What is asthma?

Asthma is a condition where the smaller airways (bronchioles) of the lungs constrict (narrow). 

Asthma can start at any age, but it most commonly starts in childhood.  At least 1 in 10 children and 1 in 20 adults have asthma.  Asthma runs in some families, but many people with asthma have no other family members affected.

What are the symptoms?

The common symptoms are a cough and wheezing, with shortage of breath and a feeling of chest tightness.  Symptoms can range from mild to severe between different people and at different times in the same person.  Each episode can last just an hour or so or persist for days or weeks unless treated.

What causes asthma?

Asthma is caused by inflammation in the airways which irritates the muscles around the airways, and causes them to squeeze (constrict).  This causes narrowing of the airways so that it is more difficult for air to get in and out of the lungs.  This leads to wheezing and breathlessness.  The inflammation also causes the lining of the airways to make extra mucus which causes cough and further obstruction to airflow.

What can make asthma symptoms worse?

Although asthma was known to doctors in ancient Greece and China, when I was a child doctors firmly believed that children with the disease were simply naughty!  There is often no apparent reason why symptoms flare up but some people find that symptoms are made worse in certain situations. Triggers may include:

Infections

Pollens and moulds

Exercise

Certain drugs, including aspirin, anti-inflammatory painkillers such as ibuprofen and betablockers including those used to treat glaucoma

Smoking and cigarette fumes

Other fumes and chemicals

Certain pillows and mattresses

Emotion

Allergies to animals

House dust mite

Some foods

It is important that allergies are diagnosed by a doctor as it is rarely necessary to avoid specific foods or get rid of pets.  As a child I was terrified of bedding with feathers as I was supposedly allergic to it, but this was pure conjecture and never tested.  Smoking of course is now generally accepted as best avoided by everyone, but I have memories of the doctor visiting me at home, stethoscope in one hand and cigarette in the other!

How is asthma diagnosed?

When symptoms are typical the diagnosis is easily made by a doctor.  Two commonly used tests are spirometry and assessment with a peak flow meter, both of which measure the capacity of the lungs.  When I was a child the main tool used was x-rays and I had several every year.

What are the treatments for asthma?

This is another area which has changed markedly from my childhood.  In the children’s hospital one of the main treatments was to be made to walk up and down the corridors for hours at a time as punishment.  When every breath was precious and hard to come by this was far from easy!  Otherwise treatment was with antibiotics.  It is probably not surprising that I missed up to a third of my schooling through illness.

Nowadays the aim for most people with asthma is to prevent the symptoms from occurring so that normal life is possible for much of the time.

Most people are treated with inhalers which deliver a small dose of drug directly to the airways.  The dose is enough to treat the airways while the amount that gets into the rest of the body is small so that the possibility of side-effects is reduced.

A short course of steroid tablets (such as prednisolone) is sometimes needed to ease a severe or prolonged attack of asthma.  Most of the side-effects caused by steroid tablets occur if taken for a long time.

Does asthma go away?

About half of children who develop asthma grow out of it by the time they are adults.

For many adults, asthma is variable with some good spells and some spells that are not so good.  Although not curable, it is treatable.  Stepping up the treatment for a while during bad spells will often control symptoms.

Some other general points about asthma

It is important to learn how to use inhalers correctly.

See a doctor or nurse if symptoms are not fully controlled, or if they are getting worse.  An adjustment in inhaler timings or doses may be all that is needed.

See a doctor urgently if severe symptoms are not eased by a reliever inhaler. Emergency treatment with high-dose reliever drugs and other treatments may be needed, sometimes in hospital.  A severe asthma attack can be life-threatening.

Many asthmatics are recommended to have a flu jab every autumn.

Many GP surgeries have a specialist asthma clinic.

http://www.asthma.org.uk/

http://www.webmd.boots.com/asthma/default.htm#

http://www.blf.org.uk/conditions/detail/asthma

http://www.patient.co.uk/health/asthma

http://en.wikipedia.org/wiki/Asthma

http://www.bbc.co.uk/health/physical_health/conditions/in_depth/asthma/aboutasthma_index.shtml

http://www.hse.gov.uk/asthma/

Written by and links by Kim