- Is an allergic respiratory condition.
- There is difficulty in breathing out( Imagine blowing through a straw- the narrower it gets, the more difficult it becomes.)
- Generally runs in family. There is a history of parents or grandparents with a wheeze.
- Breathless/ fast short breaths
- A cough
- Wheeze( can present as sound-like blowing through narrow tube)
This is an allergic reaction – hence avoiding allergens help to control
- There is no permanent treatment but adequate control
- There are various types of treatment. and regular evaluation is required by medical professionals to tailor the right treatment.
- Visits should be at least once in 3 months( Unless urgent)
- There are periods where child is better and certain times when its worse
- There are triggers for worsening the wheeze
- Identifying and avoiding these triggers( See skin testing -below) help to control better
- In babies, wheeze can be caused by viruses( Hence its called virus-induced wheeze)
- Asthma is more of a clinical diagnosis assisted with some imaging/ blood test
- Chest X-ray – Your doctor can ask for it, mainly to confirm the diagnosis and rule out other conditions.
- Skin testing- Small amounts of allergy-causing particles are injected into the skin and the allergic reaction is noted.
- Spirometer- child is asked to blow through a tube. Like discussed above, the severe the wheeze(narrower tube) , the less air that can be blown out.
COMMON TRIGGERS( ALLERGENS)
- House dust mites
- Animal fur /pollen
- Smoke/ exercise
- Viral infections
UNDERSTANDING THE TREATMENT
- Good control takes multiple visits to the doctor.
- The treatment should be tailored(Customised) to each child
- The treatment is done in stages(The more frequent the symptoms, the more stronger the treatment)
- The child can be slowly weaned off the treatment and restarted when he develops first symptom( Cough/ breathlessness/ fever)
- The first line of treatment is to reverse the narrowing of tubes in lungs so child can breathe easily.
- Next if to prevent severe symptoms. Since it is most times an allergic reactions, the treatment focuses on using anti allergens( Steroids/ montelukast medication)
There are mostly 2 methods of treatment
- INHALERS-The medication should reach the lungs, hence inhalers are used.
- Oral syrups- like steroid/ anti allergens- takes longer to act but long lasting action.
Inhalers(Salbutamol or blue inhaler/ Atrovent or Ipratropium brown inhaler / steroid inhalers)
- Very fast acting
- Hence first line of treatment
- Dose depending on the age( Ask your doctor)
- Causes hyper excitability. can be given frequently – 4 hourly.
- The doses should be gradually reduced over period of days because the symptoms can rebound otherwise
- Child should carry this always
- Can be given simultaneously with salbutamol
- Ask your doctor for dose and frequency
- Generally prescribed when child has frequent symptoms
- Can be used for months together (like in rainy/ winter seasons where asthma gets worse)
- Prescribed by your doctor.
- Like oral steroids( For 3-5 days), montelukast( continued for weeks to months)
- In hospital setting in severe conditions