Respiratory conditions lead to chronic inflammation and a gradual weakening of the immune system. Here we delve deeper into the causative factors of both conditions and how herbs can help.

Asthma is a chronic inflammation of the bronchial tubes (airways) that causes swelling and narrowing (constriction) of the airways. Asthma affects approximately 5 million people in the UK. It can arise at any age, but approximately 50% of asthmatics will start to develop symptoms before the age of 10. 1 in every 11 children will develop asthma and it is classed as the most common chronic condition in the UK (asthma.org.uk).

Pharmaceutical treatments of asthma

• Bronchodilators: Bronchodilators activate the sympathetic nervous system and encourage the release of adrenaline. However, these may also overstimulate the heart causing palpitations and tremors, and should be used with caution in heart conditions, hyperthyroid, high blood pressure and extreme anxiety.  They are commonly prescribed as inhaled medicines, the most common being Salbutemol or Ventolin.
• Corticosteroids: Corticosteroids reduce inflammation in the bronchial tubes by inhibiting the inflammatory cascade. However, they also depress the immune system, reduce white blood cells, increase susceptibility to infection, osteoporosis, reduced efficacy of insulin, peptic ulcers, increase in blood pressure, fluid retention, acne and depress the body’s ability to produce corticosteroid hormones.
• Antihistamines: Antihistamines prevent histamine from attaching to receptor sites within the body, theoretically preventing the histaminic response and the body from responding to allergens. They are used to relieve mild to moderate symptoms but can cause drowsiness.
• Decongestants: Decongestants work by constricting blood vessels within the mucous membranes of the nasal passages, thereby helping to prevent fluid leakage and a ‘runny nose’. However, decongestants should not be used for more than several days, because they can cause a “rebound” effect and make the congestion worse. For example, the stagnation causes a ‘dam’ like effect which, in turn, causes a flood.

Bronchitis

Bronchitis is the inflammation of the bronchi, the air passages that extend from the bronchial tubes and directly into the lungs. An acute Upper Respiratory Infection (URI) is the most common cause of acute bronchitis. The pathology of bronchitis causes the mucosa of the affected bronchi to become inflamed, followed by a dry, nonproductive cough. This is then followed by the production of thick and sticky mucous. Shortness of breath can then result and there may be occasional crackling and wheezing after coughing. Most importantly the excessive mucus floods the ‘muco-ciliary escalator’ (see above) and drastically increases congestion and the risks of secondary infections.

Types of bronchitis

Acute bronchitis

Acute bronchitis will normally only last for between 7-14 days. Symptoms peak within three to five days after the first symptoms appear, and then often resolve within 10-14 days. Serious complications usually occur only in patients with constitutional lung weakness and an underlying chronic respiratory disorder.

Chronic bronchitis

Chronic bronchitis is a chronic pulmonary obstructive disorder (CPOD) and is characterised by a chronic productive cough. Chronic bronchitis can result from repeated attacks of acute bronchitis, or it may evolve gradually due to heavy smoking or inhalation of air-borne pollutants. It may have a repetitive pattern and gradually worsen with each occurrence. It is a very common disease in the UK with the large majority of cases being associated with smoking. A damp climate, poor housing and environmental pollution are also other important factors.

In chronic bronchitis there is both hyperplasia and hypertrophy of the mucus-secreting cells. This means that there is excess mucus production and a thickening of the bronchial walls. It is directly implicated with the formation of emphysema.

Smoking is the main cause of chronic bronchitis because it inhibits the efficient functioning of the mucociliary escalator.  

Pharmaceutical treatment of bronchitis

• Anti-pyretic, analgesic medication: This form of medication is often used to reduce fevers in acute bronchitis with the most common being aspirin and paracetamol. However, aspirin has been implicated with intestinal bleeding and blood thinning and paracetamol is toxic with alcohol and can irritate and already damaged liver.  
• Antibiotics: Antibiotics are the primary method of treatment for acute bronchitis and often include common medications such as penicillin and erythromycin. Antibiotics can disturb the intestinal flora leading to outbreaks of Candida albicans and other yeast infections.
• Anti-tussives: This form of medication will inhibit or suppress the cough reflex by depressing the medullary cough center. The most well-known medication from this category is codeine.  
• Expectorants: Expectorants help to expel mucus from the lungs by reducing its thickness.

Other treatments involve anti-allergenic, bronchodilators, corticosteroids, oxygen therapy and removal of the causative factors