Complaints & connections · borters.ch
The airways are over-sensitive and narrow in attacks — with the right long-term treatment daily life stays free.
Also known as: asthma · bronchial asthma
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
In asthma the bronchi are persistently inflamed and therefore oversensitive. To stimuli others do not notice — cold air, smoke, exertion, pollen, an infection — they narrow in attacks: the muscles around the airways tighten, the lining swells, thick mucus is added. Breathing out becomes harder than breathing in, hence the wheeze. The decisive misunderstanding is about the medicines. There are two kinds and they are often confused: the reliever inhaler widens the bronchi and works within minutes, but changes nothing about the inflammation. The steroid inhaler does nothing during an attack, but lowers the inflammation when taken daily — including on good days. Using only the first because it works and leaving the second because nothing is felt gets it exactly the wrong way round, and reliever use keeps climbing. Reaching for it more than twice a week is therefore taken as a sign that the preventive treatment is not enough. Inhaler technique matters too: a large share of inhalers is used wrongly, and the drug then does not arrive where it should. Childhood asthma often improves over the years, though not in everyone. A severe attack carries a sign that runs against every expectation: **if the wheeze gets quieter, that is not a good sign.** With very strong narrowing so little air flows that hardly any sound is made — the guideline expressly names a very quiet breath sound as a sign of severe obstruction. Whoever relaxes because it sounds calmer, while the person grows more exhausted and paler, is reading it backwards. **In children** a visible sign comes in: indrawing on breathing in — above the breastbone, between the ribs and below the rib margin. It shows the accessory muscles being called on. Whoever can no longer speak in whole sentences, whose lips turn blue, or for whom the reliever no longer helps needs the emergency number, not another puff.
It works on the inflammation, not on the feeling. Dropping it because things are fine is the commonest reason for a relapse.
A large share of inhalers is used wrongly. Ten minutes at the pharmacy often achieve more than a higher dose.
That prevents hoarseness and thrush in the mouth — the two side effects that most often make people stop.
Hay fever and asthma are one airway. Doing nothing above makes control below harder.
Even smoking on the balcony leaves residues on clothes and furniture. In children with asthma it is the single biggest lever in the household.
What to do at which signs belongs on a sheet on the fridge — nobody thinks clearly in an attack, and others in the house need to know too.
Migrating worm larvae irritate the lung and cause an asthma-like picture for a week or two. Clearly raised eosinophils are the lead that is followed.
When worm larvae travel through the lung, an asthma-like picture lasts one to two weeks with strongly raised eosinophils. It passes on its own — the worm stays in the gut and is found in the stool six to eight weeks later.
A threadworm can stay silent in the gut for decades and, under cortisone, biologicals or other immune suppression, flood lung and bloodstream. Anyone who ever went barefoot in the tropics or subtropics is looked for beforehand with a blood test — one effort, and it prevents the worst course this worm has.
Steroid inhalers lower the inflammation in the airways; they work preventively and need days to weeks. The reliever inhaler relaxes the muscle around the airways within minutes without touching the inflammation. Using only the reliever treats the attack, not what sets it off.
About five to ten in a hundred people are affected; in children it is the most common chronic condition of all. A steroid inhaler needs two to four weeks to reach full effect — so the first week says nothing about whether it helps.
A high, drawn-out sound, clearer breathing out than in. It can be absent in severe narrowing — the situation is then more serious, not better.
In some people a dry cough is the only sign, with no wheeze at all. It then gets taken for a stubborn infection for a long time.
Typical are the first minutes of exercise and stepping from warm into cold. Exercise is still good — well-controlled asthma should not keep anyone from sport.
A band around the chest that does not give when breathing out. Often mistaken for a heart problem, especially in adults.
That is not a sign the inhaler works well, but that the preventive treatment is too weak. It belongs counted and reported.
If breathlessness persists despite the reliever, if speaking becomes impossible or the lips turn blue, it is an emergency. Here you do not wait.
The body’s own cortisol is lowest between 3 and 5 in the morning, and exactly then the airways are narrowest. Waking at night with a cough is therefore no coincidence but a sign that the base treatment is not enough.
In about one in five women asthma worsens regularly around the period. Seeing that in a diary allows the treatment to be adjusted on those days instead of being puzzled.
Inhaled cortisone at high doses over years can slightly slow growth in children — on average about half a centimetre of final height. Poorly treated asthma costs more; that is the reckoning behind it.
In studies losing 5–10 % of body weight measurably improved lung function and the need for reliever inhalers. The effect showed after about 3–6 months.
In a small share of people with asthma sulphites trigger symptoms within minutes. Wine, dried fruit and pickled vegetables are mainly concerned — an individual sensitivity, not a general rule.
Cohort studies find fewer symptoms with high intake. Intervention studies show small effects after 12–14 weeks — a contribution, not a treatment.
Breathing training improves symptoms and medication need — it does not replace the rescue inhaler.
Regular endurance training improves capacity; exercise asthma is no reason to hold back.
The Lung stands for breath, skin and defence at once — that asthma, eczema and hay fever often occur together is a unity in this system, not a coincidence.
The plant ephedrine comes from — used for centuries for breathlessness and today prescription-only or banned in many countries. It drives pulse and blood pressure, and that is exactly what made it notorious in slimming products.
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AWMF nvl-002 · S3 · 2024-08 — in force
Nationale VersorgungsLeitlinie Asthma
checked 2026-09