Asthma: causes, symptoms and treatment

Medically reviewed: 15, February 2024

What is asthma?

Asthma is a disease of the respiratory tract which makes it breathable. You can also cough, with or without bad mucus, and it may beep when you breathe. The trouble comes in periods, sometimes you may feel completely healthy and sometimes you may have major inconveniences. The treatment consists of, among other things, airborne medication that you breathe in. You may need both medicines you take when you have trouble and medicines that you take regularly.

Asthma can be divided into two types of allergic and non-allergic asthma. In children, allergic asthma is the most common, while non-allergic asthma becomes more common the older you become. Children can also get a form of asthma when they are cold, so-called cold asthma or infection asthma.

Symptoms of asthma

Usually you get asthma as a child, but you can get asthma regardless of age. If you have asthma, it is common for you

• gets attacks of breathlessness, that is, it is difficult to breathe
• breathe with a beeping and wheezing sound
• have long lasting cough every time you are cold
• have long lasting cough, often at night, which you can not find any explanation for
• get breathless and cough when you exert yourself physically, for example when you exercise.

In asthma, the airways are sensitive to directions. Cold air, strong smells and smoke are examples of directions that may cause asthma attacks. Even mental factors such as stress can trigger asthma attacks. If you have an allergy you may be in trouble if you come into contact with what you are allergic to, such as pollen, fur animals or mites.

When should I call doctor?

Contact a healthcare provider if you suspect you have asthma. You can seek care at any health center you want throughout the country.

If you know that you have asthma and suddenly find it difficult to breathe and your medication does not help, seek medical attention directly at a healthcare center or emergency department.

Important to understand! In order to be part of your care and make decisions, it is important that you understand the information you receive from the healthcare staff. Ask questions if you do not understand. You can also ask for the information printed to read it in peace and quiet.

Getting diagnosed with asthma

When you come to a doctor, you must first tell me about your inconvenience. You’ll tell me when they come and if there’s something special that makes you feel the trouble. After that, the doctor is doing a body examination and examines how your lungs work. There are several different methods for examining the function of the lungs. The most common is spirometry and using a PEF meter. Both examine the lung function, but in different ways.

Spirometry

With spirometry you can measure how much air you can blow out, and how fast it goes. If the airways are tight, it is difficult to blow out the air quickly.

Usually you can do the survey at the health center. You can then blow different ways in a nozzle that is connected to a device, a spirometer. The nozzle can also be connected directly to a computer with a spirometry program. You must repeat each inflow at least three times to make the result as accurate as possible. Spirometric examination provides a more secure result and more information, compared to PEF.

A spirometry is made to check:

• if it is asthma you have, and not other respiratory or pulmonary disease COPD
• how your medicines affect lung function
• how smoking affects lung function if you smoke
• if, and if so how, your lung function is affected by, for example, your occupation.

PEF measurement

PEF is an abbreviation for Peak Expiratory Flow, which means maximum airflow during exhalation.
To find out your so-called PEF value, you can blow as hard as you can in a tube. The pipe leads to a meter that records the airflow. In asthma, the airways become crowded and the airflow becomes smaller, thus reducing the PEF value.

You usually measure PEF values ​​for two weeks. You can then borrow a PEF meter. Most often you can measure your lung function morning and evening, and if you have received a respiratory medication, you measure before and after taking the medicine. By writing your PEF values ​​in a chart for two weeks, the doctor can then see how your values ​​have been. Do you have values ​​that vary a lot, you speak because you have asthma.

PEF measurement is usually not enough to diagnose asthma, but is used in conjunction with other examination methods to confirm the diagnosis.

You can also benefit from a PEF meter to see how the treatment works and to see if you need to change the dose of any drug. Keep in mind that your values ​​are individual and can not be compared to anyone else.

Reversibility

In a reversibility test, the doctor can see if your trachea is expanded by drugs. A reversibility test is usually done at the healthcare center and proceeds as follows:

• First, your lung function is measured with spirometry.
• Then you can breathe in an airborne drug.
• After about 15 minutes, your lung function is measured again.

If you feel better after taking your medicine, it indicates that you have asthma.

Steroid Test

Depending on what the other tests showed, you can do a so-called steroid test. In such a test you will receive either cortisone as you breathe in every day for three to six months, or short-term tablets for two to three weeks. Leading the treatment for better lung function suggests you have asthma. The lung function is measured by spirometry.
Stress Test

An effort test should be done especially if you are having trouble when you are strenuous and the other surveys look good. But even if you have asthma, the test does not show it. Effort test is good for young people and young adults. An exertion test is done as follows:

• First, your lung function is measured with spirometry.
• After that, you must exert yourself intensively for at least six minutes, for example by running a treadmill or cycling on a test bike.
• Afterwards, your lung function is measured with spirometry again for fifteen to twenty minutes.

Test for airway sensitivity

There are methods that measure how sensitive mucous membranes in the trachea are. You may then inhale a substance that irritates the airways and causes them to contract. Then your lung function is measured and how it changes when you breathe even more of the annoying substance. Everyone responds to these subjects, but if you have asthma you usually react faster and more strongly. The survey may be complementary to other surveys and only done in hospitals.

NO measurement

You have more of the substance Nitrogen, NO, in the air you breathe out if you have an inflammation of the trachea, such as in asthma. The amount of NO in the exhaled air can be measured in an apparatus. Together with other studies, the NO measurement can support the physician to diagnose asthma. It can also be a way to follow up your treatment and assess how much medicine you need to take.

Allergy test

You can make an allergy test if your doctor suspects you also have an allergy, such as pollen, mites or fur animals, and that the allergy increases your asthma attacks. The most common surveys are a so-called pric test or a blood sample. Both methods of investigation are equally good.

After the investigations

Once you have done the surveys, you will find out who to contact, and when, to share the answers. You’ll also find out where to turn around if you get worse.

Asthma: what is the treatment?

The goal of asthma treatment is, among other things, that you:

• Do not have any asthma symptoms
• Do not be hindered by asthma in your daily life
• No need to take extra airborne medication
• Do not have any inconvenient side effects of your medicines
• Should have normal lung function.

Medicin for asthma

In asthma, drugs are used in several drug groups. They work in different ways and the drugs are often combined to make the effect as good as possible. What medication you use depends on the severity of your asthma. Most common is that you must combine cortisone and airborne drugs, both fast-acting and long-acting.

If you inhale most of the drugs through the mouth, it’s called inhalation. You inhale them using inhalers.

An important part of the treatment is to learn more about the disease and how your different medicines work. You can easily take control of asthma when you learn how it works. It’s good if you know:

• What you respond to, for example, if you get worse from specific topics or environments
• how your medicines work and when to use
• how your body reacts to the drugs.

At many health centers, special asthma schools are held. There you’ll learn, among other things, how the lungs work, how the drugs work, how to inhale and how to live with asthma. The asthma can be individual or in group.

Treatment plan for asthma

A written treatment plan is good for taking control of asthma. But sometimes medication must be changed if needed.  Your treatment plan for asthma should be changed if you:

• get more and more severe asthma attacks
• get cold or gets a respiratory infection
• get worse PEF values, that is, it is harder to blow air out
• should work out or otherwise strive physically
• react to pollen when it is pollen season
• have a period when you have no symptoms at all.

The best part is if you write your treatment plan with your doctor. Then you will also learn what medicines to take in different situations.

Measure yourself with PEF meters

Feel free to have your own PEF meter, to measure your lung function on a regular basis. Your doctor or asthma nurse can print a PEF meter on auxiliary card. Then you can pick it up for free at a pharmacy. Some healthcare centers also lend PEF meters.

With the meter you can see if your lung function changes, so you can increase or decrease the doses of your asthma drugs. For example, if you have experienced poorer PEFs for a long time, you may need to consult your doctor to review your medicines.

For example, if you get a respiratory infection, it is important to check the lung function frequently. You may need to change your medication so that the lung function does not get too bad.

Desensitization

You may sometimes get hyposensitivity if you have severe problems with, for example, pollen allergy or fur allergy. Hyposensibilization is also called allergy vaccination or allergy-specific immunotherapy. When the treatment is complete, asthma symptoms decrease, and thus also the drug requirement.

Alternative treatment of asthma

Alternative treatment such as acupuncture, homeopathy and herbal medicine has no proven effect in asthma.

Revisit your doctor

Astman’s severity often varies over time. Therefore, it’s good if you visit regular visits to determine whether your medication or dosage needs to be changed. Then you can also discuss with your doctor or asthma nurse if there is anything you’re wondering about. You can prepare questions to your doctor in following situations, if you:

• Get more asthma symptoms when you are cold
• The last month had a nuisance during the night with coughing, wheezing or breathlessness
• Get an asthma hurdle when you hurry or stress
• Having cough or breathlessness when you exercise
• Needed to take extra respiratory medication due to asthma symptoms in the last month
• Forget to take your medicine to prevent asthma
• Must refrain from doing anything that you want to do because of asthma.

What can I do myself if I have an asthma attacks?

Do not smoke and avoid smoky environments

You should not smoke if you have asthma. Smoking causes lung damage, which in the long term reduces the lung function. It is also harder to control asthma and asthma drugs work worse if you smoke. Talk to your doctor if you smoke and want to stop, there is some help.

Also try to avoid smoky environments. You breathe in the smoke even if you do not smoke yourself, called passive smoking. The passive smoking gives you increased inconvenience and damages your lungs.

Avoid what you are allergic to

You should avoid the substance (s) you are allergic to if you have an allergy. For example, if you react to pollen, a tip may be to weigh in the evening and at night, as the pollen content is lower than in the day.

Avoid possibly some professions

At some workplaces there may be chemicals, strong smells, flour or smoke that can worsen your asthma. Therefore, some occupations may be less good if you have asthma, for example

• baker
• fire-fighter
• painter
• plastics manufacturers
• welder
• refinisher
• veterinarian, farmer and animal husbandry if you are allergic to fur animals
• workshops where chemicals are used
• hairdresser.

Take medication before exercising

Training is good for everyone. You can exercise even if you have asthma, but you may experience asthma attacks while you work out. In order to reduce or avoid asthma attacks, you can take airborne medication just before you work out.

You do not need to apply for a dispensation to use most asthma drugs if you compete at the competition level. Previously, a number of asthma drugs were doping-classed, for example, inhalation cortisone, but they are no longer. One exception is terbutaline, which is found in Bricanyl.

Athletes at high national level still have to apply for dispensation if they use terbutaline. For other low-level athletes there is a retroactive dispensation.

Avoid certain medicines

Some asthma sufferers may experience severe asthma symptoms.

It is better to take medicines containing paracetamol if you have fever or aches. Ask your doctor, asthma nurse, or pharmacist if you are not sure which medication you can take.

What’s happening to the body during asthma attack?

Close up of lung and capillaries

As you breathe in air oxygen enters the lungs of the lungs. Each lung contains about 400 million lung blisters. In the small capillaries surrounding the lung blisters, the red blood cells in the blood absorb oxygen. The red blood cells and oxygen pass on to the heart and beyond into the body. In the capillaries surrounding the lungs, the red blood cells also emit carbon dioxide to the lungs. You then breathe out the carbon dioxide. The carbon dioxide comes from the body’s tissues.

In an asthma attack, several things occur simultaneously in the airways. The muscles around the airways contract, the mucous membrane swells, and it forms a bad mucus that can clog the small airways. Respiratory distress in asthma is therefore due to the fact that the diameter of the trachea decreases due to contraction and the increased drowsiness.

Asthma is due to a chronic inflammation of the respiratory mucosa that swells and makes it difficult for the air to get to and from the lungs. The esophagus in the trachea also becomes more sensitive to inflammation, and reacts more easily to certain substances such as pollen and fur animals. You may then have an asthma attack. You can also breathe in cold air and physical activity. Even mental factors such as stress can trigger asthma attacks.

In an asthma attack, several things happen simultaneously in the airways. The mucous membrane of the trachea swells, the muscles around the trachea are pulled together and it forms a bad mucus that can clog the small trachea that leads into the lungs. It will then be difficult to breathe. Many also get an annoying cough.

Infection asthma is due to the child’s lungs not fully developed, and not an inflammation like in allergic and non-allergic asthma.

Types of asthma

It is common for colds and other respiratory tract infections to aggravate asthma. You may also get worse when you exert yourself, for example when exercising, especially if asthma is not adequately treated.

How powerful asthma is and how it affects everyday life differs from person to person. Some only get an inconvenience occasionally while others are constantly in trouble even though they are careful with their treatment. Some people experience asthma attacks when they come into contact with some subjects that other people with asthma do not respond to.

Allergic asthma

In allergic asthma, you get breathing problems if you come into contact with substances you are hypersensitive to, so-called allergens. In asthma, it is usually pollen, fur animal or mites that cause an inconvenience.

In the blood there are special substances, antibodies that recognize what you can not tolerate. The antibodies react and trigger an allergic reaction, in this case asthma, if you inhale what you are allergic to, such as pollen. There is a rapid type of allergic reaction that occurs within 20 minutes and a slower that occurs only five to six hours after you have been in contact with the allergenic substance.

This is why you may have trouble only several hours after you have been in contact with something you are allergic to.

Non-allergic asthma

There are other factors that can trigger or worsen asthma:

• respiratory tract infections, usually because of viruses
• cold air
• tobacco smoke
• irritants like perfumes, welding smoke and exhaust gases
• effort
• some drugs like cardiovascular and blood pressure drugs from the group of beta blockers
• pain tablets containing acetylsalicylic acid or belonging to the group antiinflammatory analgesics, also called NSAIDs.

Asthma may be associated with other disorders

It is much more common to have asthma if you have an allergic sniff, that is, sniffing due to allergy. The snout is then thin and translucent. If you have allergic sniffing you may need to be treated with cortisone in your nose to be completely free of asthma symptoms.

There is also a connection between having asthma, polyps in the nose in adults and having a hypersensitivity to antiinflammatory analgesics and medicines containing acetylsalicylic acid. This means that it is more common to be hypersensitive to these drugs if you have both asthma and nasal polyps.

If you have sore throats you may have more trouble with your asthma, especially at night. The upsurge is due to acidic stomach upset in the esophagus. The very sour stomach sweeps the trachea that pulls up.

If you have breathing breaks during sleep, called sleep apnea, you may experience more asthma attacks.

What causes asthma in children?

Asthma is becoming more common in the western world, both among children (pediatric asthma) and the elderly. The reason for the increase is not entirely clear. Heredity plays a certain role, but there are other things that also matter. Allergies, air pollutants, certain substances in the workplace and chemicals may contribute to the development of asthma.

Previously, it was thought that young children would avoid meeting animals. Nowadays, it is known that farm growth reduces the risk of developing allergies.

Complications in asthma

If you get a respiratory tract infection, your asthma may get worse and you may need to change your medication. Discuss with your doctor what to do if you get more trouble, please in advance so that you are prepared. Write in your treatment plan what you agree.

Pregnancy and asthma

It is extra important that you are careful with treatment if you are pregnant, as asthma attacks may affect the fetus. Many people experience that asthma is improved during pregnancy, but some may have increased inconvenience.

You should continue with your asthma medication if you become pregnant. Always talk to your doctor if you are or are planning to become pregnant.