Asthma explained

Asthma is a condition that affects the airways. During an asthma flare-up, the muscles around the airways tighten, and the lining of the airways becomes swollen and inflamed, producing sticky mucus. These changes narrow the airways and make it difficult to breathe.

Asthma cannot be cured, but with good management most people with asthma can lead normal, active lives. A range of programs and services is available to support people with asthma.

Symptoms#

Typical asthma symptoms include:

• wheezing — a whistling noise when breathing
• shortness of breath
• a tight feeling in the chest
• coughing

These symptoms are often worse at night, in the early morning or during exercise. Symptoms may be different in children.

What triggers asthma#

Asthma tends to run in families, and it affects everyone differently — two children from the same family can have different asthma patterns and triggers. The factors that bring on symptoms also vary from person to person. Common triggers include:

• allergens such as house dust mites, pollens, pets and molds
• cigarette smoke
• viral infections, such as colds and flu
• cold air or changes in the weather
• work-related triggers, such as wood dust, chemicals or metal salts
• exercise
• some medications

Thunderstorm asthma#

Asthma can sometimes be triggered by a combination of high grass pollen levels and a certain type of thunderstorm, causing many people to develop symptoms over a short period. This is known as thunderstorm asthma. These events are uncommon and do not happen every year, but when they do they can occur during the grass pollen season, and can be sudden, serious and even life threatening.

Having good control of your asthma and hay fever helps reduce your risk. If you have ever had asthma, allergic rhinitis or hay fever, talk to your doctor about how to protect yourself during the pollen season.

How asthma is diagnosed#

There is no single test for asthma; doctors make the diagnosis based on your symptoms and tests of how well your lungs work.

Lung function is often tested using a spirometer. Spirometry measures the amount of air you can breathe in and out, and how hard and fast you can breathe out. You blow into a tube as forcefully as you can for a few seconds, and the machine measures the volume of air, your lung capacity and other values. Most adults and children over 6 years of age can do the test correctly.

Treatment#

Asthma can be well controlled with the right medication. The main types are:

• Relievers — act quickly to relax the muscles around the airways. This is the medication used during an asthma attack.
• Preventers — work slowly to make the airways less sensitive to triggers and reduce inflammation. They are taken daily to help keep you well.
• Combination therapies — preventers that contain two or three different medicines.
• Add-on medications — used to help manage severe asthma, and may include monoclonal antibodies.

Your doctor will prescribe the correct medication and explain how to use it.

Managing your asthma#

For good asthma control, it is important to:

• see your doctor for regular check-ups and work together to manage your asthma
• understand your triggers (which can be different for everyone) and try to avoid or reduce your exposure to them
• use your medications as instructed, even when you feel well
• make sure you use your inhaler correctly, including a spacer and mask where required
• ask your doctor for a personal written asthma action plan

As well as reminding you of your usual treatment, an action plan helps you recognize worsening asthma and tells you what to do in response. If your child has asthma, give copies of their action plan to the school and to anyone else who regularly looks after them.

Asthma attacks and first aid#

An asthma attack can come on gradually (for example, with a cold) or quite quickly (for example, after inhaling something you are allergic to, such as pollen). Symptoms to look out for include increased wheezing, shortness of breath, chest tightness and coughing, needing to use a reliever again within 3 hours of last taking it, and waking often at night with symptoms.

An asthma attack can become life threatening if not treated properly, even in someone whose asthma is usually mild or well controlled.

If someone is having an asthma attack, follow the instructions in their asthma action plan. If they do not have one, or you are not sure what to do, follow the standard steps of asthma first aid: help the person sit upright and stay calm, and give 4 puffs of reliever medication, taking one puff at a time, then wait and repeat as needed (a common approach is 4 puffs every 4 minutes).

In an emergency, always call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) and ask for an ambulance. Tell the operator that someone is having an asthma attack. Signs of an asthma emergency include when the person:

• is getting little or no relief from their reliever inhaler
• finds it very difficult to breathe
• is unable to speak in full sentences, or only manages one or two words per breath
• has lips that are turning blue
• has symptoms that get worse very quickly

While waiting for the ambulance, continue to follow the steps of asthma first aid.

Some facts about asthma#

• Asthma is one of the most common reasons for children to be admitted to hospital.
• It is more common among boys than girls in primary-school-age children, but after the teenage years more women have asthma than men.
• Asthma is more common in some populations than in the general population.
• People with asthma commonly have other allergic conditions, such as eczema or hay fever, and often report poorer general health and quality of life than people without asthma.
• Asthma is a major public health priority in many countries.

Key Points#

• Inflammation and tightening narrow the airways, making it difficult to breathe.
• Typical symptoms include coughing, wheezing, shortness of breath and chest tightness.
• Symptoms are often worse at night, in the early morning or during exercise.
• Triggers vary from person to person and can include allergens, smoke, infections, weather and some medications.
• Use a written asthma action plan, and call for emergency help if someone shows signs of an asthma emergency.

Where to get help and trusted information#

For evidence-based global health guidance, see Source: World Health Organization (WHO).