Asthma Management and Support

Asthma is a chronic condition where the airways become inflamed and narrow in response to triggers, making it harder to breathe. Around 5.4 million people in the UK have asthma, according to Asthma + Lung UK. It's common, treatable, and — with the right management — shouldn't significantly limit what you can do.

The problem is that many people with asthma are undertreated. They rely on their reliever inhaler (the blue one) when symptoms flare, without using a preventer inhaler daily to stop symptoms from occurring. This reactive approach leaves them vulnerable to attacks that proper preventive treatment would avoid.

Symptoms

The four main asthma symptoms are wheezing (a whistling sound when breathing), breathlessness, chest tightness, and coughing. They tend to be worse at night, in the early morning, during exercise, or when exposed to triggers like cold air, pollen, dust, or cigarette smoke.

Not everyone gets all four symptoms. Some people have a persistent cough as their only sign of asthma, particularly at night. This is called cough-variant asthma and is often missed because people don't associate coughing with asthma.

Getting a diagnosis

NICE recommends objective testing rather than diagnosing asthma on symptoms alone. The standard approach includes spirometry (a breathing test measuring airflow and lung capacity), often with a bronchodilator reversibility test — you blow into the machine, use an inhaler, and blow again to see if your airways open up.

A FeNO test (fractional exhaled nitric oxide) measures inflammation in the airways. Raised FeNO supports an asthma diagnosis. A peak flow diary over 2-4 weeks, where you measure your breathing with a small handheld device twice daily, can also help establish the variability that characterises asthma.

We offer spirometry and FeNO testing at our clinic. Results are immediate, and your GP can discuss findings and start treatment in the same appointment.

Treatment

Asthma treatment follows a stepwise approach, as outlined in the BTS/SIGN and NICE guidelines. Most people need two inhalers: a reliever (salbutamol, the blue inhaler) for immediate symptom relief, and a preventer (usually an inhaled corticosteroid like beclometasone or fluticasone) taken daily to reduce airway inflammation.

If a low-dose preventer isn't enough, the next step is adding a long-acting bronchodilator (LABA) or increasing the corticosteroid dose. Some patients use a combination inhaler that contains both.

Inhaler technique matters more than many people realise. Studies consistently show that a large proportion of patients don't use their inhalers correctly, meaning the medication doesn't reach the airways properly. If your asthma isn't well-controlled, the first thing to check is whether your inhaler technique is right.

Every person with asthma should have a written asthma action plan. This tells you what to do when symptoms worsen, when to increase your medication, and when to seek emergency help. If you don't have one, ask at your next review.

Common triggers

Triggers vary between individuals, but the most common include house dust mites, pollen, pet dander, mould, cigarette smoke, cold air, exercise, viral infections (colds and flu), and workplace chemicals or fumes. Emotional stress and certain medications (aspirin, ibuprofen, beta-blockers) can also trigger symptoms in some people.

Identifying your triggers and reducing exposure where possible is a practical step that complements medication. It won't replace inhalers, but it can reduce how often you need them.

How we can help

We offer asthma assessments including spirometry, FeNO testing, inhaler technique review, and written asthma action plans. If your asthma has been poorly controlled, or if you've never had formal lung function testing, a structured review can make a real difference.

For patients needing specialist input, we refer to respiratory consultants directly, usually within 48 hours.