Respiratory Diseases


Asthma is a chronic inflammatory disease of the respiratory tract (airways). However, inflammatory factors are not microbes.

The prevalence of asthma can vary depending on the changes in the environment and living conditions. It is estimated that asthma affects around 300 million people of all ages worldwide.

In our country, asthma is observed in approximately 5-7 of every 100 adults and 13-15 of every 100 children.

Long-acting beta-agonists may alleviate symptoms of asthma if used separately but can prevent recognition of the underlying inflammation. This category of medications should be used in the treatment of asthma together with control medications (such as cortisone).


Individuals who have certain personal and environmental risk factors may be more likely to experience asthma. Heredity (Genetic structure) is a significant risk factor for individuals and their relatives. Some of the conditions we experience in our environment also play a significant role in genetically predisposed people’s development of asthma and the seriousness of the disorder.


In patients with asthma, the airway walls are highly susceptible to swelling, edema, and stimulation due to inflammation. In response to some external stimuli, patients’ airways get narrower and the air is prevented from entering and exiting through the lungs. As a result, symptoms such as cough, shortness of breath, chest tightness, and wheezing appear. The severity of asthma symptoms can differ in individual cases and as time passes in the same person’s case.

Asthma symptoms are repetitive and include seizures and usually occur at night or in the early morning. The emergence of patients’ complaints that did not exist before or the increase of existing complaints is defined as an asthma attack. Patients feel good between attacks (crises).


Some environmental factors may cause symptoms such as shortness of breath, cough, and wheezing to reappear or increase in asthmatic patients. These factors are called triggers. Allergens such as house dust, pollen and mold fungi, cigarette smoke, stimuli in the workplace environment, and some medications, as well as indoor or outdoor air pollution, can be stated as triggering factors. Some patients with asthma have allergies to pets. Patients should be aware of these triggering factors that disturb them and stay away from them as much as possible. Recurrent respiratory infections can trigger asthma attacks in patients, and simple flu can lead to shortness of breath. The complaints of asthma patients generally increase during the winter months.

Psychological conditions such as stress and anxiety, agitation, and irritability may often result in asthma symptoms occurring or rising.

Patients with asthma can do sports; however, pre-workout warm-up exercises, wearing a mask while training in cold weather, and utilizing a fast-acting breathing inhaler 15 minutes before workout beginning provide a more comfortable workout.


Not all asthma patients are allergic, or asthma has not been observed in everyone who has an allergy. However, allergens may cause symptoms of asthma or exacerbation of the disease in some sensitive individuals. Pollen, house dust mites, mold fungi, cockroaches, animal feathers, and some nutrients are common allergens.


The complaints that caused the patients to go to the doctor and the detailed history taken from the patients constitute the first step of the diagnosis of asthma. It should not be underestimated that there are occasions where patients with asthma have no symptoms or all of the findings of the examination are pretty normal. The most important examination used in both diagnosis and follow-up of the disease is pulmonary function tests with and without medication.


Asthma can be managed with the correct treatment; but, untreated asthma can also seriously limit the everyday lives of patients. For this reason, the most important factors in the treatment are regular use of medicines and doctor control.

Drugs used in the treatment of asthma eliminate non-microbial inflammation in the airways and related airway stenosis.

The main drugs of treatment are called controlling (inflammatory-reducing) drugs. The group comprises steroids (drugs that include cortisone), drugs that influence the leukotriene system, long-acting beta-agonists, drugs that regulate theophylline, and anti-IgE. These drugs would show their effects when they are used regularly in the long term. Therefore, patients should use this group of drugs regularly even if they do not observe any complaints.

Long-acting beta-agonists may relieve asthma symptoms if used individually but, can prevent a notice of the underlying inflammation. This group of drugs should be used together with controlling drugs (such as cortisone) in the treatment of asthma.

Medicines like short-acting beta-agonists, anticholinergics, and theophylline indicate rapid effects. This group of medicines is called bronchodilators (reducing stenosis in airways). These medications should be used regularly or only when necessary, depending on the severity of the disease.

Many of the medications used in asthma treatment are inhaled and go straight to the infected region, that is to say, the airways. Subsequently, the proper usage of inhalation tools and the washing of the mouth with water and spitting it after the use of cortisone-containing medications is very critical both in improving therapeutic effectiveness and in decreasing potential side effects.

Asthma medicines are not addictive or do not lead to immunization in long-term usage of medications, and have no appetizing or weight gaining effects.

Asthma with Questions and Answers, General Directorate of Primary Health Care Services, Republic of Turkey Ministry of Health
Life with Asthma, Turkish Thoracic Society Asthma, and Allergy Working Group, Educational Book Series 2009


COPD is “Chronic (persistent, recurrent) Obstructive Lung Disease”.  It’s not progressive and fully reversible, so it’s a condition that can be prevented and treated.

Inhalation of other toxic substances and particles, primarily cigarette smoke, induces non-microbial inflammation in the airways in certain people. This inflammation makes the airways narrowed. The narrowing of airways causes restrictions during the air entry and exit to the lungs and makes it hard to breathe. It is much more apparent when exhaling.

COPD typically arises with chronic bronchitis and emphysema history. Chronic bronchitis is a condition characterized by cough and expectoration that occurs for two consecutive years for at least three months of the year. Emphysema disrupts the air sacs in the lung, and these sacs lose their capacity to extend and contract through respiration. As a consequence, there is a contraction of the airways once again.

COPD is relatively popular. Two out of every 10 people in our country and the world are COPD. Because of COPD, 3 million people die each year. It is the world’s fourth most critical cause of death and our country’s third major cause of death. Over the years the frequency of COPD is projected to increase more.


Chronic cough, sputum generation, and increasing shortness of breath are the major patient symptoms. Cough and expectoration are typically the first signs arising in the morning more frequently.

During actively moving, the shortness of breath increases gradually over the years and can take place during short distance walks, trying to dress, speaking, and even rest. Later on, COPD may also cause heart problems.


Smoking is the most significant risk factor for COPD. Passive exposure to cigarette smoke coupled with the use of tobacco such as hookahs, pipes, and cigars can often contribute to COPD.

Aside from cigarettes and tobacco products, the usage of wood, coal, or turd for heating or cooking indoors, exposure to dust, smoke, and unhealthy gasses in the workplace are significant risk factors for COPD development.

COPD is more likely to take place in coal and metal workers, in the grain and textile sector, in the production of cement, wood, and paper.


Early diagnosis is one of the most significant factors that influence the course of COPD disease, but many of the patients may not realize whether they have this condition. People who have smoked for over 20 years, or who have certain risk factors such as cough and sputum and shortness of breath may consider the possibility of COPD.

In the diagnosis, the examinations and laboratory tests are conducted after taking the stories of individuals and their professional details. The diagnosis is verified by pulmonary function tests (blowing test, breath analysis). Such examinations, besides making a diagnosis, are used to assess the severity of the disease and to monitor the course of the disease.


Smoking cessation is the first and most critical stage in COPD treatment since cessation in smoking is the most significant element that prevents disease progression. Measures to prevent environmental and occupational air pollution other than cessation of smoking are also significant factors that reinforce treatment success.

Drug treatment involves two groups; some steroids are used for inhalation (cortisone) and airway dilator (bronchodilator) medications.

Airway dilator medications reduce the shortness of breath by expanding the airways. There are three groups of these medications. These are beta-agonist drugs called salbutamol, terbutaline, salmeterol, formoterol and indacaterol, and anticholinergic drugs and theophylline called ipratropium, tiotropium, and glycopyrronium.

Steroids (cortisone) are used in severe patients to decrease nonmicrobial inflammation in the respiratory system. When inhalation involves steroid-containing medications they will also cause side effects in the mouth, such as aphonia and fungal infection. Rinsing and spitting a cup of water in the mouth after taking the medication minimizes these side effects.

COPD also has phases (attacks, exacerbations) in which recurrent symptoms of patients escalate and typically need care and treatment at home or in hospital. The most frequent cause of the attacks is infections.

In addition to drug treatment, in the small range of cases, medical strategies such as influenza and pneumonia vaccination, respiratory rehabilitation services, oxygen therapy, and surgical procedures are also applied.

COPD, T.R. Ministry of Health, General Directorate of Primary Health Care
Life with COPD, Turkish Thoracic Society Educational Books Series, Ankara 2011