Asthma is a common long-term condition that can cause coughing, wheezing, chest tightness and breathlessness.
The severity of these symptoms varies from person to person. Asthma can be controlled well in most people most of the time, although some people may have more persistent problems.
Occasionally, asthma symptoms can get gradually or suddenly worse. This is known as an “asthma attack”, although doctors sometimes use the term “exacerbation”.
Severe attacks may require hospital treatment and can be life threatening, although this is unusual.
What causes asthma?
Asthma is caused by inflammation of the small tubes, called bronchi, which carry air in and out of the lungs. If you have asthma, the bronchi will be inflamed and more sensitive than normal.
When you come into contact with something that irritates your lungs – known as a trigger – your airways become narrow, the muscles around them tighten, and there is an increase in the production of sticky mucus (phlegm).
Common asthma triggers include
- house dust mites
- animal fur
- pollen
- cigarette smoke
- exercise
- viral infections
The reason why some people develop asthma is not fully understood, although it is known that you are more likely to develop it if you have a family history of the condition.
Asthma can develop at any age, including in young children and elderly people.
Who is affected?
In the UK, around 5.4 million people are currently receiving treatment for asthma.
That’s the equivalent of 1 in every 12 adults and 1 in every 11 children.
Asthma in adults is more common in women than men
Symptoms
The symptoms of asthma can range from mild to severe. Most people will only experience occasional symptoms, although a few people will have problems most of the time.
The main symptoms of asthma are
- wheezing (a whistling sound when you breathe)
- shortness of breath
- a tight chest – which may feel like a band is tightening around it
- coughing
These symptoms are often worse at night and early in the morning, particularly if the condition is not well controlled. They may also develop or become worse in response to a certain trigger, such as exercise or exposure to an allergen.
When to speak to your GP
You should speak to your GP if you or your child
- have asthma symptoms
- have asthma and treatments are not helping, you’re needing to use your inhaler more often, or you need advice about using your inhaler
- have asthma and your symptoms are not improving or are stopping you doing your usual activities or waking you up at night
- have symptoms that are worse at work and get better on holiday – asthma may be triggered by substances (allergens or chemicals) inhaled there
Asthma attacks
When asthma symptoms get significantly worse, it is known as an asthma attack or “acute asthma exacerbation”.
Asthma attacks often develop slowly, sometimes taking a couple of days or more to become serious, although some people with asthma are prone to sudden, unexpected severe attacks.
It is important to recognise attacks early and take appropriate action.
How to recognise an asthma attack
During an asthma attack, the symptoms described above may get worse and – if you’re already on treatment – your inhaler medication may not work as well as it normally does.
You might be monitoring your asthma using a device called a peak flow meter, and there may be a drop in your peak expiratory flow.
What to do if you or your child are having an asthma attack
Don’t ignore it.
Contact your GP or asthma clinic as soon as possible, or consult and use your asthma action plan if you have one.
Signs of a particularly severe asthma attack can include
- your reliever inhaler (which is usually blue) is not helping symptoms as much as usual, or at all
- wheezing, coughing and chest tightness becoming severe and constant
- being too breathless to eat, speak or sleep
- breathing faster
- a rapid heartbeat
- feeling drowsy, exhausted or dizzy
- your lips or fingers turning blue (cyanosis)
Call 999 to seek immediate help if you or someone else has symptoms of a severe asthma attack.
Inhalers
Asthma medicines are usually given by inhalers – devices that deliver medication directly into the lungs as you breathe in.
Who is at risk?
Although the cause of asthma is unknown, a number of things that can increase your chances of developing the condition have been identified.
These include
- a family history of asthma or other related allergic conditions (known as atopic conditions) such as eczema, food allergyor hay fever
- having another atopic condition
- having bronchiolitis (a common childhood lung infection) as a child
- childhood exposure to tobacco smoke, particularly if your mother also smoked during pregnancy
- being born prematurely, especially if you needed a ventilator to support your breathing after birth
- having a low birth weight as a result of restricted growth within the womb
Some people may also be at risk of developing asthma through their job.
Asthma triggers
Likely asthma triggers to look out for
Respiratory tract infections
Particularly infections affecting the upper airways, such as colds and the flu
Allergens
Including pollen, dust mites, animal fur or feathers
Airborne irritants
Including cigarette smoke, chemical fumes and atmospheric pollution
Medicines
Particularly the class of painkillers called non-steroidal anti-inflammatory drugs (NSAIDs), which includes aspirin and ibuprofen, and beta-blockers sometimes given for high blood pressure or some types of heart disease
Emotions
Including stress or laughing
Foods containing sulphites
Naturally occurring substances found in some food and drinks, such as concentrated fruit juice, jam, prawns and many processed or pre-cooked meals
Weather conditions
Including a sudden change in temperature, cold air, windy days, thunderstorms, poor air quality and hot, humid days
Indoor conditions
Including mould or damp, house dust mites and chemicals in carpets and flooring materials
Exercise
Food allergies
Including allergies to nuts or other food items
Once you know your asthma triggers, you may be able to help control your condition by trying to avoid them.
Occupational asthma
In some cases, asthma is associated with substances you may be exposed to at work. This is known as occupational asthma.
Some of the most commonly reported causes of occupational asthma include exposure to:
- isocyanates (chemicals often found in spray paint)
- flour and grain dust
- colophony (a substance often found in solder fumes)
- latex
- animals
- wood dust
You may be at an increased risk of developing occupational asthma if you are regularly exposed to substances such as these through your work.
Occupations that are commonly associated with the condition include
- paint sprayers
- bakers and pastry makers
- nurses
- chemical workers
- animal handlers
- welders
- food processing workers
- timber workers
Outlook
For many people, asthma is a long-term condition – particularly if it first develops in adulthood.
Asthma symptoms are usually controllable and reversible with treatment, although some people with long-lasting asthma may develop permanent narrowing of their airways and more persistent problems.
For children diagnosed with asthma, the condition may disappear or improve during the teenage years, although it can return later in life. Moderate or severe childhood asthma is more likely to persist or return later on.