Thursday, September 13, 2012

Understanding Asthma

Monika Pis, PhD, CPNP

Asthma is one of the most chronic illnesses in children. According to the National Center of Health Statistics, 1 out of 7 children have asthma. Although it is unclear why, the prevalence of asthma is on the rise. Some say it may result from climate change, increased exposure to allergens, or even inadequate exposure to childhood illnesses that in the past would prepare the immune system to fight off offenders better. 

According to the National Institute of Health, boys are more likely than girls to get asthma, but girls are more likely than boys to have asthma as adults. Up to 75% of children with asthma will outgrow it in adolescence. In many other children, symptoms become less severe as they grow older. 

How do lungs work?
Your child breathes air in through the nose or mouth. The air then moves from the throat into the trachea, a windpipe leading to the lungs, where it divides into branches called bronchi. Bronchi divide further into bronchioles that end in alveoli (sacs surrounded by blood vessels). In the alveoli, oxygen exchange takes place. Oxygen that is breathed in passes into the bloodstream and gets distributed through the blood flow to all organs. On the other hand, carbon dioxide passes from the blood stream into the lung and gets exhaled.

Click here to watch a video on how lungs work. 

What happens in lungs with asthma?
Asthma is a chronic inflammatory condition of the lungs. Inflammation within the bronchioles results in a swollen airway that restricts airflow to the lungs. In addition, mucus is produced inside the airway, creating a mucus plug that partially blocks them, and muscles that line the airway may constrict, thus restrict the airflow even further. These reversible inflammatory changes in the lung result in coughing at night, as well as coughing, running out of breath, or wheezing with crying, laughing, and physical activity.

The inflammation of the airways makes them sensitive, resulting in spasms that may be brought on by various triggers. The most common triggers are allergens, smoke, pollution, exercise, cold weather, humidity, and respiratory illness. 

What are asthma symptoms?
Many children with asthma have no daily symptoms. They become symptomatic only when they are exposed to a trigger. These asthma flare-ups may come on suddenly and be severe. Other children have daily symptoms that require daily medication that keeps the inflammation in the airway under control. 

If a child persistently starts to cough, run out of breath, complains of chest tightness, or wheezes after coming in contact with a pet, after or during exercise, or when he/she goes outside when it is cold, these symptoms are suggestive of asthma. A child with asthma might cough at night when not sick, he or she might cough, run out breath, or wheeze with crying, laughing, or physical activity.

How is asthma treated?
Identifying asthma triggers allows eliminating or decreasing exposure to the known triggers, thus decreasing the frequency and severity of symptoms. All children with asthma should have a bronchodialotor available to them at all times, a rescue medication in an inhaler or a nebulizer that reverses a bronchospasm, narrowing of the airway due to the muscle spasm brought on by a trigger. Since bronchospasms may happen suddenly and unexpectedly, a bronchodialator might be life saving. 

Children who exhibit daily symptoms of asthma should see an allergist for identification of allergic triggers of their symptoms. They may need a daily anti-inflammatory medication to keep their lungs healthy.

Asthma resources for parents:

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