Asthma

What is Asthma?

Asthma is a chronic inflammatory disease that affects 1 out of 10 children in the United States and is characterized by inflammation of the lower airways and swelling of the surrounding tissues. This in turn causes air passages to narrow and can lead to wheezing and difficulty breathing.

What are the Signs of Asthma?

It is important to recognize asthma because of the significant effects it can have on a child's health. Children with uncontrolled asthma may have difficulty sleeping, exercising, attending school regularly, and enjoying normal childhood activities. Signs that your child may be suffering from asthma include:

  • frequent nighttime cough
  • rapid breathing or difficulty breathing that causes your child to use extra muscles in the neck, chest, and belly to push air out
  • wheezing (noisy breathing with exhaling)
  • refusing to participate in physical activity with peers

What Causes Asthma Symptoms?

In children prone to asthma a variety of triggers may lead to increased asthma symptoms, including upper respiratory infections, allergens, cigarette smoke, exercise, and cold air.

How is Asthma Treated?

Although asthma is a chronic condition, a variety of treatment options do exist. In general, controlling your child's asthma symptoms will help them to feel better and participate in physical activities normally. Many children have only occasional symptoms and thus only require medications on an occasional basis. Other children have symptoms that are frequent and severe enough that they have to take medication every day.

Medications for asthma management can generally be categorized as short-acting, quick relief medicines and long-acting, preventive controllers.

Quick relief medications act rapidly to relax muscles around the airways so that the narrowed passages can open up. Albuterol and Xopenex are the commonly used medications in this category. They help to relieve the wheezing and chest tightness that the patient may feel and are thus used primarily on an as needed basis.

Long-acting "Controller" medications are typically administered on a daily basis. Their purpose is to decrease long lasting airway inflammation and constriction, thus decreasing the number of days or nights that your child may have symptoms. It is important to remember that controller medications are NOT used for the acute relief of symptoms. However, in the midst of an asthma flair your doctor may recommend increasing the amount of controller medication your child is taking. Long-acting medications may include QVAR, Flovent, Advair, or Pulmicort.

In the midst of a severe asthma attack, some patients may also require a steroid medication to be administered by mouth for several days. These medications, including prednisone and prednisolone, quickly and significantly decrease inflammation of the airways.

When Should I Contact the Doctor?

Whenever a child has an asthma attack, they should be started on their quick relief medications right away. If their symptoms fail to improve with this medication, it is advisable to contact our office. Reasons to call the doctor sooner include: severe wheezing, labored breathing, shortness of breath, lethargy, inability to speak, bluish discoloration of the lips, or with other concerns.

Furthermore, as children grow and develop, it is possible that previously effective treatments may become inadequate. Signs that your child may need more aggressive management may include: more frequent or severe episodes of coughing, wheezing, and shortness of breath, more frequent visits to our office or the Emergency Department, or a failure to respond to the usual treatments being administered. If these signs become evident, be certain to communicate this concern with your physician.

What Else Can be Done Beyond Medicine?

In addition to appropriate medication use, you as a parent can also work to reduce your child's exposure to potential triggers. Specifically, this can include complete elimination of cigarette smoke exposure, good hand hygiene to reduce transmission of cold viruses, and avoidance of known allergens (dust, molds, etc.).

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