Asthma

In most cases, asthma itself cannot be cured, but advanced treatment approaches make it possible to significantly control the disease. With the right treatment, nearly 100% of normal function is achievable. During your consultation with one of our avi Medical doctors, you will receive individual advice, and together we can — particularly in the case of asthma — find the right treatment to provide quick relief.

Throughout your entire asthma treatment, our doctors will be your constant companion and always there for you.

Depending on the severity of the condition, symptoms occur with varying frequency and intensity. Symptoms may show seasonal variation depending on the cause of the asthma. Complaints often arise at night and in the early morning hours. Symptoms of asthma may include:

• Shortness of breath and breathlessness
• Tightness in the chest
• Laboured exhalation
• Wheezing, also known as "stridor"
• Restlessness and anxiety, accompanied by an elevated heart rate
• Possible blue discolouration of the fingernails and lips due to oxygen deficiency

In principle, there are many different causes that can lead to asthma. A general distinction is made between allergic and non-allergic asthma, though mixed forms may also occur. Genetic inheritance relating to allergies and asthma plays a significant role, but occupational and environmental triggers are also involved in the development of asthma. There are different triggers for each form, which need to be identified individually. We are happy to advise you on this so that you can specifically avoid these stimuli.

Asthma is a combination of two components: a persistent tendency towards bronchial inflammation and an external influence that triggers the inflammation.

Allergic asthma is triggered by allergenic substances in the environment (e.g. pollen and animal dander). Genetic inheritance (60–80% heritability) plays a particularly important role, especially in allergies such as hay fever or house dust mite allergy. It often manifests from the second year of life in association with dermatitis, enteritis, or rhinitis. Children are therefore affected by allergic asthma more frequently than adults. The most common triggers are inhalation allergens — those inhaled with air that reach the mucous membranes. If such an allergy goes untreated, a so-called "floor change" can occur, in which, for example, simple hay fever develops into allergic asthma.

Non-allergic asthma typically begins in adulthood and is triggered by non-specific stimuli. Possible triggers include viral or bacterial infections (infection-associated asthma) or various irritants such as smoke, air pollutants, or cold air. Intense laughter or psychological stress can also trigger asthma attacks.

Often mixed forms of the two types of asthma are present, whereby childhood allergic asthma transitions into non-allergic asthma in adulthood.

The number of people affected has increased markedly in recent decades in particular. One reason for this is the rise in hygiene standards. As most diseases and pathogens are kept under control, the immune system becomes understimulated. This leads to harmless substances being overrated and then attacked by the immune system. An allergic reaction occurs, which can also develop into asthma through a floor change. Together with your avi doctor, we can specifically identify the cause and determine the most appropriate therapy for you.

In most cases, asthma itself is not curable, but advanced treatment approaches make it possible to significantly control the disease. With the right treatment, nearly 100% of normal function is achievable. Asthma treatment is divided into non-pharmacological and pharmacological therapy, and the two complement each other well.

The goal of non-pharmacological therapy is disease control and achieving freedom from symptoms through comprehensive patient education. Those affected learn how allergens or other triggers can be avoided through stimulus shielding and what else can help in preventing asthma attacks. Breathing therapy, physiotherapy, and above all regular aerobic exercise — which helps to desensitise asthma — are also part of non-pharmacological treatment. One form of treatment for allergic asthma is hyposensitisation, in which allergens are administered to the patient at regular intervals over a period of time, with the aim of the body becoming accustomed to the allergens so that no further immune reaction is triggered.

For pharmacological treatment of asthma, various inhaled forms (inhaler) are available, allowing the active ingredients to reach their target site — the lower airways — in a more targeted manner and at higher concentrations. Depending on the severity of the disease, there is maintenance therapy and on-demand therapy, also known as relievers and controllers. A reliever is a spray used only for acute, episodic symptoms. It is therefore mainly used as on-demand therapy for acute use and rapid relief of symptoms. Reliever medications are often administered via inhalers or sprays so that the active ingredient can act directly at the affected site — the lungs. This rapidly achieves relaxation of the bronchial muscles and dilation of the narrowed bronchi. Controllers are used for long-term prophylactic therapy. Inhaled anti-inflammatory corticosteroids (cortisone) reduce chronic airway inflammation in asthma or dilate the bronchi over several hours. For controllers to work effectively, it is very important that medications are taken regularly.

The goals of your asthma therapy at avi are:

• Freedom from symptoms (the longest possible periods without an asthma attack)
• Rare or no exacerbations
• Undisturbed, restful sleep
• Normal lung function
• As unrestricted as possible daily performance
• The ability to participate in sport

It is our goal to make you the "manager" of your own condition, so that work, daily life, and leisure continue to bring you unclouded enjoyment! Book your asthma appointment at one of our avi GP practices or via video consultation, and together we will find the right therapy.