FAQs about asthma

·         What is asthma?

·         What causes asthma?

·         What are the things that can set off (or trigger) asthma symptoms?

·         How might asthma affect my lifestyle?

·         How is asthma treated?

·         Why can't I take tablets to control my asthma?  

·         Helping you to control your asthma

·         How do I know if my symptoms are getting worse?

·         What you must do during an attack

What is asthma? 

Asthma is a condition that affects the airways - small tubes that carry air in and out of the lungs.  When a person with asthma comes into contact with an asthma trigger, the muscle around the wall of the airways tightens so that the airway becomes narrower.  The lining of the airways becomes inflamed and starts to swell.  Often sticky mucus of phlegm is produced.  All these reactions cause the airways to become narrower and irritated - leading to the symptoms of asthma.

The common symptoms of asthma are:

• coughing
• wheezing or a whistling noise in the chest
• getting short of breath
• a tight feeling on the chest 

 What causes asthma?

Asthma can start at any age.  It is difficult to know what causes asthma, but so far we know that:

• asthma can be irritated
• many aspects of modern lifestyles - such as changes in housing and diet and a more hygienic environment - may have contributed to the rise in asthma
• smoking during pregnancy increases the chance of a child developing asthma
• second-hand smoke increases the chance of developing asthma
• irritants in the work place may lead to a person developing asthma
• environmental pollution can make asthma worse, but it has not been proven to cause asthma

What are the things that can set off (or trigger) asthma symptoms?

A trigger is anything that irritates the airways and causes the symptoms of asthma to appear.  Everyone's asthma is different and you will probably have several triggers.  Common triggers include colds or flu, tobacco smoke, exercise and allergies to things like pollens, furry or feathery animals or house-dust mites.

How might asthma affect my lifestyle?

Some people may have to change parts of their lifestyle because of worsening asthma symptoms.  It can be difficult to identify exactly what triggers your asthma.  Sometimes the link is obvious, for example when your symptoms start within minutes of coming into contact with a cat or pollen.  Some people have a delayed reaction. By avoiding the triggers that make your asthma symptoms worse, and by taking your asthma medicines correctly, you can reduce unnecessary symptoms and continue to enjoy your usual lifestyle.

How is asthma treated?

There are some excellent treatments available to help you to control your asthma.  The most effective way of taking most asthma treatments is to inhale the medicine so it gets straight into your lungs.  There are a variety of inhalers available and it is important that you use a device that you are comfortable with and can use properly.  Your doctor or nurse will advise you on the most appropriate device and should demonstrate how to use it correctly.

There are two main types of asthma medicine - relievers and preventers:

• Reliever inhalers are usually blue and you take them to relieve symptoms.  They work quickly by relaxing the muscles surrounding the narrowed airways.  They are essential in treating asthma attacks.  If you need to use your reliever inhaler 3-4 times in a week, you should go back to your doctor or nurse and have your symptoms reviewed so that they can be kept under control
• Preventers usually come in brown, red, or orange inhalers.  They work by controlling the swelling and inflammation in the airways, stopping them from being so sensitive and reducing the risk of severe attacks.  They build up over a period of time so they need to be taken every day, usually morning and evening, even when you are feeling well.  Most preventers contain a steroid medicine.  It is important to understand that it is not the same as anabolic steroids used by athletes to improve their performance.

There are other types of medicine that can be added to your reliever and preventer inhaler if needed.  For information about new medicines that may be more effective for you, speak to your doctor or nurse.

Why can't I take tablets to control my asthma?

The most effective way of taking most asthma treatments is to inhale the medicine so it gets straight into the lungs.  Most preventer treatments contain steroids and taking them by inhalers means that a much lower dose of the steroid can be used and because the inhaled medicine goes straight down to the airways where it is needed, very little is absorbed into the rest of the body.

When steroids are taken in tablet form the dose is much higher (one steroid tablet gives 50 times the dosage of a puff from a standard steroid inhaler) and most of it will be absorbed into the rest of the body, not just your lungs.  Using steroid tablets regularly for long periods of time (months or years) can have serious side effects such as brittle bones (osteoporosis), bruising easily, diabetes, cataracts, increased hunger, heartburn and indigestion.  They may make you feel depressed, or have mood swings or a fattened face.

Helping you to control your asthma

To help you to control your asthma symptoms, your doctor or nurse should discuss with you the best way you can control your symptoms and as part of this should give you a written record of your asthma medicines and what to do if your symptoms get worse.  At your review, ask them for an asthma card and a personal asthma action plan.

How do I know if my symptoms are getting worse?

If your symptoms are getting worse you may recognise some or all of the following:

• needing more and more reliever treatment
• waking at night with coughing, wheezing, shortness of breath or a tight chest
• having to take time off work because of your asthma
• feeling that you cannot keep up with your normal level of activity or exercise

If you experience any of the above you should visit your doctor or nurse to get your asthma back under control.

What you must do during an attack

• Take two puffs of your reliever (blue) inhaler
• Sit up and loosen tight clothing
• If no immediate improvement during an attack, continue to take one puff of reliever inhaler every minute for five minutes or until symptoms improve
• If your symptoms do not improve in five minutes - or if you are in doubt - call 111 or a doctor urgently especially if:
• You are too breathless or exhausted to talk
• Your lips are blue