How is asthma managed and treated?

GB39977 DOP 04.2023

Is it possible to reduce asthma over time?

Whilst there is no current cure for asthma, a well-managed lifestyle and action plan can usually keep your asthma under control.

Many people with asthma maintain a healthy lifestyle by using their medication as prescribed and actively avoid any personal triggers. It may not always be possible to avoid triggers completely - such as dust mites, pets, pollen, or disinfectants - but being aware of what causes a flare-up can help minimise the risk of needing urgent medical attention.

Asthma management guidelines

Dr Krishna Vakharia, a GP and Patient.info's clinical director advises those with asthma to draw up a management or action plan , which helps you and others to review what steps need to be taken to minimise your risk of suffering with an asthma attack or severe symptoms - and what actions to take if you do have an attack.

You plan should include important information, such as the type of medication you take, as well as identifying any personal triggers.

Managing asthma is likely to be a daily commitment. The following tips can help keep your asthma under control while still enabling you to go about your everyday life.

Use your inhaler and/or tablets correctly to keep any symptoms under control

There are two types of inhalers - relievers and preventers.

Relievers work by relaxing the muscles in your airways to open them up, allowing you to breathe more easily. They deliver medicine quickly to where it is needed, so work within minutes. However, standard reliever inhalers only work for a few hours.

In addition, most relievers don't reduce swelling and inflammation, which is key to preventing symptoms in the first place. This is where preventers, which contain a low dose of steroid come in. Because the steroid is delivered directly to where it's needed, you need a much smaller dose than the amount of steroid contained in tablets. The steroid is different to anabolic steroids, the type used by bodybuilders.

Preventers need to be taken regularly to work properly. Some combination relievers contain both a small amount of steroid and a long-acting version of reliever medicine, providing the benefits of both reliever and preventer together.

Check any other medication you require to see if it's suitable for people with asthma

Some medications can trigger an asthma flare-up. Aspirin can trigger asthma, as can beta-blockers (which are used for heart conditions), and non-steroidal anti-inflammatory drugs (such as ibuprofen).

If you have concerns about a medicine that you are currently taking, do not stop taking it without consulting your doctor first.

Adapt to a healthy lifestyle to reduce the risk of a severe attack

A varied diet, not smoking, and getting regular exercise can hugely decrease the severity and risks that come alongside your asthma symptoms.

While there is no specific recommended diet for asthma, there is evidence that a whole-food diet, rich in fruit and vegetables, may improve overall asthma control and reduce the risk of asthma flare-ups. A healthy diet may also keep your weight within the ideal range. This is important because people living with obesity are more likely to have flare-ups and may not get as much benefit from asthma medications.

If you smoke, it puts your lungs at great risk of damage as it can irritate the airways, causing swelling, narrowing, and sticky mucus. Being exposed to smoke through passive smoking can also irritate the airways.

With regard to physical activity, it's important to do the right type of exercise for you at the right times. Exercise can improve your lung capacity, improve cardiovascular fitness, and increase endurance.

However, aerobic exercise has been known to trigger or worsen asthma in a proportion of people. This is called exercise-induced asthma or exercise-induced bronchoconstriction (EIB). If you have EIB, it's still important to exercise - the benefits in the long term will greatly outweigh the risks - but you may need to take extra precautions such as using your reliever before you exercise.

How to manage asthma at home

Asthma is managed by establishing a plan with your doctor and sticking to it, taking necessary medications, and avoiding triggers where possible.

You should keep your inhaler to hand to ensure you can access immediate relief should your usual symptoms occur. You should also keep track of the expiry date on your inhaler to ensure your medication is effective.

Management of asthma in children

"An asthma plan and having a routine to take the preventer are a great way to keep things under control in children. This is something that can be put together with the help of your GP or asthma nurse. Regular asthma reviews with your GP surgery are also important in keeping on top of your child's asthma," says Dr Vakharia.

Asthma UK says that, if your child's asthma is managed well, it's likely they'll be able to do all the things they enjoy without asthma symptoms getting in the way.

Getting to know your child's medication is crucial to keeping their asthma under control. Likewise, you should stick to the plan their GP has created and attend regular reviews. Over time, you should become better acquainted with your child's triggers as you keep a record in between appointments.

Other tips from Asthma UK in managing your child's asthma include:

• Ease your child's worries about their asthma and taking medication.

• Get into a routine with their preventer inhaler.

• Take their inhaler everywhere with you.

• Regularly check their inhaler technique to ensure it is correct.

• Get help for yourself and other relatives in stopping smoking if necessary.

• Encourage your child to stay active.

Asthma management in children does not have to be scary, and spotting triggers can become fun. This can be especially beneficial for younger children and reduce their panic around having asthma.

For example, Asthma UK offers a My Asthma pack with a calendar and a set of smiley face stickers to encourage your child to keep an eye on their asthma symptoms.

How is severe asthma treated?

The importance of maintaining your asthma management plan cannot be stressed enough when it comes to reducing the risk of severe asthma attacks.

Dr Vakharia says that injections can also be a treatment option for those suffering particularly badly. These are known as biologic therapies and can only be prescribed by a specialist.

A surgical procedure known as bronchial thermoplasty is a further, non-serious form of treatment for those with severe symptoms. This medical procedure can help people to open their airways. As time passes, severe asthma causes the smooth muscle tissue lining the airways to thicken, so this procedure is a heat treatment that reduces the amount of thickened muscle.