Asthma is a chronic respiratory condition that affects the airways, causing them to become inflamed and narrowed. According to the Global Initiative for Asthma (GINA), approximately 262 million people worldwide have asthma. In the UAE, asthma prevalence is estimated at 8–13% of the population.
Understanding Asthma
In asthma, the airways:
- Become inflamed (swollen and irritated)
- Produce excess mucus
- The muscles around the airways tighten (bronchoconstriction)
This makes it harder to breathe and causes symptoms such as:
- Wheezing (a whistling sound when breathing)
- Shortness of breath
- Chest tightness
- Coughing (often worse at night or early morning)
Common Asthma Triggers
Triggers vary between individuals but commonly include:
- Allergens: Dust mites, pet dander, pollen, mould
- Respiratory infections: Colds and flu
- Air pollution and dust: Particularly relevant in the UAE
- Exercise: Especially in cold or dry air
- Weather changes: Sudden temperature changes, humidity
- Tobacco smoke and strong odours
- Stress and strong emotions
- Certain medications: Aspirin, NSAIDs, beta-blockers (in some people)
- Air conditioning: Cold, dry air from AC units, and dust in AC filters
Diagnosis
Asthma diagnosis typically involves:
- Medical history and symptom assessment
- Spirometry: Measures how much and how fast you can exhale
- Peak flow testing: Measures the speed of exhalation
- Reversibility testing: Improvement after inhaling a bronchodilator
- Fractional exhaled nitric oxide (FeNO): Measures airway inflammation
Treatment
Preventer Inhalers (Controllers)
- Contain inhaled corticosteroids (ICS) such as beclometasone, budesonide, or fluticasone
- Must be used daily, even when feeling well, to reduce airway inflammation
- GINA 2023 recommends that all adults and adolescents with asthma should receive ICS-containing treatment
Reliever Inhalers (Rescue)
- Short-acting beta-agonists (SABAs) such as salbutamol provide quick relief
- Should be used only when needed for symptom relief, not as a regular treatment
- GINA notes that relying solely on SABA without ICS is associated with increased risk of severe asthma attacks
Long-Acting Medications
- For moderate to severe asthma, your doctor may add:
- Long-acting beta-agonists (LABAs) - always in combination with ICS
- Leukotriene receptor antagonists (e.g., montelukast)
- Long-acting muscarinic antagonists (LAMAs)
Inhaler Technique
Correct inhaler technique is critical. Studies show that up to 70–80% of patients use their inhalers incorrectly, significantly reducing medication effectiveness. Ask your doctor or pharmacist to demonstrate proper technique, and have it checked regularly.
Asthma Action Plan
Every person with asthma should have a personalised asthma action plan. NICE guideline NG245 recommends that this should include:
- 1Daily management: Which medications to take regularly
- 2Symptom worsening: How to recognise early signs and what to do
- 3Emergency steps: When to seek urgent medical help
Signs of Worsening Asthma
- Needing your reliever inhaler more than 3 times per week
- Waking at night due to asthma symptoms
- Symptoms affecting daily activities
- Peak flow readings below your personal best
Emergency Signs (Call for Help)
- Severe breathlessness (unable to speak in full sentences)
- Reliever inhaler not providing relief within 10–15 minutes
- Lips or fingernails turning blue
- Drowsiness or confusion
- Silent chest (no wheeze during severe attack - this is dangerous)
Asthma in Children
- Asthma is the most common chronic disease in children
- Wheezing in young children is common and does not always mean asthma - your paediatrician will assess
- Children should use a spacer device with their inhaler for more effective medication delivery
- Regular review by a healthcare professional is important as children grow
Living Well With Asthma
- Identify and avoid your personal triggers
- Take preventer medication as prescribed, every day
- Attend regular asthma reviews (at least annually)
- Keep your reliever inhaler accessible at all times
- Stay physically active - exercise is safe and beneficial for most people with asthma (discuss with your doctor)
- Get the annual flu vaccine (recommended for all people with asthma)
This article is for informational purposes only and does not replace professional medical advice. Always consult your doctor for personalised guidance.