Sudden shortness of breath

Question

I have cystic fibrosis and have difficulties in adapting from cold to warm and from warm to cold temperatures. When I leave or enter a building I get really short of breath and start coughing in particular if I need to walk a bit.
Especially during the winter (with temperature changes of 20 degrees or more ) I have a lot of problems. What can I do? I am really bothered by this nearly daily.

Answer

Dear,

We do understand your concern but we will like to point out that ECORN does not replace a consultation with your doctor. For your specific problem you have to go and see your own doctor.
In general we can state that shortness of breath and coughing spells brought on by temperature changes fit the description of ‘bronchial hyperactivity’. This means that the airways overreact to specific triggers such as changes in temperature, exercise or smoke. The response of the overreactive will lead to narrowing of the airways after being exposed to a trigger and this results in coughing, shortness of breath and tightness of the chest.
Bronchial hyperreactivity is typical for patients with asthma but can also be present in other airway diseases such as cystic fibrosis. Also in CF, during increase in lung infection, the airway hyperreactivity can temporarily get worse.
Patients bronchial hyperreactivity often have an improvement of their symptoms after taking bronchodilators such as salbutamol. Treatment can also consist of long-acting bronchodilators via inhalation (ie. formoterol or salmeterol). American guidelines advise to treat all cystic fibrosis patients with bronchodilators. In Europe this treatment is prescribed on indication. If there is concomitant asthma, corticosteroids via inhalation should be started (puffs like fluticasone, budesonide, beclomethasone) possibly in combination with a bronchodilator. There is some controversy whether treatment with asthma medication is of real benefit for patients with cystic fibrosis and especially whether most patients should be treated with them or whether they should be used rather seldomly.

In case of hyperreactive airways other things besides drugs can be of help such as warming the air you breath in by inhaling via your nose or using a scarf to cover your mouth and nose.
We hope that this general information is of use to you but again advise you to go and consult your doctor.
Kind regards
M. Proesmans, J. Dankert-Roelse, K. De Boeck

23.04.2009