Asthma is a long-term condition that affects the airways and can cause breathing difficulties. It is common and can affect people of all ages, although it usually starts in childhood, but you can develop it in adulthood too.

In order to effectively manage asthma, it’s important to know exactly what the signs or symptoms are.

The severity of your asthma will affect how often you experience these symptoms. Some people with asthma get them every now and then, while others experience them regularly.

Our doctors can discuss any breathing difficulties you're having. They'll listen to you breathing during your consultation and identify any symptoms that could indicate asthma.

The symptoms of asthma in children are largely the same as they are in adults. What’s often different is the cause and times of day when they occur.

There are signs you can look out for if you’re worried that your child might have asthma. For example, your child may cough a lot when they’re playing, laughing or crying.

The main asthma symptom for young children is a cough. You may also notice some wheezing, but this isn’t uncommon in very young children as their airways are smaller.

If you’re at all concerned about your child’s health, our doctors can provide all the help and reassurance you need.

Sometimes you may experience an asthma attack - the symptoms may come on suddenly, or develop over a few days. Look out for:

• Severe and constant chest tightness that feels like it’s getting worse
• Wheezing and coughing that feels like it’s getting worse
• Breathlessness that’s stopping you doing everyday activities
• Very fast breathing
• Increased heart rate
• Drowsiness, dizziness or confusion
• Blue lips or fingernails
• Pale skin
• Sweating
• Panic or anxiety

If your symptoms don’t improve despite using your asthma medication, this could also be a sign that it is an asthma attack.

The symptoms of asthma are similar to the symptoms of many other conditions. For example, chest tightness and shortness of breath can also be caused by allergies, while coughing can be caused by something like a chest infection.

It can be difficult to tell exactly what’s wrong without speaking to a doctor. However, there are a few clues you can look out for, such as:

• Symptoms that occur regularly
• Symptoms that only occur in response to certain triggers
• Symptoms that get worse at certain times of day, such as early in the morning or late at night

If any of these apply to you, it’s worth seeing a doctor to confirm your asthma diagnosis. This will allow you to start treatment and ensure your symptoms don’t get in the way of your life.

If you are experiencing symptoms that you think may mean you have asthma, you should speak to a doctor.

The doctor is likely to ask about your medical history, whether asthma runs in your family and what symptoms you have been experiencing. They’ll want to know whether you’ve noticed whether the symptoms happen at a particular time or place, and how they affect you.

The doctor may refer you for tests to confirm an asthma diagnosis, these can include:

• spirometry - you breathe into a machine that measures your lung function, so how much air you can hold in your lungs and how fast you breathe out
• peak flow test - this is a hand held device you blow into that measures how fast you can breathe out to measure your lung function
• FeNO (fractional exhaled nitric acid) test - this tests for inflammation in your lungs by measuring how much nitric oxide you breathe out
• airways responsiveness test - this test measures how your airways react when they are exposed to known triggers of asthma and it’s done in hospital.
• allergy test - if allergens trigger your asthma symptoms, you may be tested to find out what you’re allergic to.

Diagnosing asthma is much more complicated for children than it is for adults. There are a number of reasons for this.

If your child is aged under five, their lungs aren’t developed enough to gain any meaningful results from a spirometry or peak flow test.

As these tests aren’t as reliable at this stage, younger children are often diagnosed with ‘suspected asthma’. This means the doctor thinks it’s a possibility, but will need to observe your child over a longer period to make a full diagnosis.

They may suggest a trial treatment, where your child uses a certain medicine for 2-3 months to see if it has an effect on your child’s symptoms.

If your child responds well, it’s likely that they do have asthma. Your doctor can then use the results from the trial treatment to work out the lowest effective dose needed when full treatment starts.

It is important that you get a diagnosis for asthma as this will help you get the condition under control and have access to the treatment you need as soon as possible.

If you think your child has asthma, getting them diagnosed is important as it will help them with their breathing problems and stop it affecting their daily life.

Asthma is a long-term condition and you will need regular reviews to monitor how you are doing and how effective your treatment is. This gives you the chance to discuss any further symptoms you have experienced or any concerns you have with the doctor.

The reviews will allow the doctor to change any existing medications or suggest other treatments if needed.

People with asthma often find that certain things can trigger their symptoms, make them worse or lead to an asthma attack. Common asthma triggers include:

• allergies, such as pollen, dust mites, animal fur and dander
• an infection, such as a cold, flu
• alcohol - some people find that certain types of alcohol can trigger asthma symptoms, with red wine being the most common according to Asthma UK - it’s thought to be the histamine the alcohol contains
• air pollution
• smoke - if you have asthma and you are a smoker you should take steps to stop - if you are a smoker and your child has asthma, even if you don’t smoke near them, even just the smell of cigarette smoke on your clothes could make their asthma worse
• fumes, such as paint fumes, solvents or cleaning chemicals
• mould
• emotions, such as stress
• weather changes, such as thunderstorms, and fluctuating hot and cold temperatures
• exercise - staying active is good for you if you have asthma. If exercise triggers your asthma you may need different treatment to help you control the symptoms
• medications, such as aspirin, anti-inflammatory medication or beta-blockers.

Triggers will vary from person to person - work with your GP to find out your triggers, so that you can avoid them in the future.

If your symptoms are mild, you know what triggers your asthma and it’s possible to avoid it, this might be all the treatment you need.

Asthma triggers can include:

• Smoking
• Outdoor allergens, such as pollens from grass, trees and weeds
• Indoor allergens, such as pet dander, dust mites and mold
• Certain drugs and food additives
• Irritants in the air, such as smoke, chemical fumes and strong odours
• Colds, the flu or other illnesses

This inhaler is usually brown or orange, and you should use it every day in order to control your symptoms and reduce sensitivity to asthma triggers. It’s normally prescribed to people who suffer from symptoms regularly.

It contains a low dose of corticosteroids that can stop your airways from swelling. Due to the possible side effects of steroids, your doctor will prescribe an inhaler that contains the lowest dose of medicine possible for controlling your asthma. If you feel your preventer inhaler isn’t working, you should see your doctor about it.

It’s important to use your preventer inhaler exactly as directed by your doctor. If you stop using it because you’re feeling fine, the effects will wear off and you won’t feel the benefit.

You’ll probably have a reliever inhaler as well, as you’ll still need it to manage an outbreak of asthma symptoms. Generally, you should not use your preventer inhaler in this situation, as it won’t work quickly enough – although there are some newer brands that are used in both situations.

Reliever inhaler

You’ve probably seen one of these before. It’s the blue inhaler that asthma sufferers use to relieve their symptoms as and when they need to, particularly if they’re having trouble breathing.

It contains medicine that widens your airways within a couple of minutes and makes it easier to breathe. There are different types of reliever inhaler available.

• Metered-dose inhaler - requires you to press a button to release the medicine
• Breath actuated inhaler - activated as soon as you inhale
• Dry powder inhaler - releases a powder instead of a spray

If you’re having to use your reliever inhaler more than three times a week, it’s recommended that you see a doctor, as you may need a stronger form of treatment to prevent asthma symptoms occurring.

How to use your inhaler

In order for your asthma inhaler to be effective, it’s important to use it correctly. A survey from Asthma UK found that up to a third of inhaler uses aren’t using them properly.

Simply put, if your inhaler technique is wrong, it probably isn’t working. The exact technique varies depending on the type of inhaler you have. Our doctors will be more than happy to demonstrate the correct way to use your inhaler, so feel free to ask if you’re not sure!

If your inhaler doesn’t deal with your asthma symptoms, our doctors can prescribe tablets.

Leukotriene receptor antagonists

Unlike an inhaler, these don’t contain steroids. Rather than offering an anti-inflammatory, they block the chemicals released by your immune system when an asthma trigger is nearby. They are usually taken once a day.

Theophyllines

Asthma triggers will often cause the muscles in your neck and chest to tighten, closing your airways and making it difficult to breathe. These tablets relax the muscles around your airways, keeping them open and ensuring you can breathe normally.

If your symptoms are very severe and leave you at risk of an asthma attack, you may need a stronger treatment. Our doctors can prescribe:

Steroids

Steroids can prevent your airways from swelling. While they can work very well if all else fails, the risk of side effects means that your doctor will want to carefully monitor your steroid usage. You shouldn’t change your dosage without consulting them first.

Biological Treatments (such as Omalizumab and mepolizumab)

You may be prescribed these medicines if you suffer from severe asthma and your symptoms have proved difficult to control with other forms of treatment. They’re given as an injection around once a month by a specialist. Our doctors can provide the necessary referral for you to receive this treatment.

1. Take one to two puffs of your reliever inhaler immediately.
2. Sit down and try to take slow, steady breaths.
3. If you do not start to feel better, take two puffs of your reliever inhaler (one puff at a time) every two minutes. You can take up to 10 puffs.
4. If you've forgotten your inhaler, you don’t feel better after taking your inhaler as above, or you are worried at any time, call 999.
5. If an ambulance doesn’t arrive within 10 minutes and you are still feeling unwell repeat step 3.

If you didn’t go to the hospital because of your asthma attack, it’s recommended that you see a doctor within 24 hours. If you needed hospital treatment, you should still see a doctor for a follow-up appointment within 48 hours.

Our experienced GPs can review your health and see if you need to change your treatment to prevent another attack.

The treatment for your asthma will usually remain the same as before you got pregnant. Your current inhalers are normally considered safe to use while pregnant. You should speak to a doctor or your asthma nurse if you become pregnant or you plan on trying for a baby.

You will need extra support during your pregnancy and at the birth to reduce the risk of having an asthma attack and to make sure your symptoms are managed properly.

If you are finding your asthma is getting worse during your pregnancy, a doctor will be able to review your treatment to see if something else would be more effective.

You may need more regular check-ups than normal to make sure your symptoms are still under control. Poorly controlled asthma in pregnancy increases the risk of a premature birth or your baby having a low birth weight, so it’s important to try to keep it under control as best you can.

Your symptoms won’t harm your baby or pose a risk to the pregnancy. However, evidence suggests that if both parents have asthma, it’s more likely that your baby will too.

It’s important to continue taking your asthma medication throughout your pregnancy. Doing so poses no risk to your baby.

Asthma medication is perfectly safe provided you stick to the dosage outlined by your doctor. Avoiding triggers wherever possible will also help keep symptoms under control.

Even if your asthma has got worse during your pregnancy, studies suggest that any problems should have died down by week 36. You shouldn’t experience any asthma-related issues when the baby arrives.

It’s unusual for asthma to flare up while you’re giving birth. During labour, your body produces hormones that contain natural steroids that will keep symptoms under control. In the unlikely event you do have trouble breathing or start coughing, it’s safe to use your reliever inhaler. Make sure you keep it close to hand, just in case.

Most forms of pain relief during labour are safe. If you’re worried about your asthma symptoms, talk to a doctor beforehand. Ensure you have a clear plan in place for dealing with your asthma during labour and confirm a preferred form of pain relief.