Asthma Q&A

Ask the Consultant

Dr Rahul Mogal is regarded as one of our top Consultants specialising in Respiratory and General Medicine.

He completed his CCST in Respiratory Medicine in 2014. He is trained as a respiratory specialist in London, having gained experience at the Royal London and London Chest Hospitals.

Here we ask him about asthma, the causes, the symptoms, diagnosis and treating or managing the condition.

Dr Rahul Mogal
Asthma is a common long term or chronic respiratory condition that affects airways which carries air in and out of your lung.  From time to time, the muscles surrounding these airways constricts after becoming irritated by inflammation. The airways are narrowed further by swelling of airways and production of extra mucus and sufferers may wheeze and struggle to draw a full breath.

Dr Rahul Mogal

We do not know what exactly causes asthma but we know that in asthma there is an inflammation of the airways which causes the muscles around your airways to tighten, making your airways narrower. The cause of asthma is likely to be combination of factors such as genetic (inherited), environmental (chemicals, dust) etc.

Exposure to various irritants and substances can trigger signs and symptoms of asthma. Common asthma triggers include:

  • house dust mites
  • animal fur
  • pollen
  • cigarette smoke
  • exercise
  • viral infections

Dr Rahul Mogal

Asthma can affect any age but about half of asthmatics develop symptoms before the age of 10 years. It then tends to become less severe in teenagers but can come back in later life. Asthma affects more boys than girls but in adults it is more common in women than men. In the UK, around 5.4 million people are currently treated for asthma. That is one in every 12 adults and one in every 11 children.

It tends to run in families so if there is a family history of asthma or of other allergies such as hay fever or eczema, an individual may be more likely to develop asthma. In adults who develop asthma for the first time in their 30s or older, it is called as late onset asthma and in this group allergy is much less common. In late onset asthma, there may be history of exposure to chemicals in their work environment, and some may be sensitive to chemicals in drugs or their diet (i.e. aspirin-sensitive asthma or salicylate intolerance).

Dr Rahul Mogal

Typical symptoms of asthma includes:

  • shortness of breath
  • wheezing - a whistling sound when you breathe
  • tightness in the chest – like a band is tightening around it
  • coughing
One of the characteristics of asthma is that the symptoms are variable and can range from mild to severe. Symptoms are often worse at night and early in the morning, particularly if the condition is not well controlled. They may also develop or become worse in response to a certain trigger, such as exercise or exposure to an allergen.

Dr Rahul Mogal

Peak Expiratory Flow (PEF) test - to measure the flow of air out of the lungs. If, over a period of time, the morning and evening values vary by more than 15%, or treatment for asthma improves the readings by more than this value, this is indicative of asthma.

Lung function test - This is useful in assessing the breathing in more detail. It involves breathing into a machine which records the airflow and volumes during various breathing manoeuvres. A reversibility test may be used to assess your response to a bronchodilator (reliever to open up your airways) such as salbutamol. In asthma there is usually a marked improvement in lung function measurements after a dose of medication.

Airway responsiveness or challenge tests - This highly specialised test is sometimes used to diagnose asthma when the diagnosis is not clear from the more simple tests mentioned above. It is carried out only in the hospitals and measures how your airways respond when they come into contact with a trigger.

Nitric oxide (FeNO) test - This test measures the amount of nitric oxide in your breath. When your airways are inflamed — a sign of asthma — you may have higher than normal nitric oxide levels.

Imaging tests - A chest X-ray and high-resolution computerized tomography (CT) scan of your lungs and nose cavities (sinuses) can identify any structural abnormalities or diseases (such as infection) that can cause or aggravate breathing problems.

Allergy tests - this can be performed by a skin test or blood test. Allergy tests can identify allergy to pets, dust, mould and pollen. Tests can also be carried out to see if you are allergic or sensitive to certain substances known to cause occupational asthma. If important allergy triggers are identified, this can lead to a recommendation for allergen immunotherapy.

Dr Rahul Mogal

Although there is no cure for asthma, with appropriate treatment you should be able to lead a full and unrestricted life. Treatment usually involves learning to recognise your triggers, taking steps to avoid them and tracking your breathing to make sure your daily asthma medications are keeping symptoms under control.

The most common form of treatment is medication taken through an inhaler, also called a pump or a puffer. Inhalers contain measured doses of medication that you take into your airways when you breathe in, with few or no side effects.

There are many different types of inhalers but the most common types are reliever and preventer inhalers. Reliever inhalers relieve asthma symptoms as and when they do occur while preventer inhalers try to stop asthma symptoms from occurring

Other treatments: Depending on the type and severity of your asthma you may benefit from other forms of asthma therapy such as tablets.

Dr Rahul Mogal

I thoroughly love chest medicine and find it fascinating. While it is a great profession that allows you to help people, it is fascinating and very rewarding.

Dr Rahul Mogal

The highlight of my career to date is becoming a chest consultant and I aim to develop patient centred services with the help of patient involvement.

To find out more about allergy testing and allergy specialists call us on 0808 101 0337 or make an online enquiry.

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