Recognizing asthma in children is not an easy task. There are two reasons for this. One, the symptoms of asthma are also shared by several other respiratory diseases. Second, children are often not able to express their difficulty in a manner that would allow an easy diagnosis.
Asthma in children
Asthma affects a large number of children in the world. In United States alone, it is estimated to affect around 9 million children and is one of the three leading causes of school absenteeism. It is more common in households belonging to the lowest socio-economic strata, probably because of poor hygiene andfrequent infections. However, the most dangerous aspect of asthma is the fact that its incidence in children is on the rise.
Asthma in children: what is it
Asthma is a disease of respiration wherein breathing becomes difficult, strained and associated with coughing and discomfort. It happens because of the inflammation and swelling of the walls of smaller wind pipes. In the process of breathing, the inhaled wind passes first through the nose or mouth to enter the single wind pipe in neck called 'trachea', which gets divided into two 'bronchi', one on either side, in the chest. Each bronchus then gets divided and subdivided into a branched structure of 'bronchioles', which finally terminate in air spaces called 'alveoli' where exchange of oxygen and carbon dioxide takes place. The walls of these structures are lined by 'mucosal' cells which secrete mucus. When for any reason there is swelling or inflammation of this respiratory mucosa, breathing becomes difficult. In severe cases, the swelling of mucosa can block the air passage leading to a bronchial spasm.
Asthma in children: symptoms
The main symptoms of asthma include persistent or intermittent coughing, difficulty in breathing, shortness of breath, wheezing, and chest congestion or a feeling of tightness in the chest. Generally the affected child may have only one or a few of these symptoms. Thus it is important to be conscious of the possibility of asthma in all children who are having frequent cough and breathing difficulty. In many children, asthma can be silent, which means that the symptoms are mild and not apparent enough to suggest asthma till the time some other factor like infection precipitates its worsening. In many children the only symptom may be difficultyin outdoor activities like coughing or wheezing that is triggered by outdoor exercise. In many children there are frequent bouts of pneumonia or chest infection, with no intermittent symptom.
Causes of Asthma in children
It is also important to understand that asthma is a group of disorders, all of which lead to inflammation of bronchiolar mucosa and its resultant symptoms. In that sense it is not one single disease. Asthma can be caused by two main causes, infection and allergy. Infection can be the main cause of asthma or it can be a precipitating factor, and infection needs to be taken care of in most children. It can be a viral infection or a bacterial one. The most common cause however is allergy, which can be to any kind of dust, pollen, molds or pet dander. Allergy can also result from sudden temperature changes of air.
Diagnosing Asthma in children
All children having frequent coughs and respiratory difficulties need to be investigated for the possibility of asthma. But at the same time, it should also be remembered that casually placing a label of asthma on a child in a tender age and making her conscious of the fact can have a damaging psychological impact. Hence the diagnosis of asthma should not be allowed to become a psychological burden on a child, even when the necessary precautions like staying away from dust, pollen and smoke and keeping the environment at home and around is emphasized.
Treatment of Asthma in children
Asthma cannot be cured, but it can be managed with due precautions and immediate treatment in case of worsening. The treatment for it is basically of two types, one as a short term therapy to get rid of immediate symptoms, and the other is to prevent these episodes and reduce their frequency. The former consists of bronchodilator drugs, while the latter consist of those that reduce the irritability of mucosal lining and improve their strength.