When asthma triggers, the narrowing of the airways causes shortness of breath. As the person tries to breathe in and out, there is insufficient room for air to flow properly; causing them to wheeze and gasp for air.

As the airways become inflamed and additional mucus is produced, the irritation causes the body to respond by coughing. The combination of coughing and insufficient airflow will quickly deprive the body of oxygen and make it harder to breathe.

For some people, asthma is a minor nuisance. For others, it can be a major problem that interferes with their daily activities and may even lead to a life-threatening asthma attack. Depending on your environment and daily life, your asthma symptoms may get better or even worsen over time. As such, it is important to keep track of your symptoms and work with your doctor to adjust treatment where necessary.

The symptoms of asthma may vary for each individual, you may experience one or a combination of the following symptoms:

• Shortness of breath

• Feeling tightness or pain in your chest

• Wheezing when exhaling

• Episodes of coughing or wheezing that worsen when affected by a respiratory virus (the common cold or flu)

• Trouble sleeping caused by shortness of breath, coughing or wheezing

A person’s symptoms may also trigger or worsen in response to an asthma trigger such as exercise, respiratory virus or allergy. When a person’s asthma flares up or gets worse for a short time, it is known as an asthma attack. While most people are aware that asthma attacks can happen suddenly, many are unaware that asthma attacks may also trigger and build up over the course of a few days.

Symptoms of an asthma attack may present as:

• Severe or constant wheezing, coughing and tightness in the chest

• An inability to speak, sleep or eat properly due to shortness of breath

• A faster heartbeat / breathing to pump more oxygen throughout the body

• Feeling confused, exhausted, dizzy or drowsy

• Fingers and lips becoming blue due to lack of oxygen

• Your reliever or inhaler is not helping your symptoms

• Fainting

A person’s symptoms or asthma attack usually occur in response to an condition, chemical or substance known as asthma triggers. Common causes or triggers of asthma include:

• Infections like the common cold or flu

• Allergic reactions to pollen, dust mites or animal fur

• Smoke and pollution from vehicles, factories or fires

• Second-hand tobacco smoke from smokers

• Medicines, particularly anti-inflammatory medication such as ibuprofen or aspirin

• Intense exercise or physical activity

Occupational Asthma

In some people, asthma symptoms and attacks may also occur from the substances they are exposed to at work. This is known as occupational asthma. Common chemicals or substances that can trigger occupational asthma are:

• Chemicals often found in spray paint)

• Rosin (a substance often found in solder fumes)

• Proteins found in latex, flour, cotton, wheat or papain (a digestive enzyme found in papayas)

• Animal substances (certain proteins found in animal fur, hair, scales, saliva or body wastes)

• Wood dust

Examples of occupations exposed to asthma triggers:

• Animal handlers

• Bakers

• Chemical workers

• Nurses

• Paint Sprayers

• Timber workers

• Welders

When it comes to occupational asthma, the inflammation of the lungs usually occurs due to long-term exposure to asthma triggers or as an allergic response. Because the inflammation builds up over time, the irritation and development of asthma in a person may also progress depending on the frequency of their exposure to the triggers.

A person will have increased risk of asthma if they:

• Have existing allergies – The same substances or triggers for existing allergies may also trigger symptoms of asthma in certain people.

• Have or had bronchiolitis – Bronchiolitis is a condition that causes inflammation and congestion of the lungs similar to asthma, but it is caused by an infection and is common in children. If you have or had bronchiolitis, you are also at risk of developing asthma.

• Work around asthma triggers – A person who is frequently exposed to triggers or is exposed to high volumes of triggers is at an increased risk of developing occupational asthma. Although it is a known risk factor, there are also people with allergies or asthma that work around lung irritants but do not develop symptoms.

• Have a family history of allergies or asthma – A genetic disposition towards asthma may be passed down in the family. A person is at risk of asthma if their first-degree relative (siblings or parents) have asthma.

• Smoke – Smoking increases a person’s risk of asthma and lung diseases. A mother who smokes during pregnancy will also increase her child’s risk of developing asthma and lung diseases.

If you think you’re having an asthma attack or are on the verge of one, you should:

1. Avoid lying down. Sit in an upright position to allow your lungs to expand and contract fully. Take slow, deep breaths and do not panic. Panic will cause your heart to beat faster and your breathing to become ragged, so keep your breathing calm and consistent.
2. Take 1 puff of your inhaler every 30 to 60 seconds alongside your breathing exercise.
3. When your medications don’t work, if you feel worse despite using your inhaler / medications, or if you do not have your inhaler with you; call an ambulance.
4. Continue to breathe consistently and use your inhaler until the ambulance arrives.

There is no cure for asthma, but there are treatment options to manage the symptoms of asthma so you can live a normal life. Inhalers are the main and most common form of treatment for people with asthma. It is a device that contains medication and comes in a few types. When you experience symptoms of asthma, using an inhaler will let you breathe in the medication and allow it to travel down to the affected areas of the airway.

Types of inhalers:

Preventer inhalers – Preventer inhalers are the most important treatment for asthma. These inhalers contain steroids to reduce the inflammation of the airways and are taken daily to prevent or slow the progression of asthma symptoms. When the medication takes effect, it helps to prevent the sudden exacerbation (flaring up) of an asthma attack. These inhalers are crucial to reduce the risk of future asthma attacks and it is recommended to take preventer inhalers regularly.

Reliever inhalers – Reliever inhalers can be taken as required to ease symptoms of asthma whenever you feel breathless, wheezy or tight-chested. The medications in relievers work to relax the muscles in your airways, causing it to open up and allowing you to breathe. A person with occasional symptoms every now and then will only need a reliever inhaler to manage their symptoms. Relievers can also be taken before exercise or sports to avoid exercise-induced asthma. Relievers are also known as bronchodilators.

Oral medication – If inhalers at not enough in helping you manage your asthma, then tablets may also be prescribed to help ease or prevent symptoms.

In rare cases where medication and inhalers do not work for severe cases of asthma, alternative forms of treatment such as injections or surgery may be required.

Injection shot – For people with severe asthma, injection shots can be administered every few weeks to help control their symptoms. However not all injections for asthma are suitable for everyone; you will need to consult a specialist to have injections prescribed.

Surgery – Bronchial thermoplasty is a surgical procedure that reduces the thickened muscle in the airways and allows people with severe asthma to breathe more easily. Severe asthma causes the muscles in the airways to thicken over time, narrowing the airways and making it harder to breathe as time goes on. Through bronchial thermoplasty, the thickened muscle tissue is removed and the airways open up; while also making it less likely for the airways to contract and narrow afterwards. This allows for better breathing and also fewer asthma attacks in the future. This form of treatment is only recommended if you have severe asthma that cannot be regulated with inhalers and medications.

Always consult a respiratory physician or a doctor for treatment of asthma, as everyone’s bodies are different and will present different symptoms. Our respiratory physicians will know best on how to alleviate your symptoms and provide a proper asthma management plan for you.