Asthma
What is asthma?
Asthma is a disease that causes the airways of the lungs to sometimes squeeze closed. There is often excess mucus, and inflammation that can lead to scarring.
How do I know if my child has asthma?
While the typical sign of asthma is wheezing, wheezing doesn’t always mean asthma. However, wheezing regularly, or with certain triggers (cold weather, viruses, running) is possibly asthma. Other children with asthma just have a cough that doesn’t get better, have chest pain or tightness, or can’t keep up with other kids while playing.
If your child has some of these symptoms, especially if someone else in their close family has asthma, then talk to your pediatrician. Your pediatrician will want to know all about your child’s problems, how long it’s been, any family with similar problems, and if there are any other issues, such as allergies or eczema. They will also check for any other reasons for the problems, if necessary.
Sometimes, that’s all that’s needed to do a trial of asthma medication. Other times more tests are needed. These may include X Rays, pulmonary function testing, and blood tests, among others.
What causes asthma?
While we don’t know the exact mechanism that causes someone to have asthma, we do know that someone is more likely to have asthma if they have a close family member with asthma, especially a parent. Similarly, people with allergies and eczema may be more likely to get asthma. We do know that some injuries to the lungs, either from lung infections or irritants as a young child or chemicals and dusts in older people can also trigger asthma.
How is asthma treated?
For the most part asthma will be diagnosed and treated by your pediatrician. There are times, however, when treatment will be referred to a pulmonologist or other asthma specialist; if the asthma is too severe, if the diagnosis is unclear, or if the child needs treatment that general pediatricians don’t generally work with.
There are four general groups that asthma is classified into to help with treatment; mild intermittent, mild persistent, moderate persistent, and severe persistent. These are based on how often symptoms happen in the day or night, how often rescue inhalers may be used, lung function testing, and how exercise is tolerated. Visits to the hospital, and hospitalizations – especially in the ICU – also are taken into account.
Initial asthma treatment is based on what class of asthma a child has. After that, at return visits treatment can be changed depending on how the child is breathing and if there are issues with the medicines.
There are two kinds of medication used in asthma – rescue and long term control. Rescue medication is used only when the child is having an exacerbation, or acute worsening of their asthma. The most commonly known is albuterol, but others include short course oral steroids and atrovent. Overusing these medications can have serious side effects, and usually means the controller medications need to be increased.
Controller medicines are used regularly in order to keep the asthma symptoms as minimal as possible. Ideally, with controller medications the rescue medications wouldn’t need to be used at all. They also decrease the underlying inflammation that can cause scarring and permanent damage. These medicines include inhaled steroids, montelukast, and monoclonal antibody (for certain severe cases), among others.
Many times, especially in children, asthma is associated with allergies. Allergy medicines, allergy testing, and allergy shots can help in those instances.
It can also be helpful to evaluate the child’s environment for things that may trigger asthma attacks. Tobacco smoke, dust, and other air pollutants can be improved with removing sources, cleaning soft toys, and HEPA filters. Wearing a scarf across the mouth and nose can help in cold seasons. Practicing good hand hygiene can prevent some viral respiratory tract infections.
Can asthma be cured?
No. There are some children that wheeze only when they’re little, but that is not asthma. While it may have moments of more or less symptoms true asthma cannot be cured.
Bottom line.
Asthma is a chronic condition that cannot be cured. With proper treatment and monitoring, however, your child may have an active, normal life.
Links.
Asthma at National Heart, Lung, and Blood Institute. Video.
Asthma at American Academy of Allergy Asthma & Immunology.
Asthma at Asthma Initiative of Michigan.
