What is asthma?
Asthma is a condition involving the airways, which are the tiny tubes carrying air in and out of the lungs. In asthma, the airways are affected in three different ways.
- Abnormal 'twitchiness' or sensitivity
- Inflammation
- Blockage with mucus
So the airways of someone suffering with asthma are different from those of someone who does not have asthma, even when they are not having an asthma attack.
When you come into contact with something you are allergic to, or an irritant, the muscles around the walls of the airways tighten, inflammation increases and more mucus is produced. The resulting narrowing of the airways produces asthma symptoms.
What are the symptoms of asthma?
The symptoms of asthma vary from person to person. The most common ones are:
- Dry irritating cough
- Wheezing
- Shortness of breath
- Tightness in the chest
These symptoms may be present more or less all the time, or just occasionally. They may come on without warning and you may have good days and bad days. In some people, especially children, a cough is the main symptom.
What is the difference between a trigger and an irritant?
A trigger is something that triggers your asthma. Everyone's asthma is different so people have different triggers. You may find you have several triggers and it is important to know exactly what they are. Common asthma triggers include:
- Indoor air pollution such as pet dander, dust mite allergens, and funguses
- Outdoor air pollution from trains, planes, and factories, as well as pollen
- Viral infections, like colds and flu
- Exercise
Irritants tend to affect everyone with asthma and tend to have a more transient effect on asthma symptoms while triggers make asthma worse for a longer time period. Common irritants are cold air (especially going from a warm to a cold environment), cigarette smoke, chemical fumes and aerosol sprays.
What causes asthma?
It is not completely clear what causes asthma, but it is more likely if you have a family history of asthma, eczema or allergic disease. Asthma rates have been increasing in recent years, so it is speculated that some aspects of modern life, such as cleaning products or changes in diet, have contributed to this. It is known that smoking during pregnancy increases the risk of a child having asthma. Outdoor air pollution and exposure to chemicals in the workplace have also been shown to cause otherwise preventable asthma.
Asthma can start at any age, although it tends to start before the age of ten in around half of all cases. Childhood asthma is more likely in families with a history of allergy. A child may grow out of asthma but will have a higher chance of suffering from late-onset asthma. Late-onset asthma, starting in the 30s and beyond, may follow a chest infection or exposure to chemicals at home or in the workplace and is less likely to be allergy-related. To find out more visit our Asthma Causes information page.
How is asthma diagnosed?
The presence of the symptoms described above will make your doctor suspect asthma. Monitoring your lung function with a peak flow meter, a device that measures the flow of air out of the lungs will help confirm the diagnosis. If over a period of time, morning and evening peak flow readings vary by more than 15%, then an asthma diagnosis is likely. Another indicator of asthma is if asthma medication improves peak flow readings.
There are also more complicated lung function tests that can be done in the hospital which may help confirm the diagnosis.
How is asthma treated?
There is no cure for asthma. But the condition can usually be managed successfully so you can lead a full and active life.
Treatment is based upon trigger avoidance (i.e. allergen avoidance) and medication. Keeping a diary of times and situations when your asthma is worse will help you identify your asthma triggers, which is the first step in avoidance. A high efficient air purifier, HEPA vacuum cleaner, non-allergic bedding, and allergy friendly cleaning products will limit your exposure to allergens in your home. Transforming your bedroom into an 'allergen-free space' by effectively practising allergen avoidance will allow you to get a better nights sleep, and allows your immune system to recover. To find out more visit our Asthma Treatments information page.
There are two kinds of asthma medication - relievers and preventers.
- Relievers. These are inhaled drugs that are taken to relieve asthma symptoms. They rapidly relax the muscles around narrowed airways, making it easier to breathe again. Reliever inhalers are usually blue.
- Preventers. These are inhaled drugs that help to control the swelling and inflammation in the airways, and stop them being so sensitive to triggers. It is important to take them every day, even if you feel well because the protective effects build up over time. Preventer inhalers are usually brown, red, or orange.
There are also some asthma treatments taken in tablet form, usually if you have had a severe asthma attack or if your condition is not controlled well by inhalers.
Managing asthma
Your treatment plan is intended to keep you free of asthma symptoms night and day. If you feel this is not happening, then visit your doctor or asthma nurse to review your treatment. Warning signs that your asthma is not well-controlled include:
- Waking in the night with coughing, wheezing or tightness in the chest
- Feeling short of breath when you wake up in the morning
- Needing more and more reliever, or finding your reliever is not working very well
- Not being able to continue your usual level of activity or exercise because of asthma symptoms
What is an asthma attack?
Gradual worsening of your asthma symptoms over a number of days may lead to an attack, in which:
- Your reliever does not help with the symptoms
- Symptoms get worse
- You find yourself too breathless to speak, eat or sleep
An asthma attack can be very frightening so it is important to know what to do before it actually happens. Here is what to remember:
- Take your reliever immediately.
- Sit down and make sure any tight clothing is loosened. Do not lie down.
- If there is no immediate improvement, take one puff of inhaler every minute for five minutes or until your symptoms improve.
- If your symptoms do not improve within five minutes - or if you are in any doubt - seek medical advice. Do not worry about causing a fuss, even at night.
- If you do have to go to the hospital, take details of your medicine with you.
- Make sure you see your doctor or asthma nurse for a review, within 48 hours of the attack.
- Continue to take a puff of inhaler every minute until help arrives.