Last updated on 24 January 2022
What is asthma?
Asthma is a recurring problem with your airways. The tubes that connect your lungs and respiratory system become inflamed and narrow, so air can no longer pass through easily. The inflammation also results in sticky mucus build-up within the bronchial tubes. This causes the wheezing and breathlessness that characterises asthma.
General asthma symptoms include:
- Chest pain
- Chest tightness
- Shortness of breath
Asthma affects everyone differently, so if you are diagnosed, it’s important to know your symptoms so you can manage the condition.
Causes of asthma
While the exact cause of asthma is unknown, there are risk factors that make asthma more common in some people. These risk factors are:
Asthma is often inherited and if members of your family are sufferers you are more likely to develop asthma too.
Having atopic dermatitis, eczema or similar skin conditions may make you more predisposed to asthma, probably because you are more sensitive to allergens in general.
In children, boys are more likely to suffer from asthma. In adults, women are more likely to be asthma sufferers.
If you are overweight, you may have an increased risk of developing asthma, or worsened symptoms if you are asthmatic.
Research suggests that smokers are much more likely to develop respiratory illness. Asthma is also more difficult to control in smokers.
Common triggers of asthma
Although there is no single cause of asthma, the most common triggers are:
Most asthma sufferers are allergic to something. Some typical allergens include pollen, pet dander, mould and dust mites. If you are aware of what you are allergic to, you should try to avoid it.
Although exercise is necessary for maintaining optimal health, strenuous exercise can sometimes trigger an asthma attack. Exercise-induced asthmatics should avoid strenuous aerobic workouts in favour of low intensity exercise that doesn’t lead to an attack. Using ventolin or salbutamol puffs before physical exercise can prevent asthma attack.
If you have acid reflux and stomach acid reaches your throat or airways, it can lead to inflammation, irritation and asthma.
Sinus infections cause inflammation and excessive mucus production, much like asthma. If you have both, they can occur together and worsen as the infection progresses.
In the same way that allergens such as pet hair can cause a reaction that triggers an asthma attack, your body’s allergic response to food such as shellfish, nuts or eggs can cause a flare-up.
It is vital that you avoid these triggers where possible if you know that you are susceptible to asthma. It is also very important to prevent the onset of symptoms by taking any medication your doctor has prescribed, particularly for conditions like acid reflux. Although asthma can’t be cured, you can manage it effectively if you are aware of your triggers.
What is an asthma attack?
An asthma attack is a flare-up of asthma symptoms. During an attack, your airways narrow dramatically and you can no longer breathe effectively. The severity of an asthma attack can range from mild to severe, but they are often sudden and can be scary. It can cause death if not treated promptly.
If you have asthma, keep an eye out for the early warning signs of an attack. These include a persistent cough, heavy breathing after exercise, feeling stressed and tired, and waking up breathless or coughing in the early morning. These early signs may give you the opportunity to treat the attack and prevent it from becoming serious or life-threatening.
Asthma attack symptoms
If your asthma attack is severe, it is very important to go to the Accident & Emergency (A&E) department. Here are some symptoms that indicate you are having an asthma attack:
- Severe wheezing
- Pain in your chest
- Rapid breathing
- Relentless coughing
- Blue or pale skin, lips, or nails
- A peak flow reading of below 80%, if you have a peak flow meter
- Present medication especially ventolin puffs not easing symptoms effectively
What to do when having an asthma attack
If you or someone you know is experiencing an asthma attack, you should call an ambulance, say that someone is having an asthma attack and request for an ambulance with oxygen. An asthma attack can be fatal as your airways may narrow to such an extent that your body is starved of oxygen.
On the way to the A&E, you should try to remain calm. Panicking will exacerbate your symptoms. If you have a bronchodilator inhaler (ventolin), which is an inhaler that opens up and relaxes your airways, you should use it. Your doctor may have given you an asthma action plan so you know what to do in an emergency. If so, follow the medication guidelines your doctor has given you on the way to the hospital.
In a respiratory emergency, you are likely to be prioritised at the hospital. If you are waiting for a doctor, remain upright and continue to take puffs of your inhaler every few minutes. Avoid lying down as it can restrict your airways and airflow even further. Alert the hospital staff at the counter and let them know that you are having an attack.
Treating asthma attacks
The emergency treatment you will be given in the event of a severe asthma attack depends on your individual symptoms. These are called rescue medications that are aimed at providing rapid, short-term symptom relief during an asthma attack. The most common remedies include:
- Oral and intravenous corticosteroids, which are medications that reduce inflammation in your airways to help air to move freely again.
- Beta agonists like VentolinTM puffs, which are the same type of medication that is found in a rescue inhaler. You may be given a nebuliser, which is a mask that fits over your mouth and nose and helps you to deeply inhale the medication.
- Anticholinergic agents that work to immediately relax your airways to help you breathe.
- Oxygen and breathing tubes, which may be necessary if your attack is particularly severe, to get enough oxygen into your body while other medications are administered.
Long term, your pulmonologist will come up with a plan to keep your asthma under control, which will usually involve inhalers specifically for the prevention and management of your symptoms.
Asthma can be a scary condition, especially in children, but millions of people live with asthma worldwide and most have a very normal life. Diagnosis is the first step, so if you experience any of the general symptoms of asthma, even if you’ve never had an attack, you should always see your doctor. They will be able to test your lung function and check for other indicators of the condition. If you do have asthma, they will give you appropriate medication to keep attacks at bay.
If you are diagnosed with asthma:
- Use your prescribed medication as directed
- Avoid your known triggers or allergies wherever possible
- Have an asthma action plan and ensure your family and friends know what to do
- Stay generally well with a healthy diet and appropriate exercise, being mindful of exercise-induced asthma
- Avoid smoking
- Remain proactive in managing your symptoms – have your inhaler with you at all times.
If in doubt, visit the A&E during an asthma attack to receive proper treatment.
Article reviewed by Dr Jim Teo, respiratory specialist at Parkway East Hospital
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