DR AJ Morgan, Contributor
Dear Readers,
C.P. from Portmore, St. Catherine, is worried about her 4-year-old daughter who often suffers with cold and cough. A doctor told her recently that the little girl has asthma. C.P. says she is frightened that when her daughter wheezes something 'serious' could happen. C.P. asks Lifeline what can she do to cure the condition.
There is no cure for asthma. Asthma occurs in 30 per cent of children during the first three years of life. Most of the children who wheeze in infancy stop wheezing by the time they enter school. Asthma or wheezing in youngsters is often associated with viral infections, although as children grow older and become asthmatic the wheezing is found to be linked to a strong family history of the disorder as well as Atopy.
It is the one-third of children in whom wheezing persists after the age of six years who are labelled as true asthmatics. It is not possible to tell in these youngsters when they are first seen which ones are only wheezers with vital infections and which ones will persist to become adult asthmatics.
Asthma is a chronic disease associated with tissue damage and repair which leads to changes in the lung structures. Inflammatory changes occur in the airways of even mild asthmatics.
The main symptoms of asthma are wheezing, tightness in the chest associated with shortness of breath and a cough and cold. Asthma is triggered by viral infections and allergy causing substances. It can also be stimulated by external factors to which the person is sensitive such as exercise or a "cold" environment. Recurring episodes of cough and wheezing is almost always due to asthma. Cough alone might be the only sign that a child is wheezing, especially when the cough happens at night and lasts for a long time.
Lung Function Tests (spirometry) can be performed on wheezers to confirm their condition and to determine how severe the disorder is. Lung function tests are available at some doctors office, hospitals and through the services of pulmonary specialists.
Asthma treatment aims at controlling inflammation in the lungs and to a lesser extent, to cause dilation of the constricted bronchioles. This is achieved using several different types of medication which can prevent bronchospasm or reverse bronchospasm and its associated symptoms.
Cortico steroids such as Becotide, Beclaforte, Flixotide Asmacort and several others are the most effective asthma treatments available and are safe, especially in children, as they are inhaled. They improve airway and obstruction. They also help to prevent the more permanent changes to the lung tissues.
Beta-agonists (both long and short acting) such as ventolin (salbutamol), oxis, foradil and others, prevent broncho constriction and in Jamaica still often constitute first line treatment although steroid treatment is thought to be more effective in chronic asthma. The Beta-agonists are however readily available and, those such as salbutamol, are quite inexpensive. Short acting beta-agonists such as salbutamol are the drugs of choice for treating acute exacerbations of asthma and for preventing exercise induced broncho constriction.
Sodium cromoglycate (INTAL) helps to prevent the asthma response to allergens while a newer treatment, Antileukotrines, reduce broncho constriction and are extremely effective in mild to moderate asthma.
C.P. needs to talk with her family physician about asthma and to understand what are the possible triggers. She should always have treatment readily available, perhaps in the form of inhaled steroids and Beta-agonists with a "Spacer" which uses a specially designed plastic tubing with the medication being delivered at one end and the child's mouth receiving the drug at the other end.
The home environment must be kept as clean and as dust free as is possible.
