Guide by Condition: Asthma
Posted by Mike Phipps on July 20, 2021
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Asthma is a chronic lung condition that affects airways and lung function.
Airway tubes carry air in and out of the lungs. Asthma causes the airways to sometimes become inflamed, resulting in them becoming narrower. The cells lining the airways then produce more mucus causing a shortness of breath and a reduced lung function.
Asthma can impact anyone, regardless of their age.
According to Asthma UK, 5.4 million people in the UK are currently being treated for asthma – this includes 1.1 million children. Additionally, around 200,000 people have asthma that is so severe that they are left incapacitated to some degree. This is most commonly a result of an ineffective response to what is considered a standard asthma treatment.
The causes of asthma can vary between individuals. It is important to note the difference between the causes of asthma and the triggers of asthma.
Causes are the factors that lead to someone being diagnosed with asthma. Triggers are what can cause a person already diagnosed to have an asthma attack, or flare-up.
If there are people with asthma, or allergies, in someone’s family history, then the chances of someone developing asthma within that group are increased.
Environmental factors are also believed to have an impact on whether a person develops asthma, or not. Examples of this are air pollution from traffic and air pollution from chemical plants. Furthermore, there are added hazards that can result in Occupational Asthma.
There are numerous triggers that can bring on an asthma attack. In some cases, asthma attacks can be life threatening.
Asthma in children is prevalent. Certain triggers can make it more likely for a child to develop asthma. These include smoking whilst pregnant, premature birth (before 37 weeks) and bronchiolitis.
Asthma is a long term condition and there aren’t any cures, but there are various mobility aids that lessen the impact of having an asthma attack.
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As is common with a multitude of conditions, there are various types of asthma that can affect a person differently. These types require slightly different ways of managing the condition more effectively.
Asthma can be categorised into 4 stages which are used to determine its severity. They are – Mild Intermittent, Mild Persistent, Moderate Persistent and Severe Persistent.
Mild Intermittent Asthma
Mild Intermittent Asthma usually only requires one inhaler for times when symptoms flare-up causing an asthma attack, this is called a rescue-inhaler. The asthma symptoms tend to be mild and flare-ups tend to happen as infrequently as between 2 days a week to 2 nights per month.
Mild Persistent Asthma
Mild Persistent Asthma typically means a person’s symptoms are much milder, but they are likely to occur more frequently than twice a week. The treatment required for this asthma is a low-dose inhaler that is to be used once a day alongside another inhaler, in case the asthma symptoms worsen.
Moderate Persistent Asthma
Moderate Persistent Asthma affects a person much more than the previously mentioned stages. If a person has Moderate Persistent Asthma, the symptoms are more prevalent in day-to-day life and symptoms will be present every day, if not most days. Additionally, this will affect a person at least one night a week. To manage and treat this type of asthma, a doctor will prescribe a higher dose inhaler with a rescue-inhaler to treat potential asthma attacks.
Severe Persistent Asthma
Severe Persistent Asthma causes symptoms throughout the day and most nights. It can be challenging to treat this form of asthma attack, as it doesn’t always respond to any asthma medications prescribed.
A doctor may prescribe a combination of medicines to treat the condition. This can include oral corticosteroids and inhaled corticosteroids at a higher dosage than is used for other forms of asthma, as well as a rescue inhaler – Severe Persistent Asthma can be life threatening.
Whilst some causes are unknown as to why people develop asthma, particularly in the western hemisphere, the following known causes can correspond with each type of asthma:
- being overweight
- smoking, or second-hand smoking
- exposure to chemicals
- exposure to pollution, or fumes.
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The signs and symptoms of asthma are relatively the same regardless of the triggers, or type. It is important to look out for these signs and symptoms of asthma to ensure a person can be diagnosed and treated effectively.
Effects of asthma include:
- swollen airways
- chest pain, or tightness and
- mucus in the airways.
Signs and symptoms of an asthma attack:
- breathing faster
- a fast heartbeat
- a shortness of breath
- a wheezing, coughing and a chest tightness that is constant and severe
- being too breathless to eat, or sleep
- blue lips, or fingers
- drowsiness, or confusion
- exhaustion, or dizziness.
According to Asthma UK, an average of 3 people lose their lives every day in the UK from an asthma attack. Although there is treatment available so that the condition can be managed, there isn't currently a cure, so things that trigger asthma play a vital role in controlling and keeping the risks of an asthma attack low.
Triggers are relative to each individual asthma patient and vary from person to person. Depending on the type of trigger, some are easier to control than others.
If a person has a preventative inhaler, it is important to take the recommended dose to lower the chances of a reaction to a trigger, especially where avoiding triggers can’t be done. Common asthma triggers/risk factors include pollen, cigarette smoke, colds, viruses, pets and cold air.
Exercise is vital for maintaining a healthy lifestyle both physically and mentally, but exercise-induced asthma also exists.
Indoor asthma triggers consist of a variety of elements that can affect those with asthma inside buildings. This is because air circulation may not be as good indoors, especially depending on the size of the space.
Indoor triggers range from aerosol sprays to open wood fires. Cookers, when in use, can produce fumes that can increase the chances of having asthmatic symptoms. Gas cookers, in particular, produce the most pollution due to the fact they give off nitrogen dioxide. Small particles that come from this can get into the airways and lungs, causing the airways to swell and inflame.
There are steps that can be taken to lower the risk of indoor asthma triggers such as, opening windows and using fans to help air circulation. This can sometimes have the reverse effect by bringing pollen etc into the building, so it would be wise to exercise caution while doing this.
Weather can affect an asthmatic throughout the year with some seasons posing more triggers than others. In hotter weather, there is likely to be more chance of pollutant and pollens in the air, as well as the fact when you breathe in hot air it can cause the airways to narrow which subsequently could lead to coughing and shortness of breath. In colder weather, it is possible that the cold air, once you breathe it in, can make your airways spasm, thus resulting in coughing, wheezing and other asthmatic symptoms. In addition to this, the cold weather season brings about more flu viruses and colds, which can have an adverse effect on asthma sufferers.
Mould and dampness in homes, or buildings, also increase the risk of a person getting a chest infection, or other illnesses which can affect their asthma.
Dust mites, which are known to irritate the airways, thrive in damp and warm environments and they are therefore likely to be around in a place that has damp. The issue with mould itself is that it produces spores that can be breathed in. This can then cause a person to start coughing, sneezing, or have watery eyes, triggering their allergy, which can then bring on asthmatic symptoms.
Colds, flu and chest infections are types of illnesses that can make a person’s asthma worse and trigger asthma attacks, if not managed. When someone has a cold, or flu, the airways become more inflamed and produce more mucus, making it harder to breathe. Asthma UK explains that 81% of asthma sufferers find their asthma gets worse when they have a cold, or the flu.
Chest infections can cause inflammation of the airways. Because a person with asthma is already likely to have a degree of inflammation before a chest infection, their airways are subject to further restrictions. This can commonly make it difficult to breathe and also instigate frequent and more intense coughing and wheezing.
It can be difficult to decipher between a chest infection cough and an asthmatic cough. However, typically, an asthma cough is dryer than a chest infection cough, which is more of a ‘productive’ one, and phlegm tends to be produced from this type. Using an inhaler helps to manage and improve asthma symptoms, as well as any additional symptoms from a cold, flu, or chest infection.
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It is widely noted that a lot of people diagnosed with asthma live a relatively ordinary life with little effect on their day-to-day lives. However, it is a condition that requires treatment and management to ensure a person can still live their life to the fullest.
Some steps can be taken to prevent an asthma flare-up, this includes having any medication, or inhaler(s) with you at all times.
By taking a preventative inhaler (if advised to do so by a GP), can lessen the risk of developing asthmatic symptoms when unavoidable triggers arise.
Sleeping can often be disturbed by asthmatic symptoms. If a person is coughing, wheezing, or feeling a tightness in their chest, they may be having an asthma attack. Having an inhaler by your bed at night is important so that it can be found quickly if needs be. Sleeping flat on your back can put added pressure on a person’s chest and therefore can cause a cough. At night, the body doesn’t produce as many natural steroid hormones, impacting on a person’s symptoms and the inflammation of the airways.
Living with asthma requires regular reviews by a medical team, so that they can monitor a person’s symptoms and how much of an impact they are having on someone’s life. Some check-ups may involve breathing tests to ascertain the function of the lungs, and in some cases, you may be asked to do tests to measure your peak flow, if your symptoms are worsening.
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Some people may find they need little support for their asthma, other’s may feel they need more. There are many different ways in which someone might need to be supported.
GP services and other medically trained specialists, such as an asthma nurse, will regularly be available if someone feels their condition needs to be reviewed. A patient would request a review if they are concerned that their symptoms are getting worse, or changing.
There is likely to be an action plan in place created by a medical team, so that the patient can refer to it where necessary. A GP, or nurse can assist with completing a written action plan which details a person’s triggers and any medication they may take for the condition. This can be of particular use when travelling, not only locally, but also when going on holiday abroad.
There are forums and social media pages available for asthma patients to access, so that they can get in contact with people in a similar position to themselves.
Listed below are various helplines and websites if you would like further information, or additional support.
Asthma UK helpline – 0300 222 5800 available 9 am to 5 pm from Monday to Friday
British Lung Foundation – 03000 030 555
Self-Management UK is a website which offers courses for people living with long-term conditions to assume more responsibility for their own lives and learn to manage it better.
Stress and anxiety-related helplines:
Mind – 0300 123 3393 or text 86436
Anxiety UK – 03444 775774
Samaritans – 116 123 – available 24 hours a day, 365 days a year
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Medical terms are often baffling and difficult to fully understand. To help, we have listed some frequently used terms below.
- Antihistamines – are both an over the counter and prescription drug that's used to treat allergies, such as hay fever, hives, conjunctivitis and other allergic reactions
- Bronchiolitis – is a common lung infection that causes congestion and inflammation in the small airways called the bronchioles. Bronchiolitis affects babies and young children and is mostly caused by a virus
- Chronic – refers to a human health condition that is persistent, or long-lasting
- Corticosteroids – are a type of steroid used as an anti-inflammatory to treat various allergies. It can come in different forms such as creams, inhalers, tablets and injections
- Diagnosed – the process of identifying a disease, condition, or injury from its symptoms
- Inflammed / inflame – the process by which the body fights against things that can harm it, such as infections, injuries and toxins
- Inhalers – are devices used to administer corticosteroids and other medicines, and is a portable device which can be carried around
- Lungs – the two breathing organs in the chest which remove carbon dioxide from, and bring oxygen to, the blood
- Mucus – a sticky and stringy substance produced by lining tissues in the body, acting as a protective and moisturising layer to prevent critical organs from drying out
- Occupational asthma – can result from exposure to a substance that someone is sensitive to. This causes an allergic, or immunological response
- Phlegm – is a thick matter produced by the mucus membrane in the respiratory airways
- Spasm – a sudden involuntary muscular contraction, or movement
- Trigger – something that sets off a disease, or flare up
- Virus – a microorganism, smaller than a bacterium, that invades living cells and uses the cells to keep itself alive and replicate