This test is sometimes used to diagnose asthma when the diagnosis is not clear from the more simple tests discussed above. It measures how your airways react when they come into contact with a trigger. You will be asked to breathe in a medication that deliberately irritates or constricts your airways slightly if you have asthma, causing a small decrease in your FEV1 measured using spirometry and possibly triggering mild asthma symptoms.
If you do not have asthma, your airways will not respond to this stimulus. The test often involves inhaling progressively increasing amounts of the medication at intervals, with spirometry measurement of FEV1 in between to see if it falls below a certain threshold.
In some cases, however, exercise may be used as a trigger. It may also be useful in some cases to carry out tests to check for inflammation in your airways.
This can be done in two main ways:. Skin testing or a blood test can be used to confirm whether your asthma is associated with specific allergies, such as dust mites, pollen or foods. Tests can also be carried out to see if you are allergic or sensitive to certain substances known to cause occupational asthma. Read more about diagnosing allergies. The inhaler usually contains a medicine called a short-acting beta2-agonist, which works by relaxing the muscles surrounding the narrowed airways.
This allows the airways to open wider, making it easier to breathe again. Reliever inhalers do not reduce the inflammation in the airways, so they do not make asthma better in the long term — they are intended only for the relief of symptoms. Examples of reliever medicines include salbutamol and terbutaline. They are generally safe medicines with few side effects, unless overused. However, they should rarely, if ever, be necessary if asthma is well controlled, and anyone needing to use them three or more times a week should have their treatment reviewed.
Preventer inhalers — usually brown, red or orange — work over time to reduce the amount of inflammation and sensitivity of the airways, and reduce the chances of asthma attacks occurring. They must be used regularly typically twice or occasionally once daily and indefinitely to keep asthma under control. You will need to use the preventer inhaler daily for some time before you gain the full benefit.
You may still occasionally need the blue reliever inhaler to relieve your symptoms, but your treatment should be reviewed if you continue to need them often. The preventer inhaler usually contains a medicine called an inhaled corticosteroid. Examples of preventer medicines include beclometasone, budesonide, fluticasone, ciclesonide and mometasone.
Preventer treatment should be taken regularly if you have anything more than occasional symptoms from your asthma, and certainly if you feel the need to use a reliever inhaler more than twice a week. Some inhaled corticosteroids can occasionally cause a mild fungal infection oral thrush in the mouth and throat, so make sure you rinse your mouth thoroughly after inhaling a dose.
The use of a spacer device also reduces this risk. If your asthma does not respond to initial treatment, the dose of preventer inhaler you take may be increased in agreement with your healthcare team. These work in the same way as short-acting relievers. Although they take slightly longer to work, their effects can last for up to 12 hours.
This means that taking them regularly twice a day provides hour cover. Regular use of long-acting relievers can also help reduce the dosage of preventer medication needed to control asthma.
Examples of long-acting relievers include formoterol and salmeterol, and recently vilanterol, which may last up to 24 hours. However, like short-acting relievers, long-acting relievers do not reduce the inflammation in the airways. If they are taken without a preventer, this may allow the condition to get worse while masking the symptoms, increasing the chance of a sudden and potentially life-threatening severe asthma attack.
You should therefore always use a long-acting reliever inhaler in combination with a preventer inhaler, and never by itself. In view of this, most long-acting relievers are prescribed in a 'combination' inhaler, which contains both an inhaled steroid as a preventer and a long-acting bronchodilator in the one device.
These are usually but not always purple, red and white, or maroon. If regular efficient administration of treatment with a preventer and a long-acting reliever still fails to control asthma symptoms, additional medicines may be tried. Two possible alternatives include:. If your asthma is still not under control, you may be prescribed regular steroid tablets. This treatment is usually monitored by a respiratory specialist an asthma specialist. Long-term use of oral steroids has serious possible side effects, so they are only used once other treatment options have been tried, and after discussing the risks and benefits with your healthcare team.
Omalizumab, also known as Xolair, is the first of a new category of medication that binds to one of the proteins involved in the immune response and reduces its level in the blood. This lowers the chance of an immune reaction happening and causing an asthma attack. The National Institute for Heath and Care Excellence NICE recommends that omalizumab can be used in people with allergy-related asthma who need continuous or frequent treatment with oral corticosteroids.
Omalizumab is given as an injection every two to four weeks. It should only be prescribed in a specialist centre. If omalizumab does not control asthma symptoms within 16 weeks, the treatment should be stopped. Bronchial thermoplasty is a relatively new procedure that can be used in some cases of severe asthma. It works by destroying some of the muscles surrounding the airways in the lungs, which can reduce their ability to narrow the airways.
The procedure is carried out either with sedation or under general anaesthetic. A bronchoscope a long, flexible tube containing a probe is inserted into the lungs through the mouth or nose so it touches the airways. The probe then uses controlled heat to damage the muscles around the airways. Three treatment sessions are usually needed, with at least three weeks between each session. There is some evidence to show this procedure may reduce asthma attacks and improve the quality of life of someone with severe asthma.
However, the long-term risks and benefits are not yet fully understood. There is a small risk it will trigger an asthma attack, which sometimes requires hospital admission. Relievers are a safe and effective medicine, and have few side effects as long as they are not used too much. The main side effects include a mild shaking of the hands tremors , headaches and muscle cramps.
These usually only happen with high doses of reliever inhaler and usually only last for a few minutes. Preventers are very safe at usual doses, although they can cause a range of side effects at high doses, especially with long-term use. The main side effect of preventer inhalers is a fungal infection of the mouth or throat oral candidiasis. You may also develop a hoarse voice and sore throat. Using a spacer can help prevent these side effects, as can rinsing your mouth or cleaning your teeth after using your preventer inhaler.
Your doctor or nurse will discuss with you the need to balance control of your asthma with the risk of side effects, and how to keep side effects to a minimum. Long-acting relievers may cause similar side effects to short-acting relievers. You should be monitored at the beginning of your treatment and reviewed regularly. If you find there is no benefit to using the long-acting reliever, it should be stopped. Theophylline tablets have been known to cause side effects in some people, including nausea, vomiting, tremors and noticeable heartbeats palpitations.
These can usually be avoided by adjusting the dose according to periodic measurement of the theophylline concentration in the blood. Side effects of leukotriene receptor agonists can include tummy abdominal pain and headaches. Oral steroids carry a risk if they are taken for more than three months or if they are taken frequently more than three or four courses of steroids a year. Side effects can include:. With the exception of increased appetite, which is very commonly experienced by people taking oral steroids, most of these unwanted effects are uncommon.
However, it is a good idea to keep an eye out for them regularly, especially side effects that are not immediately obvious, such as high blood pressure, thinning of the bones, diabetes and glaucoma. A personal asthma action plan will help you recognise the initial symptoms of an asthma attack, know how to respond, and when to seek medical attention.
If your symptoms improve and you do not need to phone , you still need to see a doctor or asthma nurse within 24 hours. If you are admitted to hospital, you will be given a combination of oxygen, reliever and preventer medicines to bring your asthma under control.
Your personal asthma action plan will need to be reviewed after an asthma attack, so reasons for the attack can be identified and avoided in future. As part of your initial assessment, you should be encouraged to draw up a personal asthma action plan with your GP or asthma nurse.
Have smaller-than-normal airways at birth and in early childhood. Are exposed to smoke before and after birth. Have a low birth weight. Have a parent, particularly a mother, who has allergies or asthma.
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For a mild incident, your doctor might recommend using your inhaler and practicing deep or pursed lip breathing. For shortness of breath that is not a medical emergency, there are at-home treatments such as sitting forward and diaphragmatic breathing.
Drinking coffee has also been found to relax the airways of those experiencing asthma and can enhance lung function for short periods of time. For an intense period of difficulty breathing or chest pain, you should seek medical attention immediately. Based on your specific needs, your doctor might prescribe medication including.
Your doctor may also work with you to determine long-term solutions to shortness of breath that results from asthma. The solutions might include:. Shortness of breath may be a result of asthma, but asthma is not the only underlying cause of shortness of breath. If you are experiencing shortness of breath, make an appointment with your doctor who can conduct assessments to help provide a proper diagnosis and, if necessary, develop a treatment plan.
Heartburn is the most common symptom of acid reflux. Others are asthmatic in nature. Also, if wheezing worsens even after a quick-acting medication has had time to work, which is about 15 minutes, it is time to call a doctor. Asthma wheezing is a high-pitched whistling sound that happens when breathing through swollen, constricted airways. It most often occurs during exhalations. If someone has mild wheezing and other asthma symptoms, a short-acting inhaler may manage the condition. However, most people with asthma need a combination of short-acting and long-acting medications.
Severe cases of asthma can cause symptoms, such as a bluish tinge of the lips, that indicate an individual needs immediate treatment. When this happens, they should go to the emergency room because the condition can be life-threatening. Symptoms of asthma include chest tightness, wheezing, and shortness of breath. They can vary among children and older adults. Learn more about asthma…. Sometimes, people can find it hard to tell the difference between asthma and bronchitis.
This is because both have similar symptoms that include…. An asthma exacerbation is the temporary worsening of asthma symptoms or the appearance of new symptoms. Asthma exacerbations can sometimes occur with…. Intermittent asthma causes symptoms such as shortness of breath and coughing. However, these symptoms are not present all the time.
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