Asthma

What is asthma?

Asthma often, but not always, starts in childhood. It's a chronic condition, so although some children grow out of it, most will have asthma throughout their lives. With the correct management, most people can reduce asthma symptoms and live a normal life.

Symptoms of asthma

Symptoms are often worse in the evenings and early mornings and when you're exposed to certain irritants. Symptoms of asthma include:

• Coughing

• Wheezing

• Tight chest

• Breathlessness

If your asthma isn't well-controlled, it can cause more issues, including:

• Tiredness

• Stress, anxiety or depression

• Lung infections

• Delayed growth or puberty in children

What is an asthma attack?

If asthma symptoms get significantly worse, often within a short time, this is known as an asthma attack. It can cause:

• Severe coughing, wheezing, tight chest and breathlessness

• Difficulty breathing

• Fast heart rate

• Fast breathing rate

• Lightheadedness

• Drowsiness, dizziness or confusion

• Exhaustion

• Blue lips or fingertips

• If very severe, you might collapse

Asthma triggers

Asthma attacks and flare-ups usually happen because of certain triggers. Common asthma triggers include:

• Allergies like animal fur, pollen and dust

• Exercise

• Cold weather

• Mould or damp

• Smoke

• Pollution

• Infections like a cold or flu

• Certain medications like ibuprofen

Asthma causes

There are several risk factors for getting asthma, including:

• Having a related condition like eczema or food allergies

• Family history of asthma

• Getting bronchiolitis (a childhood lung infection)

• Being around smoke as a child

• Your mother smoking during pregnancy

• Being born prematurely (before 37 weeks)

• Having a low birth weight

• Working in a job involving substances like spray paint, latex, wood dust and flour

Asthma diagnosis

If you think you might have asthma, there are several tests you can take, including:

• FeNO test – a machine that sees how much nitric oxide is in your breath, which is a sign of inflammation in your lungs

• Spirometry – you breathe into a machine that sees how quick you can breathe out and how much air you can hold in your lungs

• Peak flow test – you breathe into a device that sees how quick you breathe out. This test is repeated over a few weeks

If you're diagnosed with asthma and think your symptoms may be triggered by an allergy, you may also have a chest X-ray or allergy tests.

Asthma inhalers

Asthma inhalers come in three forms:

• Reliever inhaler - Used to improve and relieve asthma symptoms. Generally, if a reliever inhaler is needed more than three times a week, the asthma isn't well controlled

• Preventer inhaler- Used daily (usually twice) to stop symptoms from happening in the first place. There are various strengths of preventer inhaler prescribed by GPs, depending on the severity of your asthma symptoms

• Combination inhaler – These work as both a preventer and a reliever for people with more severe asthma symptoms.

You must use your inhaler correctly, or the medication won't reach your lungs effectively. Asthma.org.uk has a good resource to check your technique.

Tablets

Some people with severe asthma symptoms may also need oral medication to keep it under control. The main three options are:

• Leukotriene receptor antagonists (LTRAs)

• Theophylline

• Steroid tablets

Other treatments

If nothing else is working, you may want to think about other treatments like:

• Injections - These can help people with severe asthma control their symptoms. These are known as biologic therapies, which can only be prescribed by an asthma specialist, and they aren't suitable for everyone

• Surgery - If your asthma is very severe, you might be offered surgery known as bronchial thermoplasty

How to manage asthma

There are lots of ways you can help yourself, including:

• Avoiding your specific asthma triggers

• Using your prescribed inhaler and medication correctly and routinely

• Checking all new medicine is suitable for someone with asthma

• Stopping smoking

• Getting enough exercise (if your asthma is well managed, this shouldn't trigger your symptoms)

• Eating healthily

• Getting regular check-ups

When to see a GP

People with asthma should have a yearly review of asthma control with a GP or practice nurse. You should also be given a personal asthma plan to know what to do if your asthma symptoms are uncontrolled or if an asthma attack happens.

See a GP if you:

• Think you may have asthma and need a diagnosis

• Are using your reliever inhaler more than three times a week

• Experience symptoms that are stopping you from exercising or carrying out your normal activities or waking you from sleep

• Think you're having an asthma attack but aren't struggling for breath or having any difficulty breathing

If you're having difficulty breathing, you should go to A&E immediately.