Pediatric asthma, or asthma in children, is a disorder of the respiratory system, in which the airways are swollen and narrowed, leading to difficulty in breathing. An attack of asthma occurs when the muscles surrounding the airway tighten up and the mucosal lining of the airway swells, which limits the amount of air passing through the airways into the lungs. It can be brought on by some environmental triggers like exposure to pollen.
The bothersome symptoms of asthma can interfere with daily activities like attending school, playing sports and even sleeping. Unfortunately, there is no cure for pediatric asthma, and the symptoms may persist into adulthood. But with appropriate treatment, symptoms can be kept under check, with minimal or no damage to the growing lungs.
Symptoms And Management Of Pediatric Asthma
The triggers of asthma are varied, such as animal dander or hair, medicines like aspirin, certain chemicals, dust, exercise, pollen, mold, cigarette smoke, strong emotions and viral infections like common cold.
Other factors that predispose one to asthma in childhood are low birth weight, obesity, allergic rhinitis, sinusitis, heartburn and a family history of allergic rhinitis or eczema.
The causes of pediatric asthma are not fully understood. Asthma often runs in families, suggesting the role of genes and heredity. It is seen that the airways and lungs become inflamed upon exposure to some triggers like airborne pollen. In some cases, it flares up due to common cold or a respiratory infection.
Increased sensitivity of the immune system is thought to play a role, which gets triggered easily upon exposure to certain environmental factors. Sometimes, the symptoms of asthma can occur without any apparent triggers.
The main symptoms are breathing problems, such as breathlessness, gasping, trouble with breathing out and faster breathing than normal. Sometimes, coughing at night may be the only symptom, which often wakes up the child from sleep. Wheezing or whistling sound during breathing may be heard.
The child can be irritable and feel tired easily. Dark bags may be seen beneath the eyes. Emergency symptoms are bluish colour on lips and face, severe anxiety on account of difficulty in breathing, rapid pulse rate, sweating, and confusion or drowsiness.
Since there is no cure for asthma, the goal of treatment is to keep the symptoms under check all the time. Avoidance of known triggers helps a great deal. If your child is having negligible or no symptoms, hardly any or no flare-ups, no limitation of physical activity, minimal usage of quick-relief inhalers, then you can be sure that the asthma is well-controlled. Medications can be given for short-term relief or long-term control.
The medications that are usually given for short-term or quick relief of an acute asthma attack are inhaled bronchodilators like albuterol, levalbuterol and pirbuterol – their action is seen within minutes, and their effect lasts for several hours; inhaled ipratropium; and oral or IV corticosteroids like methylprednisolone and prednisone. Allergy-induced asthma requires to be treated with omalizumab, antihistamines, corticosteroids and allergy shots or immunotherapy.
Long -term treatment of asthma is with inhaled corticosteroids like fluticasone, budesonide, mometasone, beclomethasone, flunisolide, and others. Inhaled corticosteroids are the preferred and most common prescription for long-term control. Other drugs that can be used for this purpose include leukotriene modifiers like zafirlukast, montelukast and zileuton; combination inhalers like fluticasone with salmeterol, and budesonide with formoterol; and lastly, theophylline.
There is no definitive research supporting the efficacy of alternative therapies in asthma management. However, there is anecdotal evidence of their benefit.
Such therapies include breathing techniques like Buteyko technique and Papworth method, acupuncture, relaxation techniques like biofeedback and meditation, and homeopathy.
If asthma is properly managed, the child can lead a normal life. With age, the symptoms disappear altogether or occur less often. Very rarely, it can be life-threatening, so you should watch out for the emergency symptoms mentioned above.