What causes Asthma
Asthma is a chronic lung disease that affects over 5 million people in the United Kingdom. It is a chronic condition characterised by inflammation and narrowing of the airways and lungs, resulting in symptoms such as wheezing, shortness of breath, and coughing. Symptoms vary greatly between individuals; severe asthma can be fatal. Even though asthma is incurable, children can grow out of it during their adolescent years, and it can be well controlled and managed with treatment with minimal impact on quality of life.
Over 5 million people in the UK are currently receiving asthma treatment, with one in every five households having someone with asthma. Asthma is more common in women and children, but it can affect anyone and develop at any age. If asthma develops in adulthood, it is more likely to be chronic.
Asthma is caused by what?
Asthma does not have a single direct cause; it can be caused by a combination of multiple environmental or genetic factors. Asthma can be caused by air pollutants, outdoor allergens (such as pollen), indoor allergens (such as dust), air quality, and certain viral respiratory infections.
Asthma is also caused by genetic factors, as well as environmental factors such as family history, obesity, and psychological stress. Some medications can also cause asthma attacks in some patients. Asthma is more common in children and people who have allergies like hay fever or eczema. Children who are exposed to tobacco smoke, are born prematurely, or have a low birth weight are at a higher risk of developing asthma.
What are the signs and symptoms of Asthma?
Asthma symptoms include wheezing, shortness of breath, chest tightness, pain or pressure, and severe coughing. These symptoms are typically worse at night or in the early mornings, but they can occur at any time.
Asthma symptoms are typically triggered by asthma triggers such as:
- Anxiety or stress
- Smoke from tobacco
- Pollution in the air
- Allergies (including pollen, dust mites, animal fur, and food allergies)
- Infections of the lungs (including cold & flu)
- Medications (including aspirin, ibuprofen, and beta-blockers)
- The weather situation (cold air, a sudden change in temperature, high humidity)
If at all possible, avoid these trigger factors. If this is not possible, always carry your blue reliever inhaler with you and consider taking a preventative dose before exposure to reduce the likelihood of symptoms developing.
An asthma attack occurs when symptoms worsen. During a typical asthma attack:
- The muscles surrounding the airways contract, narrowing the airway.
- As a result of the constriction, less air passes through the airway.
- The airway becomes inflamed, allowing even less air to pass through.
- The amount of mucous in the airway increases, causing it to narrow.
Asthma attacks differ from person to person, with mild attacks being more common than severe ones. Because of a build-up of carbon dioxide in the lungs, severe asthma prevents oxygen from entering the bloodstream. If you have an asthma attack and it does not respond to treatment with a blue reliever inhaler (usually Ventolin), call an ambulance right away.
How can Asthma be diagnosed?
Asthma is a potentially serious medical condition that should always be diagnosed by your doctor, even if it can be well managed.
Based on your symptoms, your doctor will be able to diagnose asthma. It is beneficial to keep a diary of your symptoms, including when they occur, the severity of the symptoms, and any trigger factors. Your doctor will be able to make an accurate diagnosis using this information in conjunction with diagnostic tests such as spirometry, peak expiratory flow (PEF), and airway responsiveness.
A peak flow metre is used to measure peak expiratory flow. When you are diagnosed with asthma, you may be given a peak flow metre to continue taking readings morning and night while you begin treatment. This will allow your doctor or asthma nurse to track the progress of your asthma treatment and assess the efficacy of the medication such as Ventolin Inhalers you've been prescribed.
What Asthma treatments are available?
Asthma is a chronic inflammation of the airways that can cause a blockage of airflow and squeezing of the lung's air passages due to bronchial muscle contraction. (Bronchi are the two airways that lead into the lungs.) Although there is no permanent cure for asthma, there are ways to manage symptoms to avoid a full flare-up, also known as an asthma attack.
Asthma treatment has two primary goals:
- To alleviate current symptoms
- To avoid future symptoms
These two goals are met through the use of various types of inhalers and lifestyle techniques, as detailed below.
Asthma episodes, on the other hand, can be controlled and managed with medications, allowing people to live normal lives. Asthma treatment is divided into two types: short-term and long-term. Short-term medications (salbutamol and terbutaline) provide immediate relief from asthma attacks, while long-term medications (corticosteroids – beclometasone and budesonide) provide a way to control future asthma attacks.
Current symptoms such as wheezing, shortness of breath, and coughing are alleviated.
'Short-term' corticosteroid inhalers (relievers – usually blue inhalers) provide immediate relief of asthma symptoms, whereas 'long-term' corticosteroid inhalers (preventers – usually brown/purple inhalers) suppress chronic inflammation in the airways.
Salbutamol (Ventolin & Salamol) is a quick-relief medication with a short half-life that is used as the first-line treatment for asthma. It is typically used to provide immediate relief from symptoms such as shortness of breath, wheezing, or coughing. It can also be used to prevent symptoms from occurring in advance, such as before exercise. Your doctor may also prescribe terbutaline (Bricanyl), which has a similar effect to salbutamol. Salbutamol begins to work within 5 minutes and can last up to 6 hours.
When the airways are narrowed and symptoms begin to develop, relievers (Ventolin, Salamol Easi-Breathe, and Bricanyl) act quickly to open them. They can also be used to prevent symptoms from occurring before exposure to triggers, such as exercise. When wheezing and shortness of breath occur, it is critical to use your reliever as soon as possible, per your GP's or asthma nurse's asthma management plan. If your symptoms do not improve or worsen after 5 – 10 minutes and several doses of your reliever, call an ambulance right away.
Symptom prevention in the future
As previously stated, there is no permanent cure for asthma. Treatments only address the symptoms that cause an attack. Inhaled medication is typically used to prevent and treat asthma. Most mild asthma symptoms, however, can be controlled by making lifestyle changes (for example, quitting smoking), avoiding allergens and irritants (such as dust and pet dander), and using inhaled corticosteroids. Inhaled corticosteroids are a type of asthma preventer that is inhaled without swallowing and goes directly to your lungs to reduce inflammation.
The primary goal of preventers is to keep asthma symptoms under control by decreasing the sensitivity of the airway lining and reducing inflammation and mucous production. Clenil, Qvar, Seretide, Serevent, Flixotide, Symbicort, and Pulmicort are examples of preventers. They typically contain an inhaled steroid as well as other ingredients that work together to keep the condition under control when used regularly.
Corticosteroids are the most effective long-term asthma treatment. They work to reduce airway irritation and inflammation, lowering the likelihood of symptoms and an asthma attack. To treat symptoms, inhaled beclomethasone (Clenil & Qvar) is used once or twice daily. It is critical to use inhaled corticosteroid inhalers (preventers) regularly to allow for a sustained effect and effective suppression of airway inflammation. Another commonly inhaled corticosteroid is budesonide (Pulmicort).
In asthma treatment, preventers (such as Clenil and Qvar) and relievers (such as Ventolin, Salamol, and Bricanyl) are frequently combined for greater efficacy. Brown preventers are used once or twice daily (as directed by your prescriber), and blue reliever inhalers are used when symptoms arise unexpectedly.
Budesonide/formoterol (Symbicort) is another asthma treatment option, in addition to inhaled corticosteroids. Formoterol (a long-acting version of salbutamol) is combined with budesonide (a corticosteroid) to keep the airways open while also reducing irritation and inflammation.
Information on Asthma Treatment
Asthma should always be diagnosed by a doctor, and any treatments should be used according to their recommendations. Never self-diagnose asthma or use inhalers that have not been prescribed by your doctor. To ensure that your symptoms and lung function are stable, see your doctor at least once a year for an asthma check-up.
The goal of asthma treatment is to keep your symptoms under control, allowing you to use your blue reliever inhaler less frequently. If you find yourself using your reliever inhaler on a daily or more frequent basis, this is an indication that your asthma is not as well controlled as it could be.
Asthma medications are typically administered via metered-dose inhalers, asthma spacers, or nebulisers. You must learn how to use your delivery device(s) correctly from your doctor to receive the correct dose of medications. Please contact us or visit www.asthma.org.uk for advice on proper inhaler use. To effectively manage your asthma with minimal impact on your lifestyle, it is critical to use your inhalers as directed by your GP, asthma nurse, or pharmacist.
Asthma medication can cause side effects such as headaches, muscle cramps, tremors, anxiety, and dry mouth. These symptoms usually indicate that you are using your inhaler excessively or frequently. If you are experiencing side effects from your asthma inhalers, you should consult your doctor.
If you do not rinse your mouth or brush your teeth after using brown preventer (steroid) inhalers, you may increase your chances of developing oral candidiasis (oral thrush). Hoarseness, nasal congestion, headaches, rashes, dizziness, and visual changes are also possible.
Is it possible to prevent or better control asthma?
Although asthma cannot be prevented, using prescribed medication correctly and making some lifestyle changes can help to avoid the onset of symptoms and asthma attacks.
Staying away from "triggers" can help you avoid asthma exacerbations. This includes avoiding as many allergens as possible. Air filtration is another option for keeping your living environment free of allergens.
Exercise not only keeps you fit and healthy, but it can also help you keep your asthma under control. Light exercise that does not aggravate your symptoms can be beneficial in increasing lung capacity and giving you more control over your breathing.
Consult your GP or an asthma nurse regularly to review your asthma symptoms. Your asthma control may improve or deteriorate, but you should always have a plan in place with your healthcare team to ensure you know what to do in any situation. It is critical to be open and honest with your doctor, asthma nurse, or pharmacist to receive the best care. Asthma should be a well-controlled condition in which you only use your reliever a few times per week; this is the level of asthma control that everyone should strive for.
Take your inhalers as directed and practise good inhaler techniques. Using your corticosteroid preventer inhaler on a regular and as directed basis will greatly improve your chances of keeping your asthma under control and reducing your chances of having a serious asthma attack. To ensure that you are getting the most out of your inhalers, consult with your healthcare team about your inhaler technique.
Get vaccinated against the winter flu. Asthmatics are more susceptible to catching the flu, which is also a major trigger factor for asthma exacerbations. Every year around October, all people with diagnosed asthma can get a free flu shot from their GP.
If you smoke, quitting will significantly reduce the frequency and severity of your asthma attacks.
Asthma Treatment Options
Asthma is not a condition that can be treated effectively with over-the-counter medications. If you want to switch inhalers or look for another treatment, you should discuss it with your doctor at your regular asthma check-up.
Please do not 'Try' a new inhaler without first consulting your doctor.
We recommend that you visit your regular GP regularly to ensure that your inhalers are still controlling your asthma and are the best course of action for you.