Asthma is a common lung disease that typically begins in childhood but can affect people of any age. Asthma causes shortness of breath, coughing, and wheezing due to the narrowing and swelling of the airways. In the UK alone, around 5.4 million people have the condition and although there is currently no cure for asthma, there are effective treatments that can help control symptoms and keep your life as normal as possible.

What is asthma and what causes it?

Asthma is a respiratory condition caused by inflammation and narrowing of the airways. Wheeziness, shortness of breath, coughing, and chest tightness are all common symptoms. There is no single cause of the condition, but it is frequently the result of both environmental and genetic factors. For example, if other close family members have asthma, you are more likely to have it as well.

Asthma occurs more commonly in women and children, however, it can occur in anyone and develop at any age. It also varies in severity. On the other hand, some people may experience occasional mild symptoms while others have severe symptoms that impact their lives on a daily basis. Either way, asthma is a serious condition that can be life-threatening. Keeping your asthma well controlled is essential and that includes taking the right medication, knowing your triggers and having regular asthma reviews.

Can you develop asthma?

Yes! Even if you don’t show signs of asthma during childhood or even in the majority of your adulthood they can appear at any time. Adult onset asthma can be caused by the following:

  • Triggered by allergies.
  • Caused by weight gain.
  • Smoking or being exposed to smoke can cause asthma symptoms.
  • Particular viruses such as a bad cold or flu.

If you have noticed a change in your breathing or are experiencing tightness, wheezing or coughing more regularly it’s best to get checked out by a doctor.

How is asthma diagnosed?

Although it can be well managed, asthma is a potentially serious medical condition and should always be diagnosed by your doctor.

In most cases, asthma symptoms are identified by the individual or parent. A doctor’s appointment should then be made for a professional diagnosis and assessment. It’s a good idea to keep a diary of your symptoms, including when they occur, their severity, and any trigger factors as this will help with the diagnosis process.

During the assessment, your doctor will be able to make an accurate diagnosis using this information in conjunction with diagnostic tests such as spirometry, peak expiratory flow (PEF), and airway responsiveness. 

A peak flow metre simply measures how quickly you can blow air out of your lungs. It’s often used to help diagnose and monitor asthma. When you are diagnosed with asthma, you may be given a peak flow metre to continue taking readings morning and night while you begin your treatment.

What can trigger asthma? 

Asthma triggers are things that can bring on asthma symptoms or even attacks. While it’s not always possible to avoid, you should always be mindful and have a good understanding of what can cause a flare-up for you as everyone reacts differently.

Common triggers include:

  • Pets such as cats, rabbits, dogs, hamsters, rabbits and other furry animals
  • Dust mites
  • Outdoor air pollution & pollen
  • Mould
  • Strong cleaning products such as disinfectants.
  • Strong smells
  • Change in weather
  • Exercising
  • Stress

Knowing your triggers will help you manage your asthma and make the necessary changes to prevent symptoms or attacks.

What happens during an asthma attack?

An asthma attack occurs when symptoms worsen and it becomes harder to breathe. During a typical asthma attack:

  • The muscles surrounding the airways contract, narrowing the airway. As a result of the constriction, less air passes through the airway.
  • The airway becomes inflamed, allowing even less air to pass through.
  • The amount of mucous in the airway increases, causing it to narrow.

Asthma attacks differ from person to person, with mild attacks being more common than severe ones however it is still important to keep your inhaler on you at all times in case of emergency.

What should you do during an asthma attack?

If you believe you are having an asthma attack, you should immediately:

  1. Sit up straight and try to remain calm.
  2. Take one puff of your reliever inhaler (typically blue) every 30 to 60 seconds, up to a maximum of ten puffs.
  3. Call 999 for an ambulance if you feel worse at any point or if you do not feel better after 10 puffs.
  4. If the ambulance does not arrive within 10 minutes and your symptoms do not improve, proceed to step 2.
  5. If your symptoms do not improve after repeating step 2, and the ambulance has not arrived, call 999 immediately.

What should you do if you don’t have your inhaler?

If you are experiencing an asthma attack and do not have your reliever inhaler, you should: 

  1. Sit up straight to allow you to breathe easier. Bending over or lying down will further constrict your airway.
  2. Take long, deep breaths to slow down your breathing. Inhale deeply through your nose. Exhale slowly through your mouth. You wish to avoid hyperventilation.
  3. Keep as calm as possible as stress may further induce your symptoms. Anxiety tightens your chest and back muscles, making breathing more difficult.
  4. Keep your distance from the trigger. If you can avoid your trigger, do so. Once you’re in a safe place, get some fresh air, preferably in an air-conditioned environment, and try to take slow, deep breaths.
  5. If symptoms don’t ease then seek professional medical assistance. 

Whether you have your inhaler or not, it is critical that your friends and family know how to assist you in an emergency. It may be useful to share your personal asthma action plan with whoever may need to know.

What treatments are available for asthma?

Although there is no permanent cure for asthma, there are still ways to manage the symptoms to prevent a full flare-up, also known as an asthma attack.

The two main aims of asthma treatment are to prevent symptoms and to relieve symptoms — these are often recognised as brown and blue inhalers.

These two aims are managed using different types of inhalers and lifestyle techniques as detailed below.

Preventative treatment

Inhaled corticosteroids are a common type of asthma preventer that are inhaled without swallowing and go directly to your lungs, reducing inflammation. The main aim of preventers (usually a brown or purple inhaler) is to keep asthma symptoms under control by reducing the sensitivity of the lining of the airways and reducing any inflammation and mucous production. 

Types of preventers include Clenil, Qvar, Seretide, Serevent, Flixotide, and Pulmicort. They act to help reduce the irritation and inflammation of the airways, reducing the chance of symptoms and an asthma attack and need to be taken regularly to build up their effectiveness. Brown preventers are used regularly once or twice daily (as directed by your prescriber) and can take up to 14 days to kick in.

Another medication that can help with asthma symptoms is budesonide/formoterol (Symbicort). Formoterol (a long-acting version of salbutamol) is combined with budesonide (a corticosteroid) to keep the airways open while also reducing irritation and inflammation.

Relief treatment

Salbutamol (Ventolin & Salamol) are blue inhalers that act as short-acting quick-relief medication that is taken as the first line treatment for asthma — this is when you are experiencing symptoms such as chest tightness or wheezing. 

They can also be used prior to exposure to triggers, such as exercise, to stop symptoms from occurring. When wheezing and breathlessness occur, it is important to use your reliever as quickly as possible following your asthma management plan set by your GP or asthma nurse. If your symptoms are no better or worse after 5 – 10 minutes and several doses of your reliever you should call an ambulance immediately.

Alternatively, salbutamol, your doctor may choose to prescribe terbutaline (Bricanyl), which has a similar effect. Salbutamol acts within 5 minutes and can act for up to 6 hours. When wheezing and breathlessness occur, it is important to use your reliever as quickly as possible to open up your airways.

Alternative treatments for improving asthma

Asthma cannot be prevented entirely but it can be controlled. A combination of medical and lifestyle factors can make a positive impact on your condition so your symptoms don’t worsen.

Medical treatments:

  • Take your inhalers as directed, especially your preventative inhaler, which must be used on a regular basis to be effective.
  • Have regular asthma check-ups with your doctor.
  •  Get the winter flu jab as the flu can aggravate asthma symptoms.

Lifestyle changes:

  • Consider an air filtration or purifier system in your home.
  • Exercise to increase your lung capacity and gain more control over your breathing.
  • Keep your home free from dust.
  • Quit smoking.

If you need help managing your asthma, speak to your doctor who can help you create an asthma management plan as well as suggest appropriate lifestyle changes.