Asthma is a disease affecting the airways that carry air to and from your lungs. People who suffer from this chronic condition (long-lasting or recurrent) are said to be asthmatic.

1. What is Asthma?
Asthma is a diseaseaffectingthe airways thatcarry air to and from your lungs.People who suffer from this chronic
condition (long-lastingor recurrent) are said to be asthmatic.
The insidewallsof an asthmatic's airways areswollen or inflamed.This swellingor inflammation makes the
airways extremely sensitiveto irritationsand increases your susceptibility to an allergic reaction.
As inflammation causes theairways to become narrower,less air can pass through them, both to and from the
lungs.Symptoms of the narrowingincludewheezing (a hissingsound whilebreathing),chest tightness, breathing
problems, and coughing. Asthmatics usually experiencethese symptoms most frequently duringthe nightand the
early morning.
ASTHMA SYMPTOMS & DIAGNOSIS
Asthma Symptoms
Accordingto the leadingexperts in asthma,the symptoms of asthma and best treatment for you or your child may
be quite different than for someone else with asthma.
The most common symptom is wheezing. This is a scratchy or whistlingsound when you breathe. Other symptoms
include:
• Shortness of breath
• Chest tightness or pain
• Chronic coughing
• Trouble sleepingdue to coughingor wheezing
Asthma symptoms, also called asthma flare-ups or asthma attacks,areoften caused by allergies and exposureto
allergens such as pet dander, dustmites, pollen or mold. Non-allergic triggers includesmoke, pollution or cold air
or changes in weather.
Asthma symptoms may be worse duringexercise,when you have a cold or duringtimes of high stress.
Children with asthma may show the same symptoms as adults with asthma: coughing,wheezing and shortness of
breath. In some children chronic cough may be the only symptom.
If your child has oneor more of these common symptoms, make an appointment with an a llergist/ immunologist:
• Coughing that is constantor that is made worse by viral infections,happens whileyour child is asleep,or
is triggered by exerciseand cold air
• Wheezing or whistlingsound when your child exhales
• Shortness of breath or rapid breathing,which may be associated with exercise
• Chest tightness (a young child may say that his chest“hurts” or “feels funny”)
• Fatigue (your child may slowdown or stop playing)
• Problems feeding or gruntingduringfeeding (infants)
• Avoidingsports or social activities
• Problems sleepingdue to coughing or difficulty breathing

2. Patterns in asthma symptoms are important and can help your doctor make a diagnosis.Pay attention to when
symptoms occur:
• At night or early morning
• Duringor after exercise
• Duringcertain seasons
• After laughingor crying
• When exposed to common asthma triggers
Asthma Diagnosis
An allergistdiagnosesasthma by takinga thorough medical history and performingbreathing tests to measure
how well your lungs work.
One of these tests is called spirometry.You will takea deep breath and blowinto a sensor to measure the amount
of air your lungs can hold and the speed of the air you inhaleor exhale. This test diagnoses asthma severity and
measures how well treatment is working.
A FeNO test or exhaled nitric oxidetest, in patients with allergic or eosinophilicasthma,is a way to determine how
much lung inflammation is presentand how well inhaled steroids aresuppressingthis inflammation.With allergic
or eosinophilic asthma,sometimes you may feel your breathing is fine,but when you measure your exhaled nitric
oxide, itmay still besignificantly elevated, and you might do better in the long-term usingslightly more of your
inhaled steroid to suppress this inflammation.
Many people with asthma also haveallergies,so your doctor may perform allergy testing. Treating the underlying
allergic triggers for your asthma will help you avoid asthma symptoms.
Asthma medicines
The two main types of asthma medicines are relievers and preventers. These are usually in inhalers or puffers.
There is also a preventer which is a tablet, used by some people. Some other medicines (e.g. prednisonetablets)
are only used for severe asthma flare-ups.There are many different medicines and brands for asthma in Austral ia.
Relievers for adults and children
Everyone who has asthma needs a reliever (e.g. a ‘puffer’) to use when they have asthma symptoms.
In Australia,mostrelievers areavailablefrompharmacies withouta prescription.Relievers should only beused
when you or your child has symptoms (or if your doctor tells you to take itbefore exercise) and should not be over -
used.
In preschool children,wheezing may not be asthma.Wheezing does not need to be treated if your child is still
happy and activewhilewheezing and does not seem to be havingany problem breathing. If itis hard for your child
to breathe while wheezing (i.e. if you can see the muscles of your child’s chestand neck working harder to suck in
air with each breath), you must seek medical help immediately.
Preventers
Adults and adolescents

3. Most adults with asthma need to take a low dose of an ‘inhaled corticosteroid’preventer medicineevery day, as
well as takingtheir reliever when they have symptoms.
An inhaled corticosteroid medicineis usually prescribed for an adultwho:
has had asthma symptoms twice or more in the pastmonth, or
is sometimes woken by asthma symptoms, or
has had a flare-up severe enough to need an urgent visitto their GP or hospital emergency department within the
previous 12 months.
Inhaled corticosteroidsincludeseveral differentmedicines and brands.This type of preventer medicine reduces
inflammation in the airways and reduces a person’s risk of a severe asthma flare-up.Most adults can achievegood
control of asthma symptoms with a low dose.
Preventers sometimes includea second medicine as well as the inhaled corticosteroid.Theseare called
‘combination’therapies.
If you have been prescribed a preventer, you should take it every day even when you have no symptoms and a lso
duringcolds and asthma flare-ups.
Keep taking itunless your doctor decides it is safeto stop. You should not change the treatment without talkingto
your doctor, unless your asthma action plan tells you what to do.
Children
Some children with asthma need to take regular preventer treatment every day, as well as takingtheir reliever
when they have symptoms.
Children aged 6 years and over may need regular preventer treatment if they need to take their reliever more than
twice a week. Also,if they have flare-ups more often than every six weeks. The best type of medicine depends on
their symptoms and age. If your child has been prescribed a preventer, you should make sure they take itevery
day (even duringcolds and asthma flare-ups) and keep taking it unless your doctor decides it is safeto stop.
Most preschool children do not need preventer treatment. Your child may need preventer treatment if wheezing
occurs often and itis hard work to breathe when wheezing (e.g. your child’s chestsucks in whilebreathingin),if
wheezing is severe enough to interrupt eating, play,exerciseor sleep, or if your child has been hospitalised
because of breathingproblems.
Parents should not change their child’s treatment without talkingto their doctor.
Side-effects
All medicines includingcomplementary therapies have possibleside-effects.Most asthma medicines have been
taken over many years by a large number of children and adults around the world,so there is reliableinformation
about possibleside-effects.Ask your doctor or pharmacistaboutpossibleside-effects and what you can do to
avoid them.

4. The most common side-effects of inhaled corticosteroid medicines arehoarseness of the voice and fungal throat
infections.The risk can bereduced by takingthe medicineusinga spacer (a specially designed plasticcontainer
that attaches to the puffer), and by rinsingthemouth with water after usingthe puffer.
The risk of more serious side-effects with low doses of inhaled corticosteroidsisvery small.Takinghigh doses over
months or years carries a higher risk of side-effects, but most adults and children do not need high doses and this
sortof treatment is not usually recommended.
Adjusting treatment
Each person’s asthma medicines may be adjusted up and down if necessary to achievethe best possiblecontrol of
symptoms and avoid flare-ups.The aimis to use the lowest doses that control symptoms.
This means that you or your child needs regular checkups to assess asthma –not justa visitto the doctor during
asthma symptoms.
Adults should plan an asthma check-up every 6 or 12 months (even if your asthma symptoms are well controlled).
You also need a check-up soon after a flare-up,and about 1–3 months after beginning preventer treatment or
adjustingthe dose. Pregnant women with asthma should ask their doctor to check their asthma every 4–6 weeks.
Children with asthma that is well controlled need an asthma check-up every 3–6 months. Your child also needs a
check-up soon after a flare-up,and about 4 weeks after changingtreatment or adjustingthedose.
At each visit,your doctor will ask aboutsymptoms duringthe previous month. If your asthma symptoms are
causingproblems,your doctor may increaseyour treatment. This could be an increasein the number of doses
each day,a change to a stronger dose, or addinga second medicine (another inhaler or tablets).
Your doctor should also check thatyou areusingyour inhaler correctly.
If your asthma has been very well controlled for at least3 months, your doctor may suggest that you try
decreasingyour treatment. Your doctor will work out the safestway to do this with you. It’s usually bestnot to try
reducingtreatment when you are about to go on holidaysor travel,duringa cold or flu,or if you are pregnant.
A spirometry test is usually also needed for adults and children old enough to do the test. Your doctor or nurse
may do the test, or arrangefor itto be done at a testing centre.
Adults should stop if they become dizzy duringthe test, and should not do the test if they have another health
condition that could causeharm(e.g. heart attack or angina,aneurysm, recent surgery,fractured ribs or other
serious conditions).
Your doctor may ask you how often you or your child really takethe prescribed asthma medicines.Do not be
offended – most people miss doses sometimes. It is very importantfor your doctor to know what someone is
actually takingbeforethey work out whether it is the right medicine and the right dose.
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