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Asthma is a chronic problem categorised by repeated attacks of breathlessness and wheezing. Asthma currently affects over 235 millions people according to the World Health Organisation. Although asthma cannot bed cured, it can be managed

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What is asthma?

Asthma is a respiratory condition affecting the lungs. It causes the lungs and airways to become inflamed, leading to difficulty breathing. The symptoms include wheezing, coughing, breathlessness and chest tightness. An inhaler is used to clear the airways, ease breathing and prevent and treat asthma attacks. Asthma is a long term condition that usually begins in childhood but it can affect anyone at any age. 

How common is asthma?

Asthma is a common condition which affects around 1 in 11 people within the UK and roughly 1 in 5 households. 

What are the different types of asthma?

There are several different types of asthma. They differ due to specific triggers or the age or circumstance in which it developed. The different types of asthma are: 

  • Childhood asthma- this is where asthma begins during childhood
  • Adult onset asthma- this is where asthma develops during adulthood
  • Occupational asthma- this occurs due to factors in the workplace such as exposure to harmful chemicals or dust
  • Allergic asthma- this type of asthma is triggered due to coming into contact with an allergen
  • Seasonal asthma- some people only experience asthma during the winter months, or the summer if they have hay fever 
  • Severe asthma- this affects around 17% of people with asthma and describes people who struggle with their symptoms all the time and do not find relief from inhalers alone

What is an asthma attack?

During an asthma attack, the muscles around the airways tighten and make it difficult to breathe. The symptoms include:

  • Worsening of asthma symptoms- coughing, wheezing, chest tightness and breathlessness 
  • Having difficulty catching your breath 
  • Being too breathless to speak or eat
  • Your blue reliever inhaler is not providing relief 
  • You have a lower peak flow than usual 
  • A tummy or chest ache in children

An asthma attack is a medical emergency. If you, or anyone around you, has one then call 999 for an ambulance.  

How to live with asthma

Learning to manage your asthma will help you to lead a normal, happy life. If you have been prescribed a preventer inhaler, ensure you use this correctly everyday to widen the airways and reduce inflammation so you can breathe properly. Quitting smoking will help as this exacerbates asthma and is a major trigger for symptoms. Getting active and eating a healthy diet will help you to take care of yourself. It's advisable to get the annual flu jab if you have asthma, as the flu can cause difficulties for asthma sufferers. Keeping a diary to record where and when your symptoms flare up is a helpful way to identify what your triggers are. Once you know what they are, you can take steps to either avoid them or manage them accordingly. 

What can trigger an asthma attack?

Exposure to asthma triggers can cause an asthma attack. These include: 

  • Allergic reactions such as pollen, dust mites or pet dander
  • Exercise 
  • Cold weather
  • Smoking
  • Pollution 
  • The cold or flu
  • Strong emotions 

You should always carry your reliever inhaler with you in case an attack should occur. 

Symptoms

What are the symptoms of asthma?

The symptoms of asthma are: 

  • Breathlessness 
  • Wheezing
  • Coughing 
  • A tight feeling in the chest

How is asthma diagnosed?

Asthma is usually diagnosed by a GP but occasionally you may be referred to a specialist for a second opinion. They will discuss the symptoms you are experiencing, when they occur and if there is anything triggering them. They may ask if you have a family history of asthma or allergies. They will also get you to do some tests to determine whether or not you have asthma. These include: 

  • Peak flow test: this measures how fast you can breathe out. You will usually take the plastic device home to measure this over a couple of weeks and determine your peak flow score
  • Spirometry: this involves blowing into a device resembling a plastic tube which measures how much air your lungs can hold
  • FeNo test: this is a machine you blow into which will measure how much nitric oxide is in your breath. This is usually a sign of an allergic response causing lung inflammation

Asthma vs COPD

Asthma is a long term respiratory condition which can occur at any age. It causes inflammation in the lungs and airways, resulting in breathing difficulties. It can be triggered by many things including allergies, cold weather, viruses or exercise. Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term for a group of progressive lung conditions including emphysema and chronic Bronchitis. While the symptoms of COPD are similar to those of asthma, the condition is caused by damage to the lungs, the most common cause of which is smoking.

Treatment

How is asthma treated?

Asthma is mainly treated through the use of an inhaler which allows you to inhale medicine to help you breathe and alleviate symptoms. In the first instance you will be given a blue reliever inhaler which is used to ease symptoms as they occur. If you are using this more than twice a week then you will be prescribed with a preventer inhaler which is used daily to stop symptoms from flaring up. In more serious cases oral medication is given if inhalers alone are not enough to manage your asthma.

How to prevent asthma

It's impossible to prevent asthma but you can learn to manage the condition effectively to prevent your symptoms from flaring up. The best way to do this is to identify what your triggers are. These are things which cause your symptoms to flare up. The most common ones are allergies such as hay fever, animal hair or dust mites, the cold or flu virus, cold weather, damp, exercise, smoking and polluted air. If hay fever causes your asthma to worsen, then you may want to try antihistamines alongside your inhaler for example. Having regular check ups with your GP, using your inhaler correctly and avoiding smoking are all important steps to keeping your asthma under control.

How to manage asthma

There is no cure for asthma but with adequate treatment you can manage the condition so that it provides as little disruption as possible to your life. The first thing to do is to follow the action  plan provided to you by your GP and make sure you know how to use your inhaler correctly. Poor technique means not all the medicine is being distributed to your lungs so you won't be getting the full benefit. Keeping a diary to record when your symptoms occur and the details of your surrounding environment will help to identify what your triggers are. This goes a long way to managing your asthma as you can then take steps to prevent symptoms. If you have been prescribed a preventer inhaler, using it everyday will reduce inflammation in the airways and stop symptoms from flaring up. It's important to keep using it, even when you are feeling well.   

What are the different types of asthma inhaler?

There are two main types of asthma inhalers. The primary inhaler that every person diagnosed with asthma will get is a reliever inhaler. This is usually blue in colour and contains a medicine called Sambutol which may be called by various brand names such as Ventolin. These inhalers are used to relieve symptoms as they occur or to treat an asthma attack. The second type of inhaler is known as a preventer inhaler. This will be given to asthma patients who make use of their reliever inhaler three times a week or more. Often brown in colour, this inhaler is used twice daily to prevent asthma symptoms. It cannot be used to treat an asthma attack. Combination inhalers are also available to treat more severe asthma. These have a dual action and contain two types of medicine.      

How to cope with an asthma attack

An asthma attack can be fatal and it's a frightening thing to experience. Knowing what to do in the event of an asthma attack is important to help you remain calm and treat it properly. The signs of an asthma attack are: 

  • You are wheezing or coughing a lot and your chest feels very tight
  • Your reliever inhaler isn't helping 
  • You are too breathless to walk or talk
  • Your breath is faster than usual and you find it difficult to catch your breath 

Take action right away if you are having an asthma attack. Sit up straight and take a puff of your blue inhaler. Do this every 30-60 seconds until you reach a maximum of ten puffs. Call 999 if this does not help, or if you feel your symptoms are worsening at any point. If you are in any doubt then call 999 right away. If it has been more than 15 minutes since you took a puff of your inhaler, then repeat the first steps while you are waiting for help to arrive. 

After having an asthma attack, make an appointment to see your GP as soon as possible and inform them you had an asthma attack. You should do this even if you received treatment at a hospital. 

How to help children with asthma

If your child has asthma, there are lots of ways you can help them to manage it. Having a copy of their asthma action plan visible to everyone in the household, printing off copies to give to school teachers or friend's parents will ensure that they know what to do in case an asthma attack should occur. Get them into a good routine with using their inhaler and noticing symptoms. Encouraging them to use an asthma chart can help to identify what their triggers are. You can assist them to use their inhaler with a spacer. This is easier for children to manage as it means they don't have to breathe in at the same time as pressing down on the canister.

How to help someone with their inhaler

If someone is experiencing breathlessness or an asthma attack they may need help using their inhaler. Reassure the person and get them to sit up straight and talk to them in a calm manner. Ask them where you can find their blue inhaler and locate it for them. Shake the inhaler and remove the cap. Guide them to breath out as steadily as they can before getting them to seal their lips around the mouthpiece. Next they will need to press down on the canister and breathe in at the same time, holding their breath for up to ten seconds or for as long as they can manage before exhaling. If they need to take another puff, wait at least 30 seconds before repeating.

Can exercise improve asthma?

Regular exercise can have a positive effect on asthma. It will help to improve the functioning of the lungs and increase stamina to allow your breathing to get easier. It also boosts the immune system which means the body can fight off infections or viruses which may contribute to triggering your asthma symptoms.   

Side Effects

Are asthma inhalers safe to use during pregnancy?

Asthma inhalers are safe to use during pregnancy. It's very important to manage your asthma and keep taking your medication if you are pregnant. For some women with asthma, their condition gets worse during pregnancy. Using your inhaler regularly ensures that you are keeping both yourself and your baby healthy.  

Q&A

What is exercise induced asthma?

There are many different types of asthma which are triggered by certain environmental factors or activities. Exercise induced asthma is when physical exertion triggers asthma symptoms either during or after strenuous exercise. 

Can some medications cause asthma?

Certain types of medications can trigger asthma symptoms. These include Beta blockers, Aspirin, anti-inflammatory painkillers and ACE inhibitors. If you are purchasing over the counter medicines then always check the instructions to ensure they are suitable for people with asthma.

What is the connection between asthma and eczema?

Scientific studies indicate that children with eczema are 50-70% more likely to develop asthma. This is thought to be due to a protein called thymic stromal lymphopoietin which is produced by skin which does not have a protective barrier against dermatological problems. The TSL protein has been linked to triggering asthma symptoms.

Is asthma caused by lifestyle?

The cause of asthma is not known. There are many factors outwith someone's control which contribute to a person developing the condition. These include genetics, allergies, childhood bronchitis, being born prematurely and being exposed to tobacco smoke as a young child or while in the womb. 

Is asthma caused by allergies?

People with allergies are more likely to develop asthma and coming into contact with an allergen is a major trigger for asthma symptoms. These commonly include hay fever, dust mites, animal fur or food allergies. 

Can asthma be cured?

There is no cure for asthma. It is a long term condition that is managed with appropriate treatment to prevent flare ups and help you lead a normal, fulfilling life. 

Can stress cause an asthma attack?

Stress is a common trigger for asthma symptoms. It can lead to feelings of anxiety which produce physical symptoms such as a racing heart, sweating, dry mouth and breathlessness. This can escalate into a panic attack which causes difficulty breathing. If you have asthma, this can trigger an asthma attack. In general, stress can make your body more susceptible to common asthma triggers, especially if you are feeling run down, in turn causing an asthma attack.

Is asthma genetic?

Asthma is not always genetic but if there is a family history of asthma then you are more likely to develop it.

Does city pollution cause asthma?

Pollution is a common trigger which can cause asthma symptoms to flare up. It may not be possible to avoid this but managing your asthma by using your preventer inhaler correctly every day means that you won't have to worry about symptoms.

Can air purifiers and dehumidifiers help asthma sufferers?

Air purifiers and dehumidifiers are both helpful for asthma sufferers. An air purifier traps allergens like pollen or dust through a filter which reduces the likelihood of breathing them in. A dehumidifier reduces moisture caused by humidity which allow mold or bacteria to grow. Both these devices help to create a cleaner environment which does not cause irritation to the airways and lungs. 

Are asthma inhalers steroids?

Preventer inhalers contain corticosteroids. These are a type of steroid which fight inflammation to open the airways. They are not the same as anabolic steroids which are used in bodybuilding. 

Are asthma inhalers vegan?

Many asthma inhalers contain lactose which means they technically aren't vegan. However, a vegan outlook aims to avoid all animal derived products ‘as far as practical and possible.’ Inhalers only contain trace amounts of lactose. Where a lactose free medication is not available, it's important to still use your inhaler as it can be life saving. 

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