What is Asthma?

Asthma is a disease of the airways in the lungs. Its symptoms are caused by inflammation, which makes the airways red, swollen, narrower and extra-sensitive to irritants. This leads to recurrent attacks of wheezing, breathlessness, chest tightness and coughing. 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.

Asthma is a long-term (chronic) disease. 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).
Asthma is very common. Around one out of every ten people in the Western World develops asthma at some stage in their life.

What is inflammation in the airways?
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.

How does inflammation of the airways affect my asthma?
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.

Who gets asthma?
Asthma tends to run in families, which means that you are more likely to develop asthma if someone in your family already has it. Children with eczema or food allergy are more likely than other children to develop asthma.
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.

At what age does asthma start?
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.

What causes asthma?
The causes of asthma are not fully understood. Asthma is probably usually 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.
Allergens from house dust mites and pets are the most common causes, but many other allergens, such as pollen and moulds, can cause asthma. Some patients with asthma have no obvious allergies.

Is asthma a chronic disease?
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.

Is there a risk that my asthma will get worse with age?
Yes, that risk cannot be disregarded. Poorly treated asthma gets worse with age, and the lungs of people with untreated asthma function less well than those of non-asthmatic individuals. Modern asthma treatments have not been available for long enough for us to be certain whether or not lung function will still deteriorate more rapidly in people with treated asthma as they grow older. However, most asthma doctors think that regular, preventive asthma treatment can prevent your asthma from getting worse and help to preserve your lung function.

Is it worse getting asthma when you are old?
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 actually 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.

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