Breathlessness Is Not Normal – Even as an Adult
You get out of breath more easily than you used to. A cold always goes to your chest. You wheeze during exercise or wake up coughing at night. Perhaps you had asthma as a child and thought you outgrew it – or perhaps these symptoms are entirely new. Adult-onset asthma is more common than many people realise, and it deserves proper diagnosis and management.
At our practice in Zürich Seefeld, I diagnose and manage asthma comprehensively, ensuring not just symptom control but identification and treatment of underlying triggers.
What Is Asthma?
Asthma is a chronic inflammatory condition of the airways characterised by reversible airway obstruction, bronchial hyperresponsiveness, and airway inflammation. In simpler terms: your airways are inflamed, twitchy, and tend to narrow in response to triggers, causing difficulty breathing, wheezing, coughing, and chest tightness.
Adult-Onset Asthma
While asthma often begins in childhood, a significant proportion of cases develop in adulthood – sometimes in people who never had childhood asthma. Adult-onset asthma is more common in women, often less allergic (more intrinsic), frequently more severe, and often triggered by occupational exposures, respiratory infections, hormonal changes, or new-onset allergies. Obesity is an increasingly recognised risk factor.
Symptoms to Watch For
Recurrent episodes of breathlessness, wheezing (a whistling sound when breathing out), chest tightness, persistent cough (especially at night, early morning, or with exercise), reduced exercise tolerance, and symptoms triggered by cold air, allergens, exercise, or respiratory infections.
Conditions That Mimic Asthma
Not all wheezing is asthma. I carefully distinguish asthma from vocal cord dysfunction, GERD-related airway symptoms, cardiac conditions, bronchiectasis, COPD, and hyperventilation syndrome.
Our Diagnostic Approach
Spirometry with bronchodilator reversibility testing is the foundation of diagnosis. I also use peak flow monitoring, FeNO (fractional exhaled nitric oxide – a marker of eosinophilic airway inflammation), allergy testing to identify triggers, and sometimes methacholine challenge testing for unclear cases. Blood work includes eosinophil count, total IgE, and specific IgE to relevant allergens.
What We Do: Beyond the Inhaler
Inhaler technique optimisation: Up to 80% of patients use their inhalers incorrectly, dramatically reducing medication effectiveness. I teach and verify proper technique.
Stepwise therapy: Following international guidelines (GINA) with inhaled corticosteroids as the cornerstone, adding long-acting bronchodilators and other controllers as needed.
Trigger identification and management: Allergy testing and avoidance strategies, occupational exposure assessment, GERD treatment, and exercise management.
Allergy management: If allergic triggers are identified, allergen immunotherapy can reduce asthma severity and medication needs.
Anti-inflammatory support: Omega-3 fatty acids, vitamin D optimisation, and dietary strategies to support airway health.
Asthma action plan: A clear, written plan for daily management and escalation during flare-ups, empowering you to manage your asthma confidently.
Conclusion
Well-managed asthma should not limit your life. With proper diagnosis, trigger management, and optimised treatment, most asthma patients can achieve full symptom control. If you are experiencing respiratory symptoms, book an evaluation at our practice in Zürich Seefeld.
