Asthma

What is asthma?

Asthma is a condition which occurs when the upper airways constrict as a result of a particular trigger, for example an extreme reaction to some sort of allergen/stimulus such as viral infections, pollen, or even sometimes overwhelming stress or exercise.

Asthma can present at any age though it is usually not diagnosed in early childhood (especially infants) unless there is a strong family history, and typical recurrent symptoms. Many young children with asthma present symptoms similar to a condition called ‘viral induced wheeze’ which does not necessarily lead to asthma.

There is usually a family history of some sort of atopic disorder such as hay fever, eczema or other allergy.

What are the symptoms?

The child typically presents with a wheeze (a musical sound when breathing out). This sound is produced because the airway is constricted while air is breathed out. This may be associated with other symptoms such as difficulty in breathing, feeling tired and fatigued.

In severe cases this may produce exhaustion when the child starts getting extremely fatigued, meaning they may need further support such as oxygen and medication to dilate the airways.

How is it diagnosed?

Asthma is mostly a diagnosis made on basis of history and clinical findings. In clinical settings, children often have their breathing tested through examinations such as peak flow measurement, and sometimes lung function tests.

A chest X-ray can sometimes be requested in severe cases, however it is not a recommended test for diagnosis.

Treatment for asthma

There are usually 2 types of medication used:

  1. Reliever: an inhaler used to dilate the airways
  2. Preventer: an inhaler used to suppress the hyper-reactive process and inflammation.

There are also other medications known as immuno-modulators which can be used to target the process and stabilise the reactive cells causing the symptoms of asthma.

Children with severe presentation of asthma often need other supportive treatment measures such as oxygen, or in a minority of cases, a respiratory support.

Can asthma be prevented?

While the onset of the process of asthma is mostly intrinsic, an onset can be prevented by avoiding/reducing the contact with the allergens if known and possible, and taking the medications regularly as advised by the doctor.

Steroid inhaler, if prescribed, helps in preventing the further triggers if taken regularly long term, and on the doctor’s/asthma nurse’s advice.

Immuno-modulators, which suppress the process of hyper-reactivity in the airways, can help in children whose symptoms present at night, or in children who experience exercise-induced symptoms.

Can it be cured?

Many children grow out of this condition before adulthood. However, this depends on the individual and asthma can be a long-term condition.

What is the prognosis?

Asthma is usually a well-manageable condition and is not life threatening if timely treated. It is very important to recognise the symptoms, and get a doctor’s help in a timely manner.

Which specialist treats asthma?

In addition to paediatricians and respiratory specialists, in the UK there are many specialist asthma nurses who work in clinics and hospitals around the country, providing information and education to parents and children.

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