Overview
Asthma is a long-term condition in which the airways in the lungs become inflamed and narrowed, making breathing difficult. During an asthma attack, the muscles around the airways tighten and extra mucus is produced. Asthma varies widely in severity and can usually be well controlled with the right treatment.
How common is it?
About 5.4 million people in the UK receive treatment for asthma. It is one of the most common long-term conditions, affecting people of all ages.
Causes and risk factors
Asthma involves chronic airway inflammation driven by the immune system. Airways are hypersensitive and react to a range of triggers that would not affect most people.
Common risk factors
- Family history of asthma or allergies
- Having eczema or hay fever
- Exposure to cigarette smoke in childhood
- Workplace exposure to dust, chemicals, or animals
- Air pollution
- Respiratory infections in early childhood
- Obesity
Symptoms
- Shortness of breath
- Wheezing (a whistling sound when breathing)
- Chest tightness
- Persistent cough, especially at night or early morning
- Symptoms triggered by exercise, cold air, or allergens
- Difficulty sleeping due to breathing symptoms
When to see a doctor
See a doctor if you have recurrent wheezing, breathing difficulty, or a persistent cough. Call 999 for a severe attack where a reliever inhaler is not working, you are struggling to speak, or lips are turning blue.
Diagnosis
Spirometry measures how much air you can exhale and how fast. Peak flow monitoring over weeks shows variability typical of asthma. FeNO testing measures airway inflammation. Sometimes a trial of inhaler treatment confirms the diagnosis.
Treatments
Reliever inhaler (SABA)
Short-acting bronchodilators like salbutamol open the airways quickly during symptoms or before exercise. Used as needed, not daily.
Preventer inhaler (ICS)
Inhaled corticosteroids taken daily reduce airway inflammation over time. The cornerstone of asthma management. Must be taken regularly even when feeling well.
Combination inhalers and add-on therapy
Long-acting bronchodilators combined with steroids improve control in moderate to severe asthma. Monoclonal antibodies are available for severe allergic asthma.
Self-care and lifestyle
- Use your preventer inhaler every day as prescribed, not just when symptomatic
- Identify and reduce exposure to your personal triggers
- Check your inhaler technique annually with a nurse, as poor technique is the most common reason treatment fails
- Have an asthma action plan and review it with your GP each year
Prevention
Avoiding tobacco smoke during pregnancy and in early childhood reduces asthma risk. Maintaining a healthy weight and avoiding known triggers reduces attacks in established asthma.