Asthma
Asthma is a common condition affecting both small and large airways in the lungs with approximately 5.4 million people in the UK currently receiving treatment for it. Asthma can occur anytime in childhood or adult life.
Symptoms
Asthma can vary in its type and severity among individuals, but there are a number of characteristic symptoms that confirm asthma diagnosis, such as:
- Coughing
- Wheezing (a whistling sound when you breathe)
- Tightness of the chest
- Difficulty breathing
It is important to note that not all asthma sufferers will experience all of the symptoms listed above at any one time. Asthma symptoms can be managed with appropriate medication to provide immediate relief when needed in the short-term and also reduce inflammation in the airway. Most patients with asthma can live relatively normal lives provided they maintain good asthma control and take medications prescribed accordingly.
Unfortunately, patients with poor grasp of asthma control can often experience several exacerbations (worsening of asthma symptoms).
Typical symptoms of a severe asthma attack include:
- sudden worsening of asthma symptoms,
- breathing and talking with noticeable difficulty,
- quickening pulse rate,
- tightening of skin around the chest,
- flaring of nostrils whilst breathing
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The risk and frequency of exacerbations can be minimised by;
- Reducing exposure to known trigger/allergen
- Checking inhaler technique with Practice nurse/GP
- Following prescribing instructions closely
Do not hesitate to contact your GP/Practice nurse if you experience any worsening of asthma symptoms.
Changes in the airway
In individuals with asthma, the body perceives substances or particles that are often harmless as allergens (particles that provoke an immune response in individuals) and mount an immune response to get rid of any such particles. In an asthma attack, the smooth muscle forming the walls of the airway become inflamed and phlegm/mucus builds up. This causes the airway to become "twitchy" and narrow, which often results in symptoms such as coughing, wheezing etc.
The diagram below illustrates differences between a normal airway and one that is inflamed and constricted as often seen in individuals with asthma.
What causes asthma?
The cause of asthma is not completely understood. The strongest risk factors for developing asthma are a combination of genetic predisposition and/or exposure to environmental factors such as tobacco smoke that may provoke an allergic reaction or irritate the airways.
Familial link
People are more likely to develop asthma if there is a history of asthma in their family. The chances are also higher if they have a family history of allergies such as hay fever and/or eczema.
Environmental factors
Modern lifestyles, such as changes in housing, diets, and exposure to environmental pollutants are some of the factors that contribute to the increased likelihood of developing asthma. The following allergens often trigger an asthma attack in susceptible individuals;
- Indoor allergens (such as house dust mites in bedding,carpets etc and pet dander)
- Outdoor allergens (such as pollens and moulds)
- Tobacco smoke
Smoking is particularly discouraged in people with asthma as it often leads to deterioration in their condition and can increase the risks of developing chronic obstructive disease (COPD). Research supports some of the negative effects of smoking on asthma, as different studies have shown that:
- There is a strong link between smoking during pregnancy and the development of asthma in the child.
- Children whose parents smoke are much more likely to develop asthma.
- Smokers with asthma have much more difficulty managing their asthma with normal doses of drugs and often have much more severe asthma.
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- Air pollutants
- Chemical irritants in the workplace
The list cannot be exhaustive and it is important to note that individuals may react to allergen/triggers that are not listed above. Other factors known to trigger asthma symptoms include cold air, extreme emotional arousal such as anger or fear, and physical exercise.
Do I have asthma?
If you are concerned that you, or someone you know, may have asthma, make an appointment at your local GP surgery to discuss your concerns.
To make the most of the appointment, it is useful to think about the answers to the questions your GP is likely to ask. The questions are likely to focus on:
- The types of symptoms
- The frequency and severity of symptoms
- How long the symptoms last
- The symptom pattern (e.g. worse in the evening / morning or during the night)
- Possible connected diseases (e.g. viral chest infection)
- Family history of asthma, eczema, allergies (e.g. hay fever)
- Possible "triggers" that lead to worsening symptoms (e.g. animal contact, specific food types)
- Patient's age
- Patient's occupation.
The more information you can give your doctor, the more likely they are to be able to help.
Diagnosis
Asthma diagnosis can typically be confirmed using a number of tests, the most popular being the peak expiratory flow rate (PEFR) test. Using a peak flow meter, a clinician/nurse measures how much air is exhaled forcefully from the lungs. A reliever medication (used to relieve asthma symptoms on a short term basis) is then administered and a second reading is taken. Asthma diagnosis will either be confirmed or ruled out by GP/nurse based on the readings observed.
If you want to find out more about some of the specific types of asthma, click on the following links:
For more information about all aspects of asthma visit the Asthma UK website.