Asthma in adults
Published by Bupa's health information team, August 2008.
This factsheet is for adults who have asthma, or who would like information about it.
Asthma is a common condition that causes coughing, wheezing, tightness of the chest and breathlessness. Most people with asthma who take the appropriate treatment can live normal lives, but left untreated, asthma can cause permanent damage to the airways. Very rarely, a severe asthma attack can be fatal.
- Animation - How an asthma attack occurs
- About asthma
- Symptoms of asthma
- Causes of asthma
- Diagnosis of asthma
- Treatment of asthma
- Medicines
- Asthma attacks - what to do
- Living with asthma
- Questions and answers
- Related topics
- Further information
- Sources
How an asthma attack occurs
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About asthma
About one in 12 adults are treated in the UK for asthma each year. Asthma often starts in childhood, but it can happen for the first time at any age.
Asthma is a condition where the airways become irritated and inflamed. As a result, they:
- become narrower
- produce extra mucus
This makes it more difficult for air to flow into and out of the lungs and causes the symptoms of asthma.
Symptoms of asthma
Asthma symptoms may be mild, moderate or severe. They may include:
- coughing
- wheezing
- shortness of breath
- tightness in your chest
These symptoms tend to be variable and may stop and start. They are often worse at night.
Causes of asthma
The cause of an asthma attack is not always clear. However, there are several triggers that have been identified which can result in a flare up of symptoms. The most common triggers are:
- infections such as colds and flu
- irritants such as dust, cigarette smoke and fumes
- chemicals (and other substances) found in the workplace - this is called occupational asthma
- allergies to pollen, medicines, animals, house dust mites or certain foods
- exercise - especially in cold, dry air
- emotions - laughing or crying very hard can trigger symptoms, as can stress
Women are more likely to have asthma than men. Asthma often runs in families and you can inherit the tendency to get inflamed airways.
Diagnosis of asthma
If you think you have asthma, contact your GP for advice. He or she will ask you about your symptoms and if you have noticed any factors that trigger the symptoms. Your GP will also do a physical examination and may ask you about your medical history. He or she may also refer you to an asthma nurse in your GP practice.
Your GP or nurse may do one or more of the tests listed below.
- A device called a peak flow meter can help your doctor to diagnose asthma. A peak flow meter measures how much, and how fast, air can be expelled from your lungs. This device can also be used to monitor whether a treatment works for you.
- A spirometry test can also measure how well your lungs are functioning but provides more detailed information than a peak flow meter.
- Less commonly, other tests such as chest X-rays are done to make sure you don't have any other breathing problems. For example, a disease called chronic obstructive pulmonary disease has similar symptoms to asthma.
- An allergy skin test or a blood test may be done to find out whether you're allergic to certain substances.
Treatment of asthma
Asthma can't be cured. Treatments, along with removing triggers, aim to restore normal activities of daily living by reducing the frequency, severity and length of your asthma attacks. A lot of different factors are involved in asthma, so your treatment plan will be individual to you, combining medicines and asthma management in the way that works best for you.
Medicines
Inhalers
Inhalers (sometimes called "puffers") contain a gas that propels the correct dose of medicine either when the top is pressed down or on inhalation (some inhalers may be dry powder inhalers). This is inhaled into the airways. You will need to use your inhaler correctly in order for it to work properly, so ask your GP for advice.
There are two basic categories of inhaler medicines that are used for asthma:
- relievers - to treat your symptoms
- preventers - to help prevent your symptoms
You should use relievers when your asthma symptoms occur. They can be short-acting or long-acting, and are usually a blue or green colour.
Short-acting relievers (known as bronchodilators) contain medicines such as salbutamol (eg Ventolin) and terbutaline (Bricanyl) that work to widen your airways and quickly ease your symptoms.
If you're given a preventer you should use it every day - even if you don't have symptoms. They are used to help you prevent symptoms, and are usually a brown, orange or red colour.
Preventers usually contain a steroid medicine, such as beclometasone (eg Qvar) or fluticasone (eg Flixotide) that work to reduce the inflammation of your airways.
Side-effects are rare at normal doses (although inhalers can sometimes cause a sore mouth or throat). It can take up to three months for the full effect of preventer medicines to build up, but once they do, you may not need to use your reliever inhaler at all.
If your asthma isn't well controlled using a regular steroid and occasional use of a short-acting reliever, a long-acting reliever can be added to your treatment. Long-acting relievers contain medicines such as salmeterol (Serevent) or formoterol (eg Oxis). Often these medications are combined with the steroid inhalers.
If you use an inhaler, you may also be given a spacer. Spacers are devices which can help you use your inhaler correctly. A spacer is a long tube which clips onto the inhaler. You breathe in and out of a mouthpiece at the other end of the tube.
It's easier to use because it allows you to activate the inhaler and then inhale in two separate steps. Using a spacer also reduces the risk of getting a sore throat from using a steroid inhaler. When used correctly they can be as effective as nebulisers in the treatment of an acute asthma attack.
Other medicines
If you have a severe asthma attack, your GP may prescribe a course of steroid tablets, such as prednisolone. If you take steroid tablets for about a week, you're less likely to have side-effects than if you take them for longer.
Several other medicines are available as tablets and inhalers if the standard treatments aren't suitable for you, either because of side-effects or if your asthma is still not well controlled. These include tablets of montelukast (Singulair), zafirlukast (Accolate) or theophylline (eg Slo-Phyllin).
Nebulisers
Nebulisers make a mist of water and asthma medicine that you breathe in. They can deliver more of the medicine to exactly where it's needed than conventional inhalers can. This is particularly important if you have a severe asthma attack and you require emergency treatment in the home or hospital setting.
They may also be advised in some cases of asthma under the direction of a specialist. Under these circumstances you will be given a clear plan for their use.
Asthma attacks - what to do
In the event of an asthma attack you should take the following steps.
- Take your reliever treatment immediately, preferably with a spacer.
- Sit down (don't lie down) and try to relax.
- Wait five to 10 minutes - if there is no improvement repeat one puff of your reliever treatment every minute for five minutes until your symptoms go away. Make sure you tell your GP about the attack.
- If your symptoms don't go away, you should call your GP or an ambulance, but continue taking your reliever, preferably with a spacer, every few minutes until help arrives.
If you go to hospital, take details of your asthma treatments with you.
When you're discharged from hospital, your doctor will give you a plan of action to manage your asthma, or may ask you to see your GP so he or she can review your treatment.
Living with asthma
Medicines are only part of your treatment for asthma. Asthma also needs to be managed by dealing with the things that make it worse. Keep a diary to record anything that triggers your asthma - this can help you to discover a pattern. Using a peak flow meter to monitor your lung function can also help. Repeatedly low readings in a certain situation (for example, after exercise or after contact with an animal) may indicate the trigger.
Stopping smoking is good for your health and will improve your asthma symptoms.
With good management and appropriate treatment, most people with asthma lead completely normal lives.
Related topics
Further information
- Asthma UK
08457 010203
www.asthma.org.uk - British Lung Foundation
0845 850 5020
www.lunguk.org
Sources
- Background information - Asthma. UK National Libraries for Health. http://cks.library.nhs.uk, accessed 3 January 2008
- Asthma. British Lung Foundation. www.lunguk.org, accessed 3 January 2008
- British guideline on the management of asthma - A national clinical guideline. British Thoracic Society, Scottish Intercollegiate Guidelines Network (SIGN). 2007. www.sign.ac.uk
- Asthma. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 3 January 2008
- Where do we stand? Asthma UK. www.asthma.org.uk, accessed 3 January 2008
- British National Formulary (BNF). BMJ Publishing Group, 2007. 54:143-163
- Medicines for Asthma. Asthma UK. www.asthma.org.uk, accessed 3 January 2008
- Nebulisers. Asthma UK. www.asthma.org.uk, accessed 24 April 2008
- What to do in an asthma attack. Asthma UK. www.asthma.org.uk, accessed 3 January 2008
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed It has been peer reviewed by Dr John Hughes, Consultant Physician, Kent and Sussex Hospital, Tunbridge Wells, and by Bupa doctors. It has also been reviewed by Asthma UK. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: August 2008.
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