Asthma - all you need to know

asthma inhaler     chest xray     children asthma

We all suffer from breathlessness from time to time, but some people have recurrent problems with shortness of breath and wheeziness - or asthma. The number of sufferers has at least doubled over the last 25 years, and research shows that asthma is becoming especially common in women - two out of three sufferers are female. We tell you what every woman needs to know



Symptoms
Asthma is a long-term, inflammatory disease of the lungs. During an attack, the irritated airways go into a spasm producing a cough, wheeze, chest tightness and shortness of breath, which, in severe cases, can be life-threatening. As the attack progresses, the lining of the airways swell and produce excess mucus which often result in further tightness and wheezing six to eight hours later. Symptoms can develop at any age but usually begin during the first few years of life. One in four children with asthma develop symptoms in their first year.

If you answer yes to any of the following questions, you or your child could have asthma:

Adults

  • Do you sleep badly with a cough, wheeziness, or difficulty breathing?
  • Does coughing ever wake you up?
  • Have you stopped enjoying any sport because of chest problems?
  • Do you get surprisingly out of breath if you run or hurry?
  • Do you avoid smoky places because they make you wheezy?
  • Does anyone in your family have asthma or hayfever?
  • Do you have difficulty shaking off a cold?

Children

  • Do they ever wake up at night coughing?
  • Do they cough or feel chesty in the mornings?
  • Do they have to stop playing games because of coughing or breathlessness?
  • Do they avoid games or play in positions that don't need a lot of running because of chest problems?

Causes
Asthma is linked to a number of factors, including the genes you have inherited, abnormal immune function, diet and exposure to pollutants such as cigarette smoke. There appear to be two different types of asthma, however, those linked with allergies (allergic asthma) and those causing irritation in non-specific ways (non-allergic asthma). People with asthma have airways whose linings are red and swollen and which become increasingly sensitive to certain triggers. Common asthma triggers include:

Allergic Asthma

  • grass and tree pollen
  • house dust mites
  • animal fur
  • fungal spores and moulds
  • certain foods such as peanuts, eggs and milk products
  • work hazards, for example, some chemicals

    • Non-Allergic Asthma

    • viral infections, for example, colds
    • cigarette smoke
    • cold or damp air
    • exercise
    • strong emotions, for example, laughter
    • cosmetics and perfume
    • air pollution
    • hormonal changes, like periods or pregnancy in women
    • acid reflux (indigestion)
    • some drugs
    • stress

    Eight out of ten asthma attacks are caused by a viral infection of the upper airways which can stem from something as simple as the common cold.

    Back to main question page

    Asthma and diet
    Chronic inflammatory diseases, such as asthma, have been linked to an imbalance of dietary fats. These dietary polyunsaturated fats or PUFAs fall into two groups; omega-3 PUFAs derived from fish and some nut and seed oils and omega 6-PUFAs, derived mainly from vegetable oils. Ideally, we need to obtain a balanced intake of omega-3s and omega-6s, but many people eat far more of the potentially inflammatory omega-6s and too few of the protective omega-3s.

    Asthma has also been linked with low dietary levels of selenium, magnesium or B6 in some studies, while those with high intakes of antioxidants (vitamin E or vitamin C) seem to have the lowest risk. One study that analysed the diets of over 5,500 males and 5,700 females found that those with the lowest intakes of fresh fruit and salad or raw vegetables were most likely to suffer from asthma. The effect was strongest among smokers.

    Treatment
    Two main types of drugs are used to treat asthma: relievers and preventers. Short-acting relievers, like salbutamol, relax the muscles in the airways so the tubes dilate. This quickly makes breathing easier, with the effect lasting from three to six hours. Relievers can only relax your airways, however. They cannot tackle the underlying inflammation that leads to asthma in the first place. Because of this, if you need to use your reliever inhaler regularly, you should ideally use a preventer inhaler as well.

    Preventers, like cromoglycate, nedocromil and inhaled steroids damp down the inflammation that leads to asthma and, when used regularly, can prevent an attack by making your airways less sensitive. In young children, inhaled drugs are most easily given from a metered dose inhaler using a large-volume spacer device. In a more severe attack, a nebuliser, which vaporises the drug so it can be breathed down into the lungs more easily, may be needed. Someone with severe asthma will also need other drugs such as a short course of oral prednisolone (a corticosteroid) to get on top of their symptoms.

    One of the best ways to monitor how well your lungs are working is to use a peak flow meter. This shows how fast you can blow out and is a measure of how constricted your airways are. Ideally, asthma treatment will keep your peak flow score within 20 per cent of what is normal for someone of your age, sex and height who does not have asthma.

    The aim of asthma treatment is to take total control of your symptoms. You will usually be given a treatment plan that helps you tailor treatment to your symptoms, for example, stepping up the dose of a preventer drug or adding in another treatment when symptoms are worse. When asthma is under control again, treatment can be stepped down.

    Back to main question page

    Some other drugs are also used when asthma symptoms are severe. These include long-acting relievers, like salmeterol, that relax your airways for up to 12 hours and 'rescue' courses of oral steroids which are excellent at damping down more serious inflammation. If you show the following signs, it is likely that your asthma is not really under control:

  • Poor peak flow readings
  • Waking at night (or in the morning) with symptoms
  • Having to use your reliever inhaler more than once a day
  • Having to make compromises in your life because of symptoms

    If this is happening to you, ask your doctor to review your treatment or refer you to an asthma clinic.

    Self help for asthma
  • Stop smoking and try to avoid smoky places
  • Keep your home as dust-free as possible. Dusting with a damp cloth, and using a vacuum cleaner with a special filter will help
  • Wash or groom the family cat or dog regularly when the person with asthma is not around
  • Breathing exercises may help you relax and control your breathing better during an attack - a physiotherapist will be able to show you how to do them
  • Put special covers over your mattress, pillow and duvet to prevent bed mites
  • At least seven studies suggest that people with asthma have reduced symptoms and improved breathing when taking 1g to 2g vitamin C supplements daily
  • Omega-3 fish oils contain anti-inflammatory substances and seem to protect against asthma - try taking a supplement regularly
  • Take your medication correctly, as often as prescribed
  • If using an inhaler, ask the practice nurse or doctor to check your inhaler technique is good

    For more information contact the National Asthma Campaign on their helpline: 08457 010203

    Back to main question page

    Live on the Your Health message board

    		•