Asthma is a chronic inflammatory condition of the small airways of the lungs that affects more than 5 percent of children under 18 years old. It is the most common chronic illness of school-age children and is one of the leading causes of school absences.
The most common symptom associated with asthma is wheezing. Cough, shortness of breath, or chest pain or tightness may sometimes be the only symptom to suggest asthma. Obviously, not all children who cough have asthma, but if cough persists, a detailed history and physical exam is usually sufficient for a diagnosis to be made. If there is continued doubt, more sophisticated lung function tests may be performed by a specialist to clarify the cause.
Fortunately not all children who have an episode of wheezing will develop asthma. The usual cause is a viral upper respiratory infection. The likelihood of asthma being present in a child is greater if one or both parents have asthma, if the child has shown signs of allergic diseases such as eczema or hay fever, or if the child wheezes when they have no signs of a cold.
The importance of an accurate diagnosis is for effective treatment. The treatment plan developed by your physician will take into consideration several factors. Amongst these are the age of the child, the frequency and severity of exacerbations, and the nature of any known triggers. Treatment medications are divided into two main categories. Quick-relief medications, which are used during acute wheezing episodes and control medications, which are used to minimize the frequency and severity of these episodes.
The most commonly used quick-relief medication is albuterol or a chemically very similar medication levalbuterol. These medicines are inhaled and work quickly, and in most cases effectively, to relax the smooth muscles in the small airways of lungs and relieve wheezing. They are the treatment of choice during an acute exacerbation. They should not, however, be used as the only medication in moderate to severe asthma. Frequent, prolonged use of these medications reduces their effectiveness and can lead to difficulties in managing the disease. In addition to these inhaled bronchodilators, oral steroid medicines are often prescribed during wheezing episodes.
Long-term control medications include a variety of products which work to reduce the inflammation associated with asthma. Amongst the most commonly used are a variety of inhaled steroid medications. Inhaled steroids minimize the side-effects of long-term oral steroid use and are most effective when used daily. There are an increasing number of newer non-steroidal medications, taken orally or inhaled, that are also used daily to minimize asthma symptoms.
Developing and understanding a treatment plan for your child’s asthma is the most important factor in managing this common condition. Although there is no cure, effective treatment can ensure a normal, unrestricted and active life.
Dr. Charles Kisabeth
