Asthma in Childhood

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Category: Immunodeficiency Articles Published on Monday, 14 July 2008 Written by Yong Tsai, MD
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Asthma is one of the most common chronic inflammatory airway diseases of childhood. Approximately 75 to 80 percent of children with asthma develop symptoms prior to age 5. Childhood asthma is a disorder with genetic predisposition and a strong allergic component. Allergic disorders often occur within families, including closely linked conditions such as allergic rhinitis and atopic dermatitis.

Inhalant allergens, viral respiratory infections, irritants, exercise and cold air commonly trigger asthma. Inflamed airway passages become overactive, thus producing increased mucus, mucosal swelling, and muscle contraction. These changes produce airway obstruction, chest tightness, coughing, shortness of  breath and wheezing.

Wheezing, the characteristic symptom of adult asthma is not the most common symptom of childhood asthma. Wheezing episodes might not be noted in children until after 18 to 24 months of age. Any child who has frequent coughing (particularly at night or after exercise, or pneumonia or bronchitis) should be evaluated for asthma.

Childhood asthma is frequently triggered by airborne allergens. Eighty percent of children with asthma have significant allergies. The allergens involved are commonly indoor inhalants (dust mites, feathers, molds, pets, or insects, especially roaches) or outdoor inhalants (grasses, trees and weeds).

Food allergens are much less frequently the cause of asthma. Viral respiratory infections, including influenza, frequently trigger episodes. It is important for children with asthma to get vaccinated for the flu each year. Asthma can also be triggered by bacterial infections stemming from either the sinus or ear, which require antibiotic therapy.

Exercise or running also can trigger symptoms in children with asthma. Bronchodilator medications  used before exercise can prevent most of these episodes. Swimming seems to be the least asthma-provoking form of exercise. Cold air, too, can trigger asthmatic attacks. Precautions may be necessary to avoid inhalation of cold air in winter by wearing a special ski mask or heavy scarf, worn loosely over the nose and mouth.

Most people are not allergic to cigarette smoke, but cigarette smoke is highly irritating and can trigger an asthma attack. Secondhand smoke can also cause serious harm to children. Cigarette smoking should be avoided in the home of any child with asthma. Children frequently suffer from severe anxiety as a result of difficulty of breathing during an asthmatic attack. The parent should remain calm, encourage the child to relax and breathe easily, and give appropriate medications.

Although there is currently no cure for asthma, the majority of childhood asthma episodes are reversible and controllable. Through early diagnosis, reducing asthma triggers, and properly employing medications, including allergy shots, your child should be able to sleep, learn, play and enjoy a wonderful childhood.

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