Respiratory infections can be in our upper or lower airways. The common cold is an upper respiratory tract infection (URTI) and it can give us a bit of a dry cough but it’s the lower respiratory tract infections (LRTI) that really affect our lungs. From bronchitis where the infection is in the bronchial tubes to pneumonias where it lodges deeper in the alveoli of the lungs, we can find ourselves coughing constantly, bringing up thick mucous and feeling out of breath and very unwell.
Lung infections are mostly commonly caused by viruses (COVID-19 is an example) and treatment is usually to ease symptoms whilst waiting for the body to clear the infection. Sometimes and particularly with pneumonias, bacteria are to blame and in this case antibiotics will help you get better. You should see your doctor if you think you have a pneumonia.
Over 300 million people in the world have asthma and unlike infections, asthma is a life-long condition. The airways of someone with asthma are sensitive, causing them to cough, wheeze and feel tight in their chest when they have a flare up. The walls of our airways are made of smooth muscle which becomes narrow and swollen and alongside a build-up of mucous, the passage of air can be difficult.
Asthma can be triggered by respiratory infections but also by allergies, the environment, the weather and many more things. Treatment revolves around identifying triggers so they can be minimised or avoided, dampening down any inflammation in the airways and responding quickly to any flare ups with medications to reduce airway narrowing. Everyone with asthma should have a personalised treatment plan that is agreed with their doctor or asthma nurse including what to do if their symptoms worsen. Asthma can kill so it’s vital to seek and comply with treatment. Many runners have asthma and when it’s well controlled it’s safe and beneficial to run.
Some people with asthma find that exercise triggers their symptoms however there are many people who don’t consider themselves to be asthmatic but get wheeze, cough and chest tightness during or more often, after exercise. This is called exercise-induced bronchospasm (EIB) which describes how the bronchi and bronchioles spasm and narrow in response to exercise. It’s not an uncommon thing for long distance runners to experience. It’s very difficult to distinguish it from asthma and some people with EIB may in fact have an underlying asthma.
We don’t understand the cause but it may be due to the fact that the airways dry out when we’re heavy breathing on a run and cold conditions can certainly make it worse. Treatment is similar to that of asthma, giving medications (usually through an inhaler device) to minimise the airway spasm and if necessary, looking at medications to prevent any potential underlying inflammation.
It’s important to identify that our mental health is linked to our physical health. Often what’s going on in our brain manifests in genuine physical symptoms. Anxiety is a good example. In sudden acute attacks of anxiety, such as panic attacks, breathing rate can rapidly increase (hyperventilation) and it’s common to feel as if you can’t breathe. Longer term anxiety can produce feelings of chest tightness, shallow breathing and even a recurrent cough.
These are not conditions of the lungs so treatment needs to focus on addressing the underlying cause. Mental health is still often a taboo subject but thankfully people are now becoming more open and able to discuss it. Talking to and sharing your feelings with someone you trust is vital and professional help is available for those that need more in-depth counselling or anti-anxiety medications.
Tips for Healthy Lungs
1. Don’t smoke.
2. Don’t run with an infection unless it’s a minor head cold and you otherwise feel well.
3. Learn to breathe deeply, right into your diaphragm and practice it daily.
4. Run with a good posture to allow your lungs to open up fully.
5. If you have asthma, take your medications as prescribed and attend review appointments.
6. Avoid or minimise triggers which affect your lungs such as pollen or pollution.
7. Consider Pilates to help you control your breathing and improve your posture.
8. Eat a varied and healthy diet.
- Dr Juliet McGrattan