Asthma makes breathing difficult for 20% of children and 5% of adults in Singapore.* However, with proper treatment, asthma patients can still live a fulfilling life.

Dr Ng Chung Wai, Senior Consultant at SingHealth Polyclinics and Dr Tan Keng Leong, Senior Consultant from the Department of Respiratory and Critical Care Medicine at Singapore General Hospital, give detailed answers to your questions.​

Question by student

I am a primary school student. The doctor told me I have asthma, and need to use the inhaler everyday and night. I try to remember and use it most of the time.

Can I still become a sportsman? I like swimming, running and basketball. How long can I play each time without getting myself an asthma attack? Thank you doctor.

Answered by Dr. Tan Keng Leong, Senior Consultant, Singapore General Hospital

Exercise regularly as long as your asthma is well controlled. Increase your fitness by exercising regularly.

There are many examples of sportsmen who are asthmatics. World record-breaking marathon runner Paula Radcliffe from Britain has asthma since the age of 14 years.

England midfielder Paul Scholes was diagnosed with asthma when he was 21 years old, but he still went on to help Manchester United clinch the Premiership.

The recommended exercises for asthmatics include swimming and watersports. Avoid jogging and running in the open areas during periods of haze as it may aggravate your asthma.

Exercise-induced asthma often indicates that the asthma is not adequately controlled. Appropriate anti-inflammatory (controller) therapy therefore, results in the reduction of exercise-related symptoms. If you have exercise-induced asthma, you are advised to use a reliever (for example, salbutamol inhaler) 15 minutes before exercise (in addition to your regular controller medication).

Always warm up by doing 15-20 minutes of light exercise and stretching before any sports or exercise as this reduces the incidence and severity of exercise-induced asthma.

Question by parnie 3399

1. Is it true that one should not drink cold water when under asthma attack? Why so ?
2. Is asthma a hereditary ? My family seemes to have quite a few people suffering from asthma. Is it possible for my child to develop ashtma as well? I am a asthma patient myself.

Answered by Dr. Tan Keng Leong, Senior Consultant, Singapore General Hospital

1. Extreme changes in temperature may trigger asthma attacks.
2. Asthma does tend to run in families. Your children may be more likely to develop asthma if one or both of you have asthma.

Question by pearlynwan

Is there any difference between allergic asthma and bronchitis asthma? How would I know which one that I am suffering from ? Usually doctor just said, "you've got asthma."

Is it possible to use the inhaler more than what has been prescribe? Sometimes, I just feel that it doesn't reduce the attack. Should I see a doctor if such situation persist? Thanks

Answered by Dr. Tan Keng Leong, Senior Consultant, Singapore General Hospital

There is no real difference and the management is as for asthma and may include evaluation of possible trigger factors.

Trigger factors are those that aggravate asthma. Examples of these include the haze, cigarette-smoke, strong smells, housedust mites, animal danders, indoor moulds, change of weather, certain foods containing sulphite, common cold, sinus infection and certain medications such as aspirin and beta-blockers.

Avoidance of trigger factors is an important step in the management of asthma. A skin prick test may assist in determining some of the trigger factors. You should consult your doctor as it is not recommended to use the inhaler more frequently than prescribed.

You should also consult your doctor if you feel that your asthma is not controlled. Consult your doctor for a written asthma action plan to assist you in managing your asthma.

Question by lee

My son has asthma as diagnosed through the 'breathing capacity test' done early this year. He's now on preventor inhaler as well as nasal spray, and so far, so good.

Is there a difference in efficacy of the direct puff versus the 'capsule' type inhaler? I am worried my son doesn't suck in properly when using the direct puff, but I have no way of knowing; yet don't want to risk overdose by making him take extra puffs.

Also, how long does the preventor treatment normally take before we can wane off and eventually stop, provided he is diligent about it? Will he thus them be considered 'cured' of asthma and get to do more swimming, running, stay in aricon environment, etc?

Or is asthma really a lifelong condition no matter what you do?

Thanks in advance. Really appreciate this.

Answered by Dr. Tan Keng Leong, Senior Consultant, Singapore General Hospital

The difference is related to the inhaler technique which is different for the different types of inhaler. Inhaled medications are effective only if the inhaler is used correctly. You should consult your doctor who will recommend one that is suitable for your son and advise on how to use the inhaler properly.

It varies from individual to individual. You should consult your doctor who may recommend stepping up treatment if the asthma is uncontrolled and stepping down treatment when treatment is controlled.

From longitudinal studies, approximately 30 to 50 percent of children with asthma will “grow out of it” once they become teenagers, but asthma may reappear later in adult life for some. Up to two-thirds of children with asthma continue to suffer from asthma through adulthood.

Question by zanne_ooi

I have asthma since young and have to experience attack for at least 8-10 years already. The attack such as short of breath and wheezing starts coming back after the recent haze ( 2-3 months ago). It gets worse whenever the haze is around and I feel like I am the haze detector at home.

What can I do to minimize the attack ? Should I get an Inhaler and bring it with me ? Thanks

Answered by Dr. Ng Wai Chung, Consultant Family Physician SingHealth Polyclinics

An asthmatic patient tends to get asthma attacks if the asthma is not controlled and the air tubes are reactive to triggers in the environment including the haze. In order to minimize asthma attacks, it is important that asthma is controlled and an appropriate dose of preventer medications may be necessary to achieve this.

For asthma, there are two broad categories of medications (1) preventer medications which treat lung inflammation and make the lungs less sensitive, therefore less reactive to triggers such as environmental pollutants (such as the haze) and (2) reliever medications which give relief and expand the person’s airtubes which become constricted during an attack.

When environmental triggers are present (such as the haze) an asthmatic whose asthma was previously under control may experience worsening of asthma. If the patient is not on any preventer medication, it may need to be started. If an asthmatic is already using preventer medication, the dose may need to be adjusted. Therefore you should see your doctor regarding this.

All asthmatics should also be equipped with a Written Asthma Action Plan (WAAP) which is a list of instructions on what steps should be undertaken should an asthma attack occur. The WAAP instructs an asthmatic on how to (i) recognize early symptoms of an attack so that appropriate measures may be taken to prevent the attack from worsening and (ii) recognize if an attack is severe so that urgent medical attention is sought. Please see your regular doctor regarding the WAAP.

As for bringing an inhaler home, all asthmatics, no matter how well controlled previously, should have a reliever at hand (in the form of an inhaler, usually salbutamol inhaler) which serves to expand the constricted air tubes in the event of an attack.

Question by khyati_jv

my daughter having sensetive nose bcos of that she gets phlegm in chest every after 2 month seh faces the same condition we counsult so many drs some says she is alergic some says she is having asthma some says brobronchitis i m so worried about her and its really difficult bcos every time antibiotics only clears the situation if u can guide me on this thankyou

Answered by Dr. Ng Chung Wai Consultant Family Physician SingHealth Polyclinics

The medical term for ‘sensitive nose’ is Allergic Rhinitis. Many lay persons refer to Allergic Rhinitis as ‘sinus problem’ which is not totally accurate.

Patients with Allergic Rhinitis often have Asthma at the same time. Both of these conditions may manifest as ‘phlegm in the chest’. Antibiotics, unfortunately, treats neither Allergic Rhinitis nor Asthma.

Allergic Rhinitis and Asthma are not really curable diseases but they can both be controlled so much so that your child leads an otherwise healthy normal life and is not limited in terms of daily activities such as sports and school.

Diagnosis may not be easy as symptoms of Allergic Rhinitis and Asthma overlap. ie, both diseases manifest the same symptoms, lay terms used by doctors to describe these conditions to patients also overlap.

Sometimes observing how the child responds to treatment may help make the diagnosis. Do consult your doctor to sort out the issue.

Question by pearlynwan

Dear Doctor,

1. Does stress trigger asthma ?
2. How to reduce my risk of getting asthma attack ?

I am a asthma patient since childhood. I have asthma attack sometimes (average 1 or 2 times a year) thank you.

Answered by Dr. Ng Chung Wai Consultant Family Physician SingHealth Polyclinics, Outram Clinic

Emotional stress and anxiety, although not direct triggers of asthma, may worsen symptoms of asthma. When a person is under stress, fatigue and relatively reduced immunity may result in viral infection which is a common trigger for asthma attacks.

If your asthma attacks are frequent, you should see a doctor to evaluate if your asthma is controlled or not. You may also get an idea of how well your asthma control is by taking this self administered questionnaire at www.asthmacontroltest.com

To reduce the risk of getting an asthma attack, firstly the patient should achieve control of asthma. A person with uncontrolled asthma will have more frequent attacks. Other measures to reduce frequency of attacks include trigger avoidance and maintaining a healthy lifestyle with adequate rest, exercise and proper diet.

You should consult your doctor to check if your asthma is under control and if not, what steps are necessary to achieve control of asthma.

Question by judylin

Dear doctor,

Does watching TV cause asthma in children? I have read an interesting article online, it mentioned about study have showed that children who watched TV more than 2 hours per day were nearly twice as expected to develop asthma by age of 12 when compared to children who watched less than 2 hours of TV per day. Is it true? Does this mean these children were sensitive to watching television?

Answered by Dr. Ng Chung Wai Consultant Family Physician SingHealth Polyclinics

We are not aware of studies published in any prominent journals which indicate relationship between the number of hours spent watching television and subsequent development of asthma.

Ref: V10