Asthma is a common condition that affects your airways and causes difficulty with breathing. Most people with asthma who take the appropriate treatment can live normal lives, but left untreated, asthma can cause permanent damage to your airways. Very rarely, a severe asthma attack can be fatal.
Asthma affects over five million people in the UK, including over one million children. It often starts in childhood, but it can occur for the first time at any age. Adult-onset asthma can be caused by irritants in your workplace (occupational asthma), or can develop after a viral infection.
If you have asthma, your airways become irritated and inflamed. As a result, they:
This makes it more difficult for air to flow in and out of your lungs.
Asthma symptoms may be mild, moderate or severe. They may include:
These symptoms tend to be variable – not everyone gets all the symptoms and they may stop and start. They are often worse at night or in the early morning.
The causes of asthma are not always clear. However, there are often triggers that can result in a flare-up of symptoms. Common triggers include:
In children, asthma is more common in boys than in girls but in adults, women are more likely to have asthma. Asthma may run in families.
If you smoke during pregnancy, your baby is more likely to get asthma. If you smoke and have young children, they are more likely to get asthma. Premature or low birth weight babies are also more likely to develop asthma.
Your GP will ask if you have noticed any factors that trigger your symptoms.
Your GP may do one or more of the following tests to make a diagnosis.
In children under five, a diagnosis may be made just by seeing if they respond to asthma treatments.
There isn't a cure for asthma. However, treatments are available to help manage your symptoms. Your treatment plan will be individual to you, combining medicines and asthma management in a way that works best for you.
There are many types of inhalers that enable medication to be delivered directly into your airways. They may contain a dry powder or produce an aerosol of medication when you activate the device. The medicine is then inhaled into your airways. You will need to use your inhaler correctly in order for it to work properly, so ask your GP for advice.
There are two basic categories of inhaler medicines that are used for asthma:
You should use relievers when your asthma symptoms occur. They can be short- or long-acting. Short-acting relievers (known as bronchodilators) help to relax and widen (dilate) your airways. They contain medicines such as salbutamol (eg Ventolin) and terbutaline (eg Bricanyl) and quickly ease your symptoms.
If you need to use your reliever inhaler three or more times a week, your asthma may not be well controlled and your GP may need to review your symptoms.
If you're given a preventer, you should use it every day – even if you don't have symptoms – as the protective effect builds up over time.
Your GP will prescribe a preventer inhaler if you have any of the below.
Preventers usually contain a steroid medicine, such as beclometasone (eg Qvar) or fluticasone (eg Flixotide), that work to reduce the inflammation of your airways. It can take up to 14 days for preventer medicines to work, but once they do, you may not need to use your reliever inhaler at all.
A long-acting reliever can be added to your treatment if your symptoms aren't well controlled with a regular steroid (preventer) and occasional use of a short-acting reliever. They work in a similar way to short-acting relievers, but their effects last for longer – up to 12 hours, compared to four. Long-acting relievers contain medicines such as salmeterol (eg Serevent) or formoterol (eg Oxis). Often these medications are combined together with a steroid. This means both medicines are taken in one inhaler, such as in Symbicort, Seretide or Fostair inhalers.
If you use a gas propelled inhaler, you may also be given a spacer. Spacers are devices that can help you use your inhaler correctly and are particularly useful for children, or anyone who finds it difficult to use their inhaler when they have an asthma attack. Children as young as three can learn to use an inhaler with a spacer, and for babies and very young children a face mask can be attached. A spacer is a long tube which clips onto the inhaler. You breathe in and out of a mouthpiece at the other end of the tube. It's easier to use because it allows you to activate the inhaler and then inhale in two separate steps. Using a spacer also reduces your risk of getting a sore throat from using a steroid inhaler. When used correctly they can be as effective as nebulisers in the treatment of an acute asthma attack.
Nebulisers make a mist of asthma medicine that you breathe in. They can help to deliver more of the medicine to exactly where it's needed. This is particularly important if you have a severe asthma attack and you require emergency treatment in your home or hospital setting. However, if you use a spacer with your asthma medicines, it may be just as effective as a nebuliser at treating most asthma attacks. If your child has asthma, ask your GP for advice as a nebuliser may not be suitable.
If you own a nebuliser, make sure it’s serviced regularly, so it’s in good working order if you need to use it. Nebuliser servicing is available from some local lung function laboratories in hospitals, or from the equipment manufacturers.
If you have severe asthma symptoms, your GP may prescribe a course of steroid tablets such as prednisolone.
Several other medicines are available as tablets and inhalers if the standard treatments aren't suitable for you. These include montelukast (eg Singulair) or zafirlukast (eg Accolate).
You're having an asthma attack if any of the following happens:
If you have an asthma attack you should take the following steps.
If your symptoms improve and you don’t need to call an ambulance, make sure you see your GP or asthma nurse within 24 hours so he or she can review your treatment.
Medicines are only part of your treatment for asthma. You will also need to deal with the things that make it worse. Keep a diary to record anything that triggers your asthma – this can help you to discover a pattern. Using a peak flow meter to monitor your lung function can also help. If you have repeatedly low readings in a certain situation (for example, at the end of a working day, after exercise or after contact with an animal) this may indicate the trigger.
Stopping smoking is good for your health and will improve your asthma symptoms.
With good management and appropriate treatment, most people with asthma lead completely normal lives.
Produced by Rebecca Canvin, Bupa Health Information Team, September 2012.
For answers to frequently asked questions on this topic, see FAQs.
For sources and links to further information, see Resources.
This information was published by Bupa's Health Information Team and is based on reputable sources of medical evidence. It has been reviewed by appropriate medical or clinical professionals. Photos are only for illustrative purposes and do not reflect every presentation of a condition. The content is intended only for general information and does not replace the need for personal advice from a qualified health professional. For more details on how we produce our content and its sources, visit the about our health information page.
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