Dealing with asthma


Asthma affects around 5.4million people in the UK. The bulk of these cases are very treatable, says Dr Dinesh Saralaya, consultant respiratory physician at Bradford Royal Infirmary. But around half a million people have difficulty treating asthma. These sufferers may need multiple treatments and frequent hospitalisation. “Intrinsic factors may mean that the patient does not respond to treatment as normal asthmatics do,” says Dr Saralaya.

“Other factors include being female, middle-aged or overweight and diseases may co-exist with asthma and make it worse — severe hayfever, for example. The more allergy you have, the greater the risk of your asthma being poorly controlled.” Asthma can be life-threatening. The charity Asthma UK says that, on average, around three people a day die from it (although it stresses that, for most sufferers, the condition can be well-managed). The charity estimates that 75 per cent of hospital admissions for asthma are avoidable and as many as 90 per cent of the deaths from asthma are preventable.


Know the symptoms of asthma


Patients with asthma will typically have symptoms which include breathlessness, wheezing and chest tightness. These symptoms may be triggered by, for instance, sudden cold air, cigarette smoke or spicy food. Knowing your trigger is key to controlling your condition. “Asthma is a variable disease,” says Dr Saralaya. “It varies in time and in severity. I get episodic symptoms. Let’s say I catch a cold or go into a room full of cigarette smoke — well, that night I will wheeze and I’ll need my inhaler.

Asthma is an inflammatory disease so a trigger causes an inflammation in the lining of our breathing tubes, causing more sputum to be produced and altering the shape of our airways.” Treatment with inhalers (preventer and reliever) reduces inflammation and opens up the airways, increasing lung capacity.


The importance of early asthma treatment


In the UK, says Dr Saralaya, many severe asthma cases can be worsened by poor compliance to treatment — and by ignoring triggers, such as smoking. “If you have poorly controlled asthma and you smoke, it makes you less responsive to treatment and causes changes within the airway which makes your asthma worse. So cigarettes are not just bad for general health — they’re also bad for asthma control.”

One misconception is that if the sufferer feels better, they can stop treatment. “I tell my patients that if they decide to come off treatment they may be well intermittently,” says Dr Saralaya. “But in the long run their decline of lung function will be more profound than someone taking their treatment regularly.”