What an asthma diagnosis means for you

Asthma is a chronic inflammatory condition that causes swelling in the airways. It makes breathing difficult and can make some physical activities challenging or even impossible during an attack.

In Singapore, about 5% of adults and 20% of children have asthma.

Typically, it is characterised by difficulty in breathing.

Other symptoms include

• Shortness of breath
• Wheezing
• Chest tightness
• Cough
• Trouble sleeping caused by shortness of breath, coughing or wheezing
• Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu

Asthma is usually diagnosed clinically based on your symptoms. A simple peak flow meter test can be done during a consultation with your doctor. More accurately, a lung function test (spirometry) can also be arranged to measure the airflow out of your lungs. Other lung function tests detect inflammation in the airways or sensitivity of the airways.

It is not clear why some people get asthma and others don’t, but it’s thought to be caused by a combination of environmental and genetic (inherited) factors. There is no single cause that has been identified for asthma.

Some patients who acquired asthma in their childhood may “grow out” of their asthma, but children will still require both maintenance and rescue inhalers like adults. Some medicines may not be safe in young children. It is recommended to check with your doctor if your child has been diagnosed with asthma.

Different people have different triggers. Common triggers for asthma include:

• Indoor allergens (such as house dust mites and pet dander)
• Outdoor allergens (such as pollens and molds)
• Chemical irritants (such as perfume or strong chemical odour)
• Air pollutants and irritants, such as smoke and haze
• Certain medications, including beta blockers and some NSAIDS
• Cold air and drinks
• Citrus fruits
• Exercise
• Stress
• Respiratory infections, such as the common cold

• Inhalers – A preventer inhaler may be used daily to prevent attacks, together with a reliever inhaler to be used only during attacks. Preventer inhaler are usually steroid based to reduce airway inflammation while reliever inhaler contain salbutamol to open up airways. It is important to learn the ways to use these inhalers correctly.
• Non-inhaler medications – These are not first line medication and include tablets to reduce the inflammation in your airways or short courses of oral steroids during asthma flares.

There is no prevention for asthma as there are a variety of causes. Action plans below can help to minimise the risk of recurring and severe attacks.

• Follow your asthma action plan prescribed by doctor.
• Get vaccinated for influenza and pneumonia.
• Identify and avoid asthma triggers.
• Monitor your breathing and learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath
• Identify and treat attacks early. Ensure you always have your reliever inhaler at hand
• Pay attention to increasing reliever inhaler use and inform your doctor. Your doctor will usually perform an Asthma Control Test (ACT) to decide on stepping up your management plan

In short, asthma is a chronic medical condition that can be well controlled with good management. Through the avoidance of triggers, proper usage of inhalers and increased awareness of warning signs, severe life-threatening attacks can be prevented.