Asthma: symptoms, types and treatment explained

Asthma (bronchial asthma) is a condition involving long-term inflammation of the airways. According to the World Health Organization, around 262 million people worldwide were living with asthma in 2019, children and adults alike. The good news is that with proper treatment most people with asthma can live full, active lives. In this article we explain what happens in the airways, which symptoms to look out for, and how asthma is treated today.

What happens in asthma?

In asthma, the lining of the bronchi is persistently inflamed and oversensitive. When the airways meet a trigger (pollen, dust, smoke, cold air, infection, exertion), three things happen at once:

• the muscles around the bronchi tighten,
• the lining swells,
• more, and thicker, mucus is produced.

All three narrow the airways, making it harder for air to flow in and out.

Symptoms of asthma

• breathing difficulty, shortness of breath,
• wheezing (often audible without a stethoscope),
• coughing, especially at night or early in the morning,
• a feeling of tightness in the chest.

Symptoms typically come and go: they may be mild for weeks, then flare up during an infection or allergy season. For some people, the only symptom is a persistent dry cough.

Types of asthma

Allergic (extrinsic) asthma: the most common form, especially in childhood. It is triggered by allergens such as pollen, dust mites, animal dander or mould spores. It often goes together with hay fever or eczema. The allergens can be identified with allergy testing.

Non-allergic (intrinsic) asthma: more often starts in adulthood and can be triggered by respiratory infections, cold air, stress or irritants. Allergy tests do not show a trigger.

Exercise-induced asthma: symptoms appear during or after physical exertion.

Occupational asthma: triggered by substances at work, such as flour and wood dust, paints, solvents, certain metals or chemicals.

Drug-induced asthma: in some people, certain painkillers (such as aspirin) can trigger an attack.

What is an asthma attack, and when is it dangerous?

An asthma attack is when symptoms suddenly get worse. In a mild attack, the fast-acting inhaler prescribed by your doctor usually brings relief within a few minutes. However, asthma can also be life-threatening, so it is important to know the warning signs.

Call 112 immediately if:

• the fast-acting inhaler does not help, or its effect wears off quickly,
• the person cannot speak in full sentences,
• the lips or fingers turn bluish,
• the person is confused, drowsy or exhausted.

How is asthma treated today?

Asthma treatment is a medical matter and is always tailored to the individual. Its basic elements are:

• Anti-inflammatory (preventer) inhalers: regular use reduces airway inflammation and the number of attacks.
• Fast-acting bronchodilators (relievers): to ease sudden symptoms.
• Avoiding triggers: tobacco smoke, known allergens, dust mites, mould.
• Asthma action plan: a written plan for what to do when symptoms get worse.
• Regular check-ups to monitor lung function and medication doses.

Never stop your inhaler or reduce the dose without consulting your doctor, even if you feel well. Often it is precisely the preventer treatment that keeps symptoms away.

Where does salt therapy fit in?

Many people with asthma are interested in salt therapy as a natural complementary option. We have summarised what we know about it today, and what we do not, in a separate article: Salt therapy and asthma: what does the research say?

This article is for general information only and does not replace medical diagnosis or treatment. If you have symptoms, see your GP or a lung specialist.