questions to ask before asthma

Overview

Asthma is a long-term condition that affects the airways in your lungs. The airways become narrow and swollen, and they produce extra mucus, making it hard to breathe. It can cause coughing, wheezing (a whistling sound when you breathe), chest tightness, and shortness of breath.

Yes, asthma is very common. It affects about 1 in 12 adults and 1 in 10 children globally. In the UK, around 5.4 million people have asthma.

Asthma can affect anyone, but it is more common in children, especially boys. It often runs in families. People with allergies, eczema, or a family history of asthma are at higher risk.

Symptoms

Common symptoms

• Frequent coughing, especially at night or early morning
• Wheezing: a whistling sound when you breathe out
• Chest tightness, like someone is squeezing your chest
• Shortness of breath, especially after exercise or exposure to triggers

Symptoms in children

• Frequent coughing, especially during play or at night
• Getting tired quickly during physical activity
• Breathing faster than usual
• Complaining of chest pain or feeling 'tight'

Symptoms in older adults

• Wheezing that may be mistaken for other lung problems
• Shortness of breath that limits daily activities
• Coughing that produces mucus
• Difficulty catching breath after simple tasks

Causes

Main causes

• The exact cause of asthma is not fully known. It is likely a mix of genes and environment.
• Asthma often starts because of a trigger that causes the airways to become inflamed and narrow.
• Common triggers include pollen, dust mites, pet dander, mold, cold air, smoke, and exercise.

Risk factors

• Having a family history of asthma or allergies (eczema, hay fever)
• Being born with a low birth weight or early (preterm)
• Living in an area with high air pollution or second-hand smoke
• Having a viral respiratory infection like bronchiolitis as a child
• Exposure to occupational triggers like chemicals or dust (work-related asthma)

When to see a doctor

See a doctor urgently if:

• If you have a sudden asthma attack and your reliever inhaler is not helping
• If your symptoms wake you up at night more than once a week
• If you need to use your reliever inhaler more than three times a week for symptom relief
• If your peak flow readings (if you use a meter) drop below 60% of your personal best

Book a routine appointment if:

• If you think you might have asthma – your doctor can do tests to check
• For a regular asthma review to see if your treatment plan is working
• Before making changes to your medication or adding new treatments

Diagnosis

Doctors diagnose asthma by taking a detailed history of your symptoms, doing a physical exam, and performing breathing tests. They may also check for allergies or try a trial of asthma medication to see if it helps.

Tests that may be done

• Spirometry: you blow into a machine that measures how much air you can exhale and how fast
• Peak flow monitoring: a small device you blow into to measure how well your lungs are working
• FeNO test: you breathe into a device that measures inflammation in your airways
• Allergy tests: skin or blood tests to see if you react to common triggers

What to expect at your appointment

Your doctor will explain each test to you and tell you what to do before them (for example, avoid taking certain medicines). The tests are not painful, but you may feel a little short of breath or dizzy during spirometry. Most tests take about 30 minutes. After a diagnosis, you will work with your doctor to create an asthma action plan.

Treatment

Asthma treatment is about controlling symptoms and preventing attacks. It usually involves using inhalers regularly, avoiding triggers, and having a written action plan. Most treatments work by reducing swelling in the airways or quickly relaxing the muscles around them. Treatment is personal – you and your doctor will find what works best for you.

Self-care at home

• Identify and avoid your asthma triggers – keep a diary if needed
• Use your inhalers exactly as prescribed, even when you feel fine
• Check your peak flow regularly if your doctor recommends it
• Get vaccinated against flu and pneumonia (if your doctor advises)
• Have a written asthma action plan that tells you what to do when symptoms get worse

Medical treatments

Medical treatments for asthma include two main types of inhalers: preventer inhalers (taken daily to reduce inflammation and prevent symptoms) and reliever inhalers (used when you have symptoms to quickly open the airways). Some people may need a combination inhaler. In severe cases, additional treatments like tablets, injections, or specialized therapies may be used. Your doctor will discuss the options with you and adjust your treatment as needed.

When is surgery considered?

Surgery is not a usual treatment for asthma. In very rare cases, a procedure called bronchial thermoplasty may be considered for severe asthma that does not respond to other treatments. This involves using heat to reduce the smooth muscle in the airways. Talk to your specialist if you think this might be an option for you.

Living with this condition

Living with asthma means paying attention to your symptoms and triggers every day, but it does not have to stop you from doing what you enjoy. Most people with asthma can work, exercise, travel, and have an active social life. The key is to take your medication regularly and follow your action plan.

Lifestyle tips

• Keep your home and workplace free of dust, mold, and pet dander
• Use allergy-proof covers on pillows and mattresses
• Avoid smoking and second-hand smoke
• Check air quality and pollen forecasts, and limit outdoor time on high days
• Carry your reliever inhaler with you at all times

Diet and exercise

A healthy, balanced diet can help your overall health and may reduce inflammation. Exercise is good for your lungs, but it can also trigger symptoms if not managed. Your doctor can give you advice on how to exercise safely, such as warming up slowly and using your reliever inhaler before exercise if needed. Swimming, walking, and yoga are often good choices.

Mental health and emotional wellbeing

Living with a chronic condition like asthma can sometimes cause stress, anxiety, or depression. Worrying about attacks or feeling limited can be tough. It is important to talk to your doctor or a mental health professional if you feel overwhelmed. Support groups can also help you connect with others who understand.

Prevention

There is no known way to prevent asthma from developing, but you can reduce the risk of it starting in children by avoiding smoking during pregnancy and keeping children away from smoke. For people who already have asthma, you can prevent attacks by taking your medications regularly, avoiding triggers, and having an action plan.

Vaccines

Vaccines cannot prevent asthma, but getting the yearly flu vaccine and the pneumonia vaccine (if your doctor recommends it) can help prevent serious respiratory infections that can trigger asthma attacks.

Screening programmes

There is no routine screening for asthma in the general population. However, if you have a family history of asthma or symptoms like persistent coughing or wheezing, your doctor may recommend tests earlier. Children at high risk may be monitored more closely.

Complications

If left untreated

• Asthma attacks that require emergency care or hospitalization
• Permanent narrowing of the airways over time
• Sleep problems and fatigue due to nighttime symptoms
• Missed school or work days
• Poor exercise tolerance and reduced quality of life

Long-term outlook

With proper treatment and management, most people with asthma can keep their symptoms under control and live a full life. While asthma is a chronic condition, it does not have to slow you down. Working closely with your healthcare team and following your action plan can make a huge difference. Many people with asthma successfully manage their condition and continue to do everything they love.

Find support

International organisations

• Asthma and Allergy Foundation of America (AAFA) ↗
• Global Initiative for Asthma (GINA) ↗

Local organisations

• Asthma + Lung UK ↗ · United Kingdom

Helplines

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