Asthma: Symptoms, Causes & Treatments

What is asthma?

Asthma is a chronic lung condition that narrows the airways. The main features, which cause the common symptoms that many patients experience, are:

• Reversible obstruction to the airways, caused by a reaction to various triggers
• Inflammation – it is not uncommon for asthma sufferers to also have other inflammatory conditions, such as eczema (skin inflammation) or allergic rhinitis (inflammation inside the nose)

In Singapore, the number of people who die from asthma every year has decreased by 56.8% (per 100,000 people) since 1990, at an average of 2.5% a year. Though the numbers are better now, ongoing awareness of asthma is still important, especially if you are trying to manage the condition.

What are the symptoms of asthma?

Symptoms of asthma include:

• Wheezing/noisy breathing
• Coughing
• Tight feeling in the chest
• Shortness of breath

Children experiencing asthma may also cry, lose their appetite, have a stomach ache, vomit, become tired quickly, or get puffed out more when running and playing.

The severity and frequency of your symptoms can vary, depending on how well your asthma is controlled. Although it is rare, asthma can be fatal, so it is important to know your triggers and take your medication properly.

What triggers asthma?

Asthma triggers vary for different people. Some common triggers include:

• Dust mites
• Pollen
• Pet hair
• Mould
• Cigarette smoke
• Viral infections, eg. a cold or the flu
• Cold air or changes in the weather
• Work-related triggers, eg. wood dust, chemicals or metal salts
• Certain medications

How do doctors test for asthma?

Experiencing asthma-like symptoms? Your doctor may be able to diagnose asthma during a clinical exam. If, for whatever reason, the exam is inconclusive, a lung function test can confirm the diagnosis.

Once a diagnosis is made, your doctor will schedule follow-up appointments to monitor your symptoms. They will usually check if your asthma is suitably controlled using a peak expiratory flow rate test, which measures your ability to blow out air.

What is an asthma management plan?

Asthma management is all about empowering you to take an active role in the long-term management of your asthma. Your doctor will help you to identify realistic management goals, including choosing an initial treatment that suits you, discussing your risk factors and preferences, and regularly reviewing and adjusting your treatments.

In addition, your doctor will be able to provide useful information, skills and tools for self-management, such as how to manage flare-ups as well as other conditions that may affect or exacerbate your asthma. They can also give you advice on smoking, healthy eating, physical activity, healthy weight and immunisation where appropriate.

What medications are available to manage asthma?

You have 2 main choices when it comes to asthma medication: relievers and preventers.

Relievers instantly provide relief from asthma symptoms, but have minimal or no effect on the long-term management of asthma. Typically known as 'blue inhalers', they can help to stop symptoms quickly – but the effects wear off quickly, too. Increasingly using your reliever indicates that your asthma is not under control (consult your doctor if you are concerned about increasing inhaler use).

Meanwhile, preventers, as the name suggests, are commonly used to prevent episodes of acute asthma flare-ups. These inhalers often contain a combination of medications that help to open the airways for longer, addressing the underlying problem and often leading to better long-term control. The type of inhaler and the dosage for this depends on things like your age, preference, asthma severity and frequency.

If you have a child with asthma, they may find it difficult to use an inhaler, because it requires carefully coordinating the process of taking a breath with squeezing at the right time. If you do decide they need a preventer, they may also require an additional device to help them get the right amount of medication into their lungs, depending on their age. Known as spacers, these are large plastic or metal containers featuring a mouthpiece and hole for the inhaler.

Your doctor will advise you on how often to take these medications. Using inhalers incorrectly or stopping using them completely can make your asthma worse. Ultimately, this could lead to a life-threatening situation.

What is a written action plan and why do I need one?

Your doctor can help you to create a written action plan so that you can better manage your asthma. It helps you to remember which medications to use on a daily basis and at what dosage, as well as what to do if your symptoms get worse. With this plan in place, you will know exactly when and how to seek urgent medical help, and what to do while you wait for medical help to arrive.

Here is a sample of a written asthma action plan from the Ministry of Health.

A summary of good asthma management

Your doctor will prescribe the right medications for you. Ensure that you:

• See your doctor for regular follow-ups so you can work together to manage your asthma
• Understand your triggers for asthma – these can be different for everyone so get to know your body
• Try to avoid or reduce your exposure to these triggers
• Use your medications as instructed by your doctor, even when you feel well
• Are using your inhaler correctly
• Follow your written action plan

Although asthma is a chronic condition, you can lead a normal active lifestyle if you work closely with your doctors to create a tailored treatment plan.