Asthma
Asthma belongs to the chronic allergic diseases (such as Hay fever; Atopic dermatitis). Unlike a classic allergy, which appears only when a person is exposed to a specific allergen, Asthma may worsen by many triggers. The most common of them are “Cold” (Viral infections of the upper airways) pollution, dust, cigarette smoke, air conditioners, mold and even cockroaches.  Some children with Asthma may cough after running, swimming or even laughing or crying. 
 
The inflammation, a reaction of the immune system cells inside the lungs, causes the airways to become swollen and narrow and increases production of Mucus (Phlegm) which causes the child to cough. If narrowing of airways is severe enough it will cause breathing difficulties and wheezing (the sound of air flowing through narrow airways) and rarely, can also be life threatening. 
 
How do we diagnose Asthma?
 
Asthma is quite common, especially in childhood. About 7 – 10% of children may experience Asthma. 
 
The most common symptom of Asthma is a cough that goes on and on and doesn’t improve. But cough can be caused by many other reasons (Infections, like Flu or Sinusitis; Irritants like dust smoke or pollution; Allergies; and even Gastric reflux) it is sometimes difficult to differentiate between a simple cough and Asthma. 
 
In Adults, diagnosing Asthma is usually easier. We can perform a “Lung function capacity test” that measures the lung volume and flow of air and can indicate Asthma. In children, it’s impossible to perform this test due to lack of proper compliance. 
 
To diagnose a child with Asthma we need to consider many factors: 
  
  • Pattern of cough: Prolonged coughing, a cough that worsens at night, a cough that worsens after physical activities, a cough that causes vomiting - All are typical of Asthma cough.
  •  History of other Atopic conditions: If the child suffers from Atopic Dermatitis or Allergic Rhinitis – it raises the suspicion of Asthma.
  • History of special infections: Bronchiolitis infection in the past increases the risk to develop Asthma. Recurrent Pneumonia might be caused by untreated Asthma.
  • Antibiotic use: There is a strong relation between antibiotic treatment and development of Asthma. The younger the child is and the more antibiotic courses he received – the more risk he has to develop allergies or Asthma.
  • Family history: Are other family members suffer from Asthma or Atopic conditions? Are there smokers in the family? 
  • Paracetamol use during pregnancy: Increases the risk of the baby to develop Asthma by more than twice.
  • Caesarean section delivery: Large studies show that babies who were born in CS had 79% increased risk of developing Asthma compared with babies born in a natural delivery.
  • Response to Asthma treatment: If a child responds to inhalation treatment, it highly suggests Asthma.  
      
How do we treat Asthma? 
 
The treatment of Asthma is with 2 groups of medications:
 
Bronchodilators – e.g. Ventolin, Salbutamol (By inhalation) that widen the airways. 
 
Anti inflammatory medications  – e.g. Steroids (inhaled or oral); Singulair. These medications reduce inflammation, swelling and mucus production. 
The treatment of Asthma is tailored to the child’s condition. Children may respond differently to treatment, some respond quickly while others slowly.  Some need only inhalation treatment while others will require additional oral treatment.
 
Environmental triggers should be eliminated in order to prevent recurrence or worsening of Asthma symptoms (e.g. cigarette smoking, dust, air conditioning, mold on walls etc.) 
 
For further information, please contact our doctors. 
 
Pediatrician – Family Medical Practice
 
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