Asthma affects millions of Filipinos, especially in urban areas. Learn how to manage your asthma triggers, use inhalers correctly, and live an active life despite this chronic condition.
Asthma in the Philippines: A Growing Concern
Asthma affects approximately 12 million Filipinos, making it one of the most common chronic respiratory conditions in the country. In Metro Manila alone, the prevalence is particularly high due to air pollution, traffic emissions, and urbanization. Yet despite its prevalence, many Filipinos with asthma don't have their condition properly controlled—leading to preventable emergency room visits, hospitalizations, and even deaths.
The good news is that asthma, while not curable, is highly manageable. With proper understanding, medication, and lifestyle adjustments, people with asthma can lead active, fulfilling lives. This comprehensive guide will help you take control of your asthma and breathe easier.
"Well-controlled asthma means you can exercise, work, sleep through the night, and do everything you want to do. If your asthma is limiting your life, it's not properly controlled—and that can be changed." — Philippine College of Chest Physicians
Understanding Asthma: What Happens in Your Airways
Asthma is a chronic inflammatory condition of the airways—the tubes that carry air in and out of your lungs. In people with asthma, these airways are persistently inflamed and hypersensitive, meaning they overreact to certain triggers.
During an asthma episode, three things happen simultaneously:
- Inflammation: The airway lining swells, reducing the space for air to flow
- Bronchoconstriction: The muscles around the airways tighten, further narrowing them
- Mucus production: The airways produce excess mucus, blocking air passages
The result is the classic asthma symptoms: wheezing, coughing, chest tightness, and shortness of breath.
📊 Asthma Severity Levels
- Intermittent: Symptoms less than twice a week, no interference with normal activities
- Mild Persistent: Symptoms more than twice a week but not daily, minor limitation of activities
- Moderate Persistent: Daily symptoms, some limitation of activities, nighttime symptoms weekly
- Severe Persistent: Symptoms throughout the day, extremely limited activities, frequent nighttime symptoms
Common Asthma Triggers in the Philippines
Identifying and avoiding your triggers is essential for asthma control. Common triggers in the Philippine setting include:
Environmental Triggers
- Air pollution: Vehicle emissions, industrial smoke, and poor air quality in Metro Manila and other urban areas consistently rank among the worst in Asia
- Dust mites: These microscopic creatures thrive in the Philippines' humid climate and are found in mattresses, pillows, carpets, and upholstered furniture
- Cockroach allergens: Cockroach droppings and body parts are powerful asthma triggers, especially in urban areas
- Mold and mildew: Flourish in damp conditions common during rainy season
- Pet dander: From cats, dogs, and other furry animals
Indoor Air Quality Issues
- Cigarette smoke: Both direct smoking and secondhand smoke are major triggers
- Cooking smoke: Wood-fired cooking and fumes from frying
- Burning of trash: Common in many communities but produces irritating particles
- Strong odors: Perfumes, air fresheners, cleaning chemicals, paint fumes
- Incense and candles: Commonly used but can trigger symptoms
Other Triggers
- Weather changes: Sudden temperature drops, high humidity, thunderstorms
- Respiratory infections: Colds, flu, and other viral infections
- Exercise: Especially in cold, dry air or during high pollution days
- Emotional stress: Strong emotions can trigger or worsen symptoms
- Medications: Aspirin, NSAIDs, and beta-blockers in some people
- Food allergies: Shellfish, peanuts, and other allergens
Asthma Medications: Understanding Your Treatment
Asthma medications fall into two main categories, and most people with persistent asthma need both:
1. Controller Medications (Long-term)
These medications reduce inflammation and prevent symptoms. They must be taken daily, even when you feel well.
- Inhaled corticosteroids (ICS): The most effective controllers (e.g., budesonide, fluticasone). They reduce airway inflammation over time.
- Long-acting beta-agonists (LABA): Relax airway muscles for 12+ hours. Usually combined with ICS.
- Combination inhalers: Contain both ICS and LABA in one device (e.g., Seretide, Symbicort)
- Leukotriene modifiers: Pills that block inflammatory chemicals (e.g., montelukast)
⚠️ Common Mistake: Stopping Controller Medication
Many patients stop taking their controller inhaler when they feel well, thinking they're "cured." This leads to worsening inflammation and more frequent attacks. Controller medications work by reducing background inflammation—they must be taken consistently, even during symptom-free periods.
2. Reliever Medications (Quick-relief)
These medications provide rapid relief during asthma attacks by quickly relaxing airway muscles.
- Short-acting beta-agonists (SABA): Work within minutes (e.g., salbutamol/Ventolin). The classic "rescue inhaler."
- Anticholinergics: Sometimes added for severe attacks (e.g., ipratropium)
Important: If you're using your reliever inhaler more than twice a week (aside from before exercise), your asthma isn't well-controlled, and you should see your doctor about adjusting your controller medication.
Using Your Inhaler Correctly: Step-by-Step Guide
Studies show that up to 90% of inhaler users make at least one mistake. Incorrect technique means less medication reaches your lungs. Here's the proper technique for different inhaler types:
Metered-Dose Inhaler (MDI) with Spacer
✅ Proper MDI Technique
- Remove the cap and shake the inhaler well (10-15 shakes)
- Attach the spacer if using one (recommended for all ages)
- Breathe out completely, away from the inhaler
- Place the mouthpiece between your teeth and close your lips around it
- Press the canister once while breathing in slowly and deeply (3-5 seconds)
- Hold your breath for 10 seconds (or as long as comfortable)
- Breathe out slowly through your nose
- Wait 30-60 seconds before taking a second puff if needed
- Rinse your mouth with water after using steroid inhalers to prevent thrush
Dry Powder Inhaler (DPI)
- Open the device and load the dose as instructed
- Breathe out completely, away from the device
- Place the mouthpiece in your mouth and seal your lips
- Breathe in quickly and deeply
- Remove the inhaler and hold your breath for 10 seconds
- Breathe out slowly and close the device
Creating an Asthma-Friendly Home
Since you spend significant time at home, reducing triggers there can dramatically improve your asthma control:
Bedroom Strategies
- Encase mattresses and pillows in allergen-proof covers
- Wash bedding weekly in hot water (at least 55°C/130°F)
- Remove carpets if possible; use washable rugs
- Keep pets out of the bedroom
- Use air conditioning to control humidity and filter air
- Vacuum with HEPA filter weekly
General Home Tips
- Control humidity below 50% to reduce dust mites and mold
- Fix water leaks promptly to prevent mold growth
- Avoid using air fresheners, scented candles, and incense
- Use exhaust fans when cooking
- Keep windows closed during high pollution or pollen days
- Don't allow smoking anywhere in the house
- Clean regularly to reduce cockroach and pest populations
Asthma Action Plan: Your Personalized Guide
Every person with asthma should have a written Asthma Action Plan developed with their doctor. This plan tells you:
- Green Zone (Doing Well): What medications to take daily when you're feeling good
- Yellow Zone (Caution): How to adjust medications when symptoms worsen
- Red Zone (Emergency): What to do during a severe attack and when to seek emergency care
Peak flow monitoring can help you identify worsening asthma before symptoms appear. Your doctor can help you establish your personal best and set zone boundaries.
🚨 When to Seek Emergency Care
- Severe shortness of breath—can't speak full sentences
- Lips or fingernails turning blue or gray
- No improvement after using rescue inhaler
- Rapid worsening of symptoms
- Chest feels tight and ribs are pulling in with breathing
- Peak flow reading in red zone (below 50% of personal best)
- Feeling exhausted from breathing effort
Exercise and Asthma: Yes, You Can Be Active
Many people with asthma worry about exercise, but physical activity is actually beneficial for asthma control. It strengthens respiratory muscles, improves cardiovascular fitness, and can reduce inflammation over time.
Tips for Exercising with Asthma
- Use your rescue inhaler 15-30 minutes before exercise if recommended
- Always warm up gradually for 10-15 minutes
- Exercise indoors when air quality is poor
- Avoid exercising in very cold or dry air
- Choose activities with breaks (tennis, volleyball) over continuous exertion (long-distance running)
- Swimming is often well-tolerated due to warm, humid air
- Have your rescue inhaler accessible during exercise
- Cool down gradually after exercise
Living Your Best Life with Asthma
Asthma doesn't have to limit your life. Many Olympic athletes, professional sports players, and world leaders have asthma. The key is working with your healthcare provider to achieve and maintain control.
Signs Your Asthma is Well-Controlled
- You sleep through the night without symptoms
- You can exercise without significant limitation
- You miss no school or work due to asthma
- You use your rescue inhaler less than twice a week
- You have no emergency room visits or hospitalizations
- Your peak flow readings stay in the green zone
"The goal of asthma treatment isn't just to survive attacks—it's to prevent them entirely and live without limitation. If asthma is affecting your quality of life, don't accept it as normal. Work with your doctor to find the right treatment plan." — Dr. Michael Garcia, Pulmonologist
Take Control of Your Asthma Today
Asthma is a journey, not a destination. Your symptoms and needs may change over time, requiring adjustments to your treatment plan. Stay engaged with your healthcare provider, learn your triggers, take your medications as prescribed, and don't let asthma define what you can achieve.
Breathe easy, live fully. With proper management, asthma is just a small part of who you are—not a limitation on who you can become.
