Asthma

Asthma is an inflammatory reaction along the bronchial tree. An allergic trigger or infection causes an increase in mucous, giving a cough, and small circular muscles along the lining start to tighten, giving wheezing. The person feels shortness of breath - as if he or she is breathing through a straw.

The most common cause of asthma for young children is respiratory viruses. As they attach to the respiratory lining, they induce a cascade of immune responses that trigger histamine release. This leads to increased mucous production and microscopic swelling of the lining. As immune cells migrate to the respiratory lining in response to the infection, there can be tightening of the underlying muscles, giving wheezing in the asthmatic child.

The reasons why some people wheeze and others don't are very complex. It is thought that asthmatics respond to respiratory viruses with a 'hyperactive' profile of T cells, cytokines and other immune substances. A tendency towards asthma can be inherited. The environment also plays a big role. When a child has a virus, the respiratory lining is more susceptible to airborne allergens. While a child is fighting off a bronchial infection, the T cells that have been mobilized can be turned into "allergy" cells, so that a child can become sensitized to smoke, smog and other irritants when exposed to them during a cough/cold.

Many medicines are used for asthma. Some are used to stop an attack and others are used to prevent them. Bronchodilators have been used for decades, and more recently, new medications such as inhaled steroids and leukotriene modifiers have been used to "calm" the asthmatic's overactive immune response.

Three excellent web sites for asthma are:

  • - American Assoc of Asthma, Allergy & Immunology
  • - Asthma & Allergy Foundation of America
  • - Department of Health; NY State

How to deal with an asthma attack

  • - for immediate relief, use a bronchodilator (albuterol or xopenex) to "open" the bronchial passages and repeat every 4-6 hours
  • - to calm the immune response, use a steroid (an oral steroid or inhaled form), and continue it for the next five days
  • - if an environmental trigger caused the asthma flare, remove your child from the irritant. Most asthma episodes in children are triggered by respiratory viruses, but airborne allergens, like pets or second hand smoke, can worsen wheezing.
  • - If your child is not improving with the bronchodilator and steroid, you need to take your child to the doctor or emergency room for further treatment.

In the days after an asthma flare:

  • - avoid air irritants (aerosol sprays, animals, smoke, strong perfumes, dusty places) for at least 10-14 days
  • - avoid blasts of cold, dry air, wear a scarf over your nose/mouth when outdoors in cold weather
  • - drink warm or room temperature fluids, especially those with vitamin C
  • - tea is beneficial (rose hip tea helps decrease phlegm and ceylon teas contain minute amounts of the bronchodilator, theophylline)
  • - phase out the bronchodilator as wheezing subsides (usually over a couple of days)
  • - phase out the anti-inflammatory (inhaled or liquid steroid) over three to five days
  • - if symptoms worsen, fevers arise, or there's no improvement, it is important to see the doctor again.
  • - a preventative medicine like Intal or a leukotriene inhibitor might be started if there have been recurrent bouts of it or if it was a particularly severe asthma attack.

It takes a while for people to learn about asthma and become familiar with the symptoms and various medications. It's important to ask questions and try to learn as much as you can. The majority of young children outgrow asthma, or have episodes that are fewer and farther between. Lots of research is being done on asthma. In the years to come, we can expect new medications with fewer side effects. We will also know more about asthma's causes and prevention.