asthma treatment options overview

Overview

Asthma is a long-term condition that affects the airways in your lungs. The airways become inflamed and narrow, making it harder to breathe. With the right treatment, most people with asthma can keep symptoms under control and live an active life.

Yes, asthma is one of the most common long-term health conditions in the world. It affects people of all ages, and the number of people diagnosed is large and growing.

Asthma can affect anyone, but it often begins in childhood. Some people develop asthma later in life as adults. It can run in families, and people with allergies are more likely to have it.

Symptoms

Common symptoms

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

Symptoms in children

• Coughing at night or during play
• Poor feeding or trouble sucking in infants
• Tiredness and less energy
• Breathing faster than usual

Symptoms in older adults

• Shortness of breath during normal activities
• Waking up at night with coughing or wheeze
• Fatigue during the day
• Worsening of symptoms with colds or flu

Causes

Main causes

• The exact cause of asthma is not fully known, but it is likely a mix of genetics and the environment.
• The airways are very sensitive and overreact to certain triggers.
• Inflammation and muscle spasms narrow the airways and make breathing difficult.

Risk factors

• A family history of asthma, allergies, or eczema
• Personal history of allergies like hay fever or pet allergies
• Exposure to tobacco smoke, especially in childhood
• Air pollution or workplace irritants like dust and chemicals
• Obesity
• Viral respiratory infections, especially in young children

When to see a doctor

See a doctor urgently if:

• You have asthma symptoms that are getting worse rapidly or not responding to treatment.
• You have a severe asthma attack or need emergency care — call your local emergency number immediately.

Book a routine appointment if:

• You have new symptoms that might be asthma.
• You need a check-up or a review of your treatment plan.
• Your symptoms are affecting your sleep, work, exercise, or daily life.
• You have side effects from your medicine or are concerned about how well your inhaler is working.

Diagnosis

There is no single test for asthma. Your healthcare provider will ask about your symptoms, your medical and family history, and may do breathing tests. They will also check to see if there are signs of other conditions that can cause similar symptoms.

Tests that may be done

• Spirometry — you blow hard into a machine that measures how much air you can exhale and how fast.
• Peak flow test — you blow into a small handheld device to measure how well air moves out of your lungs.
• FeNO test — you breathe into a tube that measures inflammation in your airways.
• A steroid trial or bronchial challenge test may be used if the diagnosis is not clear.

What to expect at your appointment

Diagnosis usually starts with your family doctor. If needed, they may refer you to a specialist for more tests. The process is straightforward and non-invasive. You will be asked to perform breathing tests and may be given a peak flow meter to use at home to track your breathing over time.

Treatment

The goal of asthma treatment is to control symptoms, prevent attacks, and help you live normally. Treatment is not one-size-fits-all — it is adjusted based on how often you have symptoms and how severe they are. Most treatment is given through inhalers, which get the medicine directly into your airways.

Self-care at home

• Learn what triggers your asthma and try to avoid those triggers.
• Use your inhaler correctly — ask your healthcare provider or pharmacist to check your technique.
• Take your preventer medicine every day, even when you feel well.
• Make and follow a written asthma action plan with your healthcare provider.
• Keep your reliever inhaler with you at all times.

Medical treatments

Treatment approaches are generally grouped into reliever inhalers (taken when symptoms happen to quickly open the airways) and preventer inhalers (taken daily to reduce airway inflammation and prevent symptoms). Some people use combination inhalers that contain both a preventer and a long-acting reliever. Other options include add-on treatments, such as oral tablets, nebulisers for severe attacks, or biologic therapies given by injection for severe asthma that does not respond to standard inhalers. Your healthcare provider will tailor the choice and strength of your medicines based on your level of control. Do not stop or change your treatment without advice from your healthcare provider.

When is surgery considered?

Surgery is not a treatment for asthma. However, some people with severe asthma may have a procedure called bronchial thermoplasty, which is a non-surgical, minimally invasive treatment that reduces the amount of muscle in the airway walls. This is only offered in very selected cases and is not a first-line treatment.

Living with this condition

Living with asthma means managing it every day. Use your preventer inhaler regularly as prescribed, and always keep your reliever inhaler close by. Check your inhaler technique regularly — many people do not use their inhalers correctly. Follow your asthma action plan and know what to do when symptoms get worse.

Lifestyle tips

• Avoid or reduce contact with known triggers such as tobacco smoke, dust mites, pet fur, and pollen.
• Do not smoke and avoid others' smoke.
• Keep your home well ventilated and reduce dampness.
• Stay at a healthy weight — excess weight can make asthma harder to control.
• Try to avoid catching respiratory infections like colds and flu by washing hands regularly and getting recommended vaccinations.

Diet and exercise

There is no special asthma diet, but eating a healthy, balanced diet supports your overall health and lung function. Exercise is good for you and can improve your fitness and asthma control. Remember to warm up and cool down, and always keep your reliever inhaler nearby during physical activity. If exercise triggers your symptoms, speak to your healthcare provider — they can help adjust your treatment or activity plan.

Mental health and emotional wellbeing

Living with a long-term condition like asthma can sometimes cause stress, anxiety, or low mood. Worrying about when the next attack might happen is very common. These feelings are important to talk about. Your healthcare provider can work with you to manage both your physical and mental health, and support groups can also help.

Prevention

Asthma cannot always be prevented, but you can reduce the risk of an asthma attack by controlling triggers and taking your treatment regularly. Early diagnosis and a good action plan can also help keep symptoms under control and prevent complications.

Vaccines

People with chronic lung conditions like asthma are often eligible for flu, pneumococcal, and COVID-19 vaccines. Vaccination helps prevent infections that can make asthma worse. Check with your local health service for guidance.

Screening programmes

There is no routine screening test for asthma in the general population. However, if you have asthma-like symptoms, it is important to get assessed early to receive an accurate diagnosis and a treatment plan.

Complications

If left untreated

• Frequent asthma attacks that require emergency care
• Permanent narrowing or “remodeling” of the airways over time
• Loss of sleep and reduced quality of life
• Time off work or school
• In rare cases, life-threatening attacks

Long-term outlook

The outlook for people with asthma is very good. With modern treatments and self-management, most people achieve good control and can do almost everything that someone without asthma can do. The key is to take your medicines as prescribed, avoid your triggers, and have a plan in place for when symptoms flare up. You are not alone — many people live full, active lives with asthma.

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