Word on Health

Word on Asthma

Our grateful thanks to Dr Andy Whittamore and  Asthma + Lung UK for their contribution to our on-air report, which you can hear again via the audio player below, and for allowing us to republish the information below.  Find out more via the Asthma + Lung UK website. 

To download the Asthma + Lung UK asthma action plan that Dr Whittamore mentioned in our radio report click here.  

You can get advice and support about asthma by calling a respiratory nurse specialist on the Asthma + Lung UK Helpline, 0300 222 5800 (9am-5pm; Monday-Friday) or you can WhatsApp them on 07378 606 728.   

What is asthma?  Asthma is a very common long-term lung condition. It affects the airways that carry air in and out of your lungs.

In the UK, 5.4 million people have asthma. That's one in every 12 adults and one in every 11 children.

People with asthma often have sensitive, inflamed airways. They can get symptoms like coughing, wheezing, feeling breathless or a tight chest.

Asthma symptoms can come and go. Sometimes people may not have symptoms for weeks or months at a time.

Asthma needs to be treated every day, even if you feel well, to lower the risk of symptoms and asthma attacks.

The most common symptoms of asthma are

Coughing - A cough that keeps coming back is a symptom of asthma. It’s more likely to be asthma if your cough is accompanied by other asthma symptoms, like wheezing, breathlessness or chest tightness.

Not everyone with asthma coughs. If you do cough it’s usually dry, or someone with uncontrolled asthma might have thick clear mucus when they cough. The right treatment can mean you’re cough-free most of the time.

Wheezing - a high-pitched whistling noise coming from your airways, mostly when you breathe out. Some people feel their asthma isn’t taken seriously because they don’t wheeze. You may still have asthma even if you haven't noticed a whistling sound - so don’t put off seeing your GP.

Breathlessness - Finding it hard to breathe, or getting breathless, is another common asthma symptom. Some people with asthma notice this gets worse when they do exercise, and it can put them off staying active.

It’s normal for most people to get a bit out of breath with exercise, but if you’re noticing it’s bringing on asthma symptoms, see your GP or asthma nurse. The good news is that if asthma is well controlled most people can exercise without any problems.

Some people may find it difficult to take a deep breath in, or a long breath out. One of the symptoms of an asthma attack is that it’s very hard to breathe. People who are very breathless might struggle to talk, eat or sleep.

Chest tightness - is often described as having a heavy weight on the chest or feeling like a band is tightening around your chest.

It may also feel like a dull ache, or a sharp stabbing pain in the chest. It can make it difficult to take a deep breath in.

Experiencing one or more of these symptoms could mean you have asthma. It’s more likely to be asthma if your symptoms keep coming back, are worse at night, or happen when you react to a trigger – such as exercise, weather or an allergy.

Cause or trigger?  What causes asthma is different to what triggers asthma:

  • The causes are the underlying reasons why someone gets asthma in the first place.
  • Triggers are things like dust mites or pollen that can make asthma symptoms worse.

The good news is that most people who develop asthma can manage it well.  

Asthma can run in families - You’re more likely to develop asthma if it’s in your close family, such as your parents or brothers and sisters. This is partly down to genetics and partly down to the shared environment you live and grow up in.

If you have asthma yourself, your child is much more likely to have asthma too, particularly if both parents have asthma. There’s slightly more chance of asthma being passed on by the mother than the father.

But having someone with asthma in your close family doesn’t mean you or your child will definitely get it. And people can get asthma without anyone in their family having it.

Allergies make asthma more likely - Children with allergic rhinitis (an itchy or runny nose due to an allergy, like pollen) or eczema, or a family history of allergies, are more likely to develop asthma. Children with a food allergy are said to be four times as likely to have asthma as children without a food allergy.

So, if your child is wheezing or coughing, and they also have a history of allergic rhinitis (such as hay fever), eczema, or a food allergy, it’s much more likely that their symptoms are due to asthma.

Sometimes allergies overlap and sometimes your child will grow out of one allergy and develop another. For example, a small child with eczema may go on to have a food allergy, and then, as they get older, hay fever, and then asthma.

Babies born early or small - A child is more at risk of asthma if they were born prematurely (before 37 weeks), especially if they needed a ventilator to help them breathe after the birth.

A low birth weight can also be a risk factor for asthma.

Bronchiolitis - If your child has had a few episodes of bronchiolitis, they could be more at risk of getting asthma as they get older.

Bronchiolitis is caused by a virus, usually the respiratory syncytial virus (RSV). It‘s mostly babies and young children under two years old who get bronchiolitis. It leads to swelling in the lungs and airways, cough, and wheeze.

Your baby is more at risk of bronchiolitis if you smoke.

Croup - Children with a history of croup may also be more at risk of developing asthma. Like asthma, croup has symptoms like coughing and feeling breathless.

Sometimes asthma gets missed because parents think it’s croup. But croup is very rare after the age of five, so if your child is still being treated for croup after this age, your GP should check to see if they have asthma.

Exposure to substances at work - Occupational asthma is a type of asthma caused by certain things found in the workplace, such as chemicals or dust from flour or wood.

If you haven’t had asthma before and then get it because of the work you do, and if your symptoms improve when you’re not at work, you probably have occupational asthma. See your GP as soon as possible for advice. If they think there is an occupational cause for your asthma they should refer you to a specialist.

Occupational asthma is a common cause of adult-onset asthma.

Female hormones - Hormones can play a part in the development of asthma. After puberty more girls than boys get asthma.

And some women first develop late-onset asthma during or after the menopause. Hormones are a common cause for women developing asthma in later life.

Smoking - Research has shown that smoking during pregnancy and smoking around your baby or child, both significantly increase the risk of a child developing asthma or other breathing problems.

And smoking also has a part to play in adult-onset asthma. The good news is, quitting smoking can really lower your risk of asthma symptoms.

Pollution - Air pollution, like traffic fumes, can make asthma symptoms worse.

Studies also show that air pollution may play a part in causing asthma too. For example, children living near very busy roads are more likely to develop asthma.

Obesity - Being obese or very overweight (having a high Body Mass Index or BMI) increases your risk of asthma attacks.

Research also suggests a link between excessive weight gain in young children and their risk of developing wheeze and asthma.

Putting on excess weight during pregnancy is also thought to increase a child’s risk of getting asthma. And babies born with a high birth weight may have an increased risk of asthma.

For all of us maintaining a healthy weight is important. If you are very overweight, losing weight can improve asthma symptoms.

Low levels of vitamin D - Some studies suggest a link between very low levels of vitamin D and children with wheeze, allergic rhinitis, and asthma. Good levels of vitamin D during early pregnancy have been found to lower the risk of early wheezing in children.  It’s thought that vitamin D deficiency may be adding to the numbers of people with asthma and other allergies.

Your GP can do a blood test to check your vitamin D levels. If they are low they may suggest supplements.

Antibiotics - The widespread use of antibiotics in early childhood and during pregnancy has been linked to an increase in allergies and asthma.

It’s thought that antibiotics may be one of the reasons why there are more people with asthma and allergies.

Antibiotics can be lifesaving, but we can all play a part by making sure we only take antibiotics when necessary. If we do need to take them, it’s important to take them exactly as prescribed. The NHS has more information about using antibiotics safely.

Modern lifestyles and living conditions - Changes in how we live and work, from more rural to more urban environments, may have a role in causing asthma.

Research suggests that we have less contact with the ‘friendly bacteria’ that thrive in more rural, natural environments. For example, studies show that children growing up on farms, and exposed to ‘friendly bacteria’, are less likely to develop asthma and allergies. This is sometimes called the ‘hygiene hypothesis’.

Nevertheless, “personal and home cleanliness is still important,” says Dr Andy Whittamore, Asthma + Lung UK’s in-house GP. 

If you have symptoms like coughing, wheezing, breathlessness, or a tight feeling in your chest, see your GP as soon as possible.

Managing asthma symptoms

If you are diagnosed with asthma, for most people the right treatment will mean you can live a normal, active life. Whilst there is no cure for asthma, taking your medicines as prescribed will usually mean you can live with little to no symptoms.

If you find your symptoms are getting worse, speak to your GP or asthma nurse as soon as you can.

Know the signs of an asthma attack - You’re having an asthma attack if:

  • your blue reliever isn't helping, or you need to use it more than every four hours
  • you're wheezing a lot, have a very tight chest, or you're coughing a lot
  • you're breathless and find it difficult to walk or talk
  • your breathing is getting faster and it feels like you can't get your breath in properly

You may have all of these signs and symptoms. Or you may have just some of them. For example, you may not wheeze.

Know your early warning signs

An asthma attack happens when your symptoms get much worse. This can happen quite suddenly or can build up gradually over a few days.

You can stop an asthma attack before it happens, or make it less serious so you don’t end up in hospital, by recognising when your symptoms are getting worse. 

What to do in an asthma attack

  • Sit up straight - try to keep calm.
  • Take one puff of your reliever inhaler (usually blue) every 30-60 seconds up to 10 puffs.
  • If you feel worse at any point OR you don’t 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.

When to call 999? - Don’t delay getting help if you have an asthma attack. Call 999 if your reliever isn’t helping, or lasting four hours, or you’re worried at any time.

“An asthma attack is a real emergency, and could be life-threatening,” says Asthma + Lung UK’s in-house GP, Dr Andy Whittamore.

“Getting help when you need it is so important, to make sure you’re treated quickly. Never think you’re wasting anyone’s time.”

When to see your GP - If you managed your asthma attack with your blue reliever inhaler, and your symptoms improved, you still need to make an urgent same-day appointment with your doctor. You need an urgent asthma review after the attack. 

You can get advice and support about asthma by calling a respiratory nurse specialist on the Asthma + Lung UK Helpline, 0300 222 5800 (9am-5pm; Monday-Friday). Or you can WhatsApp them on 07378 606 728.

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.