Asthma And Allergens

Overview

Asthma is a long-term condition that affects the airways in your lungs. Allergens are harmless substances that some people's immune systems react to. For people with asthma, breathing in certain allergens can make the airways become swollen, narrow, and produce extra mucus, which makes it harder to breathe.

Yes. Asthma is one of the most common chronic conditions in the world, and in the UK it affects around 5.4 million people. Many of those find that allergies play a part in their asthma.

Asthma can start at any age, but it often begins in childhood. It is more common in boys under 12, but after puberty it is more common in women. A family history of asthma, hay fever, or eczema increases the chance of developing it.

Symptoms

Common symptoms

• Shortness of breath
• Wheezing (a whistling sound when you breathe)
• Coughing, especially at night or early in the morning
• Tightness in the chest

Symptoms in children

• Frequent coughing, especially during play, at night, or when laughing
• Making a wheezing sound when breathing out
• Feeling tired or avoiding energetic games because of breathlessness
• In babies, difficulty feeding or flaring nostrils while breathing

Symptoms in older adults

• Breathlessness during normal daily activities
• A cough that does not go away or gets worse at night
• Wheezing or chest tightness
• Fatigue that is not fully explained by age or other conditions

Causes

Main causes

• Inflammation and sensitivity of the airways are the underlying problem in asthma.
• Allergens are common triggers. These include pollen, house dust mites, pet skin flakes (dander), mould, and cockroach droppings.
• Other triggers can include cold air, exercise, cigarette smoke, air pollution, chest infections, strong smells, and stress.
• Each person has their own set of triggers. Learning what yours are helps you manage the condition.

Risk factors

• Having a parent, sibling, or other close relative with asthma, eczema, or hay fever
• Having an allergic condition, such as eczema or hay fever, yourself
• Being exposed to tobacco smoke, especially during childhood
• Living in areas with high air pollution or being exposed to dust or chemicals at work
• Being overweight, or being born prematurely with underdeveloped lungs

When to see a doctor

See a doctor urgently if:

• If your symptoms are getting worse quickly and are interfering with daily life, or if your reliever inhaler is not helping, see a GP or get urgent medical advice the same day.
• If you have severe breathing trouble, do not wait — call your local emergency number immediately.

Book a routine appointment if:

• If you have a cough, wheeze, shortness of breath, or chest tightness that keeps coming back, make a routine appointment to discuss it.
• Once you have a diagnosis, see your doctor or asthma nurse at least once a year for a review, or more often if symptoms change.

Diagnosis

A doctor will ask about your symptoms, your personal and family history, and any triggers you have noticed. They will listen to your breathing and may ask you to do some breathing tests. Asthma is not always easy to diagnose, so you may need several visits and tests over a few weeks.

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 breathe out.
• Peak flow test: you blow into a small handheld device to measure your best speed of breathing out. You may be asked to track this at home for a while.
• Allergy tests: skin prick tests or blood tests can help identify specific allergens that may be triggering your asthma.
• FeNO test: you breathe into a machine that measures inflammation in your airways (nitric oxide level).

What to expect at your appointment

Most breathing tests are simple and painless. You might be asked to stop some medicines before them, so follow the doctor's advice. You may also be asked to keep a symptom diary or record your peak flow at home. Based on the results, your doctor can make a plan with you.

Treatment

Asthma treatment has two main goals: long-term control of airway inflammation and quick relief when symptoms appear. Most treatment is given through inhalers, and you will likely have two types: a preventer inhaler for daily control and a reliever inhaler for when symptoms flare up. A written personal asthma action plan helps you manage this day by day.

Self-care at home

• Learn your triggers and avoid them where possible, especially the allergens you are sensitive to.
• Use your inhalers exactly as prescribed. The preventer works best when taken every day, even if you feel fine.
• Check your inhaler technique with your doctor or pharmacist — many people use inhalers incorrectly.
• Monitor your symptoms and peak flow readings, and write down any changes for your review.
• Take part in asthma education or a self-management programme if offered.

Medical treatments

Medical treatment depends on how frequent and severe your symptoms are. It usually begins with a low-dose preventer inhaler taken each day. If that does not control asthma well, your doctor may increase the dose or add a combination inhaler containing two different medicines. A reliever inhaler is used for quick relief of symptoms. Some people with severe asthma may be offered additional oral medicines or injectable 'biologic' treatments that target the inflammation in the airways. For certain allergies, immunotherapy (allergy shots or tablets) may help reduce sensitivity to triggers. Your doctor will tailor the treatment to your needs, explain each option, and review it regularly. Remember, always take your asthma medicines as prescribed — never change or stop them without medical advice.

Living with this condition

Living with asthma means getting to know your own breathing patterns. Follow your written action plan, take your preventer medicine daily, and carry your reliever inhaler with you. Notice the situations that make your symptoms worse, and plan ahead — for example, if pollen is high, keep windows closed and avoid outdoor activities during peak times.

Lifestyle tips

• If you smoke, get help to stop. This is one of the most important steps for your lungs.
• Keep your home less dusty by vacuuming regularly, washing bedding in hot water, and using allergen-proof covers if you are sensitive to house dust mites.
• If you have pets and are allergic, keep them out of the bedroom and consider hard flooring instead of carpets.
• Stay physically active, and use your reliever inhaler before exercise only if your asthma plan says to.
• Manage stress with relaxation exercises, breathing techniques, or talking to someone you trust.

Diet and exercise

There is no special diet that cures asthma, but eating a balanced diet with plenty of fruits and vegetables supports good overall health. Regular exercise is recommended, as it strengthens your lungs. If exercise triggers symptoms, talk to your doctor about ways to help, such as warming up properly or using your reliever inhaler beforehand.

Mental health and emotional wellbeing

Living with asthma can sometimes cause anxiety, especially if you have had severe attacks. Stress and strong emotions can actually make asthma symptoms worse. It is completely normal to worry. Share your concerns with your doctor or asthma nurse, and consider asking for additional support if anxiety is affecting your daily life.

Prevention

Asthma itself cannot always be prevented, but asthma attacks can be greatly reduced. The key is to avoid your known triggers, take your preventer medicine as prescribed, and follow a written action plan. Good everyday management helps keep the airways calm and less sensitive.

Vaccines

People with asthma are encouraged to have the seasonal flu vaccine and the pneumococcal vaccine. These help protect against infections that can make asthma worse. Ask your doctor, nurse, or pharmacist what vaccinations are recommended for you.

Screening programmes

There is no routine screening test for asthma in the general population. However, if you have allergy symptoms or a family history, it's wise to discuss them with a doctor, as earlier diagnosis can lead to better control.

Complications

If left untreated

• Frequent asthma attacks that can be frightening and may require emergency care
• Permanent narrowing or remodelling of the airways over time
• Poor sleep and fatigue from night-time asthma symptoms
• Absences from school or work and limits on daily activities
• In severe cases, life-threatening breathing failure

Long-term outlook

For most people, asthma is very manageable. With a correct diagnosis, a personalised action plan, and regular reviews, the large majority of people with asthma enjoy full, active lives. Even if you have had serious attacks in the past, working closely with your healthcare team can make a real difference.

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