Asthma is a disease of the airways in the lungs. Its symptoms are caused by inflammation, which makes the airways red, swollen, narrower and extra-sensitive to irritants. This leads to recurrent attacks of wheezing, breathlessness, chest tightness and coughing. Mild attacks can settle down without treatment, but treatment usually helps them to resolve more quickly. Appropriate treatment can also reduce the risk of further attacks. If you experience a serious attack you should seek emergency help.

Asthma is a long-term (chronic) disease. Your asthma does not stay the same, but changes over time, and every person with asthma has good and bad days or longer periods of time.

Inflammation of the airways causes asthma symptoms (wheezing, breathlessness, chest tightness and coughing) by restricting or limiting the airflow to and from the lungs. It does this by causing:

• Swelling of the airways, which makes them narrower
  
• Tightening of the muscles that surround the airways (also called bronchoconstriction), which makes them even narrower
  
• the production of too much mucus, which can plug up or block the airways
  
• Longer-term damage to the walls of the airways, which prevents them from opening as widely as a normal airway.

Inflammation is a reaction to infections and other triggers in the lining of the airways and the underlying tissue. The inflammation makes the airways red, swollen, narrower and extra-sensitive.

Asthma tends to be hereditary, which means that you are more likely to develop asthma if someone in your family already has it. Children with eczema or food allergies are more likely to develop asthma.

An allergy to pollen, house dust mites or pets also increases your chance of developing asthma. Exposure to tobacco smoke, air pollution or other inhaled irritants can also cause asthma symptoms.

Asthma symptoms can begin at any age. About half of all people with asthma experienced their first symptoms before the age of ten. However, many children with asthma have their first asthma attack before the age of 6.

The causes of asthma are not fully understood. It is thought that asthma is caused by a mixture of hereditary factors (those you are born with) and environmental factors. How these factors work together is still largely unknown.

Allergens from house dust mites and pets are the most common causes of asthma symptoms. However, many other allergens, including pollen and molds, can cause asthma symptoms. Still, some patients with asthma have no obvious allergies.

Yes. Asthma is a chronic (long term) disease that causes inflammation and narrowing of the airways. Some degree of inflammation is usually present, even at times when a person with asthma is not aware of any symptoms. 

If asthma is left untreated, a patient will experience asthma symptoms, called an asthma attack. Mild attacks often do not require treatment, but treatment can help symptoms resolve more quickly. Appropriate treatment can also reduce the risk of further attacks. If you experience a serious asthma attack, seek emergency help by dialing 999.

Yes. Poorly treated asthma gets worse with age. Additionally, the lungs of individuals with untreated asthma function worse than those of non-asthmatic individuals. Modern asthma treatments have not been available long enough to know their impact on lung function. However, most healthcare professionals think that regular, preventive asthma treatment can prevent asthma from getting worse and can help preserve lung function.

No. However, asthma is often more severe when it begins at an older age. In addition, an older person with additional medical problems, such as heart disease, may have more difficulty dealing with an asthma attack than a younger person.

It is noteworthy that what is called asthma in elderly people is sometimes actually chronic obstructive pulmonary disease (COPD). COPD is a collective name for chronic bronchitis and emphysema, two diseases that are almost always caused by smoking. Many of the symptoms of COPD are similar to those of asthma (e.g. breathlessness, wheezing, production of too much mucus, coughing, etc.). 

COPD is generally a more serious disease than asthma. Changes in the airways are much more difficult to treat and it usually has more serious outcomes. Compared to asthma, COPD can also cause greater long-term disability and have a greater effect on the heart and other organ systems.

Yes. An itchy, runny or blocked nose due to hay fever or allergies (called allergic rhinitis) can make asthma harder to control. The good news is that treating the symptoms in your nose and throat can also improve your asthma symptoms.

Corticosteroid nasal sprays are effective treatments for managing allergic rhinitis. They can be used every day for a long term if needed, just like preventers for asthma.

If your doctor has told you to take your preventer medication every day, yes. Preventer medications help make your airways less sensitive by reducing the amount of redness and swelling (inflammation) in your lungs. Preventers must be taken regularly to work properly – they help keep asthma symptoms under control and help prevent asthma attacks.

Taking medication every day can be difficult. Ask your doctor, pharmacist or asthma educator to explain your medications. Adhering to a medication routine can be easier if you know what the various medications are, how they work and why you need them. Ask for a personal written asthma action plan. Asthma action plans have instructions on when and how you should use each of your medications.

You can do several things to help prevent your asthma symptoms getting worse or developing into an asthma attack.

• Know what triggers your asthma and try to avoid or reduce your exposure to these triggers
  
• Take your medications as instructed by your doctor, even when you feel well
  
• Follow your personal written asthma action plan, developed with your doctor
  
• Make sure you are using your inhaler (puffer) properly

Finding a good general practitioner (GP) and pharmacy close to home can help you manage your asthma. Most people can have their asthma managed by a GP (Primary Health Center) and pharmacist (often with help from an asthma educator or nurse) and don’t need to see a respiratory specialist for routine care. 

If you have allergies that affect your asthma, your GP may suggest you see a doctor who specializes in asthma treatment. These doctors are called Specialists in Clinical Immunology, Allergy Specialists, or Allergists.

Possibly. Less than one in nine adults with asthma are sensitive to aspirin and similar medicines like ibuprofen (called nonsteroidal anti-inflammatory drugs, or NSAIDs). And aspirin-intolerant asthma is even less common in children. However, if you have experienced sensitivity to aspirin or one type of NSAIDs, you are likely to react to other types of NSAIDs too. Ask your doctor or pharmacist about risk factors for aspirin-intolerant asthma and whether you can stop avoiding these pain relievers.

No. Most asthma medications have very good safety profiles for use in pregnancy, so don't stop or change your asthma medications without first speaking with your doctor. Remember, if you can't breathe, neither can your baby.

Speak to your GP to make sure that your day-to-day asthma is under control with appropriate medications and that your personal written asthma action plan is up to date so you know what to do if your asthma flares up. Ensure your whole healthcare team (e.g. obstetrician, midwife) know that you have asthma and how you manage it.

No. The ‘milk myth’ – the idea that milk makes mucous or that dairy triggers asthma – has been busted by scientists for some time. Cow’s milk and other dairy foods very rarely trigger asthma symptoms in people without milk allergy. 

Limiting dairy in your diet can have significant health and nutrition effects, particularly for children, so talk to your doctor first if you have any concerns about food reactions.

The liquid inside your puffer is a mixture of medicine and propellant (the substance that forces the spray into your lungs). The medicine droplets tend to settle separately from the propellant inside your puffer when you aren't using it.

This means that if you take a dose without shaking, you could be inhaling just the propellant and no medicine. The mixture settles back quickly, so you need to re-shake before each puff.

Latest research shows that a puffer with spacer works just as well as a nebulizer for treating asthma in almost all circumstances, including during an asthma attack. A puffer with spacer is also simpler, cheaper, easier to handle, more portable, and has fewer side-effects.

If you or a family member still uses a nebulizer for day-to-day or emergency asthma management, ask your doctor if you can make the switch.

Moving to another city or even country is a big step if your asthma or allergies are the only reason you are considering such a move. Unfortunately, moving may not have as much impact as you hope.

Asthma is triggered by different factors for different people. Many people with asthma and allergies have an underlying allergic sensitivity (called atopy). For example, if you are allergic to grass and pollen, you might have fewer symptoms upon first moving from an inland region to a coastal area. However, while a different climate may help in the short term, over the long term you might develop sensitivities to triggers in your new environment, such as dust mites.

Before making such a move, speak to your doctor and/or asthma educator about your asthma and allergy concerns. There may be some simple steps you can take in your current home.