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Respiratory diseases

Respiratory diseases, such as allergies, asthma or bronchitis, are among the so-called widespread diseases. You can read about what can help here.

Allergy, asthma, bronchitis: The most common respiratory diseases

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.

Allergy: Causes, symptoms, and treatment

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.

Asthma: Causes, symptoms, and treatment

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.

Acute bronchitis: Causes, symptoms, and 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.

Symptoms: How to recognise acute 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), in-flammation 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).

Treatment: How to treat acute 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:

Chronic bronchitis: Causes, symptoms, and treatment

In contrast to acute bronchitis (link 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 chronic bronchitis

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 chronic bronchitis

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.

COPD: Causes, symptoms, and treatment

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.

Cough: What are the causes and types?

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.

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