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Asthma symptoms and causes

Chris Turner, Doctor and Medical Writer, BSc and MBBS | Jul 29, 2022

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Asthma is a common lung condition that often begins in childhood. This guide will look at what causes asthma, its symptoms and the different types. If you have asthma or know someone who does, read on for the answers to some common questions you might have.

In this guide, we’ll cover:

What is asthma?
What causes asthma?
What are the symptoms of asthma?
What are the types of asthma?
How will my asthma be diagnosed?
Why is my asthma not getting better?
When is it not asthma?

What is asthma?

Asthma is a condition that affects the airways in the lungs. It causes the air passages to rapidly narrow (bronchospasm), leading to shortness of breath. This can be accompanied by the production of sticky phlegm.

Asthma often, but not always, begins in childhood. Asthma symptoms can range from mild to severe. If not treated, inflammation can cause permanent changes to your lungs.

What causes asthma?

It isn’t fully understood what causes someone with asthma to have airways that can narrow. You’re more likely to get asthma if you have any of the following risk factors:

You have eczema or allergies, including hay fever
You have a family history of asthma, eczema or allergies
You had respiratory (lung) infections as a baby
You were born prematurely
You have been exposed to cigarette smoke, including in the womb
You are exposed to high levels of air pollution

While the cause of asthma isn’t fully known, many people with asthma have what are known as triggers. These are substances or situations that bring on asthma symptoms. They can include pollen, dust mites, smoke, exercise and stress.

What are the symptoms of asthma?

There is a range of possible asthma symptoms, with each person getting a different set. Symptoms can include:

Cough

Cough is a common symptom of asthma. It often happens at night or after exercise and sometimes comes with mucus. An asthma cough won’t respond to antibiotics unless associated with an infection.

Wheezing

Wheezing is a whistling noise caused by breathing out through narrowed airways. In asthma, this usually occurs when your symptoms worsen, and you might also have a tight chest.

Difficulty breathing

When you have asthma, you should not feel breathless under normal conditions. If something triggers your asthma and your airways begin to narrow, you may feel short of breath.

Chest tightness

This can happen if your asthma gets worse or during an asthma attack. It’s a feeling like a band being tightened around your chest.

Fatigue

If your asthma is not completely controlled, you may find that you are being woken up at night by your symptoms.

Rapid breathing

One of the indications that you asthma might be getting worse, possibly leading to an asthma attack, is faster breathing (increased respiratory rate).As with many other signs, if they do not resolve rapidly when taking your reliever inhaler, you should seek medical attention.

Anxiety

Anxiety is more common if you have asthma, and your healthcare team may ask you if you ever feel anxious. You may find chest tightness and difficulty breathing can make you agitated, especially if you’re having an asthma attack.

Workout fatigue

If you have asthma, especially exercise-induced, you may find yourself especially tired after a workout. If you find that you’re getting progressively more exhausted after exercise, it may be a sign that your asthma is not as well controlled as it could be. If this is the case, you should talk to your doctor about ways to better manage your asthma.

Asthma attack signs

An asthma attack is when your symptoms worsen and aren’t controlled by your usual medication. Signs of an asthma attack can include:

Severe coughing
Wheezing not relieved by inhalers
Shortness of breath
Chest tightness
Fatigue

A severe asthma attack can be life-threatening. You should call 999 for an ambulance immediately if your symptoms are getting rapidly worse despite using your inhalers or if you get any of the following:

Blue or grey discolouration of the lips, face or nails
Extreme difficulty breathing
Unable to complete sentences
Confusion
Extreme anxiety or agitation
Rapid pulse

What are the types of asthma?

There are several different types of asthma. Your doctor will be able to tell you if your asthma fits into one of these groups.

Allergic asthma

This is asthma triggered by an allergy (for example, pollen). In this case, it’s essential to avoid your trigger as much as possible and always carry your prescribed inhalers.

Non-allergic asthma

In this case, there is no allergic trigger for asthma. This condition often develops later in life.

Occupational asthma

This is asthma directly related to exposure to a substance in your work environment. Triggers can include dust from flour and latex.

Cough-variant asthma

In this type of asthma, coughing is the main or only symptom. You should visit your GP for any persistent cough to determine the cause.

Nocturnal asthma

This is when your asthma symptoms are much worse at night. Ensuring you have the correct medications and taking them at the right time helps ensure a good night's sleep.

How will my asthma be diagnosed?

If you’re experiencing breathlessness, cough or other respiratory symptoms, your GP will want to find out as much as possible. That includes when it started, what brings it on, and if any other symptoms are associated with it.

The doctor will examine you, including listening to your chest with a stethoscope. They’ll probably ask you to perform a breathing test called a ‘peak expiratory flow test’ or ‘peak flow’ to see if you have evidence of narrowed airways.

They may also ask to perform spirometry, which involves exhaling from a full breath through a device called a spirometer.

Even once you’ve been diagnosed, if you’re experiencing repeated wheezing, coughing or shortness of breath, you should speak to your GP or asthma nurse and re-evaluate your asthma management plan.

Why is my asthma not getting better?

If you notice your asthma symptoms become worse or the following describe you, your asthma may not be well controlled:

Difficulty sleeping because of your asthma or cough
Symptoms like coughing, wheezing, shortness of breath or a tight chest
Your asthma interferes with your normal everyday activities

Another sign that your asthma may not be under control is suddenly needing to use your reliever inhaler more often than usual. We can give you lots of advice and support on managing your asthma so you can get on and enjoy your life to the full. Just pop into your local LloydsPharmacy for more information.

When it's not asthma

Occasionally other medical conditions can have similar symptoms to asthma. These include:

Lung conditions:

Chronic obstructive pulmonary disease (COPD), a chronic lung condition
Pneumonia and other chest infections
Allergies
Reactions to environmental pollutants (like dust)
Tumours in the lungs or the chest
Genetic conditions such as cystic fibrosis

Heart and blood vessel conditions:

Heart attacks or angina
Congestive heart failure
Pulmonary embolism, which is a blood clot inside the lung
Having a panic attack
Obesity which causes shortness of breath

Digestive disorders:

Hiatus hernia, in which part of the stomach pushes into the chest and affects breathing
Gastro-oesophageal reflux disease (GORD), where stomach contents come up into the throat
Aspiration, when a foreign body, such as food, is sucked into the airways while inhaling

Find help through our Online Doctor

For some further advice, visit our Online Doctor. If you need to order your inhaler, we can provide them with either same day collection or next day delivery.

Asthma is a chronic condition that affects many people. With the right help, devices and equipment, and medication, it should not change how you live your life. Visit our asthma and allergies blog to find a wealth of further information about asthma, inhalers, and tips and advice on managing your condition.

References

www.nhs.uk/conditions/asthma
https://cks.nice.org.uk/topics/asthma/background-information/risk-factors
https://cks.nice.org.uk/topics/asthma
https://cks.nice.org.uk/topics/asthma/management/newly-diagnosed-asthma
www.asthma.org.uk/advice/understanding-asthma/types
www.ncbi.nlm.nih.gov/pmc/articles/PMC3182093
https://cks.nice.org.uk/topics/asthma/diagnosis/differential-diagnosis
www.asthma.org.uk/advice/asthma-attacks
https://cks.nice.org.uk/topics/asthma/management/acute-exacerbation-of-asthma
www.bmj.com/content/bmj/304/6833/998.full.pdf