Diseases associated with airway obstruction are widespread diseases. By far the most significant cause is smoking.
What is airway obstruction?
According to DigoPaul, an obstruction occurs when the airways are narrowed or blocked. This can happen through external influences such as foreign bodies or tumors, but is more often triggered by pathological processes that take place inside the bronchial system. This airway obstruction in the narrower sense causes the reduction of the lumen of the airways in different ways.
This can be a spasm of the bronchial muscles (bronchospasm), a thickened bronchial mucous membrane, an increased accumulation of tough mucus or a combination of these components. The narrowing increases the breathing resistance and initially makes it difficult to breathe out because the volume of the chest and lungs is reduced and the airways come under pressure.
When you inhale, the chest expands and pulls the lungs with it. The bronchi are made wide and the increased resistance does not initially come into play. This only happens at an advanced stage or in the event of severe seizures.
Causes
The basic cause for the development of an airway obstruction is the tendency of the bronchial system to react excessively to stimuli from the environment. This hyperreactivity is the basis on which chronic obstructive airway diseases develop. In bronchial asthma, there is an unspecific hypersensitivity to external stimuli such as heat and cold and allergenic substances.
These can trigger an asthma attack, which leads to a spasmodic contraction of the bronchial muscles. In bronchitis, the bronchial mucosa is overly sensitive to toxins and pathogens that are inhaled. Smoking plays by far the most important role in the chronification of this disease. But other noxae such as quartz or flour dust to which people are exposed at work can also drive this process forward.
External influences are initially a purely mechanical obstacle. On the one hand, these can be foreign bodies that are swallowed when eating or by children when playing with small parts. On the other hand, there are also tumors and metastases that compress or break through the bronchial walls from the outside and grow into the interior.
Symptoms, ailments & signs
Large foreign bodies in the windpipe or the bronchial branches can lead to acute, life-threatening attacks of suffocation or severe shortness of breath (dyspnoea). Inhalation is particularly restricted. The narrowing caused by tumors and metastases and the resulting impairment of respiratory function develop slowly.
Bronchial asthma occurs in attacks and in the acute stage is characterized by pronounced dyspnoea, which is often accompanied by fear of suffocation. Severe asthma attacks can be life-threatening. Chronic obstructive bronchitis develops from recurrent acute bronchitis.
In the course of the disease there is also shortness of breath, which worsens as the disease progresses. At first it only occurs during exercise, later also when at rest. In addition, the bronchial mucous membrane swells and produces more viscous mucus, which collects inside the bronchi. This triggers persistent coughing attacks with sputum. Chronic obstructive bronchitis can develop into pulmonary emphysema, in which the alveoli are enlarged.
The gas exchange that takes place there is hindered by this and by the reduced respiration. The lack of oxygen that develops in the blood and in the tissues causes a blue discoloration (cyanosis) that is particularly visible on the lips and the tips of the fingers and toes. In addition, it often leads to a reduction in performance.
Diagnosis & course
The clinical picture of a chronic obstructive airway disease usually provides enough information for a suspected diagnosis, which can be confirmed by various additional examination methods. Imaging tests such as x-rays and computed tomography can provide information about the extent and type of the disease.
Lung function tests such as spirometry and whole-body plethysmography are used to check lung volumes, breathing resistance and lung capacities. Bronchial asthma has a typical attack-like course. Acute asthma attacks of varying severity are followed by periods of largely or complete freedom from symptoms. The development from acute to chronic obstructive bronchitis and pulmonary emphysema, on the other hand, takes place in successive stages.
Complications
Airway obstruction often leads to serious, sometimes life-threatening complications. Airway obstruction initially increases the risk of pneumoconiosis and other specific lung diseases associated with shortness of breath, coughing fits and pain.
In severe cases, the obstruction causes respiratory failure, that is, a failure of the respiratory system. The consequences of this are shortness of breath, syncope, chest pain and fatigue, but also serious secondary diseases such as tachycardia and tachypnea.
The long-term complications range from chronic shortness of breath to lung and organ failure. Another complication of anthracosis is pulmonary hypertension, which occurs in the course of the disease and leads to severe disability or even death in a large number of those affected. Typical initial symptoms such as throat irritation, yellow sputum and difficulty breathing are less severe.
If the course is chronic, the initially mild complications can sometimes develop into serious illnesses. If a pneumothorax develops from the airway obstruction, shoulder pain, dry cough with bloody sputum, asthma-like attacks and acute COPD-like cough symptoms can occur.
Since the airway obstruction itself is a serious illness, the complications are usually serious and remain permanent if left untreated. With early and comprehensive treatment by a doctor, there are usually no complications.
When should you go to the doctor?
Airway obstruction is common in many respiratory and lung diseases and causes respiratory problems. In the case of COPD or asthma, for example, airway obstruction always occurs in the regular course.
These and other obstructions of the airways always require the opinion of a doctor, because they can be very stressful or even life-threatening. Pulmonologists or internal medicine specialists should be consulted. The lower airways are affected by bronchial and lung diseases.
For people who have already been diagnosed with an airway obstruction, it turns out that they also treat it if possible. In addition to regular examinations of the airways, the underlying disease, etc., it is also advisable to consult a doctor in the event of an acute deterioration in breathing that is outside the usual limits. It is possible that an obstruction may worsen, the airways shift or even collapse. All of these things are noticeable when breathing and can make it necessary to call an emergency doctor.
People who suddenly experience breathing problems should always consult a doctor or have them come, especially if they have the feeling that they are breathing against resistance. In the case of sudden breathing problems, there may be an airway obstruction caused by acute tissue damage.
For example, an upper airway obstruction occurs in the unconscious when the tongue falls back. Tumors in the neck area can also create resistance to breathing. If acute shortness of breath occurs, an emergency doctor should always be notified in such cases of airway obstruction.
Treatment & Therapy
The therapy aims on the one hand to eliminate or avoid the factors that cause the narrowing of the airways. The most important component is smoking cessation. An already existing constriction and inflammatory processes are treated with medication. Bronchodilators (bronchodilators) can be given orally or as a fast-acting spray, for example during an acute asthma attack.
Corticosteroids are often used as anti-inflammatory substances. Secretolytics are agents that mobilize the mucus in the airways and promote its removal. They can be taken orally or brought in by inhalation. Breathing therapy can aid this process. Breathing techniques are used by physiotherapists, who the patients learn and can then continue on their own.
For asthmatics, learning specific breathing exercises and breathing-relieving positions is important in order to be better able to survive an acute attack. Breathing devices that train exhalation and help loosen the mucus can also be used.
In particularly serious cases, when the dyspnea is very severe and the performance is clearly limited, a need-based administration of oxygen may be necessary, in rare cases artificial ventilation. In all diseases that lead to an accumulation of mucus, care must be taken to ensure that there is sufficient fluid intake.
Outlook & forecast
The cause of the airway narrowing is largely responsible for a prognosis. If it was caused by smoking, the chances of recovery are good. With a complete renouncement of the stimulants, the organism regenerates step by step. After 5 years at the latest, all symptoms will normally have disappeared and the respiratory tract will be permanently free of any impairment.
In the case of a chronic illness such as bronchitis or asthma, the prospects for a permanent cure are less optimistic. As soon as the inflammatory process of the respiratory disease begins or an asthmatic attack is triggered, the symptoms increase. Nevertheless, with today’s medical options, they can be treated quickly and easily. Within a few days or weeks, the bronchitis usually heals and the airway constriction has disappeared.
In the case of asthmatics, the airways are cleared after just a few minutes with an inhalation. Due to the recurring process, a routine in dealing with the diseases returns in everyday life, but a complete cure is not achieved.
If the airway obstruction is due to a genetic or acquired cause, relief can only be achieved through surgery. With a slight disposition of the airways, various breathing techniques are learned in order to experience as few complaints as possible in everyday life. In severe cases, changes must be made to the vessel walls.
Prevention
Prevention consists in avoiding the causative and triggering factors. First and foremost, of course, is smoking cessation. But also respiratory protection measures at the workplace and the avoidance of climatically unfavorable conditions are part of it. Measures to reduce stress are important for asthmatics.
These can be used in isolation, such as with autogenic training, meditations, and other relaxation techniques. But there is also the possibility to combine the aspects of sport, breathing technique and relaxation with techniques such as yoga and tai-chi.
Aftercare
One of the goals of follow-up care is to prevent the airway obstruction from falling again. This requirement can be achieved in many cases. Smoking in particular is the primary cause of obstruction or narrowing of the airways. It is scientifically proven that ending nicotine addiction contributes to healing, insofar as consumption is actually responsible for the typical complaints.
In many other cases, too, preventive measures that the patient can take themselves are effective. Inhaling certain substances and baths with essential oils can possibly prevent illness. A doctor will provide information on suitable measures. Basically, immunity does not build up after a single illness.
Those affected may therefore suffer from the airway obstruction again after a period of improvement for the same or a different reason. With certain diseases such as genetic causes and asthma, however, there are no chances of a cure. Aftercare is becoming a constant issue.
Imaging methods such as CT or X-rays provide information about the progress of the airway obstruction. Sick people get relief through certain inhalations or breathing techniques. The attending physician continuously prescribes medication or, if necessary, orders therapies. This prevents complications.
You can do that yourself
With regard to the possibilities for self-help in everyday life, a distinction must be made between obstructions of the airways caused by illness and obstructions caused by external influences.
In the event of an airway obstruction due to an external influence (swallowed food, etc.), an attempt must be made to remove the object by tapping hard on the back. Under certain circumstances, the person concerned can still do this himself. Other people are required for further measures.
Airway obstruction caused by illness can be alleviated in part by inhaling certain substances and essential oils. Inhalation takes place by adding the active ingredients to a few liters of hot water. Also bathrooms are possible, yet still relax the chest area, which can also lead to a freer breathing.
All plants and oils whose ingredients have a relaxing (and possibly expectorant) effect are suitable. As a decongestant has ginger proven in teas and mixed drinks with honey can be drunk slowly.
The most important measure, however, is to avoid irritants that narrow the airways. Those affected can always put on simple breathing masks if they feel they may be exposed to harmful substances. Just cigarette smoke, dusty basement and loaded by chemical gases places to avoid.
Even breathing techniques can be learned. Various training courses are available for this, which are also adapted to different diseases.
