Causes and risk factors
An overly sensitive immune system is the main cause for developing asthma in children. Some factors that may cause to develop childhood asthma are inherited traits, airway infections at a very young age, exposure to environmental factors. When there is increased immune system sensitivity, it causes the lungs and airways to swell and produce mucus when exposed to certain triggers like viral infections such as the common cold, exposure to air pollutants, such as tobacco smoke, allergies to dust mites, pet dander, pollen, weather changes or cold air, physical activity, strong emotions, chemicals in the air and food. Children have small and narrow airways than adults, which makes asthma especially serious for children. Risk factors that may increase child’s likelihood of developing asthma include previous allergic reactions, including skin reactions, food allergies or hay fever (allergic rhinitis), sinusitis, family history of asthma, allergic rhinitis, hives or eczema, low birth weight, obesity, chronic runny or stuffy nose (rhinitis), severe lower respiratory tract infection, such as pneumonia.
Clinical presentation
Frequent, intermittent coughing, whistling or wheezing sound when exhaling, shortness of breath, chest congestion or tightness, chest pain are the presenting symptoms. Other signs and symptoms include disturbed sleep caused by shortness of breath, coughing or wheezing, bouts of coughing that gets worse with a respiratory infection, such as cold or flu, delayed recovery or bronchitis after a respiratory infection, trouble breathing that may limit play or exercise, fatigue, which can be caused by poor sleep, persistent night-time cough is a common sign of asthma. Symptoms like difficulty in breathing, bluish colour to the lips and face [cyanosis], severe anxiety due to shortness of breath, rapid pulse, sweating, decreased level of alertness, severe drowsiness or confusion may be seen during attack of asthma.
Investigation
Medical history by the patient and Clinical examination by the paediatrician helps in diagnosis. Investigations include chest x-ray, haemogram for eosinophil count, pulmonary function test, peak flow measurements, and arterial blood gas measurement.
Treatment
Treatment involves both preventing symptoms and treating an asthma attack. The treatment is focused on keeping the symptoms under control. It includes avoiding triggers, using medications such as bronchodilators. Long-term control medications reduce the inflammation in the airways that cause asthma. The Quick-relief medications help to open the swollen airways that limit breathing. Sometimes, medications are required to treat allergies. These medications depend on child’s age, symptoms, asthma triggers. Long-term control medications need to be taken every day. Types of long-term control medications include Inhaled corticosteroids. Quick-relief medications are needed for rapid, short-term symptom relief during an asthma attack, before exercise if child’s doctor recommends it. These inhaled bronchodilators can rapidly ease symptoms during an asthma attack. These medications act within minutes, and effects last several hours. Oral and intravenous corticosteroids relieve airway inflammation caused by severe asthma. Treatment for allergy-induced asthma include oral and nasal spray antihistamines, decongestants as well as corticosteroids. Immunotherapy injections are generally given once a week for a few months, then once a month for a period of three to five years.
Other Modes of treatment
The other modes of treatment can also be effective in treating childhood asthma. Homoeopathy is a science which deals with individualization considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly the ayurvedic system of medicine which uses herbal medicines and synthetic derivates are also found to be effective in treating childhood asthma.
