Chronic asthma is a long-term condition where the airways are inflamed, narrow, and produce extra mucus, causing breathing difficulties. Symptoms may come and go, but inflammation persists even when a person feels well. Proper management helps prevent severe attacks and improves quality of life. If you’re experiencing these issues, you can get a licensed healthcare provider consultation through Hope Plus.
Asthma symptoms can be triggered by allergens, infections, smoke, cold air, exercise, or missed medications. Children and adults can both have chronic asthma, and attacks can range from mild to life-threatening.
Key Takeaways
- Chronic asthma is a persistent inflammatory disease of the airways.
- Symptoms may include wheezing, cough, chest tightness, and breathlessness.
- Management is stepped according to severity, from mild to severe.
- Avoiding triggers and following prescribed treatment can prevent attacks.
Causes and Triggers
Chronic asthma may be influenced by:
- Allergies, such as dust, pollen, or animal fur
- Respiratory infections
- Cigarette smoke or indoor pollution
- Cold or dry air
- Exercise, especially in children
- Missing or stopping prescribed inhalers
Symptoms
- Wheezing or whistling sound when breathing
- Persistent cough, often worse at night or early morning
- Chest tightness or pressure
- Shortness of breath
- Fatigue or difficulty completing normal activities
- Severe attacks can cause blue lips or fingertips
Diagnosis
Healthcare providers diagnose asthma through:
- Reviewing symptoms and medical history
- Physical examination and listening to the chest
- Measuring oxygen levels with a pulse oximeter
- Using a peak flow meter to assess airway obstruction
- Ruling out other causes of cough and breathlessness
Management of Chronic Asthma
Healthcare providers follow a stepped approach, adjusting treatment according to the patient’s symptoms and response. Before starting new treatments, providers check that the diagnosis is correct, inhaler technique is proper, and triggers for attacks are controlled.
Step 1: Intermittent Asthma
- Symptoms occur less than once per week
- Night-time symptoms occur less than twice per month
- Normal daily activity
Treatment: Salbutamol inhaler 100–200 micrograms as needed, often with a spacer for children. Patients move to Step 2 if symptoms or inhaler use increase.
Step 2: Mild Persistent Asthma
- Symptoms more than once per week but less than once per day
- Night-time symptoms more than twice per month
Treatment: Regular inhaled corticosteroids (e.g., beclomethasone 100–400 micrograms every 12 hours for adults, 100–200 micrograms for children) plus salbutamol as needed. Dose is assessed and adjusted after one month.
Step 3: Moderate Persistent Asthma
- Daily symptoms affecting activities
- Night-time symptoms more than once per week
- Daily use of salbutamol
Treatment: High-dose inhaled corticosteroids, salbutamol as needed, and in adults, a trial of aminophylline 200 mg every 12 hours may be considered.
Step 4: Severe Persistent Asthma
- Daily symptoms with frequent night-time episodes
- Daily use of salbutamol
- Children under 12 are referred to a specialist clinic
Treatment: High-dose inhaled corticosteroids, regular corticosteroid tablets (prednisolone 10–20 mg daily), and salbutamol tablets if inhalers are unavailable. Children’s doses are carefully calculated by weight.
Rescue Course
At any step, during acute worsening, a 3–5 day course of oral prednisolone may be given:
- Child <1 year: 1–2 mg/kg daily
- Child 1–5 years: up to 20 mg daily
- Child 5–15 years: up to 40 mg daily
- Adults: 40–60 mg daily
Stepping Down
Once asthma is controlled, providers may reduce treatment gradually, reviewing every 3–6 months.
Cautions
- Medicines like morphine, propranolol, or other beta-blockers can worsen asthma and are avoided.
- Sedatives should not be given to children with asthma.
Prevention
Patients can reduce attacks by:
- Avoiding triggers such as cigarette smoke, aspirin, known allergens, and cold air
- Treating respiratory infections promptly
- Keeping a reliever inhaler handy during sports or exercise
- Maintaining good medication adherence and proper inhaler technique
Frequently Asked Questions (FAQs)
1. Can chronic asthma be cured?
Chronic asthma cannot be completely cured, but symptoms can be controlled with proper medication and trigger management.
2. How often should asthma treatment be reviewed?
Every 3–6 months, or sooner if symptoms worsen or attacks become more frequent.
3. Can children with asthma exercise?
Yes, but they should use a reliever inhaler before exercise and avoid known triggers.
4. What are the warning signs of a severe attack?
Unable to speak full sentences, use of chest muscles for breathing, blue lips or fingertips, or feeling faint or confused.
5. How does medication help prevent attacks?
Inhaled corticosteroids reduce inflammation, and reliever inhalers open the airways during attacks. Proper use prevents severe exacerbations.
