Asthma is a chronic inflammatory condition that affects the airways. It causes wheezing, breathlessness and chest tightness as the airways in the lungs narrow and the flow of air is obstructed. Asthma is a common condition and affects one in 10 Australians – that’s over two million people. Most people with asthma who take the appropriate treatment can live normal lives.
Asthma often starts in childhood, but it can happen for the first time at any age.
If you have asthma, your airways become irritated and inflamed. As a result, they become narrower and produce extra mucus. This makes it more difficult for air to flow into and out of your lungs.
Asthma symptoms may be mild, moderate or severe. They may include:
These symptoms tend to be variable and may stop and start. They are often worse at night.
The cause of asthma isn't always clear. However, there are often triggers that can result in a flare up of symptoms. Common triggers include:
In children, asthma is more common in boys than in girls but in adults, women are more likely to have asthma than men. Asthma often runs in families. If you smoke during pregnancy, your baby is more likely to get asthma.
If you smoke and have young children, they are more likely to get asthma. Premature or low birth weight babies are also more likely to develop asthma.
Your doctor will ask about your symptoms and examine you. They may also ask you about your medical history and if you've noticed any factors that trigger your symptoms.
Your GP may do one or more of the following tests to make a diagnosis:
In children under five, a diagnosis may be made just by seeing if they respond to asthma treatments.
There isn't a cure for asthma. However, treatments are available to help manage the symptoms. If asthma is left untreated, it can cause permanent damage to the airways. Very rarely, a severe asthma attack can even be fatal. So ensure you speak to your GP to get the right advice.
It's important to have a written asthma action plan that can help you track and manage your asthma. This will be individual to you, combining medicines and asthma management in a way that works best for you. It will explain how to recognise worsening asthma, provide clear instructions about when you should adjust the amount of medicine you take if your asthma gets worse and will give instructions about when to see your GP or go to hospital.
You should take your asthma plan with you when you visit the GP so he or she can review and update the instructions if necessary. Talk to your doctor about developing an action plan.
Inhalers contain gas or dry powder that propels the correct dose of medicine either when you press the top down or when you inhale. The medicine is inhaled into your airways. You will need to use your inhaler correctly in order for it to work properly, so ask your GP for advice.
The categories of inhaler medicines that are used for asthma are:
Use relievers when your asthma symptoms occur as outlined in your asthma action plan. They can be short or long-acting. Short-acting relievers (known as bronchodilators) contain medicines such as salbutamol and terbutaline that work to widen your airways and quickly ease your symptoms.
If you're given a preventer you should use it every day - even if you don't have symptoms. Preventers usually contain a steroid medicine, such as beclomethasone or fluticasone that work to reduce the inflammation of your airways. It can take up to 14 days for preventer medicines to work, but once they do, you may not need to use your reliever inhaler regularly or even at all.
If your symptoms aren't well controlled with a regular steroid inhaler (preventer) and occasional use of a short-acting reliever, a symptom controller may be added to your treatment. This contains a long acting reliever combined with steroid inhalers.
Always read the accompanying consumer medicines information leaflet and talk to your pharmacist if you have any questions.
If you use a gas propelled inhaler, you may also be given a spacer. Spacers are devices that can help you use your inhaler correctly and are particularly helpful for children. Children as young as three can learn to use an inhaler with a spacer, and for babies and very young children, a face mask can be attached. A spacer is a long tube which clips onto the inhaler. You breathe in and out of a mouthpiece at the other end of the tube.
It's easier to use because it allows you to activate the inhaler and then inhale in two separate steps. Using a spacer also reduces the risk of getting a sore throat from using a steroid inhaler. When used correctly they can be as effective as nebulisers in the treatment of an acute asthma attack.
You can talk to your doctor, asthma educator or pharmacist for more advice on using spacers.
Nebulisers make a mist of water and asthma medicine that you breathe in. They can help to deliver more of the medicine to exactly where it's needed. This is particularly important if you have a severe asthma attack and you require emergency treatment in the home or a hospital setting.
However, the Australian Asthma Management Handbook says using an inhaler and a spacer is preferred over using a nebuliser wherever possible.
If your child has asthma, ask your GP for advice as a nebuliser may not be suitable.
If you have severe asthma symptoms, your GP may prescribe a course of steroid tablets such as prednisone. You need to take these as directed.
Several other medicines are available as tablets and inhalers if the standard treatments aren't suitable for you. Talk to your GP or pharmacist for more information.
If you have an asthma attack follow the instructions in your written asthma action plan.
The National Asthma Council Australia recommends the following asthma first aid to help somebody having an asthma attack:
If you go to hospital, try to take your asthma medicines and asthma action plan with you. Make sure you see your GP when you go home from hospital so they can review your treatment and asthma action plan.
Medicines are only part of your treatment for asthma. You will also need to deal with the things that make it worse.
With good management and appropriate treatment, most people with asthma can lead completely normal lives.
National Asthma Council Australia
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Cates CJ Crilly JA Rowe BH. Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma. Cochrane Database of Systematic Reviews. 2006, Issue 2. Art. No.: CD000052. DOI: 10.1002/14651858.CD000052.pub2
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National Institute for Health and Clinical Excellence (NICE). Inhaled corticosteroids for the treatment of chronic asthma in adults and in children aged 12 years and over. [online] Mar 2008 [accessed 11 Jul 2011] Available from: http://guidance.nice.org.uk/TA138
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Last published: 30 July 2011
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