Asthma Information - Basic Facts about Asthma

What is asthma?

People with asthma have sensitive airways in their lungs. When they are exposed to certain triggers, their airways narrow (see picture) making it hard for them to breathe.

There are two main factors that cause airways to become narrow:

1.The inside lining of the airway becomes red and swollen (this is called inflammation) and extra mucus (sticky fluid) may be produced.

2.The muscles around the airways tightens (this is called bronchoconstriction).

Why do people get asthma in the first place?

The causes of asthma are not really understood, but there is often a family history of asthma, eczema or hayfever. Asthma can begin at any age and change over time. Unborn babies whose mothers smoke during pregnancy, and children exposed to smoke in early childhood, have a higher risk of developing childhood asthma.

What are the main symptoms of asthma?

• Coughing

• Shortness of breath

• Tightness in the chest

• Wheezing - a high pitched raspy sound on breathing

The symptoms of asthma may vary from person to person, and from time to time. Some people may have all these symptoms while other people may only have a wheeze or cough.

What triggers asthma symptoms?

Every person can have different asthma triggers.

The most common asthma triggers are:

• Colds and flu

• Exercise (this can be managed)

• Inhaled allergens - ( eg pollens, moulds, animal hair and dust mite)

• Cigarette Smoke

• Changes in temperature and weather

• Certain drugs (eg aspirin and some blood pressure medications)

• Chemicals and strong smells

• Some foods and food preservatives, flavourings and colourings

• Some occupations

In some people it can be difficult to know what triggers asthma!

Can asthma be cured?

Asthma cannot be cured but it can be controlled so that you are able to carry out your daily activities without asthma symptoms. Controlling asthma involves:

1.Taking asthma medications as directed

2. Monitoring asthma

3. Staying active and healthy

4. Avoiding triggers whenever possible

5. Having a written asthma action plan

6. Visiting the doctor regularly

Each of these will be explained in more detail in the next section.

1. Asthma medications

The best way of controlling your asthma is by taking medications as directed. There are three main types of medications:

Preventers
Inhalers: Flixotide, Intal Forte, Pulmicort, Qvar and Tilade
Tablets: Accolate and Singulair

These medications make the airways less sensitive and keep you well. Preventers reduce the redness and swelling inside the airways and dry up mucus. They may take a few weeks to make people feel better. The medication containers are normally autumn coloured (brown, orange or yellow).

Preventers usually need to be taken every day, even when feeling well. Do not stop taking your Preventer unless advised by your doctor.

During a severe attack of asthma when there is little response to reliever medication, your doctor may prescribe a short course (2-14 days) of Prednisone/Prednisolone tablets or syrup to quickly make you well.

Relievers
Airomir, Asmol, Bricanyl, Epaq and Ventolin

These medicines provide relief from asthma symptoms (coughing, wheezing, and shortness of breath) within minutes. Relievers relax the muscle around the airways, making the airways wider and breathing easier.

Atrovent is a different type of reliever which is sometimes used with one of the relievers above.
If you need to use your reliever more than 3-4 times a week to ease asthma symptoms (other than before exercise), it may be a sign that your asthma is not well controlled - it is important to check with your doctor.

Symptom Controllers
Atrovent, Foradile, Oxis and Serevent

Symptom controllers (also called long-acting relievers) also help to relax the muscles around the airways for up to 12 hours. Symptom controllers should not be used in an asthma attack. They should only be used by people taking regular inhaled corticosteroid preventers, ie Becloforte, Becotide, Flixotide, Pulmicort, or Respocort.

Combination Medications
Seretide and Symbicort

Combination of preventer and a long acting symptom controller.

2. Monitoring your asthma

Blowing into a peak flow meter is a good way to check on asthma. It will indicate whether the airways are wide open or narrow. Children under the age of seven years may find this hard to do. Parents of young children and other people without a peak flow meter, can monitor asthma by keeping a diary of asthma symptoms.

3. Exercising or being active.

Exercise helps in keeping fit and healthy and will help people to cope better with their asthma. If exercise triggers asthma ask your doctor for advice about management.

4. Avoiding triggers

Try to avoid triggers. Some triggers cannot be avoided, such as changes in the weather and colds or flu. Ask your doctor for a plan to help in these situations. Exercise should not be avoided.

5. Having an asthma action plan

Ask your doctor for a written asthma action plan. This will outline:

• How to recognise worsening asthma

• What do when this happens

• How and when to get medical help quickly

6. Controlling asthma

To make you stay at your best, you should visit your doctor regularly (even when well). The doctor should review your asthma action plan at each visit.

Remember you should feel in control of your asthma.

Recognising an asthma attack

An asthma attack can take anything from a few minutes to a few days to develop. During an asthma attack coughing, wheezing or breathlessness can quickly worsen .

Signs of a severe asthma attack include:

• Shortness of breath

• Rapid breathing

• Severe chest tightness

• Being unable to speak more than one or two words per breath

• Distress or feeling frightened

• Little or no improvement after using reliever medication (Airomir, Asmol, Bricanyl, Epaq or Ventolin)

• 'sucking in' throat and ribs

• Blue colour around the lips

During an asthma attack, young children may appear restless, unable to settle and may have problems eating due to shortness of breath. They may also have severe coughing and vomiting.

If you (or anyone in your care) have any of the above signs, call an ambulance (Dial 000)
straight away and follow the 4-STEP ASTHMA EMERGENCY MANAGEMENT PLAN (below).

4 STEP ASTHMA EMERGENCY MANAGEMENT PLAN

1. Sit the person upright and give reassurance.

2. Without delay give 4 separate puffs of a reliever (Airomir, Asmol, Bricanyl, Epaq or Ventolin). The medication is best given one puff at a time via a spacer device. Ask the person to take 4 breaths from the spacer after each puff of medication.

3. Wait 4 minutes

4. If there is little or no improvement, repeat steps 2 and If there is still little or no improvement, call an ambulance immediately (Dial 000). Continuously repeat steps 2 and 3 whilst waiting for the ambulance.

Just use the puffer on its own if you don't have a spacer.

Figures

• It is estimated that almost 2 million people in Australia have asthma.

• Up to 1 in 4 children, 1 in 7 adolescents and 1 in 10 adults will experience symptoms consistent with asthma at some time in their lives.

• The United Kingdom, Australia, New Zealand and the Republic of Ireland have the highest prevalence of asthma in the world. The prevalence of asthma appears to be highest in English speaking countries.

• Asthma has increased in recent years. The prevalence of asthma in NSW school children doubled in the period between 1982 - 1992.

• The cause of asthma is unknown. However, a number of factors have been identified which either increase the risk of, or are protective against asthma. Research is needed to explore these associations further.

Risk factors

• family history of asthma or other allergic conditions

• parental smoking

• a major respiratory infection during the first two years of life

• exposure to domestic allergens

Protective factors

• breastfeeding for greater than 6 months

• having more than 4 older siblings

• a major respiratory infection during the first two years of life

• living in village communities

Statistics

• Asthma is one of the leading causes of childhood admission to hospital and absenteeism from school and work.

• Asthma ranks among the 10 most common reasons for seeing a GP.

• In 1993-4, the cost of asthma to the Australian community was estimated to be between $478 million per annum. This includes direct medical related costs as well as indirect costs such as lost productivity.

• The estimated annual cost to a family with one child with asthma who has been admitted to hospital in previous 12 months is $884 and an average of 153 hours are spent obtaining treatment.

• In 2001, 422 people in Australia including 141 people in NSW died from asthma. The death rate from asthma is now decreasing in proportion to the increasing prevalence of the disease.

• Although there is no cure for asthma, illness and death associated with asthma can be reduced with proper diagnosis, medical management and education.

• Most people with asthma lead a normal life and can participate competitively in sport. Many of our leading sportsmen and women have asthma.

More Information

For information on a specific asthma topic, please contact the Asthma Foundation in your state or territory.

• Asthma New South Wales

• Asthma Northern Territory

• Asthma Queensland

• Asthma South Australia

• Asthma Tasmania

• Asthma Victoria

• Asthma Western Australia