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Asthma and coughing in children: prevention and treatment

Posted by hospital | Posted in Pediatrics | Posted on 07-02-2013

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Asthma is one of the most common chronic respiratory diseases found in children.  It is characterized by the presence of certain symptoms and a positive outcome in a series of diagnostic tests. Though there is no way to prevent its onset, what we can do is improve our control over the disorder thus that the children it affects can go about their lives normally.

The main symptoms that define asthma are episodes of coughing and respiratory difficulties. It is a disease that can appear at random, perhaps once or multiple times a year in the form of persistent coughing, either during exercise or while resting. However, in some cases—for example, when asthma is triggered by seasonal allergies—it tends to arise around the same time each year.

While it is true that not every coughing episode is linked to asthma, it is important to point out that coughing is still the main sign that parents must rely upon to prevent asthma attacks in their children. This is because other signs, such as tight chest or neck muscles, shortness of breath, or wheezing, appear once asthma attacks have already become more advanced.

Any child under the age of three who starts to have repeated bronchial problems and whose family has a history of asthma should be closely monitored until he or she is old enough to undergo the diagnostic tests for asthma. Although it is still under review, thus far it looks like children who have a (nuclear) family history of the disease are more likely to get it at some point in the future. In addition, in all cases, it is clear that an early diagnosis in children can help prevent the disorder from advancing further, as well as preclude the appearance of additional symptoms such as chest tightness or an elevated heart rate.

“How is asthma diagnosed?” is one of the most common questions asked by concerned parents who come to appointments wondering if their children might have this respiratory disease.  Specialized medical care, a detailed study of each child’s medical history, and precise diagnostic tests are the tools used to detect asthma. With regard to how it is treated, there are two main forms of medication: quick-relief medications used to treat acute symptoms and long-term control medications used to prevent further exacerbation, keeping crises to a minimum.

The most effective treatments for asthma attacks are the short-acting bronchodilators salbutamol and terbutaline. These inhaled medications reverse bronchoconstriction and are best for treating sudden, severe asthma symptoms. Furthermore, there are studies that indicate that adding inhaled corticosteroids like budesonide to this treatment can improve its efficacy since the corticosteroids decrease the bronchial inflammation that always accompanies an acute asthma attack. In the cases of particularly serious asthma attacks, these inhaled medications can be complemented with oral corticosteroids. In short, asthma is typically treated with bronchodilators and, as a bronchial anti-inflammatory, corticosteroids.

Long-term control of asthma is generally sought via medications that act on the origin(s) of the problem, such as allergies or inflammation. There are many options for treatment that can be considered depending on the individual medical history of each patient; some examples are montelukast and inhaled corticosteroids.

In Pediatrics Services at Xanit International Hospital, we use an indicator called the “asthma predictive index” to help us determine what type of treatment and monitoring is appropriate for each individual patient. Spirometry  is one of the most important of the allergy and other tests we use for asthma detection. It is sometimes done in the form of a post bronchodilator test and at times a measurement of the fraction of exhaled nitric oxide (FeNOx) is taken. It is important to point out that, of these tests, the latter is the only one that is suitable for children under the age of four.

Once your child’s asthma has been diagnosed, personalized monitoring of his or her condition is essential in order to make sure the proper tests are administered and to ensure the appropriate long-term treatment.

In sum, that is how we help children with asthma enjoy their lives!

Dr. Carlos Hermoso Torregrosa

Pediatric Lung Specialist at Xanit International Hospital

Dr. Francisco Jesús García

Head of Pediatric Services at Xanit International Hospital