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Asthma

What is asthma?

Children's asthma is a respiratory disorder that is chronic or ongoing with time and is caused by narrowing or obstruction of the airways or breathing tubes.

The obstruction is caused by three processes:

  • Inflammation of the airways leads to swelling.
  • Clogging of the airways is caused by mucus or phlegm.
  • Tightening of the airways occurs with constriction or narrowing of the muscles in the breathing tubes.

How is asthma in children treated?

After the diagnosis of pediatric asthma is established, children are categorized into groups by the frequency of their symptoms. Asthma education is then initiated to help families and patients to understand symptoms and treatment plans. Issues of environmental control are discussed that relate to specific family conditions.

Medications are then often prescribed for long term control or for quick relief.

Long-term control medicines are used daily and help to control inflammation.

This group includes:

  • inhaled steroids
  • inhaled cromolyn sodium
  • inhaled nedocromil sodium
  • long acting beta agonists
  • oral medications called leukotriene modifiers
  • IgE blockers

Quick relief medications are given to relieve acute or new symptoms.

These include:

  • inhaled or oral albuterol
  • oral steroids

Goals of asthma treatment include:

  • Closely monitor asthma symptoms and maintain a scheduled plan of asthma care.
  • Treat any additional physical problems that may cause asthma, for example, chronic nasal symptoms, sinusitis, or gastroesophageal reflux.
  • Identify potential triggers and reduce or eliminate exposure.
  • Develop a treament plan for chronic or daily care and a specific plan for increased asthma episodes that is tailored to the child and the family.
  • Allow participation in activities to the fullest of the child's ability.

What are the symptoms

Asthma by definition is recurrent and reversible episodes of airway obstruction.

Symptoms include:

  • cough
  • wheezing described as a whistling sound heard on exhalation or breathing air out
  • chest tightness
  • breathlessness or shortness of breath
  • tired feeling or lack of energy
  • feeling short of breath with activity or exercise

What causes asthma?

Increased sensitivity or reactivity of the airways causes asthma. This increased airway sensitivity causes the inflammation or swelling, mucous production and bronchial tube narrowing. Certain substances or events can initiate an asthma episode and are called triggers.

Some common triggers include:

  • Allergies such as: cat or dog dander, dust or dust mites, molds, cockroaches, grasses or other plants
  • Upper respiratory infections
  • Inhaled cigarette smoke
  • Strong colognes or chemical smells in cleaning products
  • Environmental effects like cold air or high humidity
  • Exercise or strenuous activity
  • Emotional stresses (can include laughter)

Exposures to these triggers can often increase the asthma symptoms and can lead to an asthma episode.

How is asthma diagnosed?

Asthma is usually diagnosed by a thorough history of previous or present symptoms and by findings on physical examination. Often, medical records of documented symptoms or physical findings are helpful.

Pulmonary function tests which measure airway obstruction or flows can also be very helpful at the time of diagnosis and can be used as a method of following the progress of asthma treatment.

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