FAQs about asthma

Asthma is a condition that affects the airways – the 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 walls of the airways tightens so that the airway becomes narrower. The lining of the airways becomes inflamed and starts to swell. Often sticky mucus or 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 in the chest.

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

• asthma can be inherited
• 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 workplace may lead to a person developing asthma
• environmental pollution can make asthma symptoms worse, but it has not been proven to cause asthma.

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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 pollen, furry or feathery animals or house-dust mites.

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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.

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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 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. Their effect builds 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, such as preventer tablets and long-acting relievers. For information about new medicines that may be more effective for you, speak to your doctor or nurse.

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Many people with asthma use a preventer that contains a low dose of inhaled steroid. Here are some points to remember:

• The steroids used to treat asthma are corticosteroids – a copy of the steroids produced naturally in your body.
• They are completely different to the anabolic steroids used by bodybuilders and athletes.
• Inhaled steroids go straight down to the airways, so very little is absorbed into the rest of the body.
• Your doctor will prescribe the lowest possible dose.
• Children should be monitored closely, especially for growth.

Occasionally, if your asthma symptoms become severe, your doctor may give you a short course of steroid tablets. They work quickly and powerfully to help to calm down your inflamed airways. Short courses of tablets, anything from 3–14 days, will not give any long-term side effects. Steroid tablets can lower the body's resistance to chickenpox, so you should contact your doctor if you are taking steroid tablets and come into contact with chickenpox.

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The most effective way of taking most asthma treatments is to inhale the medicine so it gets straight into your lungs. Most preventer treatments contain steroids and taking them by inhaler 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 (moon face).

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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 medicine card and a personal asthma action plan.

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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 of 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.

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• 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 999 or a doctor urgently, especially if:

• You are too breathless or exhausted to talk
• Your lips are blue.

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This is one of the main concerns of many women with asthma. Like other allergic conditions, such as hay fever and eczema, asthma often runs in the family, but asthma is a complex condition and other genetic and environmental factors determine whether a child goes on to have asthma.

Research funded by Asthma UK is suggesting that reducing exposure to allergens such as house-dust mite and furry pets (such as cats and dogs) during pregnancy and the first year of the baby's life might reduce the risk of your baby developing asthma. Some, but not all, studies have shown that breast-feeding in the first few months of life may reduce the chance of your baby developing allergic conditions, including asthma.

Studies have also shown that mothers who do not smoke during pregnancy are less likely to have children that develop asthma and wheezing in infancy.

Your asthma treatment won't harm your baby - in fact, your baby will do best if you are breathing well and easily, so it is important that your asthma is well controlled.

If you are concerned about your asthma, speak to your doctor, nurse or midwife.

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For confidential and independent advice about asthma, phone the Asthma UK Adviceline to speak to our asthma nurse specialists through an interpreter.

Asthma UK Adviceline
08457 01 02 03
9am-5pm, Monday–Friday
Calls charged at local rates (UK only)

You can also email an asthma nurse specialist using the form below.

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To reach people with asthma whose first language is not English, we are keen to recruit volunteers who are fluent in English and languages other than English. To discuss ways you can help us, please contact Claire Randolph, Community Development & Volunteering, 020 7786 4922, volunteer@asthma.org.uk.

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