Asthma is a long-term condition where your airways become inflamed and tight in response to a trigger, and mucus production increases. The airways get narrow and gunky, affecting the delivery of oxygen from the air to your lungs, and this makes breathing much harder work.
Asthma is common in childhood, but many outgrow it by their teens. Common causes include allergies and irritants in the environment, exercise, or you may have a genetic tendency. Most cases are mild and managed at home with inhalers, but a few people suffer a severe form, where they may require input from a specialist. You may need constant treatment, or it may flare up from time to time.
There are four key symptoms to look out for: chest tightness, feeling short of breath, a cough or a wheeze (a high-pitched sound when you breathe out). You may find you feel short of breath overnight or first thing in the morning, as this correlates with fluctuations of a hormone called cortisol. Symptoms might come and go. These symptoms also signal a flare-up of asthma that's previously been quiet or well-controlled.
Allergic asthma is commonly triggered by pollen, which appears in the spring and summer, house dust mite and pet dander. You may not notice straight away, it may take time to become sensitised and for symptoms to appear. Non-allergic asthma is caused by environmental irritants such as mould, pollution, smoking and possibly industrial chemicals if used at work (occupational asthma). In these cases, it's not so much allergens as chemicals that irritate in susceptible people.
Some people only get asthma during exercise or with a cough and cold, and others find asthma only appears in winter months. Stress is a trigger for some, and hormonal changes, such as puberty, pregnancy or the menopause, causes a change to asthma in others.
You may have other atopic conditions, such as hay fever, eczema or food allergies, and these may run in your family. This makes allergic asthma more likely.
With these symptoms you should book an appointment with your doctor to have this assessed. They will listen to your symptoms and any triggers, take your vital signs and listen to your chest. They may suggest you keep a symptom diary, record your peak flow with a special device, and may give you an inhaler to trial which should relieve symptoms.
They will review your diary and symptoms after a couple of weeks to see if they’ve improved.
A diagnosis is made in two ways: a trial of treatment (a reliever inhaler) is assessed with your symptoms and peak flow scores. Or your doctor may organise lung function tests, usually with your practice nurse, where a machine records how well you exhale. On the basis of either of these or both, you will likely be prescribed two types of inhaler, a reliever inhaler for any symptoms and a preventer inhaler for daily use. They will review you regularly to check progress, changing doses or medications as needed, until your asthma has stabilised.
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