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Asthma in childhood
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
By Dr. Yong H. Tsai
Published in The Daytona Beach News-Journal
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