THE COMPLEXITY OF ASTHMA IN CHILDREN

Asthma is an inflammatory disease that affects the airways-the small tubes that carry air in and out of the lungs. Children with asthma have airways that are extra sensitive and react to substances called triggers which irritate them.

Asthma make sides of air ways in lungs inflamed and swollen Air tubes become narrow with sticky mucous. All this makes it difficult for air to go in and out of tubes.

SYMPTOMS

• Coughing
• Wheezing
• Chest tightness
• Shortness of breath
• Coughing

Dr. V.V. Ramana Prasad, Consultant Pulmonologist, KIMS Hospitals, said, “A trigger is anything that irritates the airways and causes the symptoms of asthma. Some of the triggers are dust, smoke, pollen, cold air or change in weather, strong emotions such as laughing and crying, carpets, stuffed toys, hair of animals. Asthma may coexist with dryness of skin called eczema, allergic rhinitis where the child may have snoring, running nose and mouth breathing. Asthma may be associated with food allergies. But unnecessary restriction of food is not necessary.” 

DIAGNOSIS

Making diagnosis in children is sometimes challenging because wheeze and cough are also common in children who do not have asthma.  Diagnosis of asthma is made by careful clinical examinations, history and in older children is confirmed by lung function tests. Allergy test can be done in children with allergies.

• All wheezes is not asthma
• All asthma does not wheeze

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TREATMENT

Medications are of two types,

Preventers: preventer protects child’s air tubes by making them less sensitive to asthma and triggers. Take preventers daily as advised. Preventers are inhaled corticosteroids.

Reliever: Should be used on “as and when needed”. It helps to relax the muscle. An increasing use of

relievers indicates poor control of asthma.

Inhalers are used as first line of therapy. Contrary to the belief that they are reserved for nonresponsive Asthma. Inhaler is better than tablets or syrup because very small quantity of medicine is delivered directly to the lungs. Therefore the effect is instantaneous. Inhaler dose is negligible compared to tablet as in inhalers it is in micrograms and in tablets it is milligrams. Side effect is negligible.

Inhaler should be used through spacer in children for adequate drug delivery. Smaller children require mask also.

Identifying the triggers and avoiding them, taking the right medication and regular check-up form foundation for asthma treatment.  Correct diagnosis and treatment is necessary as children with mild asthma outgrow if properly treated.

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