The truth about asthma

Any parent whose child has asthma knows the agony of watching a little one fighting for breath. Asthma is a very common lung condition which usually, but not always, comes on in childhood and tends to run in families.

Any parent whose child has asthma knows the agony of watching a little one fighting for breath. Asthma is a very common lung condition which usually, but not always, comes on in childhood and tends to run in families. It makes the airways narrow temporarily, stopping vital air getting to the lungs to deliver oxygen to your body. Symptoms include wheezing, breathlessness, cough and chest tightness. Episodes can last from an hour to days. Fortunately, there are several effective treatments - so do see you're GP if you think this might be you.

The size of the problem

In the UK at least one in 10 children, and one in 20 adults, has asthma. In the USA the figure for children is slightly lower at 9.3%, but it's estimated that about 8% of adults have a diagnosis of asthma.

Testing to tease out the cause

Your GP may give you a peak flow meter - a small tube you blow into - to keep a record over a couple of weeks of how hard you can puff at different times. Otherwise, he or she may send you for a spirometry. This test involves blowing into a machine to see how much air you can blow out in one second, and how much air you have in your lungs. It can often be done in your practice.

What's the treatment?

The mainstay of asthma treatment is inhalers, which let you breathe medicine straight into your lungs, where it's needed. If your symptoms are mild, you may only need a 'reliever' inhaler to take when you have symptoms. If you're more wheezy or have persistent problems, your doctor will usually add in a 'preventer' inhaler, taken regularly to stop symptoms coming on.

It's essential to use your inhalers properly so the medicine gets to your lungs. There are several kinds of inhaler, and some people find one kind easier to use than another. Ask your nurse to take you through practice versions if the different types if you're having problems with yours. If you're in any doubt about the instructions, do ask. I discovered one patient who'd been told her asthma was caused by being allergic to her cat, and she used to spray her inhaler onto her beloved moggy's fur!

How can I help myself?

  • Don't smoke (obviously!) and avoid smoky rooms
  • Avoid sudden changes in temperature
  • If your symptoms are brought on by exercise or allergy to animals, take your reliever inhaler before you exercise or visit your sister's cat!
  • Get a 'flu jab every winter from early October
  • Get a pneumococcal vaccination every 10 years
  • Take regular treatment (tablets and/or eye or nose drops) for hay fever, if you have it - hayfever symptoms can worsen asthma.

Could it be COPD?

Chronic Obstructive Pulmonary (lung) Disease, or COPD is a chronic lung problem almost always caused by smoking. Your doctor will want to test you for COPD if you're over 35, have ever smoked and bring up regular phlegm or get shortness of breath when you exercise, chronic cough, wheeze or frequent winter chest infections. The recommended way to distinguish between asthma and COPD is using spirometry, testing your lung capacity before and after taking a reliever inhaler. In well controlled asthma, your lung function should be normal. Although it's possible to relieve the symptoms of COPD with inhalers, your lung function won't be normal even with treatment. It is possible to have both asthma and COPD, especially if you are or have been a smoker.

Should I worry?

If you get asthma symptoms for the first time as an adult, your doctor will want to rule out other conditions. Apart from COPD, a condition called heart failure, where your heart isn't pumping strongly enough, causes shortness of breath and sometimes wheezing. Unlike asthma, it can also give rise to swollen ankles and breathlessness when you lie flat. Your doctor may suggest a blood test, a chest x ray and possibly a referral to a heart specialist if they suspect this.

It's crucial to have regular checks if you have asthma, to see how you're doing. Your doctor should discuss an 'asthma management plan', with advice on what to do it your symptoms get worse. He may recommend increasing your preventer inhaler when you get a bad cough, for instance. If you have a severe attack of asthma which leaves you too breathless to speak or isn't relieved by your inhaler, you must seek urgent medical help.

With thanks to 'My Weekly' magazine where this article was originally published.

Dr Sarah is unable to provide medical advice or respond directly to questions concerning your health. If you have health concerns we recommend contacting your GP.