Asthma can be defined simply as reversible airways obstruction. It is one of the commonest chronic diseases worldwide and has prevalence in the UK of approximately 15 per cent in children and 8-10 per cent in adults.
The reversible obstruction occurs because there is:
inflammation of the airways which makes them narrower
constriction of the airway muscles which also makes them narrower
increased mucous which gets in the way of air moving in and out of the lungs
It affects both large and small airways. Some individuals are affected only occasionally, for example if they have a cough or cold, go out into cold, dry air, or exercise.
Most have mild to moderate symptoms which are prevented or relieved by appropriate inhaled medications which are safe and effective. Others have much more severe asthma which requires several types of medicine and which can be serious enough to go to hospital.
Most children with asthma either grow out of it in adolescence or suffer much less as an adult, although a proportion go on to suffer with it throughout adult life.
In an asthma attack a sufferer finds it very difficult to breathe. The chest feels tight and there is a wheeze. Often they will breathe fast or hyperventilate in an effort to get as much oxygen as they can, but this does not often help. Using their reliever (usually a blue inhaler) as soon as possible will help alongside trying to calm their breathing rate down. Most people with asthma know their condition well and will know what to do. Medical aid should always be sought if someone is not getting better. Every year there are 1-2,000 deaths from severe asthma, and not being able to breathe should always be treated as an emergency.
Could I have asthma?
The symptoms of asthma are usually those of recurrent wheeze, cough, breathlessness and chest tightness. Often sleep is disturbed or you may have difficulties when exercising. Frequently there is a family history of asthma or allergy, sometimes it co-exists with other atopic conditions such as eczema and hay fever, and the symptoms of asthma may be made worse by allergies e.g. to cats, pollens, dust or respiratory infections. Other medical problems can cause similar symptoms so a doctor will want to ask you questions, examine you and perform some breathing tests which may require you to keep a ‘Peak Flow’ diary or breathe into a device called a Spirometer.
Peak Flow measures how hard you can blow and is lower in people who are suffering with asthma. It is measured in litres per minute.
Spirometry measures more precisely the volume of air you can expel in one second followed by the volume you can blow out in total. Someone without asthma should be able to blow 70% of their lung volume out in the first second.
Modern treatment is effective at treating and preventing the symptoms of asthma.
Having an annual review with the nurse or doctor is the best way to ensure that you are getting the best and most up-to-date treatment.
The aim of treatment is to prevent symptoms so that you hardly ever need to use ‘reliever’ medication. This can be by avoiding triggers that you know make it worse, not smoking, and if necessary by taking preventative medication which is safe and effective.
Relievers – these inhalers (usually blue) directly relax airway muscle, opening up airways and making it easier to breathe.
Preventers – these medicines act to reduce the inflammation and mucous in the airways, and help to reduce airway muscle contraction. These are usually inhalers too, although sometimes various tablets are also used.
Flu Vaccination – each year a vaccine is developed to protect you from the current most virulent strains of influenza virus. It is available from GP surgeries in the autumn and is well worth having if you have asthma that requires regular prevention treatment, (or certain other chronic conditions, or are over 65).
Where to find out more
If you think you may have asthma and want to find out more then you can make an appointment to see one of the nurses or doctors at the Health Centre.
If you, or someone you are with, suffer an asthma attack and it is an emergency you should call 999.