Chronic respiratory diseases: asthma

Asthma is a common lung condition that causes sporadic breathing difficulties. It often starts in childhood, although it can also develop in adults, and affects people of all ages. There is currently no cure, but treatment can help control the symptoms. Patients can live full and rewarding lives with the right treatment and management. Asthma is caused by the swelling and narrowing of the tubes that carry air to and from the lungs.

Common symptoms include breathlessness, coughing and wheezing. The severity and frequency of the symptoms vary from person to person, and for some, become worse during physical activity and at night. Symptoms sometimes get significantly worse. This is commonly known as an asthma attack. 

Asthma attacks can be fatal but are largely preventable and manageable. Breathlessness, coughing and wheezing will be worse than usual, and the patient may be too breathless to speak, eat or sleep. If a person appears to be having an asthma attack they should sit up straight and take slow, regular breaths (ideally using a spacer), and take regular breaths from their inhaler, as per their treatment plan instructions. If possible, a medical professional should be contacted immediately. Regular checkups and the right treatment will help prevent asthma attacks. 

Asthma is incurable, but manageable. Treatment and vigilance and regular medical checks are crucial. Patients can live rewarding, fulfilling lives with the right treatment. Asthma is often treated using an inhaler to breathe in medicines.

It can be difficult to coordinate breathing using an inhaler – especially for children and during emergency situations. Using a “spacer” device makes it easier to use an aerosol inhaler and helps the medicine to reach the lungs more effectively. A spacer is a plastic container with a mouthpiece or mask at one end, and a hole for the inhaler in the other. A home-made spacer, made from a 500-ml plastic bottle, can be as effective as a commercially-manufactured inhaler.

People with ongoing symptoms will need to take daily medication for the long-term. It’s also important for people living with asthma to avoid triggers. With medical support, individuals should learn what their own triggers are and take steps to avoid them. 

Symptoms can also cause sleeplessness, daytime fatigue and missing commitments such as school and work. 

Many different factors have been linked to an increased risk of developing asthma, although it is often difficult to find a single, direct cause.

• Asthma is more likely if other family members also have asthma – particularly a close relative, such as a parent or sibling.
• Asthma is more likely in people who have other allergic conditions, such as eczema and rhinitis (hay fever).
• Urbanisation is associated with increased asthma prevalence, probably due to multiple lifestyle factors.
• Events in early life affect the developing lungs and can increase the risk of asthma. These include low-birth weight, prematurity, exposure to tobacco smoke and other sources of air pollution, as well as viral respiratory infections.
• Exposure to a range of environmental allergens and irritants are also thought to increase the risk of asthma, including indoor and outdoor air pollution, house dust mites, moulds, and occupational exposure to chemicals, fumes, or dust.
• Children and adults who are overweight or obese are at a greater risk of asthma.

Asthma is one of the most common chronic diseases among children worldwide. Asthma affected an estimated 262 million people in 2019 and caused 461 000 deaths. Treatment and effective management of asthma saves lives.