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The condition of asthma (also called reactive airway disease) may be an occasional annoyance or a disruptive, frightening and at times life-threatening illness. During childhood as many as 10 percent of girls and 15 percent of boys will be affected at least once by this problem, which is the most common reason for children's admissions to hospitals in the United States. Of those affected, some will have had their first episode by the first birthday, and nearly 90 percent experience it by the age of 5. The majority of children with asthma have occasional episodes that can be treated relatively easily. But some develop severe and persistent symptoms that can be stressful for everyone in the family. Usually the more seriously afflicted children have a family history of asthma and/or allergic disease and show signs of trouble during their first year of life. At least half of all asthmatic children become symptom-free eventually - at least in part because their airways enlarge as they grow.
Asthma is characterized by a tendency of the muscles surrounding both large and small airways to undergo spasmodic contractions, resulting in coughing, wheezing or both. The events that trigger wheezing vary from person to person but can include:
- illness (especially colds, bronchitis and sinusitis)
- exercise
- emotional upset
- exposure to smoke, dust, pollen, mold, air pollution, animal danders
- cockroach infestation
- certain foods
Some teenage girls may wheeze during the days prior to their menstrual periods. Wheezing may also be provoked by certain medications such as aspirin. An important characteristic of asthma is that this spasm of constriction is reversible; with medication or time, the airway will return to normal.
Another important component of asthma is inflammation. Even when not in spasm, the inner lining of an asthmatic child's airways may be chronically inflamed with swelling, increased mucus production and large numbers of inflammatory cells. Treating the wheezing while ignoring the inflammation will usually result only in temporary improvement.
Treatment of asthma involves medications called bronchodilators, such as, albuterol (Proventil or Ventolin) or terbutaline (Brethaire). They act to immediately relieve wheezing and usually maintain improved airflow for four to six hours. These are usually taken through metered dose inhalers (MDIs), which dispense measured bursts of medication. For very young children, as well as older children with more severe asthma, a home nebulizer device may be more appropriate. This converts liquid medication into an aerosol form that is easily inhaled using a face mask or mouthpiece. It is essential to talk with a pediatrician to understand which form of treatment is best suited for your child. |
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