asthma when to seek care

Overview

Asthma is a long-term lung condition that makes the airways inside your lungs swell and become narrow. This can make it harder to breathe and can cause coughing, wheezing, and a tight feeling in your chest. With good care, most people with asthma can live full and active lives.

Yes, asthma is very common. It affects millions of people around the world, and in the UK about one in every 12 adults and one in every 11 children has asthma.

Asthma can start at any age, but it is most often diagnosed in childhood. It may be more common in people who have allergies, a family history of asthma, or who are exposed to tobacco smoke or air pollution.

Symptoms

Common symptoms

• Wheezing – a whistling sound when you breathe out
• Shortness of breath
• A feeling of tightness in the chest
• Coughing, especially at night or early morning

Symptoms in children

• Rapid breathing or panting
• Difficulty feeding or eating because of breathing trouble
• Tiredness and low energy due to poor sleep
• Less interest in playing or running around

Symptoms in older adults

• More breathlessness than usual with everyday activities
• Fatigue and weakness
• Coughing that lasts a long time
• Confusion or drowsiness in severe cases – this can be a sign of low oxygen

Causes

Main causes

• Inflammation and swelling inside the airways of your lungs
• Airways that are very sensitive and react strongly to triggers
• Narrowing of the airways due to muscle tightening around them

Risk factors

• A family history of asthma or allergies like hay fever or eczema
• Having allergies – for example to pollen, dust mites, or pet hair
• Smoking or being around tobacco smoke
• Air pollution or workplace dusts and chemicals
• Frequent respiratory infections in early childhood

When to see a doctor

See a doctor urgently if:

• If you think you or your child is having an asthma attack – seek urgent care same day
• If symptoms are not getting better after using your reliever inhaler as directed
• If you are using your reliever inhaler very frequently, such as more than a few times a week

Book a routine appointment if:

• If you are newly experiencing breathing symptoms – make an appointment to get checked
• If you have asthma and need a regular review of your treatment (usually every 6 to 12 months)
• If your symptoms interfere with sleep, exercise, work, or school

Diagnosis

Your doctor will ask about your symptoms, your medical and family history, and listen to your lungs. They may ask you to do some breathing tests to measure how well air moves in and out of your lungs. There is no single test that diagnoses asthma – it is based on the whole picture.

Tests that may be done

• Spirometry – you blow into a tube to measure how much air you can breathe out and how fast
• Peak flow measurement – a small handheld device that checks how fast you can blow out air, often done at home over a few weeks
• A trial of treatment – your doctor may give you a reliever inhaler and see if your symptoms improve

What to expect at your appointment

The diagnosis process may take time. You may be asked to track your symptoms at home, and you might be referred to a lung specialist for further tests. The goal is to get an accurate diagnosis so you can start the right treatment as soon as possible.

Treatment

Asthma treatment usually involves inhalers. There are two main types: a reliever inhaler that helps open your airways quickly when you feel symptoms, and a preventer inhaler that is used every day to reduce inflammation and stop symptoms from happening. Your doctor will help you find the best plan for you. Treatment is not one-size-fits-all – it can be adjusted based on your symptoms and your lifestyle.

Self-care at home

• Make and follow your written asthma action plan
• Identify and avoid your personal triggers, like cold air, pollen, or smoke
• Use your inhalers exactly as prescribed – don't skip doses
• Show family and friends how to help if you have an attack
• Check your technique with your doctor or pharmacist to make sure you are using your inhaler correctly

Medical treatments

Medical treatment for asthma is personalised. It typically starts with a reliever inhaler used when needed. If symptoms are more frequent, a preventer inhaler taken daily may be added. Your doctor might also suggest combined inhalers or other controller medications. All of these work to reduce airway inflammation and keep airways open. Your treatment plan should be reviewed regularly and can be stepped up or down based on how are you doing. Never change your medicines without talking to your doctor first.

When is surgery considered?

Surgery is not a usual treatment for asthma. However, in severe cases that do not respond to medicines, there are some specialist procedures that might be considered – these are only offered in expert centres and are not surgery in the traditional sense. Your asthma team will explain all options if they apply to you.

Living with this condition

Living with asthma is mostly about staying on top of your routine. Keep your inhaler close by, take your preventer every day if you are prescribed one, and notice changes in your symptoms early. A good action plan can help you know exactly what to do when your breathing worsens.

Lifestyle tips

• If you smoke, try to quit – your doctor or local stop-smoking service can help
• Avoid second-hand smoke and heavily polluted areas when possible
• Keep your home well ventilated and reduce dust and mould
• Stay physically active – regular gentle exercise can strengthen your lungs
• Get enough sleep and manage stress, as stress can make asthma worse

Diet and exercise

A healthy, balanced diet helps overall health and can support your immune system – there is no special 'asthma diet.' Exercise is generally good for people with asthma, especially when symptoms are well controlled. Warm up properly, and if cold air triggers you, cover your nose and mouth with a scarf or exercise indoors. Always use your reliever inhaler before exercise if your doctor has advised that.

Mental health and emotional wellbeing

Living with a long-term condition like asthma can sometimes cause anxiety or low mood, especially if you worry about having an attack. This is normal and nothing to be ashamed of. If you find that worry is affecting your daily life, talk to your doctor – support is available, and anxiety can also make asthma symptoms worse.

Prevention

Asthma itself cannot always be prevented, especially if it runs in your family. However, you can often prevent asthma attacks by avoiding your known triggers, taking your preventer medicines as prescribed, and following your action plan. Good control is the best prevention.

Vaccines

Everyone with asthma is encouraged to keep up to date with their routine vaccinations, including the annual flu vaccine and COVID-19 vaccines. Respiratory infections can make asthma worse, so protecting yourself against them is a good idea. Speak to your doctor or pharmacist about which vaccines are recommended for you.

Screening programmes

There is no routine screening for asthma in healthy people. If you have symptoms that could be asthma, you should see your doctor for a full assessment rather than waiting for a screening programme.

Complications

If left untreated

• Frequent asthma attacks that may require emergency care or hospital stays
• Permanent narrowing of the airways, leading to long-term breathing difficulties
• Poor sleep and tiredness, which can affect work, school, and relationships
• Low oxygen levels, which can be dangerous and require urgent medical help

Long-term outlook

The outlook for asthma is very good. With the right treatment, most people can control their symptoms and live completely normal lives. While asthma can be serious, it is also highly manageable – and countless people with asthma are athletes, artists, parents, and professionals. Building a good partnership with your healthcare team and following your care plan gives you the best chance of staying well.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.