Asthma is a common respiratory condition that can produce a variety of symptoms depending on factors like the type of asthma experienced and the affected individual’s physiology. To help support the health and well-being of those affected by this condition, our experts have put together this comprehensive guide on everything you need to know about asthma, including asthma treatment options, answers to commonly asked questions, and more.
What is asthma?
Asthma is a chronic respiratory condition that results in the narrowing of the airways in the lungs. It is characterised by several airflow obstructions and bronchospasms (sudden constrictions of the muscles in the walls of the smallest airways in the lungs, known as bronchioles) which can cause breathing difficulties.
Individuals with asthma are often highly sensitive to allergens because of how an antibody called immunoglobulin E (IgE) reacts to allergens in their body. Once allergens are inhaled by an asthmatic individual, IgE binds to the allergens in the airways, triggering the release of inflammatory mediators that cause swelling in the airway walls and an increase in mucus production. The combination of these effects results in typical symptoms such as coughing and wheezing (we discuss asthma symptoms in more detail further down in this guide).
How do you get asthma?
Individuals are more likely to get asthma if they have a family history of the condition or similar allergic conditions like hay fever (known as a ‘genetic predisposition’). Certain genes that help regulate the immune system and determine airway sensitivity in the lungs can be passed on from parents to their children, resulting in asthma.
It is also possible to get asthma through environmental factors like exposure to tobacco smoke early in life which can cause changes in gene expression (even if the individual is not genetically predisposed to asthma).
What is an ‘asthma attack’?
The term ‘asthma attack’ is commonly used to describe acute asthma exacerbations characterised by sudden increases in the intensity and severity of asthma symptoms. During an asthma attack, the airways become swollen and inflamed, and the surrounding muscles contract. This produces extra mucus which can cause the bronchial tubes to narrow even further, making it increasingly difficult to breathe.
Understanding the different types of asthma
Allergic asthma
Allergic asthma is the most common type of asthma and is triggered by the inhalation of allergens such as dust mites, pet dander, and pollen.
Seasonal asthma
Seasonal asthma is typically a subtype of allergic asthma. It occurs when the airways become inflamed as a result of increased exposure to certain allergens such as pollen during spring. In some instances, seasonal asthma may occur due to environmental factors such as cold air during the winter.
Non-allergic asthma
Non-allergic asthma is triggered by factors that are unrelated to allergens, including stress, exercise, or environmental factors like cold air. For example, seasonal asthma that is specifically triggered by winter is a form of non-allergic asthma.
Occupational asthma
Occupational asthma is specifically caused by allergens at the workplace of the affected individual such as chemical fumes or dust. This type of asthma is a subtype of allergic asthma, however, it is often categorised separately because it is caused by triggers that are specifically encountered at the workplace which requires workplace-specific strategies for management that are part of occupational health and safety regulations.
Exercise-induced asthma
As the name suggests, exercise-induced asthma is caused by physical exertion as opposed to allergens or environmental stimuli. With that said, it is worth noting that exercise-induced asthma is more likely to occur when the air is cold and dry, as these conditions can increase the risk of irritation felt in the lungs due to airway constriction if the individual engages in physical activity.
Brittle asthma
Brittle asthma is a rare type of asthma that is more severe, making it more difficult to control through treatments that are normally prescribed for asthma such as bronchodilators and steroids.
Childhood asthma
Childhood asthma refers to any of the types of asthma discussed above that produce symptoms in individuals below the age of 20. Some children may be more susceptible to experiencing asthma symptoms because their immune and respiratory systems are still developing, making them more prone to triggers such as allergens.
Late-onset asthma
Late-onset asthma refers to any of the types of asthma discussed above that affect individuals above the age of 20. In some instances, this type of asthma can be caused by factors other than allergens and environmental stimuli such as hormonal changes experienced during pregnancy.
Asthma symptoms
Asthma symptoms can differ based on the specific type of asthma experienced by the individual, the frequency and severity of attacks, individual triggers and personal physiological factors such as lung capacity. With that said, several symptoms of asthma tend to affect individuals regardless of their asthma type:
- Shortness of breath, coughing and/or wheezing caused by bronchial stenosis (narrowing of the airways) and mucus overproduction
- Chest tightness or pain caused by bronchoconstriction (tightening of the muscles surrounding the airways) and swollen airway walls that take up more space in the chest cavity
- Wheezing when exhaling (a common sign of asthma in children) caused by bronchial stenosis (narrowing of the airways)
- Sleep troubles, caused by shortness of breath, coughing or wheezing stemming from airway inflammation and bronchoconstriction.
Asthma treatment
Asthma treatment involves the administration of bronchodilators or corticosteroids through a delivery system designed to ensure these medications reach the affected airways through the bloodstream.
Bronchodilators
Bronchodilators help relax and widen the airways in the lungs, making it easier to breathe following an asthma episode. One of the most commonly used bronchodilators is known as a beta-2 agonist.
Beta-2 agonists such as Salbumatol (Ventolin) stimulate receptors on the smooth muscle cells within the airways, relaxing and opening them up. They typically come in canisters that can be attached to a reliever inhaler (also known as a rescue inhaler) and must be pumped to administer the medicine.
Beta-2 agonists like Salbumatol (Ventolin) can also be administered using an inhaler spacer such as the Aerochamber Plus Asthma Spacer. This device consists of a large empty tube that attaches to the inhaler, making it easier to breathe in the beta-2 agonist to the deepest part of the lungs.
Corticosteroids
Corticosteroids prevent inflammation in the lungs by suppressing the activity of inflammatory cells and mediators such as cytokines. Corticosteroids also boost the body's production of anti-inflammatory proteins, further curbing inflammation. This dual action improves lung function by reducing airway swelling and mucus production, making it easier for the affected individual to breathe.
Answering common questions about asthma
Is asthma a disease or a condition?
According to the NHS, asthma is a lung condition that requires long-term treatment.[1,2] However, some prominent medical organisations like the WHO refer to asthma as a disease because of the medical definition of the word (a disorder that is not a direct result of physical injury).[3]
How do you get asthma?
An individual can get asthma from their parents if they are genetically predisposed to this condition. Asthma can also result from childhood exposure to allergens such as tobacco smoke and polluted air. In some instances, asthma can develop in individuals who are exposed to workplace chemicals for an extended period (known as ‘occupational asthma’).
What is classed as severe asthma?
Severe asthma is when asthma symptoms persist despite treatment. Individuals with severe asthma may need to use rescue inhalers and medication frequently and/or visit a specialist doctor routinely.
Is brittle asthma treatment different to regular asthma treatment?
Yes - brittle asthma treatment is more specialised given the rarer and more severe nature of this type of asthma in comparison with other types.
What foods help asthma?
Some studies[4] suggest that the magnesium sulphate found in foods like flour and cheese can potentially block calcium from binding to muscle proteins in the lungs, preventing muscle contraction that might contribute to airway constriction. Research also shows that foods containing omega-3 fatty acids such as salmon and chia seeds can benefit people with asthma (provided they are not allergic) because omega-3 fatty acids can inhibit the production of excessive inflammatory mediators in the body.[5]
For more information on what foods can help asthma and what foods may exacerbate symptoms, refer to our expert guide on asthma and nutrition.
Can you grow out of asthma?
It is not possible to grow out of asthma, however, some children may see an improvement in symptoms as they get older because of a potential change in the responsiveness of their airways, reducing the impact of inflammation and airway constriction during an asthma episode.
What’s the best treatment for asthma symptoms?
There is no single best treatment for asthma symptoms as the effects of the condition can vary from person to person. It is recommended to speak with a doctor to develop a personalised plan and ascertain eligibility for medication such as bronchodilators that can provide relief from symptoms.
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