Asthma - the facts
Asthma doesn’t just leave small children gasping for breath – it affects adults too. Up to 1 in 12 people aged over 65 has asthma.
What is asthma?
Asthma is a lung condition where inflammation in your airways makes the muscles around your airways go into spasm. This cuts the air getting into your lungs, causing symptoms of shortness of breath, wheezing, chest tightness and cough.
What causes asthma?
In children, asthma is usually caused by allergy. Young people with asthma often have other ‘allergic’ conditions like hayfever or eczema in the family.
When asthma starts in adulthood, allergy is less likely. The most common triggers include:
- Cigarette smoke (including passive smoking).
- Catching a cold.
- Irritation of the airways from perfumes or chemicals (including home cleaning products).
- Occasionally, chemicals or dust at work.
How do I know it’s asthma?
In older people, asthma is often confused with other conditions causing shortness of breath. These include chronic obstructive pulmonary disease (COPD) - almost always caused by smoking – and heart failure, in which your heart doesn’t pump blood efficiently enough around your system. Your GP will do tests of your lung function – how much air you have in your lungs and how fast you can blow it out. You may also need a chest X-ray and blood tests to exclude other conditions.
Is asthma dangerous?
Most asthma symptoms can be controlled. However, if you have a severe asthma attack, it’s important to seek medical help quickly, as occasionally asthma can be life-threatening. Getting treatment early is crucial to prevent this. Symptoms to worry about include:
- Being too breathless to finish a whole sentence (or to speak at all).
- No relief of symptoms from taking your ‘reliever’ inhaler.
- Breathlessness with a very fast heartbeat.
What are the treatments?
Most treatments for asthma are given in the form of inhalers. They are largely divided into ‘relievers’ which open your airways by relaxing the muscles and ‘preventers’ which reduce inflammation and stop symptoms from happening. You only need to take relievers when you are breathless or wheezy. Preventers need to be taken regularly, even when you’re feeling well, to work best. The most common preventers contain low doses of steroids – if your symptoms are very bad you may need steroid tablets (see below).
How can I help myself?
There are lots of ways to improve your symptoms:
- Avoid smoky rooms (and smoking – obviously!).
- Animal fur can make symptoms worse. Try avoiding cats and dogs and see if it helps.
- Get a flu vaccine every year, and ask your doctor if you need a vaccine against pneumococcus (every 10 years).
- Avoid sudden changes in temperature – very cold or very hot, humid weather can bring on symptoms.
- Some people find their asthma gets worse in hay fever season. Consider taking antihistamines and stay indoors when pollen counts are high.
Are steroids dangerous?
Steroids get a very bad press. We hear about athletes and bodybuilders who abuse them, and ‘roid rage' (steroid rage) because of their effects on mood. But these steroids, called ‘anabolic steroids’, are different from the kinds used safely to treat many medical conditions.
All of us produce steroids in our bodies. In very large doses, steroids can cause thinning of the bones (osteoporosis), thinning of the skin, high blood pressure and even diabetes. However, most medicines containing steroids – especially inhalers and most creams used to treat skin problems – contain only small amounts. Some people need steroids, which are very effective for conditions like polymyalgia (severe muscle aching usually affecting the over-55s) or some chest diseases. Your doctor will keep your dose as low as possible to control your symptoms. If you’re taking them for more than a few weeks, ask your doctor if you need medicine to avoid thinning of the bones.