Asthma is a chronic condition characterized by the inflammation of the airways to the lungs. The inflammation and narrowing of the airways releases mucus which makes it extremely difficult to breathe normally and is symptomized by coughing, wheezing and shortness of breath. The effects of asthma may be of varying degrees. For some people it is could be similar to an allergy, while for others it can cause life-threatening situations every time an asthma attack takes place. Being a chronic condition, asthma manifests itself at a very young age. And although it becomes easier to deal with the symptoms and triggers of asthma as one becomes older, the same thing is very difficult to do for children.
Asthma is one of the most common chronic illnesses in children. It occurs when small air passages in the lungs easily get inflamed and overreact to allergens and respiratory viral infections. When the muscles in the walls of the small air passages are stimulated by environmental allergens or infections, they release inflammatory agents that result in narrowing of the airways (bronchoconstriction). This obstructs airflow and leads to the symptoms of asthma.
Below are some of the symptoms which cause asthma:-
- Expiratory wheezes (a whistling sound when exhaling)Shortness of breath
- Chest tightness
- Intermittent dry cough that can wake children at night
- Less physical activity than usual because exercise can induce asthma
Causes of childhood asthma
- Family history of asthma
- Personal history of atopic dermatitis (skin allergies) or allergic rhinitis (such as hay fever)
- Exposure to air pollutants, especially cigarette smoke
- A combination of environmental exposures, inherent biologic, and genetic susceptibilities
Lifestyle changes to reduce risk of an asthma attack
- Eliminate or reduce problematic environmental exposure
- Environmental tobacco smoke elimination or reduction in home and automobiles
- Allergen exposure elimination or reduction in sensitized asthmatic patients: Animal dander: pets. Pests (rat, mice), Dust mites, cockroaches, molds.
- Other airway irritants wood or coal burning smoke strong chemical odors and perfumes
- Treat co morbid conditions like Rhinitis, sinusitis, Gastroesophageal reflux.
Dr. Sivanandam Sundaram
Aster Clinic -Al Khail
Asthma is a challenging condition, especially in children. It can affect all areas of your child’s life. In childhood asthma, the lungs and airways become easily inflamed when exposed to certain triggers, such as inhaling airborne pollen or catching a cold. Childhood asthma can cause bothersome daily symptoms that interfere with school, sports, and sleep. Children may doubt their ability to participate in sports or band. They may feel embarrassed or feel different from their peers because of the need to avoid situations that may trigger asthma.
Childhood asthma isn’t a different disease from asthma in adults, but children do face unique challenges. Asthma in children is a leading cause of emergency department visits, hospitalizations and missed school days. For some childhood asthma can’t be cured, and symptoms may continue into adulthood. But with the right treatment, you and your child can keep symptoms under control and prevent damage to growing lungs.
The underlying causes of childhood asthma aren’t fully understood. Developing an overly sensitive immune system generally plays a role. Some factors thought to be involved include: Inherited traits, Some types of airway infections at a very young age, Exposure to environmental factors, such as cigarette smoke or other air pollution, Increased immune system sensitivity causes the lungs and airways to swell and produce mucus when exposed to certain triggers.
Reaction to a trigger may be delayed, making it more difficult to identify the trigger. These triggers vary from child to child and can include:
Viral infections such as the common cold, Exposure to air pollutants, such as tobacco smoke, Allergies to dust mites, pet dander, pollen or mold, Physical activity, Weather changes or cold air and Sometimes, asthma symptoms occur with no apparent triggers.
Lifestyle and home remedies
Steps to help avoid triggers vary depending on what triggers your child’s asthma. Here are some things that may help:
-Maintain low humidity at home. If you live in a damp climate, talk to your child’s doctor about using a device to keep the air drier (dehumidifier).
-Keep indoor air clean. Have a heating and air conditioning professional check your air conditioning system every year. Change the filters in your furnace and air conditioner according to the manufacturer’s instructions.
-Reduce pet dander. If your child is allergic to dander, it’s best to avoid pets with fur or feathers.
-Keep dust to a minimum. Clean regularly and reduce dust that may aggravate nighttime symptoms by replacing certain items in your bedroom. For example, encase pillows, mattresses and box springs in dust-proof covers. Consider removing carpeting and installing hard flooring, particularly in your child’s bedroom. Use washable curtains and blinds.
-Reduce your child’s exposure to cold air. If your child’s asthma is worsened by cold, dry air, wearing a face mask outside can help
-Don’t allow smoking around your child. Exposure to tobacco smoke during infancy is a strong risk factor for childhood asthma control
-Help your child maintain a healthy weight. Being overweight can worsen asthma symptoms, and it puts your child at risk of other health problems.
Keep these tips in mind to make life as normal as possible:
-Make treatment a regular part of life. If your child has to take daily medication, don’t make a big deal out of it, it should be as routine as eating breakfast or brushing teeth.
-Use a written asthma action plan. Work with your child’s doctor to develop your child’s action plan so that your child can identify symptoms early and deal with it. Also, give a copy of it to all of your child’s caregivers, such as child care providers, teachers, coaches and the parents of your child’s friends.
-Be encouraging. Focus attention on the things your child can do, not on the things he or she can’t. Encourage normal play and activity. Don’t limit your child’s activities out of fear of an asthma attack — work with your child’s doctor to control exercise-induced symptoms.
-Be calm and in control when facing asthma symptoms. Don’t get rattled if you see asthma symptoms getting worse. Focus on your child’s asthma action plan and involve your child in each step so that he or she understands what’s happening.
Dr. Anoob Stephen
Aster Clinic, Bahrain
What is asthma?
Asthma is a chronic inflammatory disorder of the airways, characterized by recurrent, reversible, airway obstruction. Airway inflammation leads to airway hyperreactivity, which causes the airways to narrow in response to various stimuli, including allergens, exercise, and cold air.
Asthma is the most common chronic disease of childhood. Asthma accounts for more school absences and more hospitalizations than any other chronic condition.
What are causes of Asthma?
Many things can cause asthma, including
- Allergens- mold, pollen, animals
- Irritants- cigarette smoke, air pollution
- Weather- cold air, changes in weather
- Infections- flu, common cold
What are the signs and symptoms of asthma in children?
The most common symptoms of childhood asthma are coughing and wheezing.
- Coughing is typically non-productive and can frequently be the only symptom.
- Wheezing is a high-pitched whistling sound produced by turbulent airflow through narrowed airways.
Other common symptoms include:
- Difficulty breathing
- Chest tightness
- Poor exercise endurance
Symptoms are often worse with exertion or during the night, night coughs are also very common. Symptoms can also have a seasonal variation, which can be due to environmental allergies.
The physical exam in asthma is often completely normal. Occasionally, wheezing is present. In an asthma exacerbation, the respiratory rate increases, the heart rate increases, and children can look as if they are having difficulty in breathing. They may require accessory muscles to breathe.
How is asthma in children diagnosed?
The diagnosis of asthma in children is often a purely clinical diagnosis. A typical history is a child with a family history of asthma and allergies who experiences coughing and difficulty breathing when playing with friends and/or who experiences frequent bouts of bronchitis or prolonged respiratory infections. Improvement with a trial of asthma medications essentially confirms the diagnosis of asthma.
Spirometry is a breathing test to measure lung function for children around 5 years of age. The vast majority of younger children are diagnosed with asthma based on statistics.
What is the prognosis for asthma in children?
The prognosis is more in young children who wheeze with viral respiratory infections and who have no symptoms in between these episodes. Children with recurrent symptoms tend to have ongoing asthma later in life.
Can asthma in children be prevented?
While there is no certain way to prevent asthma, experts continue to look at things that may reduce a child’s chance of getting asthma.
- Controlling tobacco smoke is important because it is a major cause of asthma symptoms in children and adults. If your child has asthma, try to avoid being around others who are smoking. And ask people not to smoke in your house.
- Pregnant women who smoke cigarettes during pregnancy increase the risk for wheezing in their newborn babies.
- Avoid exposure to dust, pollens, allergic foods and keeping pet animals/ birds at home.
- Avoid sudden change in temperatures/ weathers.
- Avoid cleaning dust and carpets at home when your child is around.
- Consider keeping your child inside when air pollution levels are high.
- Other irritants in the air (such as fumes from gas, oil, or kerosene, or wood-burning stoves) can sometimes irritate the bronchial tubes. Avoiding these may reduce asthma symptoms.
Dr. Sameer (Pediatrician)
Aster Clinic, Bahrain