asthma overview for patients

Overview

Asthma is a long-term (chronic) condition that affects the airways in your lungs. The airways become swollen, narrow, and produce extra mucus, making it harder to breathe. With the right care, most people with asthma can live full and active lives.

Yes. Asthma is one of the most common long-term conditions worldwide. Around 300 million people live with it.

It affects people of all ages, backgrounds, and fitness levels. It is slightly more common in children and often runs in families.

Symptoms

Common symptoms

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

Symptoms in children

• Coughing that gets worse with exercise or at night
• Tiredness and less energy during play
• Rapid breathing or drawing in of the ribs
• Complaining that the chest 'hurts' or feels tight
• Struggling to keep up with friends during physical activity

Symptoms in older adults

• More frequent breathlessness that limits daily activities
• A lingering cough that may be mistaken for other conditions
• Feeling very tired because breathing takes extra effort
• Wheezing that may be less obvious than in younger people
• Difficulty sleeping due to breathlessness

Causes

Main causes

• The exact cause of asthma is not fully known, but it often develops from a mix of genetics and environmental factors.
• In many cases, the immune system overreacts to common substances such as pollen, dust mites, or pet dander.
• Viral infections early in life can play a role in some people.
• Certain chemicals or irritants at work can cause occupational asthma.

Risk factors

• Family history of asthma or allergies (such as eczema or hay fever)
• Having allergies
• Frequent respiratory infections as a child
• Exposure to tobacco smoke in early life
• Air pollution or poor air quality
• Being overweight
• Working in jobs with dust, fumes, or chemicals

When to see a doctor

See a doctor urgently if:

• You need to use your reliever inhaler more than every 4 hours
• Symptoms wake you up at night regularly
• You cannot do your usual activities because of breathlessness
• You have a cough or wheeze that lasts more than a few weeks

Book a routine appointment if:

• For regular asthma reviews (at least once a year)
• To update your written asthma action plan
• Before making changes to your medication
• If you want help to reduce triggers such as smoking or allergens

Diagnosis

There is no single test for asthma. Your doctor will listen to your symptoms, ask about your medical and family history, and carry out breathing tests to see how well your lungs work.

Tests that may be done

• FeNO test – a quick breath test that measures inflammation in the airways
• Spirometry – blowing into a machine to measure how fast and how much air you can breathe out
• Peak flow test – a handheld device to measure how quickly you can blow air out
• Challenge tests – exercising or inhaling a substance to see if symptoms appear
• Allergy tests – to identify specific triggers

What to expect at your appointment

Your appointment may take up to an hour. The tests are painless, though breathing into a tube can make you feel a little light-headed or tired. You will likely be asked to use your reliever inhaler before or after. Write down your symptoms beforehand so you do not forget anything. After diagnosis, you will receive a plan to manage your asthma.

Treatment

Asthma treatment focuses on preventing symptoms and stopping flare-ups. The two main types of inhalers are relievers (to quickly open the airways during an attack) and preventers (used daily to reduce swelling in the airways). Your doctor will tailor the treatment to your needs.

Self-care at home

• Take your preventer inhaler every day, even if you feel fine
• Learn and follow your written asthma action plan
• Identify and avoid your triggers (such as tobacco smoke, dust mites, or pollen)
• Check your inhaler technique with your doctor or pharmacist—this matters more than most people think
• Keep your reliever inhaler with you at all times

Medical treatments

Inhaled medications are the backbone of asthma care. A short-acting reliever is used when symptoms appear and to prevent exercise-related symptoms. Long-acting preventer inhalers are used daily to reduce inflammation and are often combined with a corticosteroid. In more difficult cases, your doctor might suggest add-on treatments such as inhalers with a different mechanism, or biologic therapies given by injection—these are usually only for severe asthma under specialist care. Antibiotics are only used if there is a bacterial infection, not for a typical asthma attack.

When is surgery considered?

Surgery is not a usual treatment for asthma. Some procedures are being studied for severe asthma (such as bronchial thermoplasty), but these are not commonly recommended and would only be considered by a specialist if other options have failed.

Living with this condition

Living well with asthma is mostly about small daily habits. Taking your preventer inhaler exactly as prescribed keeps the airways calm, so asthma is less likely to interfere with school, work, exercise, or sleep. A written action plan will tell you what to do if symptoms flare.

Lifestyle tips

• Do not smoke and avoid second-hand smoke
• Use a spacer device with your inhaler if you can, for better medicine delivery
• Keep your home free of dust mites by washing bedding in hot water and using allergen-proof covers
• Manage indoor humidity to reduce mold and cockroaches
• Stay indoors on high-pollution or high-pollen days when possible

Diet and exercise

There is no special asthma diet. A balanced, varied diet supports your immune system, and maintaining a healthy weight may reduce pressure on your lungs. Exercise is good for asthma—it strengthens the heart and lungs. Tell your doctor if exercise triggers symptoms; they can help you use a reliever beforehand or adjust your treatment.

Mental health and emotional wellbeing

Living with a condition that can suddenly restrict your breathing is stressful. Anxiety and asthma often feed each other: stress can trigger symptoms, and symptoms can cause more anxiety. It is important to talk to your healthcare team about how you feel, and to seek support if worry interferes with daily life.

Prevention

You cannot always prevent asthma from developing, but you can reduce the risk of attacks. The most effective ways are avoiding triggers, taking preventative medication, and stopping smoking. Childhood asthma risk may be lower when babies are not exposed to tobacco smoke and when women plan pregnancies with supported care.

Vaccines

Staying up to date with vaccines helps. The flu vaccine and the COVID-19 vaccine are especially recommended for people with asthma because respiratory infections can trigger serious flare-ups. Talk to your doctor or pharmacist about what is appropriate for you.

Screening programmes

There is no routine screening test for asthma in the general population. If you have frequent cough, wheeze, breathlessness, or chest tightness, see a doctor for a breathing assessment.

Complications

If left untreated

• Frequent emergency visits and hospitalizations
• Permanent narrowing of the airways (airway remodeling)
• Poor sleep and fatigue, affecting school or work
• Reduced quality of life with difficulty exercising and doing daily tasks
• Severe asthma attacks that can be life-threatening

Long-term outlook

With modern treatment, most people with asthma can control their symptoms and live active, normal lives. The goal of treatment is not to limit you—it is to help you breathe with ease. Regular check-ins and following your action plan make a big difference. Many people with asthma become excellent self-managers and rarely have flare-ups.

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