brittle asthma

Hi - I'm new to the forum but not to asthma. Mine is getting worse after recent nasty chest infection. Been reading the posts with interest and would like to know what is brittle asthma?

[Hidden]

'Brittle' asthma isn't used everywhere (some hospitals/consultants consider it to be an old-fashioned term, preferring the term 'difficult' asthma).

There are two types of brittle asthma:

Type 1: large variation in peak flow between morning and evening readings (diurnal variation) despite maximal medical treatments

Type 2: characterised by very sudden and severe attacks on a background of reasonably stable asthma

The diagnosis of brittle asthma should only be made in a specialist centre by a consultant with special interest in difficult asthma, though the term is often thrown around quite carelessly in hospitals and by GPs. Sometimes they are clear about what it means; other times it's used to mean (interchangeably) severe asthma/unstable asthma/an asthmatic who can worsen relatively quickly. As a result of this lack of clarity, some doctors are a bit sceptical about the use of the term 'brittle', even when it's used appropriately.

In the setting of a specialist centre, it probably is a helpful term, as it can direct different management approaches, but in 'normal life' it's isn't really that helpful, though it can sometimes make doctors a bit more cautious if used. However, what they understand by the term may vary considerably! The words 'severe' or 'difficult' are probably just as good for getting people to sit up and take notice!

I'm sure you'll also get feedback from people who have an official diagnosis of brittle asthma (which I don't), but I hope this gives you a basic idea!

Wishes

[Hidden]

Wow what a thorough reply! Many thanks Wishes.

[Hidden]

hey, i have brittle asthma, and the explantion my consultant told me is that it basically means i am complicated, on maximum asthma treament, and no matter what i do, one minute i can be perfectly fine, the next i could be having a full blown attack with no warning at all!! i have to wear a medi alert necklace to.

[Hidden]

I have type 1 brittle asthma diagnosed by a specialist respiratory consultant. He says it means asthma symptoms all the time despite being on high levels of medication. It affects my daily life activities. My peak flow varies a lot throughout the day.

Plumie