Asthma

Asthma

Asthma attacks kill 3 people in the UK each day. But many of these deaths could be avoided. 

Every 10 seconds someone has a potentially life-threatening asthma attack.

Find out what your risk of having an attack is using Asthma UK’s asthma attack risk checker.

If you’re on the right asthma treatment, your chance of having an attack is greatly reduced.

Visit a doctor or asthma nurse at least once a year for a check-up and to discuss your treatment.

Symptoms of Asthma

The main symptoms of asthma are:

    • a whistling sound when breathing (wheezing)
    • breathlessness
    • a tight chest, which may feel like a band is tightening around it
    • coughing
    • unexplained weight loss

The symptoms can sometimes get temporarily worse. This is known as an asthma attack.

When to see a GP

See a GP if you think you or your child may have asthma.

Several conditions can cause similar symptoms, so it’s important to get a proper diagnosis and correct treatment.

The GP will usually be able to diagnose asthma by asking about symptoms and carrying out some simple tests.

Find out more about how asthma is diagnosed.

Treatments for Asthma

Asthma is usually treated by using an inhaler, a small device that lets you breathe in medicines.

The main types are:

    • reliever inhalers – used when needed to quickly relieve asthma symptoms for a short time
    • preventer inhalers – used every day to prevent asthma symptoms happening

Some people also need to take tablets.

Causes and triggers of Asthma

Asthma is caused by swelling (inflammation) of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow.  This makes it more difficult to get air in and out of the lungs.

It may happen randomly or after exposure to a trigger.

Common asthma triggers include:

    • allergies (to house dust mites, animal fur or pollen, for example)
    • smoke, pollution and cold air
    • exercise
    • infections like colds or flu

Identifying and avoiding your asthma triggers can help you keep your symptoms under control.

How long Asthma lasts for

Asthma is a long-term condition for many people, particularly if it first develops when you’re an adult.

In children, it sometimes goes away or improves during the teenage years, but can come back later in life.

The symptoms can usually be controlled with treatment. Most people will have normal, active lives, although some people with more severe asthma may have ongoing problems.

Complications of Asthma

Although asthma can normally be kept under control, it’s still a serious condition that can cause a number of problems.

This is why it’s important to follow your treatment plan and not ignore your symptoms if they’re getting worse.

Badly controlled asthma can cause problems such as:

    • feeling tired all the time
    • underperformance at, or absence from, work or school
    • stress, anxiety or depression
    • disruption of your work and leisure because of unplanned visits to a GP or hospital
    • lung infections (pneumonia)
    • delays in growth or puberty in children

There’s also a risk of severe asthma attacks, which can be life threatening.

Symptoms

Most children and adults with asthma have times when their breathing becomes more difficult.

Some people with severe asthma may have breathing problems most of the time.

The most common symptoms of asthma are:

wheezing (a whistling sound when breathing)breathlessnessa tight chest – it may feel like a band is tightening around itcoughingunexplained weight loss

Many things can cause these symptoms, but they're more likely to be asthma if they:

happen often and keep coming backare worse at night and early in the morningseem to happen in response to an asthma trigger like exercise or an allergy (such as to pollen or animal fur)

See a GP if you think you or your child may have asthma, or you have asthma and are finding it hard to control.

Asthma attacks

Asthma can sometimes get worse for a short time – this is known as an asthma attack. It can happen suddenly, or gradually over a few days.

Signs of a severe asthma attack include:

wheezing, coughing and chest tightness becoming severe and constantbeing too breathless to eat, speak or sleepbreathing fastera fast heartbeatdrowsiness, confusion, exhaustion or dizzinessblue lips or fingersfainting

Read about what to do during an asthma attack.

Causes

The exact cause of asthma is unknown.

People with asthma have swollen (inflamed) and "sensitive" airways that become narrow and clogged with sticky mucus in response to certain triggers.

Genetics, pollution and modern hygiene standards have been suggested as causes, but there's not currently enough evidence to know if any of these do cause asthma.

 

Who's at risk

A number of things can increase your chances of getting asthma.

These include:

having an allergy-related condition, such as eczema, a food allergy or hay fever – these are known as atopic conditionshaving a family history of asthma or atopic conditionshaving had bronchiolitis – a common childhood lung infectionexposure to tobacco smoke as a childyour mother smoking during pregnancybeing born prematurely (before 37 weeks) or with a low birth weight

Some people may also be at risk of developing asthma through their job.

 

Asthma triggers

Asthma symptoms often occur in response to a trigger.

Common triggers include:

infections like colds and fluallergies – such as to pollen, dust mites, animal fur or featherssmoke, fumes and pollutionmedicines – particularly anti-inflammatory painkillers like ibuprofen and aspirinemotions, including stress, or laughterweather – such as sudden changes in temperature, cold air, wind, thunderstorms, heat and humiditymould or dampexercise

Once you know your triggers, trying to avoid them may help control your asthma symptoms.

Asthma UK: asthma triggers 

 

Work-related asthma

In some cases, asthma is associated with substances you may be exposed to at work. This is known as occupational asthma.

Some of the most common causes of occupational asthma include:

isocyanates (chemicals often found in spray paint)flour and grain dustcolophony (a substance often found in solder fumes)latexanimalswood dust

Paint sprayers, bakers, pastry makers, nurses, chemical workers, animal handlers, timber workers, welders and food processing workers are all examples of people who may have a higher risk of being exposed to these substances.

Asthma UK: occupational asthmaHealth and Safety Executive: asthma at work

Diagnosis

Asthma can usually be diagnosed from your symptoms and some simple tests.

A GP will probably be able to diagnose it, but they may refer you to a specialist if they're not sure.

 

Seeing a GP

The GP may ask:

what symptoms you havewhen they happen and how oftenif anything seems to trigger themif you have conditions such as eczema or allergies, or a family history of them

They may suggest doing some tests to confirm if you have asthma.

These cannot always be done easily in young children, so your child may be given an asthma inhaler to see if it helps relieve their symptoms until they're old enough to have the tests.

 

Tests for asthma

The main tests used to help diagnose asthma are:

FeNO test – you breathe into a machine that measures the level of nitric oxide in your breath, which is a sign of inflammation in your lungsspirometry – you blow into a machine that measures how fast you can breathe out and how much air you can hold in your lungspeak flow test – you blow into a handheld device that measures how fast you can breathe out, and this may be done several times over a few weeks to see if it changes over time

After you're diagnosed with asthma, you may also have a chest X-ray or allergy tests to see if your symptoms might be triggered by an allergy.

Treatment

There's currently no cure for asthma, but treatment can help control the symptoms so you're able to live a normal, active life.

Inhalers, which are devices that let you breathe in medicine, are the main treatment. Tablets and other treatments may also be needed if your asthma is severe.

You'll usually create a personal action plan with a doctor or asthma nurse.

This includes information about your medicines, how to monitor your condition and what to do if you have an asthma attack.

Get an asthma action plan on Asthma UK

 

Inhalers

Inhalers can help:

relieve symptoms when they occur (reliever inhalers)stop symptoms developing (preventer inhalers)

Some people need an inhaler that does both (combination inhalers).

Watch a short video from Asthma UK to learn how to use your inhaler properly

Read on to learn more about the different types of inhaler.

 

Reliever inhalers

Most people with asthma will be given a reliever inhaler. These are usually blue.

You use a reliever inhaler to treat your symptoms when they occur. They should relieve your symptoms within a few minutes.

Tell a GP or asthma nurse if you have to use your reliever inhaler 3 or more times a week. They may suggest additional treatment, such as a preventer inhaler.

Reliever inhalers have few side effects, but they can sometimes cause shaking or a fast heartbeat for a few minutes after they're used.

Asthma UK: reliever inhalers

 

Preventer inhalers

If you need to use a reliever inhaler often, you may also need a preventer inhaler.

You use a preventer inhaler every day to reduce the inflammation and sensitivity of your airways, which stops your symptoms occurring. It's important to use it even when you do not have symptoms.

Speak to a GP or asthma nurse if you continue to have symptoms while using a preventer inhaler.

Preventer inhalers contain steroid medicine.

They do not usually have side effects, but can sometimes cause:

a fungal infection of the mouth or throat (oral thrush)a hoarse voicea sore throat

You can help prevent these side effects by using a spacer, which is a hollow plastic tube you attach to your inhaler, as well as by rinsing your mouth after using your inhaler.

Asthma UK: preventer inhalers

 

Combination inhalers

If using reliever and preventer inhalers does not control your asthma, you may need an inhaler that combines both.

Combination inhalers are used every day to help stop symptoms occurring and provide long-lasting relief if they do occur.

It's important to use it regularly, even if you do not have symptoms.

Side effects of combination inhalers are similar to those of reliever and preventer inhalers.

Asthma UK: combination inhalers

 

Tablets

You may also need to take tablets if using an inhaler alone is not helping control your symptoms.

 

Leukotriene receptor antagonists (LTRAs)

LTRAs are the main tablets used for asthma. They also come in syrup and powder form.

You take them every day to help stop your symptoms occurring.

Possible side effects include tummy aches and headaches.

Asthma UK: LTRAs

 

Theophylline

Theophylline may also be recommended if other treatments are not helping to control your symptoms.

It's taken every day to stop your symptoms occurring.

Possible side effects include headaches and feeling sick.

Asthma UK: theophylline

 

Steroid tablets

Steroid tablets may be recommended if other treatments are not helping to control your symptoms.

They can be taken either:

as an immediate treatment when you have an asthma attackevery day as a long-term treatment to prevent symptoms – this is usually only necessary if you have very severe asthma and inhalers do not control your symptoms

Long-term or frequent use of steroid tablets can occasionally cause side effects such as:

increased appetite, leading to weight gaineasy bruisingmood changesfragile bones (osteoporosis)high blood pressure

You'll be monitored regularly while taking steroid tablets to check for signs of any problems.

Asthma UK: steroid tablets

 

Other treatments

Other treatments, such as injections or surgery, are rarely needed, but may be recommended if all other treatments are not helping.

 

Injections

For some people with severe asthma, injections given every few weeks can help control the symptoms.

The main injections for asthma are:

benralizumab (Fasenra)omalizumab (Xolair)mepolizumab (Nucala)reslizumab (Cinqaero)

These medicines are known as biologic therapies. They are not suitable for everyone with asthma and can only be prescribed by an asthma specialist.

The main side effect is discomfort where the injection is given.

Asthma UK: biologic therapies for severe asthma

 

Surgery

A procedure called bronchial thermoplasty may be offered as a treatment for severe asthma. It works well and there are no serious concerns about its safety.

You will be sedated or put to sleep using a general anaesthetic during a bronchial thermoplasty.

It involves passing a thin, flexible tube down your throat and into your lungs. Heat is then used on the muscles around the airways to help stop them narrowing and causing asthma symptoms.

Asthma UK: bronchial thermoplasty

 

Complementary therapies

Several complementary therapies have been suggested as possible treatments for asthma, including:

breathing exercises – such as techniques called the Papworth method and the Buteyko methodtraditional Chinese herbal medicineacupunctureionisers – devices that use an electric current to charge molecules of airmanual therapies – such as chiropractichomeopathydietary supplements

There's little evidence to suggest many of these treatments help.

There's some evidence that breathing exercises can improve symptoms and reduce the need for reliever medicines in some people, but they should not be used instead of your medicine.

Asthma UK: complementary therapies for asthma

 

Work-related asthma

If you seem to have occupational asthma, where your asthma is linked to your job, you'll be referred to a specialist to confirm the diagnosis.

If your employer has an occupational health service, they should also be informed, along with your health and safety officer.

Your employer has a responsibility to protect you from the causes of occupational asthma.

It may sometimes be possible to:

substitute or remove the substance that's triggering your asthma from your workplaceredeploy you to another role within the companyprovide you with protective breathing equipment

Find out more:

Asthma UK: occupational asthmaHealth and Safety Executive: asthma at work

Living with Asthma

With treatment, most people with asthma can live normal lives. There are also some simple ways you can help keep your symptoms under control.

 

Things you can do

If you have asthma, things you can do to help include:

using your inhaler correctly – Asthma UK has information about using your inhaler, and you can ask a nurse or GP for advice if you're still not sureusing your preventer inhaler or tablets every day – this can help keep your symptoms under control and prevent asthma attackschecking before taking other medicines – always check the packet to see if a medicine is suitable for someone with asthma, and ask a pharmacist, doctor or nurse if you're not surenot smoking – stopping smoking can significantly reduce the severity and frequency of the symptoms areexercising regularly – exercise should not trigger your symptoms once you're on appropriate treatment; Asthma UK has advice about exercising with asthmaeating healthily – most people with asthma can have a normal dietgetting vaccinated – it's a good idea to have the annual flu jab and the one-off pneumococcal vaccination

Asthma UK has more advice about how to manage your asthma

 

Identify and avoid your triggers

It's important to identify possible asthma triggers by making a note of where you are and what you're doing when your symptoms get worse.

Some triggers can be hard to avoid, but it may be possible to avoid some, such as dust mites, pet fur and some medicines.

Find out more about how to prevent allergies

Speak to a doctor or asthma nurse for advice if you think you've identified a trigger for your symptoms.

Asthma UK: asthma triggers

 

Regular check-ups

You'll have regular contact with your doctor or asthma nurse to monitor your condition.

These appointments may involve:

talking about your symptoms – for example, if they're affecting your normal activities or are getting worsea discussion about your medicines – including if you think you might be experiencing any side effects and if you need to be reminded how to use your inhalerbreathing tests

It's also a good chance to ask any questions you have or raise any other issues you want to discuss.

You may be asked to help monitor your condition between appointments. For example, you may be advised to check your peak flow if you think your symptoms may be getting worse.

Your personal action plan should say what to do if your symptoms get gradually or suddenly worse. Contact your doctor or asthma nurse if you're not sure what to do.

 

Cold weather and asthma

Cold weather is a common trigger for asthma symptoms.

There are things you can do to help control your symptoms in the cold:

carry your reliever inhaler with you at all times and keep taking your regular preventer inhaler as prescribedif you need to use your inhaler more than usual, speak to your doctor about reviewing your treatmentkeep warm and dry – wear gloves, a scarf and a hat, and carry an umbrellawrap a scarf loosely over your nose and mouth – this will help warm up the air before you breathe ittry breathing in through your nose instead of your mouth – your nose warms the air as you breathe

Asthma UK: weather and asthma

 

Travelling with asthma

Asthma should not stop you from travelling, but you'll need to take extra precautions when going on holidays and long trips.

Make sure you have enough medicine with you, and keep your reliever inhaler easily accessible.

If you've not seen your doctor or asthma nurse for a while, it's a good idea to see them before you travel to review your personal action plan and make sure it's up to date.

Your doctor or asthma nurse can also advise you about travelling with asthma.

Asthma UK: asthma and travel

 

Pregnancy and asthma

Asthma does not affect your chances of having children, and the vast majority of women with asthma will have a normal pregnancy.

Generally, treatment stays the same during pregnancy. Most asthma medicines, particularly inhalers, are considered safe while pregnant or breastfeeding.

But you should speak to your doctor or asthma nurse for advice if you become pregnant or are planning a pregnancy.

This is because:

your symptoms may get worse during pregnancy (although some women find they improve) so your treatment may need to be reviewed regularlypoorly controlled asthma in pregnancy can increase the risk of complications like pre-eclampsia and premature birthextra precautions may need to be taken during labour to avoid an asthma attack, although attacks during labour are rare

Find out more:

Asthma and pregnancyAsthma UK: asthma and pregnancy

Asthma at school

Most children with well-controlled asthma can learn and participate in school activities without being affected by their condition.

But it's important to ensure the school has up-to-date written information about your child's asthma medicines, including what they are, how much they take and when they need to take them.

Staff at the school should be able to recognise worsening asthma symptoms and know what to do in the event of an attack, particularly staff supervising sport or physical education.

Your child's school may have an asthma policy in place, which you can ask to see.

Asthma UK: asthma at school and nursery

 

Talking to others

Many people with long-term health conditions such as asthma experience feelings of stress, anxiety and depression.

You may find it helpful to talk about your experience of asthma with others. Patient organisations have local groups where you can meet people who have been diagnosed with asthma and have undergone treatment.

If you feel you're struggling to cope, talk to a GP. They will be able to give advice and support. Or you can find depression support services in your area.

HealthUnlocked: asthma community

British Lung Foundation: Breathe Easy support groups

 

Financial issues and help

Paying for your medicines

Most adults with asthma will need to pay a prescription charge for their medicines.

If you need to take a lot of medicines, paying for each item individually could get quite expensive. You may find it cheaper to get a prescription prepayment certificate. This is where you pay a one-off charge for all your prescriptions over a 3- or 12-month period.

You will not need to pay for your medicines if you do not normally pay prescription charges. For example, all under-16s are entitled to free prescriptions.

Read more about prescription costs to find out if you're entitled to help with your prescription charges.

Asthma UK: managing the cost of your medicines

Benefits

Depending on how severely asthma affects you on a daily basis, you may be entitled to some benefits, such as:

Employment and Support Allowance – a benefit paid to people who are not able to work because of ill health or disabilityPersonal Independence Payment – a benefit that helps with some of the extra costs caused by long-term ill health or a disability if you're aged 16 to 64Attendance Allowance – a benefit for help with the extra costs you may have if you're 65 or over and have a physical or mental disability, and need someone to help look after you

If you're on a low income, you may also be entitled to some help with healthcare costs.

Asthma UK: benefits and severe asthma

GOV.UK: benefits

Work-related asthma

If you develop asthma because of your work, and this is fully documented by your doctor and your employer, you can make a claim for Industrial Injuries Disablement Benefit.

This is a weekly amount paid to people with asthma caused by work-related exposure to a specific substance known to be associated with asthma.

Health and Safety Executive: substances that cause asthma

Asthma Attacks

Asthma attacks kill 3 people in the UK each day. But many of these deaths could be avoided.

Every 10 seconds someone has a potentially life-threatening asthma attack.

Find out what your risk of having an attack is using Asthma UK's asthma attack risk checker.

If you're on the right asthma treatment, your chance of having an attack is greatly reduced.

Visit a doctor or asthma nurse at least once a year for a check-up and to discuss your treatment.

 

Symptoms of an asthma attack

Signs that you may be having an asthma attack include:

your symptoms are getting worse (cough, breathlessness, wheezing or tight chest)your reliever inhaler (usually blue) is not helpingyou're too breathless to speak, eat or sleepyour breathing is getting faster and it feels like you cannot catch your breathyour peak flow score is lower than normalchildren may also complain of a tummy or chest ache

The symptoms will not necessarily occur suddenly. In fact, they often come on slowly over a few hours or days.

 

What to do if you have an asthma attack

If you think you're having an asthma attack, you should:

Sit up straight – try to keep calm.Take one puff of your reliever inhaler (usually blue) every 30 to 60 seconds up to 10 puffs.If you feel worse at any point, or you do not feel better after 10 puffs, call 999 for an ambulance.If the ambulance has not arrived after 10 minutes and your symptoms are not improving, repeat step 2.If your symptoms are no better after repeating step 2, and the ambulance has still not arrived, contact 999 again immediately.

Never be frightened of calling for help in an emergency.

Try to take the details of your medicines (or your personal asthma action plan) with you to hospital if possible.

If your symptoms improve and you do not need to call 999, get an urgent same-day appointment to see a GP or asthma nurse.

This advice is not for people on SMART or MART treatment. If this applies to you, ask a GP or asthma nurse what to do if you have an asthma attack.

 

After an asthma attack

You should see a GP or asthma nurse within 48 hours of leaving hospital, or ideally on the same day if you did not need hospital treatment.

About 1 in 6 people treated in hospital for an asthma attack need hospital care again within 2 weeks, so it's important to discuss how you can reduce your risk of future attacks.

Talk to a doctor or nurse about any changes that may need to be made to manage your condition safely.

For example, the dose of your treatment may need to be adjusted or you may need to be shown how to use your inhaler correctly.

 

Preventing asthma attacks

The following steps can help you reduce your risk of having an asthma attack:

follow your personal asthma action plan and take all of your medicines as prescribedhave regular asthma reviews with a GP or asthma nurse – these should be done at least once a yearcheck with a GP or asthma nurse that you're using your inhaler correctlyavoid things that trigger your symptoms whenever possible

Do not ignore your symptoms if they're getting worse or you need to use your reliever inhaler more often than usual.

Follow your action plan and make an urgent appointment to see a GP or asthma nurse if your symptoms continue to get worse.

 

Advice for friends and family

It's important that your friends and family know how to help in an emergency.

It can be useful to make copies of your personal asthma action plan and share it with others who may need to know what to do when you have an attack.

You can photocopy your existing plan, or you could download a blank personal asthma action plan from Asthma UK and fill it in for anyone who might need a copy.

Or you could take a photo of your action plan on your phone, so you can show or send it to others easily.