Asthma

Asthma is a condition in which your airways narrow and swell and may produce extra mucus. This can make breathing difficult and trigger coughing, a whistling sound (wheezing) when you breathe out and shortness of breath.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with daily activities and may lead to a life-threatening asthma attack.

Asthma can't be cured, but its symptoms can be controlled. Because asthma often changes over time, it's important that you work with your doctor to track your signs and symptoms and adjust your treatment as needed.

Symptoms

Asthma symptoms vary from person to person. You may have infrequent asthma attacks, have symptoms only at certain times — such as when exercising — or have symptoms all the time.

Asthma signs and symptoms include:

  • Shortness of breath
  • Chest tightness or pain
  • Wheezing when exhaling, which is a common sign of asthma in children
  • Trouble sleeping caused by shortness of breath, coughing or wheezing
  • Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Signs that your asthma is probably worsening include:

  • Asthma signs and symptoms that are more frequent and bothersome
  • Increasing difficulty breathing, as measured with a device used to check how well your lungs are working (peak flow meter)
  • The need to use a quick-relief inhaler more often

For some people, asthma signs and symptoms flare up in certain situations:

  • Exercise-induced asthma, which may be worse when the air is cold and dry
  • Occupational asthma, triggered by workplace irritants such as chemical fumes, gases or dust
  • Allergy-induced asthma, triggered by airborne substances, such as pollen, mold spores, cockroach waste, or particles of skin and dried saliva shed by pets (pet dander)

When should you see a doctor?

Severe asthma attacks can be life-threatening. Work with your doctor to determine what to do when your signs and symptoms worsen — and when you need emergency treatment. Signs of an asthma emergency include:

  • Rapid worsening of shortness of breath or wheezing
  • No improvement even after using a quick-relief inhaler
  • Shortness of breath when you are doing minimal physical activity

Contact your doctor...

  • If you think you have asthma. If you have frequent coughing or wheezing that lasts more than a few days or any other signs or symptoms of asthma, see your doctor. Treating asthma early may prevent long-term lung damage and help keep the condition from getting worse over time.
  • To monitor your asthma after diagnosis. If you know you have asthma, work with your doctor to keep it under control. Good long-term control helps you feel better from day to day and can prevent a life-threatening asthma attack.
  • If your asthma symptoms get worse. Contact your doctor right away if your medication doesn't seem to ease your symptoms or if you need to use your quick-relief inhaler more often.
  • Don't take more medication than prescribed without consulting your doctor first. Overusing asthma medication can cause side effects and may make your asthma worse.
  • To review your treatment. Asthma often changes over time. Meet with your doctor regularly to discuss your symptoms and make any needed treatment adjustments.

Causes

It isn't clear why some people get asthma and others don't, but it's probably due to a combination of environmental and inherited (genetic) factors.

Asthma triggers

Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:

  • Airborne allergens, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste
  • Respiratory infections, such as the common cold
  • Physical activity
  • Cold air
  • Air pollutants and irritants, such as smoke
  • Certain medications, including beta blockers, aspirin, and nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) and naproxen sodium (Aleve)
  • Strong emotions and stress
  • Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine
  • Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat

Risk factors

A number of factors are thought to increase your chances of developing asthma. They include:

  • Having a blood relative with asthma, such as a parent or sibling
  • Having another allergic condition, such as atopic dermatitis — which causes red, itchy skin — or hay fever — which causes a runny nose, congestion and itchy eyes
  • Being overweight
  • Being a smoker
  • Exposure to secondhand smoke
  • Exposure to exhaust fumes or other types of pollution
  • Exposure to occupational triggers, such as chemicals used in farming, hairdressing and manufacturing

Complications

Asthma complications include:

  • Signs and symptoms that interfere with sleep, work and other activities
  • Sick days from work or school during asthma flare-ups
  • A permanent narrowing of the tubes that carry air to and from your lungs (bronchial tubes), which affects how well you can breathe
  • Emergency room visits and hospitalizations for severe asthma attacks
  • Side effects from long-term use of some medications used to stabilize severe asthma

Proper treatment makes a big difference in preventing both short-term and long-term complications caused by asthma.

Diagnosis

See a GP if you think you or your child may have asthma. Several conditions can cause similar symptoms, so it's important to get a proper diagnosis and correct treatment.

The GP will usually be able to diagnose asthma by asking about symptoms and carrying out some simple tests.

Find out more about how asthma is diagnosed.

Treatment

Asthma is usually treated by using an inhaler, a small device that lets you breathe in medicines.

The main types are:

  • reliever inhalers – used when needed to quickly relieve asthma symptoms for a short time
  • preventer inhalers – used every day to prevent asthma symptoms occurring

Some people also need to take tablets.

Managing a lifestyle with asthma

While there's no way to prevent asthma, you and your doctor can design a step-by-step plan for living with your condition and preventing asthma attacks.

  • Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan.
  • Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life.
  • Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.
  • Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.
  • Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath.
  • But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter. A peak flow meter measures how hard you can breathe out. Your doctor can show you how to monitor your peak flow at home.
  • Identify and treat attacks early. If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control your symptoms.
  • When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed. Also, immediately stop any activity that may have triggered the attack. If your symptoms don't improve, get medical help as directed in your action plan.
  • Take your medication as prescribed. Don't change your medications without first talking to your doctor, even if your asthma seems to be improving. It's a good idea to bring your medications with you to each doctor visit. Your doctor can make sure you're using your medications correctly and taking the right dose.
  • Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn't under control. See your doctor about adjusting your treatment.

Why it’s important to manage your asthma

Getting into a good routine and managing your asthma well will mean:

  • You get no daytime symptoms
  • You get no night-time waking due to asthma
  • You don’t need to use reliever inhalers (usually blue)
  • You don’t have any asthma attacks and don’t need emergency treatment
  • Your lungs don’t suffer long-term damage
  • Asthma doesn’t limit your daily life (including working and exercising). 

If you’ve been diagnosed with severe asthma, please go to our severe asthma section as we have lots of special advice for you there.

Not sure how to manage your child’s asthma? Visit the following link on managing your child’s asthma for simple expert advice.

Asthma Attacks

Asthma attacks can be fatal – three people die from asthma attacks in the UK every day. If you're having an asthma attack, it is vital that you act immediately.


Follow this emergency advice if you experience an asthma attack:


You're having an asthma attack if you are experiencing any of these:

  • Your blue reliever isn't helping, or you need to use it more than every four hours
  • You're wheezing a lot, have a very tight chest, or you're coughing a lot
  • You're breathless and find it difficult to walk or talk
  • Your breathing is getting faster and it feels like you can't get your breath in properly

What to do in an asthma attack:

  • Sit up straight
    Don't lie down. Try to keep calm.
  • Take your blue inhaler
    Take one puff of your reliever inhaler every 30-60 seconds, up to a maximum of 10 puffs.
  • Call 999 if you don't feel better
    Do this if you feel worse at any point, or if you don't feel better after using 10 puffs of your reliever inhaler.
  • Take your blue inhaler again after 15 minutes
    If you're waiting for the ambulance for longer than 15 minutes, take one puff every 30-60 seconds, up to a maximum of 10 puffs. 

IMPORTANT: This asthma attack information is NOT for people on a SMART or MART regime. If you are on a SMART or MART regime, speak to your GP or asthma nurse to get the right asthma attack advice for you.


The early warning signs of an asthma attack – and how to stop it coming on:

Book an urgent appointment with your GP or asthma nurse if you are experiencing one or more of these signs:

  • Your symptoms are coming back (wheeze, tightness in your chest, feeling breathless, cough).
  • You’re waking up at night because of your asthma.
  • Your symptoms are getting in the way of your day-to-day routine (e.g. work, family life, exercising).
  • You need to use your reliever inhaler (usually blue) because of your asthma symptoms three times a week or more.

If you recognise any of these signs, they are telling you an asthma attack could be on its way. This is your chance to stop it coming on. Book an urgent appointment with your GP or asthma nurse or visit your local walk-in centre. They can help you to stop an asthma attack before it happens, or make it less serious so you don’t end up in hospital.

What to do after an asthma attack:

There are three key steps you'll need to take as soon as possible after an asthma attack. These will help stop you from having another attack. It's tempting to think that after an asthma attack you can go back to living your life as normal. Asthma attacks are not normal, even for people with asthma. You shouldn't have to accept them as part of your everyday life.

Additional Content

If you would like more educational material on the management and treatment of asthma, please click the links below:

Diet

Exercise

Smoking Cessation

Mental Health

Support

Inhalers

Child Asthma Attacks