Asthma is a chronic infection of the airways that occurs frequently. Over 5.4 million people in the UK have asthma, over one million of which are children. Asthma usually starts at a young age, but can also present for the first time later in life.
Asthma can have a huge impact on quality of life. People who have asthma periodically suffer from chest tightness, coughing and/or wheezing. Their lungs are especially sensitive to triggers like smoke, pollen, air pollution, and dust mites. When they are exposed to these triggers, their airways may constrict, letting less air pass through. When the airways constrict acutely, we call it an asthma attack . Not everyone who has asthma responds to the same triggers, and the symptoms may be more severe in some people than in others. This is because there are various kinds of asthma. An asthma patient may have several types of asthma at the same time.
Sadly, there is no cure for asthma. However, effective treatment is usually possible.
How asthma affects the airways
When people with asthma encounter the substances that trigger a response, all sorts of things happen in their lungs and airways. The mucous membranes in their lungs, throat and nose swell up and produce more mucus and fluid than normal. The tiny muscles around the airways go into spasm. Both responses constrict the airways and make it more difficult to breathe. The lungs fill up with more air than they can easily hold, and the air is not replaced quickly enough, creating a constricted feeling. During an asthma attack, a person may inhale or exhale up to 80% less air. Although this can be very frightening, it’s not generally life-threatening.
Various kinds of asthma
Since there are various kinds of asthma, no one has exactly the same asthma symptoms. We can identify four kinds:
This form of asthma is the most common. In a person with allergic asthma, chest tightness starts as soon as the person inhales the substances they’re allergic to. Examples of such allergens include dust mites, pollen from grass, weeds or trees, pet dander (skin flakes from dogs, cats, rodents and horses) or mould spores. Certain substances in foods or medicines can also trigger an asthma attack. Exposure causes the body to produce histamine, which causes an allergic reaction. People with allergic asthma are not all oversensitive to the same triggers. The intensity of the response differs from person to person.
In this type of asthma, the symptoms are caused by non-allergenic triggers. As a result, intrinsic asthma is sometimes also called non-allergic asthma. The following and other similar substances can be the culprits: smoke, perfume, petrol, exhaust fumes, paint fumes, cleaning agents, and baking/frying smells. Mist, increased air humidity and cold can also trigger symptoms.
This form of asthma mainly occurs when a person starts moving too quickly. Examples include sports-related exercise or sprinting to catch the train. A person with exercise-induced asthma needs a slow start to any physical exercise. This allows the respiratory system to get used to the transition from a resting state to high-paced activity. Asthma symptoms may get worse in response to intense emotion and stress, especially in exercise-induced asthma. Cold and air humidity may also have an impact.
Nearly one in ten people with asthma experience severe symptoms. People with severe asthma cannot go a single day without medication and regularly need to see a lung doctor for check-ups. And even then, sometimes it goes wrong because the medication doesn’t work well enough. It may even become life-threatening when someone can hardly breathe, or is unable to breathe at all. Some people with severe asthma require regular hospital treatments to manage their affliction.
What are the symptoms ?
People who have asthma have a constant mild inflammation of the airways. In pneumonia, the lungs are inflamed by a bacterial infection; this is not the case for asthma. The main symptoms of asthma are listed below:
You may experience:
- Chest tightness (mild or severe)
- Mucus build-up in your airways
- Coughing fits / coughing. The coughing may bring up mucus. This is a natural bodily response to overproduction of mucus
- Wheezing. This symptom is caused by the constricted windpipe and bronchial tubes (the branching airways that lead to the lungs). Your breathing may be rattling or rasping as a result
- Shortness of breath. In other words: you are out of breath quickly and tend to gasp or pant for air
- Fatigue, because breathing takes extra energy
- Diminished physical fitness. This makes exercise harder than normal
What is the causes?
Exactly what causes asthma is unknown. It is hereditary to some extent. A child has a 50% chance of developing asthma if one of their parents has asthma or allergies. That chance rises to 70% if both parents do. When it occurs within a family, they are also likely to have a higher rate of food allergies, hay fever and eczema. In all these cases, the body tends to overreact to triggers.
Moreover, there is a higher likelihood of developing it:
- The mother smoked during pregnancy
- The child was born prematurely
- The child’s birth rate was too low
How is it treated?
With the right treatment, it can usually be managed effectively. An effective treatment plan does require a proper diagnosis, however. There are a number of tests available. The test results let the GP get a clear overview of the health, performance and/or sensitivity of your lungs. The doctor will also ask questions about your lifestyle, any allergies, and other relevant factors. Treatments may also require you to stop smoking, get more exercise, or avoid certain substances as much as possible.
Patients are usually prescribed medication. Treatment generally involves medicine that needs to be inhaled. Some of these ‘inhalers’ widen the airways (bronchodilators). Others suppress inflammation.
A doctor may also opt to prescribe medication in a tablet form or propose an alternative course of treatment.
How can you identify an asthma attack?
When you’re having it, it’s harder to breathe because your airways are constricted. Your chest will feel tight, and you will probably have an intense coughing fit. Your breath may wheeze or rattle. Other familiar symptoms of an attack include:
- Easily tired or out of breath, during exercise and minor exertion
- Ongoing symptoms of a cold, like a stuffed or a runny nose and sneezing
- ‘Nostril flares’: your nostrils expand with every breath as your body struggles to get enough air
- Irritability, agitation, anxiety
- Frequently interrupted sleep
- Pale or blue discolouration of nail beds and oral mucosa (inside lining of lips and cheeks)
- Hunched shoulders
What triggers an attack?
The airways of people are oversensitive. As a result, they may respond intensely to various factors. This could include pet dander (skin flakes from house pets), but also dust mites, pollen, and some medications or foods. A person having an attack in response to these substances has allergic asthma. An attack can also be triggered by non-allergenic substances. This could include high air humidity, cold air, perfume or cigarette smoke. Finally, an asthma attack can be triggered by stress or intense emotion or by sudden exertion, like sprinting to catch the bus.
What happens during an attack?
If an asthma patient’s airways are triggered, they are easily inflamed. As a result, the mucous membranes in their airways swell up and produce more mucus than normal. The tiny muscles around the airways go into spasm, causing the airways to constrict. This makes it harder to breathe, so the air in the lungs is not replaced fast enough. Chest tightness occurs as the blood oxygen level drops. You will also get tired faster, even during minor exertion. The extra mucus may also cause you to cough. Shortness of breath and coughing are often the first symptoms of an attack.
What should you do about an asthma attack?
In many patients, the symptoms of an attack can be prevented or alleviated effectively by avoiding what they’re oversensitive to (triggers). Maintenance medication (anti-inflammatories) can also help control this. If they do have one they can use the medication that they were prescribed. This immediate treatment is often a bronchodilator (medication to widen the airways). When inhaled, this medication will cause the airways to widen, making it easier to breathe. This is usually enough to stop the attack.
Be quick & consistent!
It is very important for you to take your medication quickly, as soon as the symptoms start – and if you’re taking maintenance medication, you need to take it consistently and exactly as prescribed. If you don’t, your symptoms will continue to grow worse. You should also try to stay calm. Stress and intense emotions can also make an attack worse.
In emergency situations
If your attack gets worse despite treatment… Now what? A number of symptoms indicate a severe attack. Contact your doctor or call emergency services if you experience the following symptoms:
Arrange a treatment for me
- Your medication does not alleviate your symptoms
- You are so short of breath that you can hardly talk
- It is difficult or impossible to walk
- Your nails and lips are turning blue
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Last updated on October 3, 2018.