Asthma FAQs

Asthma is a common chronic disease which inflames the airways.  The airways are the small tubes that carry air in and out of the lungs. 

Asthma causes the airways to become over-sensitive and react to things they would not normally react to, such as cold air or dust mites and even family pets.  These are called triggers.

When asthma symptoms are triggered, the muscles around the wall of the airways tighten, making them narrow.  The lining of the airways also swells and sticky mucus is produced, clogging up the already narrowed airways.  With the airways narrow and clogged up with mucus it becomes difficult to breathe. 

This leads to recurrent attacks of the following symptoms, a person with asthma may suffer some of these symptoms, a combination of these symptoms or even all of them;

  • wheezing
  • breathlessness
  • chest tightness
  • coughing

Asthma is very common. Around one out of every ten people in the Western World develops asthma at some stage in their life.

Inflammation is a reaction to infections and other triggers in the lining of the airways and the underlying tissue. The inflammation makes the airways become red, swollen, narrower and extra-sensitive.

Inflammation of the airways causes asthma symptoms (wheezing, breathlessness, chest tightness and coughing) by restricting or limiting the airflow to and from the lungs. It does this by causing:

  • swelling of the airways, which makes them narrower
  • tightening of the muscles that surround the airways (also called bronchoconstriction), which makes them even narrower
  • the production of too much mucus, which can plug up or block the airways
  • longer-term damage to the walls of the airways, which prevents them from opening as widely as a normal airway.

When the airways have been inflamed for a long time, they become extra-sensitive. This means that they react faster and more strongly to various triggers, such as allergens, viruses, dust, smoke and stress.

Anyone can develop asthma.   Asthma is very common; in fact it is the most common chronic disease in Ireland.  In Ireland 1 in 5 children and 1 in 10 adults have asthma.

  • You are more likely to develop asthma if you have a family history of asthma, eczema or allergies.
  • Certain environmental factors with this family history may influence the development of asthma.
  • Research has shown that smoking during pregnancy significantly increases the risk of a child developing asthma.
  • Children whose parents smoke are more likely to develop asthma.
  • Adult asthma onset may develop after a viral infection.
  • A person may develop asthma due to an irritant exposure in the work place.
  • Allergy to pollen, house dust mites or pets also increases your chance of developing asthma.
  • Exposure to tobacco smoke, air pollution or other inhaled irritants can also cause asthma symptoms in those with an underlying tendency to asthma.

Asthma can start at any age, although about half of all people with asthma have had their first symptoms by the age of 10, and many children with asthma have had their first asthma attack before the age of 6.

Asthma is difficult to diagnose in children under the age of 2.  This is because wheezing and respiratory infections, such as bronchiolitis, are common in young children and the symptoms are similar to asthma.  If your child is under two years of age and their symptoms are bad or don't go away, your doctor may decide to give them a trial of asthma medication to help make a diagnosis.

The causes of asthma are not yet fully understood. Asthma is probably caused by a mixture of hereditary factors (those you are born with) and environmental factors, but how these factors work together is still largely unknown.

Factors which influence the risk of asthma can be divided into those which cause the development of asthma and those which trigger asthma symptoms. The development factors are primarily genetic.

The factors that trigger asthma are environmental factors such as:

  • Allergens from indoors such as house dust mites and pets are the most common triggers.
  • Allergens from outdoors such as pollen and moulds, fungi, yeasts..
  • Infections (Primarily viral)
  • Occupational triggers
  • Tobacco Smoke
  • Outdoor/Indoor air pollution
  • Diet

For more information on triggers click here

Some patients with asthma have no obvious allergies.

Yes.  Asthma is a chronic (long-term) disease that causes inflammation and narrowing of the airways. Some degree of inflammation is usually present, even at times when you are unaware of any symptoms.

If your asthma is untreated, you will have repeated attacks of asthma symptoms.

Mild attacks can settle down without treatment, but treatment usually helps them to resolve more quickly. Appropriate treatment can also reduce the risk of further attacks. If you experience a serious attack you should seek emergency help.

Your asthma does not stay the same, but changes over time, and every person with asthma has good and bad days (or longer periods of time).  However, if asthma is properly treated, you may enjoy long periods without symptoms or attacks.

Poorly treated asthma may get worse with age.  However, regular controller asthma medication can prevent your asthma from getting worse and help to preserve your lung function.

Not necessarily, but asthma is often more severe if it starts at an older age. In addition, an older person with heart disease or other medical problems may have more difficulty in dealing with an asthma attack than a younger person.

What is called asthma in elderly people is sometimes chronic obstructive pulmonary disease (COPD). COPD is a collective name for chronic bronchitis and emphysema, two diseases that are almost always caused by smoking.  Many of the symptoms of COPD are similar to those of asthma (e.g. breathlessness, wheezing, production of too much mucus, coughing).  COPD is generally a more serious disease than asthma, because the changes in the airways are much more difficult to treat, and it usually has a worse outcome. Unfortunately, COPD can cause greater long-term disability and have a greater effect on the heart and other organ systems than asthma.

Some people may have to change parts of their lifestyle because of worsening asthma symptoms. It can be difficult to identify exactly what triggers your asthma. Sometimes the link is very clear, for example when your symptoms start within minutes of coming into contact with a cat or pollen. However some people have a delayed reaction to an asthma trigger. By avoiding the triggers that make your asthma symptoms worse, and by taking your asthma medicines correctly, you can reduce your symptoms and continue to enjoy your usual lifestyle.

There are some excellent treatments available to help you to control your asthma. The most effective way of taking most asthma treatments is to inhale the medicine so it gets straight into your lungs. There are many different inhalers available and it is important that you use an inhaler that you are comfortable with and can use properly. Your doctor or asthma nurse will advise you on the most appropriate inhaler device for you and should show you how to use it correctly.  They will also advise you on an appropiate spacer device if that is recommended.



There are two main types of asthma medicine, these are called relievers and controllers.  These are equally important but do different things.

  • Reliever inhalers (usually blue) are taken when you have symptoms (like wheeze, cough or breathlessness). They work quickly by relaxing the muscles surrounding the narrowed airways making it easier to breathe. Reliever inhalers are essential in treating asthma attacks. If you need to use your reliever inhaler more than twice a week, you should go back to your doctor or nurse and have your asthma reviewed so that you can keep it under control. If you continue to need a lot of reliever medicine over a long time there is a risk that it will become less effective in you and your asthma may worsen.
  • Controller inhalers (usually brown, red or orange) work by controlling the swelling and inflammation in the airways, stopping them from being so sensitive and reducing the risk of severe attacks. The effect of controller inhalers builds up over a period of time and they need to be taken every day, usually morning and evening, even when you are feeling well. Controllers contain a corticosteroid medicine. It is important to understand that the steroids contained in preventer medicines are not the same as anabolic steroids used by athletes to improve their performance.  The corticosteroids used in controllers have limited side effects when used correctly and with a spacer device, if that has been recommended.  You should rinse your mouth after using your controller to reduce the possibility of hoarseness or oral thrush.


There are other types of medicine that can be added to your treatment regime if needed, such as steroid tablets, long-acting relievers and combination inhalers. For information about other medicines speak to your doctor or asthma nurse.  If you would like more information or advice you can also call the Asthma Adviceline on 1850 44 54 64 to speak to our team of asthma nurse specialists, or email us your query to nurse@asthmasociety.ie

Yes, in fact if you are prescribed a controller inhaler and use it properly this will greatly reduce your chance of an asthma attack. However there are some points to remember:

  • The inhaled steroids used to treat asthma are corticosteroids - a copy of the steroids produced naturally in your body.
  • They are completely different from the anabolic steroids used by bodybuilders and athletes.
  • Inhaled steroids go straight down to the airways, so very little is absorbed into the rest of the body.
  • Your doctor should prescribe the lowest possible dose.
  • Inhalers can be in spray form (aerosol) or dry powder form. If you have an aerosol inhaler, using a spacer device with your inhaler is the best way to take your medicine. A spacer is a large plastic or metal container, with a mouthpiece at one end and a hole for the aerosol inhaler at the other.
  • To avoid side effects you should use a spacer device and rinse your mouth after using your inhaler.
  • Children's treatment should be reviewed at least every 6 months.
  • All children should use a spacer for their controller inhaler.

Occasionally, if your asthma symptoms become severe, your doctor may give you a short course of steroid tablets. They work quickly and powerfully to help 'soothe' or calm your inflamed airways. Short courses of tablets, anything from 3-14 days, are unlikely to give any long-term side effects.   However, steroid tablets can lower the body's resistance to chickenpox, so you should contact your doctor if you are taking steroid tablets and come into contact with chickenpox.
 

It is important to recognise when your asthma is getting worse so you can take the necessary steps.  To make sure you act fast, and to help avoid an asthma attck, keep an eye out for the following signs:

  • Wheezing or coughing in the morning
  • Wheezing after exercise or feelingyou cannot keep up with your normal level of activity or exercise
  • Waking at night because of asthma symptoms (coughing, wheezing, shortness of breath, chest tightness)
  • Needing to take reliever medication more often than normal
  • Reliever medication is not helping to relieve symptoms

Any of these signs show that your asthma is not controlled and you should see your doctor or asthma nurse immediately to get your asthma back under control.

In an asthma attack immediately follow the 5 Step Rule:

  1. Take 2 puffs of reliever inhaler (usually blue), 1 puff at a time
  2. Sit up and stay calm
  3. Take slow steady breaths
  4. If there is not improvement, take 1 puff of reliever inhaler every minute: adults and children over 6 years of age can take up to 10 puffs in 10 minutes, children under 6 years can take up to 6 puffs in 10 minutes
  5. Call 999 or 112 if symptoms do not improve after 10 minutes or if you are worreid.  Repeat Step 4 if an ambulance does not arrive within 10 minutes.

This is one of the main concerns of many women with asthma. Like other allergic conditions, such as hay fever and eczema, asthma often runs in the family.

Researchers are trying to show which factors in the environment also play a part. Some, but not all, studies have shown that breast-feeding in the first few months of life may reduce the chance of your baby developing allergic conditions, including asthma.

Smoking during pregnancy increases the chance of a child developing asthma and wheezing in their early years. The most important thing you can do to reduce a baby's chance of asthma is to avoid cigarette
smoke.

Your asthma medicines won't harm your baby - in fact, your baby will do best if your asthma is under control, so it is important to continue with your asthma medicine. If you are concerned about your asthma, speak to your doctor, nurse or healthcare professional.

You should have your asthma reviewed by your doctor or asthma nurse if you are pregnant.
 

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