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Asthma

What is asthma?

Asthma is a condition that affects the airways of the lungs and can cause difficulty in breathing. It does not always cause symptoms, however when a person with asthma has an “attack” or a flare up, it can be very frightening. Asthma attacks happen when the airways in the lungs become narrow and inflamed. It can run in families however family members may have asthma, allergic rhinitis or atopic eczema.

What are the symptoms of asthma?

  • Wheezing (whistling sound in the chest)
  • Coughing, often at night or early in the morning
  • Tightness of the chest
  • Trouble breathing
  • Coughing, wheezing or tightness of the chest with exercise or with common colds

Asthma symptoms can vary from attacks occurring daily, weekly or monthly. Symptoms can be mild to severe. Uncontrolled asthma can lead to significant impairment in quality of life, hospitalization or even death.

 

How is asthma diagnosed?

Your doctor will ask questions such as:

  • What symptoms do you or your child experience?
  • How often do you or your child experience asthma symptoms?
  • Do the symptoms wake you or your child up at night?
  • Do the symptoms keep your child from playing or going to school?
  • Do certain things make symptoms worse, like having a cold or exercising?
  • Do you or your child respond to asthma treatments?

Your doctor will examine you and look for signs of asthma such as wheezing. In between episodes of wheezing your physical examination may be normal.

Your doctor can do a lung function test to see how your lungs are working. Most children 6 years and older can do this test. This test is useful, but it is often normal if you have no symptoms at the time of the test.

In some instances, your doctor will do an allergy test to determine which allergens to avoid which may be triggering asthma attacks.

How is asthma treated?

Asthma is treated with different types of medicines.

They are usually inhaler treatments delivered with an asthma pump. Sometimes tablets and syrups may be used in addition to the inhalers.

There are two types of asthma medications

  • Reliever medication (e.g. Ventolin, Venteze, Berotec, Duovent, Atrovent)

Short-acting beta agonists (called “SABAs” or “short-acting bronchodilators”) are       quick-relief medicines. They relax the muscles around the airways. SABAs can help stop an asthma attack. Also, if you have asthma symptoms when you exercise, it can help to use a SABA 15 minutes before exercise. Some people feel shaky after taking a SABA. If this happens, your doctor or nurse might tell you to use just one puff next time or he/she might give you a different inhaler. These medicines should only be used for quick relief of symptoms. They should not be used on a long-term basis. If you regularly need these medicines more than twice a week you have uncontrolled asthma.

  • Controller medicines (Flixotide, Budeflam, Symbicord, Vannair, Seretide, Foxair, Alvesco.)

These are inhaled steroids. They reduce inflammation in the airways. They can take a few days to work, so you will not feel the effect right away. Some of the inhaled steroids are combined with a long acting bronchodilator. These are called combination therapy and are highly effective for asthma control.  They help prevent symptoms and asthma attacks. They also help keep asthma from damaging the lungs.

Inhaled steroids come in different kinds of inhalers. The steroids used to treat asthma are safe if used in the right doses. It is exceedingly rare for these medicines to cause side effects. The doctor will give the lowest dose that works well. This reduces the chances of any side effects. The side effects could be hoarseness of the voice or oral thrush. The oral thrush can be prevented by gargling the mouth with water and spitting it out after each inhaler use. These medications are used on a long term basis. They control asthma and prevent future symptoms. These medications are used daily to prevent symptoms.

 

Leukotriene modifiers: (Singulair, Montair, Sintair, Topraz)

These are tablets and sprinkles available in different doses. Your doctor will choose the right dose and formulation. They reduce inflammation and mucus and relax the muscles around the airways. These medicines are used alone or in combination with the inhalers. They are safe but as strong as inhaled steroid medicines.

 

Spacers

Almost all children with asthma use an inhaler with a device called a “spacer.” We use an aerochamber (different according to age group) or a Vortex spacer for children.

Home Nebulizers

We do not recommend home nebulizers for asthma since it may make asthma worse. If you or your child needs nebulization it should be done in hospital with oxygen.

Medication Adherence

It is especially important that you take your asthma medication as prescribed by your doctor since failure to do so may exacerbate asthma symptoms. Asthma that is not treated with the right medicines can:

  • Prevent you or your child from participating in normal activities, such as playing sports.
  • Make children miss school.
  • Damage the lungs.

Can asthma symptoms be prevented?

You can prevent asthma symptoms by taking your medication regularly. It is also important to avoid triggers that make asthma worse.

Some common triggers include:

  • Viral respiratory tract infections like the common cold and flu.
  • Allergens (such as dust mites; moulds; furry animals; including cats and dogs and pollen from trees, grass and weeds). These can be determined by the allergy test.
  • Cigarette smoke
  • Exercise
  • Changes in weather, cold air, hot and humid air.

Can children outgrow asthma?

Some children do outgrow asthma and some do not. It is exceedingly difficult to predict if your child is going to outgrow their asthma.