Asthma control in adults

Overview

Asthma is a long-term condition that affects the airways (the tubes that carry air in and out of your lungs). In asthma, these airways become narrow and inflamed, making it harder to breathe.

Yes, asthma is very common. In the UK, about 5.4 million people have asthma.

Asthma can start at any age, but it often begins in childhood. In adults, asthma may be a new condition or a continuation of childhood asthma.

Symptoms

Common symptoms

• Shortness of breath
• Coughing, especially at night or early morning
• Wheezing (a whistling sound when breathing)
• Chest tightness or pain

Symptoms in children

• Faster or noisy breathing
• Coughing that gets worse with exercise or laughing
• Tiredness or less energy
• Trouble sleeping due to coughing or wheezing

Symptoms in older adults

• Wheezing may be less noticeable
• More frequent chest infections
• Feeling breathless after mild activity
• Coughing that won't go away

Causes

Main causes

• The exact cause of asthma is not fully understood, but it involves a combination of genetic and environmental factors.
• Common triggers for asthma symptoms include allergens (pollen, dust mites, pet dander), respiratory infections, exercise, cold air, smoke, and strong emotions.

Risk factors

• Having a family history of asthma, allergies, or eczema
• Having allergies yourself
• Being exposed to tobacco smoke as a child
• Living in an area with high air pollution
• Certain jobs where you breathe in dust, fumes, or chemicals

When to see a doctor

See a doctor urgently if:

• If your symptoms are getting worse quickly despite using your reliever inhaler
• If you need to use your reliever inhaler more than every 4 hours
• If you have severe shortness of breath or difficulty speaking

Book a routine appointment if:

• If you are coughing or wheezing regularly and it affects your daily life
• If you need to use your reliever inhaler more than twice a week
• If you are waking up at night due to symptoms

Diagnosis

Your doctor will ask about your symptoms, medical history, and family history. They will also listen to your lungs and may do breathing tests to confirm asthma.

Tests that may be done

• Spirometry – a test where you blow into a machine to measure how well your lungs work
• Peak flow test – a simple device to measure how fast you can breathe out
• Allergy tests (skin prick or blood tests) to check for allergies that may trigger asthma
• FeNO test – a test to measure inflammation in your airways

What to expect at your appointment

Diagnosis is usually straightforward, but sometimes your doctor may ask you to monitor your symptoms at home and record your peak flow readings for a few weeks. This helps them see patterns and confirm asthma.

Treatment

Treatment for asthma aims to control symptoms, prevent attacks, and allow you to live a normal life. It involves a combination of medications (usually inhalers) and lifestyle changes.

Self-care at home

• Learn to identify and avoid your asthma triggers
• Follow your written asthma action plan provided by your doctor
• Use your inhalers as prescribed, even if you feel well
• Monitor your symptoms and peak flow readings
• Get vaccinated against flu and pneumonia to reduce infection risk

Medical treatments

Most people with asthma use two types of inhaler: a preventer inhaler (taken daily to reduce airway inflammation) and a reliever inhaler (used when symptoms occur). In some cases, your doctor may recommend a combination inhaler or add-on treatments such as tablets or injections. It is important to take your medication exactly as prescribed and to have regular reviews.

When is surgery considered?

Surgery is not a treatment for asthma. Very rarely, a procedure called bronchial thermoplasty may be considered for severe asthma that does not respond to other treatments, but this is not common.

Living with this condition

With good control, you can do almost everything you want, including exercise, work, and social activities. The key is to manage your asthma daily by taking your medication and avoiding triggers.

Lifestyle tips

• Use a peak flow meter to check your breathing regularly
• Keep your home clean and free of dust and mold
• Avoid smoking and secondhand smoke
• Manage stress through relaxation techniques
• Wear a scarf over your mouth and nose in cold weather to warm the air you breathe

Diet and exercise

A balanced diet is important for overall health, but no specific diet can cure asthma. Regular exercise is good for you and can actually help your lungs work better. If exercise triggers your asthma, talk to your doctor about using your reliever inhaler before exercise.

Mental health and emotional wellbeing

Living with a long-term condition like asthma can sometimes cause stress, anxiety, or low mood. It's important to talk to your doctor if you feel this way. They can offer support and connect you with helpful resources.

Prevention

Asthma cannot be prevented, but you can reduce the risk of attacks by avoiding triggers, taking medication as prescribed, and having regular check-ups.

Vaccines

It is recommended to have the annual flu vaccine and the pneumonia vaccine to reduce the risk of infections that can make asthma worse. Talk to your doctor about these vaccines.

Screening programmes

There is no routine screening test for asthma in adults who have no symptoms. If you have symptoms, see your doctor for an assessment.

Complications

If left untreated

• Severe asthma attacks that may require emergency hospital care
• Long-term airway damage and reduced lung function
• Sleep problems due to nighttime symptoms
• Increased risk of lung infections such as pneumonia
• Reduced quality of life and ability to work or exercise

Long-term outlook

With good management, most people with asthma lead full and active lives. Asthma does not usually get worse over time, and many people find that their symptoms improve as they get older. Working closely with your healthcare team and following your action plan gives you the best chance of staying well.

Find support

International organisations

• Asthma and Allergy Foundation of America
• Asthma UK

Local organisations

• Your local health service or asthma clinic

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