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Children's Health
Asthma
 Chronic asthma is a chronic
inflammatory lung disease that causes airways to tighten and narrow, causing difficulty
in breathing. It is an chronic allergic condition which often begins in early
childhood.
When the airways become irritated, they become
narrower obstructing air from moving in and out easily. Exposure to allergies,
viral infections causing cough and cold, smoke, dust and pollution causes the
mucous membranes in the small branches of the sensitive airways (bronchi) to swell
and fill with mucus which makes breathing a struggle. Asthma attacks can also
be triggered by hard physical exertion (exercise induced asthma) and can also
be related to genetics. This can cause, coughing, chest tightness, shortness of
breath and produces a wheezing sound when breathing out.
The
symptoms, frequency, severity and duration of an asthma episode vary from child
to child. Severity of the attack depends of the extent to which bronchi are narrowed.
In a severe attack, the child may be so breathless that he may not be able to
speak and may show a bluish colour of the skin and mucus membranes due to lack
of oxygen in the blood. In such cases emergency medical care is needed.
Symptoms
in children
- Wheezing sound when
breathing out
- Coughing, wheezing or breathlessness.
- Prolonged
coughing, not because of a cold, especially at night.
- Generally feeling
unwell.
- Recurrent colds from which it takes a long time to recover.
- Chest
tightness
- Increase in pulse rate.
Diagnosis
If any of the symptoms persist, you should consult
a medical practitioner whether your child has asthma. The diagnosis of asthma
involves checking whether you have a family history of asthma, medical history
of hay fever, eczema, itchy eyes, allergies, frequent colds, nasal stuffiness
and persistent cough etc. Physical examination involves examination of the nasal
passages and listening to the lungs.
Several tests
has to be done to find out the exact cause of asthma. A chest X-ray, blood test
and sputum test are usually done along with a number of other tests for evaluating
the airway responsiveness and allergies. The airway responsiveness tests include
Spirometry, exercise challenge test and methacholine inhalation tests etc and
allergy prick skin test to confirm the presence or absence of allergies. Other possible causes of shortness of breath, wheeze, cough and chest tightness
must be investigated in order to rule these out heart disease, other lung conditions
etc.
Spirometry, a breathing test which measures the amount and rate
at which air can pass through airways is a very dependable method of making a
diagnosis. But with children under the age of five years, this test is not usually
done because of the effort and cooperation required.
Treatment
If
asthma is triggered by allergy to a particular substance, one should take measures
to avoid such allergens. Treatment includes medications and drugs which are mostly
inhaled. Drugs mainly belong to two groups (a) bronchodilators which are used
to dilate the airways like Beta 2 agonists such as salbutamol, terbutaline
(short acting drugs) and longer acting drug like salmeterol etc. and Anticholinergics
such as Theophylline, not commonly used in children. These drugs are quick acting
and relieve the symptoms of wheezing, coughing and breathlessness (b) anti-inflammatory
drugs such as Corticosteroids and sodium cromoglicate which is a good first-line
preventative treatment in children.
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