Asthma

What is asthma?

Asthma is a condition in which the airways that carry air in and out of the lungs become inflamed and sensitive. When something triggers this sensitivity, the airways narrow, the lining swells, and they may produce extra mucus, making it harder to breathe. This causes the characteristic symptoms of asthma and, in more serious episodes, an asthma attack.

Asthma often begins in childhood but can develop at any age. While there is no cure, it is a very manageable condition. With the right inhalers and an understanding of personal triggers, the large majority of people keep their asthma under good control and lead full, active lives.

Symptoms

Asthma symptoms vary from person to person and can range from mild to severe. They often come and go, and may be worse at night or early in the morning. Common symptoms include:

• •Wheezing — a whistling sound when breathing
• •Shortness of breath
• •A tight feeling in the chest
• •Coughing, often worse at night or with exercise
• •Symptoms triggered or worsened by specific things, such as exercise or allergens

Common triggers

Asthma symptoms are often set off by triggers, which differ between individuals. Identifying and, where possible, avoiding your triggers is an important part of control. Common triggers include:

• •Allergens — such as pollen, dust mites, animal fur and mould
• •Respiratory infections, like colds and flu
• •Exercise, especially in cold weather
• •Cold or dry air
• •Smoke, fumes and air pollution
• •Strong emotions and stress
• •Certain medications, in some people

Treatment and inhalers

Asthma is mainly treated with inhalers, which deliver medicine directly to the airways. There are two main types. Reliever inhalers (usually blue) are used when symptoms occur, quickly relaxing the airways. Preventer inhalers are used daily, even when well, to reduce the underlying inflammation and prevent symptoms developing — these are the foundation of good long-term control.

Using inhalers correctly, often with a spacer device, makes a big difference, so it is worth asking a nurse or pharmacist to check your technique. Most people with asthma have a personal asthma action plan agreed with their healthcare team, setting out daily treatment and what to do if symptoms worsen.

Living well with asthma

Good asthma control means having few or no symptoms, sleeping well, and being able to exercise and go about daily life normally. Taking your preventer inhaler as prescribed even when you feel fine, knowing and managing your triggers, attending regular asthma reviews, and keeping your reliever inhaler with you all support this.

It is important to recognise when asthma is not well controlled — needing your reliever inhaler often, waking at night, or symptoms limiting activity are all signs to see your doctor or nurse for a review, as treatment can usually be adjusted to regain control.

Asthma attacks: recognising and responding

An asthma attack is when symptoms suddenly worsen, with the airways narrowing significantly. Recognising the signs early and knowing how to respond can prevent an attack from becoming severe. Warning signs include your reliever inhaler not helping or being needed more than usual, increasing wheezing, coughing or chest tightness, and becoming breathless enough that talking, eating or sleeping is difficult.

Most people with asthma have a personal action plan agreed with their healthcare team, setting out exactly what to do as symptoms escalate. Typically this involves using your reliever inhaler as directed, sitting up rather than lying down, and trying to stay calm, as panic can worsen breathing. If the reliever is not helping, or symptoms are severe, it becomes a medical emergency requiring urgent help.

Signs that an attack is severe and needs emergency care include the reliever inhaler not working, being too breathless to speak in full sentences, breathing getting faster, or lips and fingers looking blue. In these situations, emergency services should be called without delay. Knowing these signs in advance, and having an action plan, helps you and those around you respond quickly and confidently.

Managing asthma triggers and the environment

Because asthma symptoms are often set off by triggers, managing your environment is an important part of keeping it controlled. While triggers vary, common ones can frequently be reduced with practical steps. For allergen triggers like house dust mites, regular cleaning, washing bedding at high temperatures and reducing soft furnishings can help. For those affected by animal fur, limiting pets' access to bedrooms may reduce symptoms.

Pollen, air pollution and cold air are harder to avoid entirely, but checking pollen forecasts, exercising indoors on high-pollution or very cold days, and covering the nose and mouth with a scarf in cold weather can all help. Avoiding tobacco smoke is particularly important, as both active and passive smoking significantly worsen asthma. Respiratory infections are a common trigger, so staying up to date with recommended vaccinations such as the flu jab is worthwhile.

Identifying your personal triggers — sometimes with the help of a symptom diary — allows you to focus your efforts where they matter most. Combined with taking preventer medication consistently, good trigger management helps keep asthma well controlled and reduces the likelihood of attacks.