asthma after diagnosis

Overview

Asthma is a long-term condition that affects the small air passages in your lungs. It causes them to become swollen, narrow, and sensitive, which can make it hard to breathe. With good care, most people with asthma can live active, full lives.

Very common. Around 5.4 million people in the UK receive treatment for asthma, and it is one of the most common long-term conditions worldwide.

Asthma can begin at any age. It often starts in childhood, but many people are diagnosed as adults, including in later life. It affects both men and women.

Symptoms

Common symptoms

• Wheezing (a whistling sound when you breathe)
• Shortness of breath
• A tight feeling in your chest
• Coughing, especially at night or early morning

Symptoms in children

• A cough that gets worse with play, laughing, or at night
• Fast breathing or working hard to breathe
• Tiredness or low energy because of trouble sleeping
• In infants, poor feeding or grunting during feeding

Symptoms in older adults

• Feeling short of breath even with light activity
• A persistent or recurring cough
• Chest tightness or heaviness
• Fatigue or confusion that may be due to low oxygen

Causes

Main causes

• The exact cause of asthma is not fully understood, but it seems to come from a mix of inherited and environmental factors.
• When you come into contact with a trigger, the airways overreact, become inflamed, and tighten, making it difficult to move air in and out.
• The airways also produce extra mucus, which can block them further.

Risk factors

• A family history of asthma, eczema, or allergies
• Having allergies, such as hay fever or pet allergies
• Having had bronchiolitis or respiratory infections in childhood
• Exposure to tobacco smoke, including in the womb
• Air pollution or workplace chemicals and dust

When to see a doctor

See a doctor urgently if:

• Symptoms that are getting worse, even with treatment
• Using your rescue inhaler more often than recommended in your asthma action plan
• Waking up at night with coughing, wheezing, or chest tightness
• Noticing your peak flow readings are falling

Book a routine appointment if:

• A new diagnosis or a review after starting treatment
• If asthma symptoms are interfering with sleep, school, work, or exercise
• At least once a year for an asthma check-up
• If you have questions or need to update your written asthma action plan

Diagnosis

Your doctor will ask about your symptoms, your general health, and your family history. They will also listen to your lungs and check your breathing. A diagnosis is usually based on a pattern of symptoms and tests that show your airways narrow and then recover, either on their own or with treatment.

Tests that may be done

• Spirometry: you take a deep breath and blow hard into a tube to measure how fast and how much air you can blow out
• Peak flow test: a small handheld device measures how fast you can breathe out; you may use it at home over time
• FeNO test: you breathe into a device to measure inflammation in your airways
• Allergy tests: skin or blood tests to check for common allergens

What to expect at your appointment

Tests are simple and usually painless. You may be asked to stop some asthma treatments before a test so the results are accurate. Your doctor will explain everything and will use the results to help create your personal action plan.

Treatment

Treatment aims to reduce inflammation in your airways, keep them open, and prevent symptoms. Most people use inhalers, which deliver medicine directly to the lungs. There are also daily controller medicines and relief medicines for times when symptoms appear. You may also get a written asthma action plan that explains your medicines and what to do at different stages.

Self-care at home

• Avoid your known triggers, such as tobacco smoke, dusty places, and pet dander
• Take your medicines exactly as prescribed, even when you feel well
• Use an asthma action plan to recognise early signs of a flare-up
• Check your inhaler technique with your doctor or pharmacist
• Keep your rescue inhaler with you at all times

Medical treatments

The main treatments are preventer inhalers, which reduce airway inflammation and are used every day, and reliever inhalers, which you use only when symptoms appear. Inhaled medicines are generally safe and effective. If asthma is not well controlled, a doctor may add other treatments, such as long-acting bronchodilators (medicines that relax airway muscles), oral medications, or injections for severe asthma. Never stop or change your medication without speaking to your healthcare provider.

When is surgery considered?

Surgery is not a treatment for asthma.

Living with this condition

Living with asthma means keeping inflammation under control while taking part in everyday life. Most people do well with a daily preventer and a reliever for unexpected symptoms. You can learn to notice early signs of a flare-up, like a cough, a tight chest, or a falling peak flow, and act early.

Lifestyle tips

• If you smoke, get help to quit — this is the single best thing you can do for your lungs
• Maintain a healthy weight, as excess weight can make asthma harder to control
• Exercise regularly — with good asthma control, exercise is safe and beneficial
• Manage stress, as strong emotions can trigger symptoms
• Create a clean, low-allergen home: dust regularly, wash bedding in hot water, and avoid strong scents

Diet and exercise

There is no special asthma diet, but eating a balanced diet full of fruits, vegetables, whole grains, and lean protein supports overall health and helps keep your lungs strong. Regular exercise can improve your breathing, and you should not avoid it. If exercise triggers symptoms, speak to your doctor — you may need a different plan, like using your reliever before exercise (only if your healthcare provider advises it).

Mental health and emotional wellbeing

Living with asthma can sometimes cause anxiety, especially during a flare-up, and stress can make symptoms worse. It is normal to feel worried or frustrated. Talk to your healthcare team if you feel anxious about your breathing. For some people, counselling or cognitive behavioural therapy (CBT) can help with the emotional side of long-term illness.

Prevention

There is no known way to prevent asthma, but you can take steps to reduce the chance of flare-ups. The most important things are to follow your treatment plan, avoid your triggers, and get your annual flu vaccine if recommended. You can also minimise exposure to tobacco smoke and air pollution.

Vaccines

Infections like colds, flu, and pneumococcal disease can make asthma worse. Staying up to date with recommended vaccines, including annual flu and COVID-19, is a simple way to protect yourself. Ask your healthcare provider which vaccines are recommended for you.

Screening programmes

There is no general screening test for asthma. If you have breathing concerns, see a doctor for proper assessment.

Complications

If left untreated

• Frequent asthma attacks that need emergency care
• Permanent narrowing of the airways over time
• Poor sleep leading to fatigue and reduced daily performance
• A fall in blood oxygen levels that can harm the body
• Missed school or work due to frequent symptoms

Long-term outlook

The outlook for asthma is very positive. With the right medicines, regular monitoring, and healthy habits, most people with asthma live long, healthy, and active lives. Some children even grow out of symptoms as they get older. You can take charge by understanding your condition and being proactive.

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