Asthma is the most common chronic disease of childhood.
The hallmark of asthma is airway inflammation.
Asthma is a disease characterized by a history of recurrent cough, wheeze, shortness of breath or tightness of chest that occurs with exposure to viral infections,exercise, aeroallergens, irritants, emotional factors that results in airway obstruction, that is relieved by a broncho-dilator.
The typical pattern is short, recurrent exacerbations of cough/wheeze(vary in severity and duration) separated by long symptom –free intervals.
The large and the small airways are narrowed in asthma. Airway narrowing occurs secondary to mucousal oedema,mucus plugging and broncho-constriction.
Symptoms of asthma in children include:
- Recurrent cough (non productive) usually worse at night and early morning.
- Cough is often worse when the child is playing or running.
- The child may wheeze
- Shortness of breath or tightness of chest
- The child may have recurrent chest infections that take a long time to get better
- Asthma is more common in children whose mum’s or dads have asthma
- Asthma is often seen in children who are atopic or have allergies
- Asthma often responds to a bronch-dilator(beta -2-agonist) and a short course of steroids
- Asthma can be often misdiagnosed as recurrent episodes of bronchiolitis.
Signs of asthma in children:
- Often the respiratory examination is normal.
- Sometimes there is evidence of hyperinflation on chest examination or x-ray.
- Children may have signs of eczema or allergic rhinitis.
- Children can have severe difficulty in breathing.
Causes of asthma:
- Currently there is no consensus as to what causes asthma.
- Asthma can be genetic.
- Environmental factors like tobacco smoke may be linked to genetic factors.
- Infective agents like Respiratory syncytial virus and rhinovirus are linked to asthma.
Treatment of asthma:
- Asthma can be controlled using medication.
- Controller medication needs to be taken twice a day every day.
- Technique of administration of inhaled corticosteroid is the cornerstone of asthma management.
- There are corticosteroids and leukotriene receptor anatagonists that can help to control asthma.
- Corticosteroids are given to children via a valve holding chamber by the inhalational route and sometimes orally if the child is very ill.
- These drugs are the mainstay of treatment for asthma.
- They help to control the inflammatory response and decrease cough,shortness of breath and wheeze.
- They can work as soon as 2 weeks but usually need to be taken for 8 weeks before an effect is seen.
- Reliever is used to reverse the airway narrowing that occurs in asthma.
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