Wednesday, October 25, 2006
A stubborn cough can be a sign of asthma
Now that fall is here, I see many cases of asthma in my office. Here is an example:
John, a 10-year-old, was practicing for the “mile run” and was unable to complete it because he ran out of breath and was coughing.
I see John in my office and discover that he has never wheezed before. However his “colds” last a long time. John’s mother said “his colds always last for weeks. Many of the times they go down to his chest.” I notice that John’s mother also coughs occasionally, and denies having asthma or allergies herself or anybody else in the family. I also learn that they have a cat and a dog in their house, and John’s parents smoked.
Asthma, or Reactive Airways Disease, is a common problem and remains one of the more under recognized conditions affecting children of all ages.
What is Asthma?
Asthma is a chronic or long-term disease of the airways. The small tubes that carry air to the deep parts of lungs generally become narrow and inflamed. There is excess mucus production which is very sticky and further narrows the airways. It is very hard to clear this thick sticky mucous, especially in children who do not have big muscles or large lung volume to generate the force needed to bring it out. Children tend to gag or throw up with an episode of continuous coughing. This type of symptom is very typical of asthma in young children – especially infants and toddlers.
Who gets Asthma?
Asthma is a common childhood condition. In the United States, 10-15 percent of children in school have or have had asthma, and it is a significant reason for absences. The number of children with asthma is increasing, and the reasons for these increases are not exactly clear.
Having parents that suffer from asthma and allergies, having pets such as cats and dogs and exposure to second hand cigarette smoke increases the risk of developing asthma. Another childhood viral infection that is common during winter months, known as respiratory syncytial virus (RSV), is also known to increase the risk. Children with asthma do not necessarily have to wheeze. Cough alone can be a common symptom of asthma as illustrated above. The lingering cough after a cold could be a mild form of asthma. Further, as happened with John, strenuous activity can bring on airway narrowing.
How is Asthma diagnosed?
Doctors usually are able to diagnose asthma from gathering all the pertinent information and by examination of the patient. Simple tests can be used to demonstrate the airway narrowing; and reversal of this narrowing with appropriate inhaled medications is a good tool. Chest X-rays are not necessary.
How is Asthma treated?
Treatment of asthma has come a long way from the early days. Typically doctors use an inhaled medication known as Albuterol, or something similar, which helps in relieving airway narrowing. In infants and toddlers, this can be achieved by the use of nebulizers that deliver the medicine in a mist form. For some, as in the case of John, use of an inhaler prior to the strenuous activity is advised.
If your child has asthma symptoms more than twice a week, there are other medications that can be utilized. These medications reduce the airway inflammation and hyper reactivity. Avoiding exposure to dust and cigarette smoke also helps.
If this seems familiar to you or you know someone that suffers from similar symptoms, talk to your doctor. Do not just assume you have a cold and are passing it around in family. It could be more than that.
Ravi Prakash, MD, is Chief of Pediatrics at Backus Hospital with a private pediatric office in Norwich. This column, which runs in the Norwich Bulletin newspaper on Tuesdays, should not replace advice or instruction from your personal physician. E-mail Dr. Prakash and all of the Healthy Living columnists at healthyliving@wwbh.org
John, a 10-year-old, was practicing for the “mile run” and was unable to complete it because he ran out of breath and was coughing.
I see John in my office and discover that he has never wheezed before. However his “colds” last a long time. John’s mother said “his colds always last for weeks. Many of the times they go down to his chest.” I notice that John’s mother also coughs occasionally, and denies having asthma or allergies herself or anybody else in the family. I also learn that they have a cat and a dog in their house, and John’s parents smoked.
Asthma, or Reactive Airways Disease, is a common problem and remains one of the more under recognized conditions affecting children of all ages.
What is Asthma?
Asthma is a chronic or long-term disease of the airways. The small tubes that carry air to the deep parts of lungs generally become narrow and inflamed. There is excess mucus production which is very sticky and further narrows the airways. It is very hard to clear this thick sticky mucous, especially in children who do not have big muscles or large lung volume to generate the force needed to bring it out. Children tend to gag or throw up with an episode of continuous coughing. This type of symptom is very typical of asthma in young children – especially infants and toddlers.
Who gets Asthma?
Asthma is a common childhood condition. In the United States, 10-15 percent of children in school have or have had asthma, and it is a significant reason for absences. The number of children with asthma is increasing, and the reasons for these increases are not exactly clear.
Having parents that suffer from asthma and allergies, having pets such as cats and dogs and exposure to second hand cigarette smoke increases the risk of developing asthma. Another childhood viral infection that is common during winter months, known as respiratory syncytial virus (RSV), is also known to increase the risk. Children with asthma do not necessarily have to wheeze. Cough alone can be a common symptom of asthma as illustrated above. The lingering cough after a cold could be a mild form of asthma. Further, as happened with John, strenuous activity can bring on airway narrowing.
How is Asthma diagnosed?
Doctors usually are able to diagnose asthma from gathering all the pertinent information and by examination of the patient. Simple tests can be used to demonstrate the airway narrowing; and reversal of this narrowing with appropriate inhaled medications is a good tool. Chest X-rays are not necessary.
How is Asthma treated?
Treatment of asthma has come a long way from the early days. Typically doctors use an inhaled medication known as Albuterol, or something similar, which helps in relieving airway narrowing. In infants and toddlers, this can be achieved by the use of nebulizers that deliver the medicine in a mist form. For some, as in the case of John, use of an inhaler prior to the strenuous activity is advised.
If your child has asthma symptoms more than twice a week, there are other medications that can be utilized. These medications reduce the airway inflammation and hyper reactivity. Avoiding exposure to dust and cigarette smoke also helps.
If this seems familiar to you or you know someone that suffers from similar symptoms, talk to your doctor. Do not just assume you have a cold and are passing it around in family. It could be more than that.
Ravi Prakash, MD, is Chief of Pediatrics at Backus Hospital with a private pediatric office in Norwich. This column, which runs in the Norwich Bulletin newspaper on Tuesdays, should not replace advice or instruction from your personal physician. E-mail Dr. Prakash and all of the Healthy Living columnists at healthyliving@wwbh.org
# posted by ----------------- @ 4:41 PM 
