Asthma is a common illness that affects mainly lower airway structures. Its incidence varies widely since it is largely affected by environmental factors. Exposure to environmental toxins such as air pollutants and tobacco smoke, contribute directly and indirectly to airway inflammation, a large component of this disease and the so called “asthma attack”.
When a patient has an asthma exacerbation (i.e. “attack”), the airways react with inflammation, narrowing, increase in mucus production and edema. This in turn, leads to obstruction, thus making that characteristic wheezing sound. Keep in mind that coughing and wheezing are not specific of asthma, therefore not every child that wheezes, has asthma. Furthermore, epidemiologic studies of asthma have found that wheezing is a common symptom in preschool children and that most of these children will not develop asthma.
Other clinical symptoms associated with asthma include chest tightness, shortness of breath and decreased exercise tolerance.
Before a formal diagnosis of asthma is made, a patient requires an evaluation with pulmonary Function test. This test can be done approximately at age 6 or older, age at which the child best follows directions and understands how to perform this test. Before this age, diagnosis is largely clinical.
Testing for allergies can help us detect previously unknown triggers or confirm suspected triggers. Most asthmatic children have positive allergy skin test results. It is important to interpret the results in the clinical context. For example, if a skin test result is negative for dog extract but playing with a dog elicits coughing and wheezing at home, the clinical observation cannot be discounted and needs to be taken into consideration.
Common triggers for asthma exacerbations are viral respiratory infections, exercise, weather changes, and exposure to tobacco or other smoke, cold or hot air, strong perfumes, etc.
Good asthma control will ensure less limitation in activities of daily living. Good control starts with proper education. Prevent frequent flare ups by taking your medication and ensuring you have an asthma action plan. Is your child’s asthma under control?