Asthma Management

Overview

Asthma is a long-term condition that affects the small tubes in the lungs. These tubes carry air in and out of the body. In asthma, these tubes can become swollen, narrow, and fill with sticky mucus. This makes it harder to breathe and can cause coughing, wheezing, and a tight feeling in the chest.

Asthma is very common. Millions of people around the world have asthma, including both adults and children. In the UK, it is one of the most common long-term conditions.

Asthma can affect anyone, at any age. It often starts in childhood, but it can also appear for the first time in adulthood. Some people have asthma attacks only occasionally, while others have symptoms every day.

Symptoms

Common symptoms

• Wheezing – a whistling sound when you breathe out
• Feeling short of breath
• A tight feeling in the chest
• A cough, especially at night or early in the morning

Symptoms in children

• Coughing, often after playing or laughing
• Tiring quickly during physical activity
• Wheezing or noisy breathing
• Complaining of a sore or tight chest

Symptoms in older adults

• Shortness of breath during everyday tasks
• A cough that will not go away
• Less obvious wheezing than in younger people
• Fatigue or trouble sleeping due to breathing issues

Causes

Main causes

• Swelling (inflammation) of the lining of the airways
• Tightening of the muscles that surround the airways (bronchoconstriction)
• Extra mucus blocking the airways

Risk factors

• A family history of asthma or allergies (such as eczema or hay fever)
• Allergies to things like dust mites, pollen, or pet dander
• Exposure to smoke, especially in childhood
• Poor air quality or air pollution
• Being overweight or obese
• Having a history of lung infections as a child

When to see a doctor

See a doctor urgently if:

• If you have asthma symptoms that are getting worse and your reliever inhaler is not helping
• If you need to use your reliever inhaler more than every 4 hours
• If you cannot sleep because of coughing or wheezing
• If you are short of breath even when resting

Book a routine appointment if:

• If you have been newly diagnosed or suspect you have asthma
• If your symptoms are interfering with your daily life, work, or school
• For a regular asthma review – at least once a year, or more often if your asthma is not well controlled
• If you want help to build a personal asthma action plan

Diagnosis

A doctor diagnoses asthma by listening to your symptoms, asking about your medical and family history, and doing breathing tests. They will also check for other possible causes of your symptoms.

Tests that may be done

• Lung function test (spirometry) – you blow into a tube to measure how fast and how much air you can breathe out
• Peak flow test – you use a small handheld device to check how well your lungs are working, sometimes at home over a few weeks
• Allergy tests – to see if allergies are triggering your asthma symptoms
• FeNO test – you breathe into a device that measures inflammation in your airways

What to expect at your appointment

The doctor will talk with you about your symptoms and may ask you to do some breathing tests. These are simple and painless. Sometimes the doctor will give you a device to use at home to track your breathing over a couple of weeks. After the tests, they will explain the results and, if you have asthma, work with you to create a plan to manage it.

Treatment

Treatment for asthma focuses on controlling the condition so you can live normally and avoid asthma attacks. It usually involves avoiding triggers and using medicines, often taken through inhalers. Your doctor will adjust the treatment over time based on how well your asthma is controlled.

Self-care at home

• Follow your personal asthma action plan agreed with your doctor or nurse
• Identify and avoid triggers, such as smoke, pollen, dust, or cold air
• Take your medicines exactly as prescribed, even when you feel well
• Keep your inhaler technique checked regularly – make sure you are using it correctly
• Monitor your symptoms and write them down if they change

Medical treatments

Medicines for asthma are usually given through an inhaler. There are two main types: a reliever, used to quickly ease symptoms during an attack, and a preventer, used regularly to reduce inflammation and stop symptoms happening in the first place. Some people may also need other treatments, such as medicines to relax the airways or, for severe asthma, injection treatments that target the cause of the inflammation. Your doctor will decide what is best for you. Always ask your doctor or pharmacist for instructions on how to use your inhaler and how often to take your medicines.

When is surgery considered?

Surgery is not a standard treatment for asthma. In very rare and severe cases, a procedure such as bronchial thermoplasty may be considered, but this is not surgery in the traditional sense. Your specialist will explain all options if your asthma is difficult to control.

Living with this condition

Living with asthma means keeping track of how you feel and making small adjustments to avoid triggers. Follow your action plan, take your medicines as prescribed, and keep your inhaler with you. Many people live a normal daily routine with asthma by doing these things consistently.

Lifestyle tips

• If you smoke, get help to quit – smoking makes asthma worse
• Avoid exposure to second-hand smoke
• Stay active – exercise is good for your lungs if your asthma is well controlled
• Try to keep indoor air clean and reduce dust and allergens
• Get enough sleep and manage stress, as stress can trigger symptoms

Diet and exercise

There is no special diet that cures asthma, but eating a balanced diet with lots of fruits and vegetables can support your overall health. Regular exercise is encouraged – swimming, walking, and cycling are good choices. Warm up properly before exercise and, if you have exercise-induced asthma, your doctor may suggest using your reliever inhaler beforehand. Always talk to your healthcare team before starting a new exercise routine.

Mental health and emotional wellbeing

Living with a chronic condition like asthma can sometimes cause anxiety, stress, or low mood. Worrying about an asthma attack can also be part of the condition. It is important to talk about these feelings with your doctor, as they can help. You should also remember to look after your mental well-being, just as you care for your physical health.

Prevention

There is no known way to prevent asthma from developing, but you can prevent asthma symptoms and attacks by managing the condition well. Avoiding your triggers, taking your preventer medicine, and following your action plan are the best ways to keep asthma under control.

Vaccines

Having certain vaccinations can lower your risk of infections that can make asthma worse. Ask your doctor about the annual flu vaccine and the pneumonia vaccine. You should also stay up to date with other recommended vaccines.

Screening programmes

Screening for asthma is not done routinely in people without symptoms. However, if you have a family history of asthma or allergies, or if you have symptoms like a persistent cough or wheezing, ask your doctor for a check-up. Regular asthma reviews are important if you already have asthma.

Complications

If left untreated

• Frequent or severe asthma attacks that may require hospital care
• Permanent narrowing of the airways
• Difficulty sleeping and tiredness due to nighttime symptoms
• Reduced ability to exercise or do everyday activities
• In rarer cases, life-threatening breathing failure

Long-term outlook

With good management, most people with asthma can lead a full, active, and healthy life. Asthma is a long-term condition, but it is not a barrier to achieving your goals. By working closely with your healthcare team, following your plan, and taking your medicines correctly, you can control your symptoms and reduce the risk of attacks. Many athletes, professionals, and people of all ages thrive with asthma.

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