Because of their high prevalence, respiratory diseases are among the group of so-called widespread diseases. Asthma, COPD (chronic obstructive pulmonary disease) and hay fever are particularly prevalent within this group. According to the DAK health report 2017 respiratory diseases are responsible for 14.7 percent of sick leave.

Respiratory diseases: upper or lower, chronic or acute?

In respiratory diseases the distinction is made between diseases of the upper and lower airways. The upper airways include the nose, paranasal sinuses, and the lower airways include the bronchi, and lungs. These diseases can be caused either by damage to the respiratory organs themselves or by an allergy (hayfever). A distinction is also made between chronic (asthma and COPD) and acute diseases (cold, sinus infection, bronchitis).

Symptoms and consequences of respiratory diseases

Respiratory diseases impair the function of the respiratory organs. The exchange of carbon dioxide from pulmonary blood vessels for oxygen from inhaled air in the pulmonary alveoli is impaired, which in turn leads to symptoms, such as a cough, sore throat, runny nose, or difficulties in breathing.

Normally our immune system fights off pathogens, such as bacteria and viruses by producing antibodies in the blood that recognise and fight harmful foreign agents. A specific antibody always matches a specific foreign substance, according to the lock and key principle. How-ever, in allergies the immune system responds abnormally: Harmless environmental agents, such as pollen or house dust mite, cause extreme defence responses. People suffering from allergies usually do not notice when they first come into contact with a foreign agent, but an allergic reaction is triggered after the body has produced a specific antibody against the substance and the person comes into contact with the allergen again.

Symptoms: How to recognise an allergy

There are many different kinds of allergens. The symptoms of allergies vary accordingly. The most common allergens are grass, pollen, house dust mites, mould, food, or dandruff from animal hair. People who suffer from allergies are not only allergic against one specific substance but against several. These people may also be suffering from a so-called cross allergy. For example, people who have an allergy against grasses are also allergic against pollen too. And people who have an allergy against pollen are often allergic against certain foods, such as nuts. Typical symptoms of allergy include, for example hay fever, swelling and red-dening of the skin and mucous membranes, runny nose, sneezing, and coughing. It is important to see an allergist if an allergy is suspected. In the worst case scenario, if treatment for a presumed harmless hay fever is delayed, a switch to a higher stage can result. This means that inflammation of the upper airways (nasopharynx) can spread to the lower airways (lungs, bronchi). Allergic asthma is a possible consequence.  

Treatment: How an allergy is treated

The most important treatment measure against an allergy is strictly avoiding the trigger. This is comparatively simple in cases with food allergies. However, it is difficult when the allergy is against pollen or house dust mite. For these types of allergies, antihistamines, eye drops, and in some cases cortisone preparations, are available for short-term relief of symptoms. In the long-term, hyposensitisation can be considered as a causative treatment approach for the allergy.

The first trees and flowers are blooming, but a sudden cough irritation clouds the joy of the long-awaited beginning of spring? A dry, painful cough can indicate a classic cold, but often has other triggers. The warmer season means the return of pollen, and with it come seasonal allergies. Rhinitis, watery eyes and irritating cough are the results. However, if these characteristics occur throughout the year, the cause may lie elsewhere. What triggers allergic cough can have and how you treat it, you will learn in this article.

How does allergic cough manifest itself?

In general, cough describes a rapid and violent expulsion of air, which occurs with or without sputum. A distinction is also made between acute and chronic cough. If the organism reacts allergically, it classifies a normally harmless substance as dangerous. This substance, in the case of an allergy sufferer the so-called allergen, triggers an immune reaction. Histamine is formed in the process. Among other things, this substance causes the bronchial tubes to contract and respiratory problems to develop, including an allergic cough.

Irritating cough (dry cough)

Irritating cough is also called nonproductive cough and is not accompanied by secretion. It occurs acutely during respiratory irritation, for example as an allergic cough when inhaling dusts or allergy-causing foreign bodies such as animal hair or pollen.

Cough with sputum (productive cough)

Coughing with noticeable mucus production may indicate inflammation of the airways or lungs. Usually, the mucus is transparent. If the sputum is yellow or greenish in color, severe inflammation of the lower respiratory tract or bacterial infection could be present.

When is an allergic cough acute and at what point is it chronic?

• Acute cough occurs for a short time, often as a result of a flu-like respiratory infection (for example, cold cough) or an allergic reaction. The body also responds to inhalation or swallowing of a foreign object with an acute cough.
• Chronic coughing lasts longer and is due, for example, to permanent allergies or more serious illnesses. In such cases, it is essential that those affected consult a doctor in order to clarify the causes of the symptoms.

Whether your irritating cough is a symptom of a cold or an allergic cough can often be recognized by additional accompanying symptoms. If, for example, a pollen allergy is responsible for the cough, those affected often also suffer from constant sneezing attacks, runny nose, watery and reddened eyes or shortness of breath.

If the cough occurs regularly or is accompanied by other symptoms, you should consult your general practitioner. He or she will diagnose the cause of your symptoms and determine whether it is an allergy or another illness.

Allergic cough: possible triggers

An allergy-related cough usually occurs acutely and can have a wide variety of causes:

• Pollen allergy/hay fever: flying pollen is inhaled and enters the respiratory tract through the nose and mouth. Therefore, the allergen triggers reactions in this area of the body: Rhinitis, coughing and sneezing attacks occur. Pollen allergy patients suffer from allergic coughing mainly at night, as the pollen load in the air is particularly high at this time. If the bronchial tubes are severely irritated, this can also lead to constriction of the airways (shortness of breath). The duration of the symptoms varies depending on the intensity. An allergy-induced cough can last from a few minutes to several hours.
• Animal hair allergy: Usually this form of allergy is not directed against the animal hair itself, but against the proteins in the fur of dogs, cats, horses or small animals such as rabbits. With contact, the body responds with allergic coughing, rhinitis, sneezing and sometimes a skin rash.
• House-dust allergy: People who are allergic to house dust are not allergic to dust particles per se, but to the house dust mite and its excretions. This form of allergy occurs mainly indoors, as dust particles accumulate in upholstered furniture, carpets or beds. Swirling can trigger an allergic cough in those affected.
• Food allergy: nuts, soy, fruit, milk - food intolerances are numerous. It should be noted that especially pollen allergy patients can also react to certain plant foods, as the material structures are often similar. Consumption causes allergic reactions comparable to those of hay fever. This is particularly the case with raw fruit. Those who still want to enjoy the fruit in question should carefully check whether heating the food will reduce the allergic effect. In the case of severe allergies, however, those affected should avoid the food.

Allergic cough should be taken seriously

You should not take an allergy-related irritating cough lightly. The persistent irritation of the airways can promote the development of other diseases, such as chronic asthma or bronchitis. Frequent shortness of breath and a persistent irritating cough not only reduce the quality of life, but also restrict normal everyday activities: Even climbing stairs or carrying groceries would require a great deal of effort. To prevent the disease from progressing, treatment by a physician with the appropriate medications and recommended therapies is urgently needed.

Allergic cough can be treated well

Due to their widespread nature, allergies are already well researched and treatable. In addition to classic home remedies, the use of antiallergic drugs such as cetirizine or desloratadine is often the treatment of choice for allergic symptoms.

Allergic cough: home remedies as an immediate help for mild symptoms

Hot water with lemon and honey can soothe a dry cough. The disinfecting effect of honey has a beneficial effect on the throat area and can prevent inflammation.

Rinsing the nose and throat with water or a saline solution clears pollen and also moistens dry mucous membranes.

Inhaling saline solution or essential oils such as eucalyptus and pine needle oil with the help of a steam bath can also help clear and moisturize the airways and soothe allergic coughs.

Medicinal treatment with anti-allergics

Allergic coughs and colds can be relieved particularly quickly and effectively by taking so-called antihistamines. Active ingredients such as cetirizine and desloratadine block the effects of histamine released during allergies and stop symptoms such as allergic cough or rhinitis.

Due to its long half-life, the active ingredient remains in the body for a long time and thus provides lasting relief from allergic symptoms. In addition, antihistamines are usually characterized by their good tolerability and are as simple as they are a long-term alternative, especially for seasonal allergies.

Desensitization to the triggers

For those who suffer severely from the symptoms of an allergy, desensitization may be an option. With the help of a physician-ordered, allergen-specific immunotherapy, the allergy is fought at its roots. If the therapy is successful, symptoms such as allergic cough, rhinitis and other allergic reactions can be significantly alleviated. It should be noted, however, that long-term treatment may often be necessary.

Asthma (medical term asthma bronchialis) is one of the most widespread chronic respiratory diseases. According to the Global Asthma Report 2014 of the Global Asthma Network Steering Group, currently 334 million people worldwide are suffering from this respiratory disease. It is estimated that six percent of adults in Germany have asthma.

Symptoms: How to recognise asthma

Asthma is accompanied by a chronic inflammation of the airways. Affected people report on attacks of shortness of breath, in particular during the night and early morning, a whistling sound while breathing in and out, and coughing and coughing up glassy viscous mucus. The mucus develops because specific messenger molecules have an inflammatory effect on the airways and cause swelling of bronchial walls.

Treatment: How asthma is treated

Asthma can not be cured so far, but in most cases it can be effectively treated. For long-term drug treatment, 5-step regimens are used in adults, children and adolescents. The intensity of drug treatment increases with higher steps. For example, medication is used as needed (step 1) or anti-inflammatory drugs are used for long-term treatment. Controlling the course of disease, regular patient trainings, and avoiding potential asthma triggers are also important cornerstones of treatment.

Bronchitis can appear in acute or chronic forms. The bronchial mucosa is inflamed in either case. The symptoms of acute and chronic bronchitis differ mainly in terms of the severity and duration of the disease. In over 90 percent of cases, acute bronchitis develops because of a viral infection. Therefore, the risk of developing acute bronchitis is particularly high during the wet and cold months of the winter. Children, the elderly, and people with weak immune systems are affected the most.

In contrast to acute bronchitis, chronic bronchitis appears over a period of at least three months in at least two successive years. The main causes of chronic bronchitis are smoking, inhalation of chemical irritants through air pollution or toxic gases, and toxic substances at the workplace. These toxins cause a long-term irritation of the bronchial mucosa, resulting in chronic inflammation of the bronchi. In addition, acute bronchitis that has not completely healed can develop into chronic bronchitis. Therefore, it is important to start the medical treatment of bronchitis soon. If the symptoms of chronic bronchitis worsen and high fever and shortness of breath appear, a visit to the doctor's office is unavoidable.

Symptoms: How to recognise acute and chronic bronchitis

Acute bronchitis becomes noticeable as a dry cough after an incubation time of a few hours or days. Accompanying symptoms of acute bronchitis are often a runny nose (rhinitis), inflammation of the larynx (laryngitis), inflammation of the trachea (tracheitis), and typical symptoms of viral or bacterial infections, such as fever, headache, and joint pain. The initially cough changes after several days and is then accompanied by white mucus (phlegm).

The main symptom of chronic bronchitis is a dry cough in the morning that develops into a productive cough with white mucus over the course of the day. An additional acute respiratory infections can worsen chronic bronchitis. In this case, treatment should be started immediately to circumvent a permanent narrowing of the airways (chronic obstructive bronchitis). However, a dry cough is often the only symptom that is seen for many years.

Treatment: How to treat acute and chronic bronchitis

Bronchitis usually runs its course without complications and is therefore easily treatable. Bed rest, drinking lots of fluids, and appropriate treatment in form of cough remedies to enable fast healing. Symptoms can also be improved with fever-reducing approaches, such as warm compresses and pain relievers, for example paracetamol.

You can find out more about a cold-associated cough on the following pages: www.eucabal.de

Since in most cases smoking is the main cause for developing chronic bronchitis, smoking should be stopped immediately. This increases the chance of stopping the condition from deteriorating. Other irritants at the workplace or in the environment must be avoided as much as possible. Bronchodilators and anti-inflammatory drugs are part of the basic treatment regimen for chronic bronchitis. It can also help to take large amount of fluids to help dilute the bronchial phlegm and facilitate its removal.

Cold, cough, hoarseness - a cold (or flu-like infection) is accompanied by annoying symptoms, but is usually harmless and disappears by itself again after a few days. A cold is usually a viral infection of the upper respiratory tract that occurs mainly in the fall and winter months. To relieve discomfort and prevent aggravation, herbal cold remedies are usually suitable in the first stages of the illness.

Causes of a cold

The trigger for a cold is an infection caused by viruses. They are often rhino, adeno, RS or parainfluenza viruses, which are transmitted by droplet or smear infection.

• When sick people sneeze or cough into the air, the cold viruses spread and can be inhaled by bystanders (droplet infection). The risk of infection is particularly high in large gatherings of people in enclosed spaces.
• The viruses can also adhere to surfaces such as door handles or bus bars and get onto the hands from there. By touching the face with the hand, the pathogens can then also enter the body via the mucous membranes of the nose, mouth or eyes (smear infection).
• If the immune system and the mucous membranes are stressed by constant cold and dry air in winter, the susceptibility to infection increases. Also, strong temperature fluctuations in summer or too cold water while taking a swim can risk a cold. However, an infection can often be quickly healed with the help of simple cold remedies.
• Other factors that can weaken the immune system and promote an influenza infection are lack of sleep, psychological strain and stress.

Symptoms of a cold

It often starts with a slightly scratchy throat or a tingling in the nose - a cold usually develops over a few days. As the viruses penetrate the mucous membranes of the nose and throat, the first signs will develop there as well if you do not use cold remedies promptly. The most common symptoms are:

• Runny nose (rhinitis): Inflamed nasal mucous membranes swell and cause nasal congestion. A constant tickling sensation and sneezing are also typical of the common cold. In addition, secretion can accumulate in the nose. This is initially transparent and watery and becomes more viscous as the cold progresses. A yellow and greenish color usually indicates bacteria. Relief is provided by nasal sprays with a decongestant effect, such as Imidin®.
• Sore throat and hoarseness: The presence of an influenza infection often quickly becomes noticeable through a mild sore throat. This often results in pain when swallowing and a hoarse voice.
• Headache: A slight, painful pressure in the forehead area can be caused by a blocked nose.
• Limb pain: fatigue, back pain and heavy arms or legs - a viral infection is often accompanied by a distinct feeling of illness.
• Fever: As a result of the body's defense reaction, an increased body temperature may occur. This is usually harmless and usually returns to normal quickly once the infection subsides.

If the immune system is attacked due to the viral infection, bacterial infections often have an easy time. Diseases such as middle ear, sinusistis or pneumonia can no longer be controlled by simple cold remedies and a doctor should be consulted.

Cold prevention and helpful herbal cold remedies

Because there is a whole range of different cold viruses, getting over a cold does not mean you are immune to another flu-like infection. To protect yourself from pathogens as a preventive measure, wash your hands regularly or use hand sanitizer. Regular ventilation of rooms - whether at home or in the office - improves the indoor climate and can help reduce the risk of infection. Those who do catch the common cold can relieve symptoms with the following tips, as well as effective over-the-counter cold remedies.

Drink plenty

A good fluid intake helps against dry mucous membranes and liquefies the secretion in the nose and bronchial tubes. Still water or warm tea are ideal. Many herbal teas further support the healing process: ginger or chamomile have an anti-inflammatory effect, while sage is the cold remedy of choice for coughs and sore throats.

Inhalation

A steam inhalation is the ideal cold remedy to relieve respiratory symptoms. The hot water vapor stimulates circulation and has a cleansing effect. Inhalation is even more effective when essential oils are added to the water. Eucabal® Inhalat contains eucalyptus and pine needle oil, which are herbal and natural cold remedies that loosen stuck, stubborn mucus and allow you to breathe freely. In addition, dried mucous membranes are soothingly moistened. Here's how:

• Bend your head over the bowl and place a towel over your head to prevent the soothing steam from escaping.
• Breathe deeply in and out for 10 to 20 minutes to allow the inhalate to flow into your airways.

Due to its gentle action and the absence of menthol-containing substances, Eucabal® is suitable for the whole family. However, small children should only inhale under supervision to avoid possible scalding. Eucabal® Inhalat is suitable for steam inhalation for children aged 6 years and older. For smaller children aged 2 years and older, a drop can be drizzled on their pajamas or pillow.

Tip: Eucabal® cold balm offers an alternative to inhalation. The herbal cold remedy is rubbed on the chest or back, the essential oils enter the respiratory tract and have an expectorant and soothing effect. Due to the absence of menthol, camphor and preservatives, it is suitable for children from 6 months for rubbing on the back.

Bath additive for colds

A hot bath during a cold is not only good for irritated mucous membranes, it also relieves tension in the limbs. A bath additive with the soothing herbal active ingredients eucalyptus, peppermint or thyme enhances the healing effect. To avoid stressing the circulation, the bath temperature should initially be around 36 °C. If you tolerate the bath well, slowly add hot water. However, if you have a fever, you should refrain from taking a bath.

Pain-relieving medications

Often, a viral infection brings headaches and aching limbs. The immune system fights the pathogens and activates helpful messenger substances for this purpose. However, these increase the body's sensitivity to pain, and the nervous system sends out pain signals that are reflected in limb pain. Painkillers such as IbuARISTO are available without a prescription in pharmacies. They contain the active ingredient ibuprofen, which not only relieves pain, but also has an anti-inflammatory effect. It also reduces fever. The tablets are taken with sufficient liquid and usually take effect after half an hour.

It is important that you should not take the over-the-counter painkillers for longer than four days - unless your treating physician has recommended otherwise. You should also pay attention to possible interactions with other medications:

• For example, painkillers such as ibuprofen can slightly weaken the effect of certain antihypertensive drugs.
• In combination with acetylsalicylic acid (e.g. ASS Aristo), the active ingredient can increase side effects and the anticoagulant effects.
• Anyone suffering from gastrointestinal problems should take ibuprofen only with a meal. Refrain from taking it altogether if you suffer from repeated bleeding in the gastrointestinal tract or have an ulcer.
• You should also refrain from taking it if you have severe liver or kidney disease, heart muscle weakness, or an unexplained blood formation disorder.
• During pregnancy, ibuprofen should be taken only in exceptional cases and after medical consultation.

If you are unsure whether ibuprofen is the active ingredient of choice for you for a cold, read the package leaflet or contact your local doctor or pharmacist.

COPD – the acronym for Chronic Obstructive Pulmonary Disease – is the second most common respiratory disease worldwide. Experts estimate that in Germany ten to twelve percent of adults 40 years of age and above suffer from COPD.

Symptoms: How to recognise COPD

COPD is a chronic respiratory disease that develops gradually, usually over years. Therefore, the disease is often not recognised by patients or diagnosed by doctors when it starts. Especially at the beginning, patients tend to dismiss COPD as "smokers cough". Typical symptoms that appear over the course of progressive respiratory disease include: Phlegm, cough, shortness of breath. Depending on the disease stage, symptoms are mild or more severe. Regardless of the severity, it is important for COPD patients to not catch infectious diseases such as the flu, for example, by getting annual flu shots. Otherwise, an apparently harmless cold can lead to sudden worsening of COPD (so-called exacerbation), which can be accompanied by massive shortness of breath and, in the worst case, hospitalisation.

Treatment: How COPD is treated

COPD is a respiratory disease that cannot be cured. The progression of the disease can, however, be slowed down when appropriate drugs are used and certain behaviours observed. The number one recommendation by experts: stop smoking immediately! Cigarette smoke is not only the number 1 risk factor for developing COPD, but also contributes significantly to the worsening of lung function in people who already have COPD. In order to maintain lung function and physical performance, doctors recommend COPD patients to participate in regular training, for example in a pulmonary sports group. Drugs that widen the bronchi (so-called bronchodilators) are part of the COPD basic therapy. Inhalable corticosteroids are usually used in cases with acute worsening or severe COPD.

In general, coughing is an essential reflex and therefore not bad as such. When accidentally swallowing or inhaling something, coughing ensures that the foreign body is moved out of the airway before it can cause damage. In the context of an illness, coughing is a common symptom that can have various causes, e.g. a flu-like infection or a chronic lung condition such as COPD. However, it can also occur in response to environmental stimuli such as dry air, dust or gases.

If the cough is a symptom associated with a cold, such as acute bronchitis, it is referred to as an acute cough. However, if it is a side effect of other chronic respiratory illnesses such as COPD or asthma, it is referred to as a chronic cough. Both the acute and the chronic cough can, in turn, be expressed as a dry or productive cough.

The difference between a dry, irritable cough and a productive cough

A dry, unproductive cough could be a respiratory reaction to various harmful stimuli, such as smoke, dust particles, or chemical vapours. A dry, irritable cough is persistent, painful and without sputum. It is most frequently caused by smoking, dust work (e.g. grinding), severe diseases of the respiratory tract such as whooping cough or tuberculosis or bronchial carcinoma, heartburn (reflux oesophagitis) or adverse reactions to medication.

A productive cough is usually the result of a viral or bacterial infection. It is often accompanied by fever, a runny nose or hoarseness and increased mucus formation. This mucous can be a breeding ground for other pathogens such as bacteria. It is therefore important to support the expectoration of mucus rather than suppressing the cough stimulus.

Cough as a symptom of a cold

The early stages of a cold are predominantly characterised by hoarseness and persistent coughing. The latter in particular is one of the most common reasons for why a doctor is consulted during the cold season. A cough caused by a flu-like infection is initially expressed as a dry (unproductive) irritable cough. As the cold progresses, those affected usually cough up sputum (productive cough) before the cough becomes dry again towards the end of the infection.

Coughing is a symptom of a cold because of viruses penetrating the respiratory tract, which leads to a disruption of the self-cleansing mechanism, which consists of both the so-called cilia in the lungs and the cough. In a healthy state, the airways are covered by a relatively thin mucus, known as surfactant, which binds foreign bodies or pathogens and is carried outwards by the constant beating of the cilia. If this mechanism is stressed, for example by particularly large foreign substances, coughing supports the respiratory tract as a protective reflex. The force of the cough, for example, then quickly removes inhaled biscuit crumbs from the lungs. However, if pathogens such as cold viruses colonise the respiratory tract, the lungs react with increased mucus formation. This can also be less fluid, so that the cilia can no longer move evenly and the body has to exert itself through more forceful coughing in order to transport the mucus to the outside. The self-cleansing mechanism is blocked and the bronchial tract can be hypersensitive to irritation. A cough that can persist for weeks is often the consequence of the airway's attempt at removing viscous bronchial mucus.

Treatment: Alleviating the cough stimulus and clearing the respiratory tract

The treatment of the symptoms is primarily based on the type of cough, because every cough is different - and the treatment should be, too. In general, not only the cough itself, but also the underlying disease, e.g. the flu-like infection, should be treated. There is a range of different medication suitable to alleviate a persistent cough and to help in supporting the self-cleansing mechanism of the respiratory tract. If, for example, mucus congests the cilia during a cold, expectorants can ensure that it liquefies so that the cilia are able to move evenly once more and transport away the pathogens. For a dry cough, abirritant medication can help to alleviate the cough stimulus. However, these so-called cough suppressants should not be used against a productive cough, as they not only inhibit the cough stimulus but also the removal of mucus and therefore pathogens. This impairs recovery.

For an acute cough, Aristo Pharma offers a range of over-the-counter medication that help alleviate the symptoms, such as Eucabal®-Hustensaft (cough syrup) against the cough stimulus (can be used for infants from the age of 12 months), Ambroxol Aristo® Hustensaft (cough syrup) for a phlegmy cough, and Bromuc® akut Hustenlöser (expectorant) that dissolves viscous mucus and facilitates coughing. Infections that have spread to the lower sections of the airways (lungs, bronchi) and also accompanied by coughing should be checked by a doctor. The same applies to coughs persisting for longer than 3-4 weeks or those which are associated with shortness of breath or chest pains.