Childhood asthma 2  



Childhood Asthma

Page- 1 Page-2 Page-3

Childhood Asthma is   number one chronic diseases of childhood, and is the most common cause of emergency room visit and hospitalization for the children under the age of 18 years. 
The cost of asthma related illness accounts to about $ 10 billion worldwide.
Asthma is the most common cause of school absenteeism due to chronic disease and also causes parents to miss days at work. Asthma often goes unrecognized in the children. Many children have more subtle symptoms including a night time cough, a cough that worsens with exercise or activity, or only a chronic cough that won't go away. In these children especially for infants and toddlers asthma can be hard to diagnose. Asthma cannot he cured, it can almost always be controlled.

A child can live an active life if asthma is controlled properly.

Is my child suffering from asthma


The Respiratory system is basically concerned with the exchange of gases between the air we inspire and the blood.  Lungs provide surface for transfer of gases through which blood gets rid of carbon dioxide and absorb oxygen which is vital for living. Lung is a cone shaped structure situated in the thorax; it is where the exchange of gases takes place.  
As the air passes through the nose and mouth, it is rapidly warmed and moistened. The nose and airways trap large particles (dust, pollen, molds bacteria) and chemicals (smoke. sprays, odors) which could cause serious injury to the lungs. The air is then transported through smaller airways. These airways branch like a tree forming millions of small airways that carry oxygen to the tiny air sacs called alveoli. The alveoli have network of capillaries around them. The gas exchange takes place here.  
The airways have a delicate cellular lining (mucosa), which is coated with a thin layer of mucous.   Foreign particles are trapped by the sticky mucus and are removed by the normal cleansing process present in the airways.  
The process is assisted by the movement of millions of tiny “whip like “structures called cilia. Cilia are present on the inner lining cells of the airways. Cilia move the mucus and trapped foreign particles up toward the mouth and nose where they, are coughed and sneezed out or swallowed.  
Bundles of muscles surround the airways and the contraction of these muscles allows airways to selectively direct the flow of air.

Back to top


Asthma is a chronic inflammatory condition of the bronchial (lung) airways. This inflammation causes the airways to become over-reactive to various stimuli, thus producing increased mucus, muscle swelling and muscle contraction
These changes produce airway obstruction, chest tightness, coughing and wheezing. If severe this can cause severe shortness of breath and low oxygen levels in the blood. This obstruction is partially or completely reversible with or without treatment.

Each child suffers a different level of severity. All children with asthma enjoy a reversal of symptoms until something triggers the next episode.


Childhood asthma is a disorder with genetic predisposition and is caused by complex interaction between genetic and environmental factors. Approximately 75 to 80 percent of children with asthma have significant allergic problem. As stated earlier asthma is a chronic inflammatory disease of the airways. Every asthmatic patient has some degree of inflammation of airways of the lungs. This inflammation is produced by many factors mainly allergy, viral respiratory infections and airborne irritants.

Studies indicate that allergic reactions produce both immediate and late phase (delayed) reactions. Research indicates that approximate half of the immediate allergic reactions to inhaled allergens are followed by a late phase reaction.  
This late phase reaction produces more serious injury and airway inflammation. This airway inflammation leads to Irritability or hyper responsiveness of the airways. In addition, prolonged airways, inflammation can cause scarring.

Back to top


The common asthma symptoms are wheezing, coughing, chest tightness, shortness of breath, faster or noisy breathing.  
Wheezing though characteristic of asthma, is not its most common symptom. Coughing is noted with even "hidden" asthma when wheezing may not be apparent to child’s family members or the physician.
Any child who has frequent coughing or respiratory, infections (pneumonia or bronchitis) should be evaluated for asthma.

The child who coughs after running or crying may have asthma. Coughing from asthma is often worse at night or early in the morning, making it hard to sleep. Infants who have asthma often have a ratty cough, rapid breathing and an excessive number of respiratory infections, “episodes of bronchitis” or “chest colds”.  Obvious wheezing episodes might not be noted until after 18 to 24 months of age.  
Chest tightness and shortness of breath are other symptoms of asthma that may occur alone or in combination with any of the above symptoms. Since these symptoms call occur for reasons other than asthma, other respiratory diseases must always be considered.
In a young child the discomfort or chest tightness may lead to unexplained irritability.

Note:  If your child has frequent coughing or respiratory infections (pneumonia or bronchitis) he or she should be evaluated for asthma.

During an acute episode, symptoms vary according to the severity.

Mild episode: Child may be breathless after physical activity such as walking. They can talk in sentences and lie down, and they may be agitated.

Moderate severe episode: Child is breathless while talking. Infants have feeding difficulties and a softer, shorter cry.

Severe episode: Child is breathless during rest, are not interested in feeding, sit upright, talk in words (not sentences), and are usually agitated.

Symptoms with imminent respiratory arrest
(In addition to the above symptoms), the child is drowsy and confused. However, adolescents may not have these symptoms until they are in frank respiratory failure. Absence of wheezing in severe asthma is associated with most severe airway obstruction and is a serious emergency situation.

Back to top

Next page


Last edited 24-4-2010