typical bronchial asthma symptoms.
After a period of intense and often perceived as threatening respiratory distress, the asthma attack usually stops by itself. In this phase, the patient begins to cough up yellow mucus (expectoration). This is still accompanied by an audible wheeze while breathing.
During an asthma attack, you may also experience the following symptoms:
- Cyanosis: bluish discoloration of the lips and fingernails due to lack of oxygen in the blood
- Accelerated heartbeat
- Bloated thorax
- Raised shoulders
- Inability to speak
- In case of severe shortness of breath: recesses of the rib cage (between the ribs, in the upper abdomen)
A very severe attack of asthma may be accompanied by a decreased heart rate, decreased blood pressure and may lead to coma without treatment.
Asthma causes and risk factors
An asthmatic has hypersensitive bronchi. Doctors call this a “bronchial hyperresponsiveness”. It causes the mucous membrane lining the bronchial tubes to swell up and produce a very viscous mucus. As a result, the inner diameter of the bronchi narrows and it is harder to inhale and exhale.
The obstruction of the respiratory tract causes an overinflation of the lungs, because especially the exhalation is difficult. As a result, the respiratory rate increases. In addition, non-ventilated areas of the lung are no longer adequately supplied with blood so that oxygen exchange is limited. This can lead to an oxygen deficiency in the blood (hypoxemia).
The exact cause of asthma is not yet fully understood. It is believed that a combination of environmental and genetic factors leads to bronchial asthma. Risk factors that favor the onset of asthma include:
- Hay fever
- Known allergies or asthma in the family
- Smoking parents during pregnancy
An asthma attack can be triggered by various stimuli. Non-specific stimuli are those that cause non-allergic asthma. These include:
- Physical exertion
- Tobacco smoke
- Air pollutants (ozone, nitrogen dioxide)
- Metal vapors or halogens (especially at work)
Furthermore, non-allergic asthma can be caused by other stimuli such as respiratory infections or medications such as acetylsalicylic acid (ASA, aspirin).
Asthma physical examination
Subsequently, your doctor will examine you physically. He pays attention to the shape of your chest, your breathing rate and if you find it difficult to breathe. He also looks at the color of your fingernails and your lips. If these are discolored bluish, this indicates a lack of oxygen in the blood (hypoxemia).
Your doctor then listens to your lungs with the stethoscope. You should breathe in and out deeply through the open mouth. If you suffer from bronchial asthma, he hears a wheeze and hum when breathing.
The increased resistance in the bronchi also prolongs the period of exhalation in an asthmatic. If there is a severe airway obstruction, the sound of breathing through the stethoscope can only be heard very quietly.
Based on the resulting knocking sound, the doctor can tell if the lungs are particularly bloated and if unnaturally much air remains in the chest during exhalation.
Asthma special diagnostics
In order to diagnose asthma, further investigations are necessary. These include:
- Cancer symptoms
- Lung function test
- X-ray of the lung
- Blood test
Lung function tests
In pulmonary function diagnostics, different tidal volumes and the dynamics of the breath are measured. The measurement is either via a pneumotachograph that measures the airflow (spirometry) or a body plethysmograph that detects the change in lung volume.
With the pneumotachograph, the patient is connected via a mouthpiece, through which he inhales and exhales. The measurement by the body plethysmograph takes place in a closed cabin where sensors determine the different pressures during inhalation and exhalation. They can be converted into the respiration-altered lung volume. Asthma sufferers have altered values due to the narrowing of the airways, especially when exhaling. Also, after exhaling, you will have more air in your lungs (residual volume).
The diagnosis of asthma can be confirmed by a repetition of the lung function test. For this purpose, after the first spirometry, the patient is allowed to inhale a fast-acting, respiratory tract-expanding medication and the examination is repeated a few minutes later. If the typical values are now better, this indicates asthma. Because asthma is characterized by the fact that the narrowing of the respiratory tract is reversible.
Likewise, the doctor can check with a so-called provocation test, whether a non-allergic asthma exists. After the first pulmonary function examination, the patient inhales a nonspecific, ie non-allergenic, irritant (metacholine) and repeats the test shortly thereafter. Metacholine irritates the bronchial muscles and causes them to contract. If the breath values are now deteriorated, this speaks for a non-allergic asthma. However, care should be taken with this test because it can lead to a severe asthma attack. Therefore, the doctor always has a fast-acting antidote at hand.
Self-test with the peak flow meter
Even at home you can measure how powerful you can exhale. For this a peak flow meter is used. It measures the maximum air flow (peak flow) when exhaling. This is usually diminished in patients with asthma. To check the effect of the treatment or to spot the threat of deterioration of your condition in good time, you should periodically determine your peak flow and keep a journal of it.
X-ray examination of the ribcage serves to detect other diseases that can sometimes cause symptoms similar to asthma. These include infectious diseases such as pneumonia or tuberculosis or certain heart diseases. Also, chronic bronchitis or COPD may be similar in appearance to asthma. During an asthma attack, an over-inflated lung can also be seen in an X-ray.
By taking a blood sample, several things can be examined. This allows you to create a blood gas analysis from arterial or capillary blood. This shows how well the lungs can oxygenate the blood and free it of carbon dioxide. In asthmatics, these values are usually changed only during an asthma attack.
Allergy tests for asthma
Once the suspicion of allergic asthma has been confirmed, it is important to find the exact trigger. The prick test is suitable for this. For this, the upper skin layer is first slightly scratched, then solutions with allergy-suspected substances (allergens) are applied. After five to 60 minutes, a local reaction to the allergen may already occur.
Asthma similar diseases
Asthma symptoms may be similar to those of other conditions. Therefore, it is important that your doctor considers other possible causes of your condition. These include, among others, the following diseases:
- Chronic obstructive pulmonary disease (COPD)
- Sarcoidosis or exogenous allergic alveolitis
- Heartburn (reflux disease) with irritation of the bronchi by accidentally inspired gastric juice
- Heart failure
- Inflammation or scarring of the respiratory tract after infections
- Cystic fibrosis
- Aspiration (penetration of fluid or foreign bodies into the respiratory tract)
- Lung infection
- Psychologically accelerated and deepened breathing