Managing Childhood Asthma: Diagnosis and Treatment Options

Childhood asthma is a chronic respiratory condition that affects a significant number of children worldwide. It is characterized by recurrent episodes of wheezing, coughing, shortness of breath, and chest tightness, triggered by various stimuli. These symptoms may be similar to those of other childhood illnesses, such as upper respiratory infections.

Asthma is one of the most common chronic diseases of childhood, and its prevalence has been steadily increasing over the years. Around 50-80% of children with asthma develop symptoms before age five. Understanding the causes, symptoms, triggers, and management strategies of childhood asthma is crucial in providing adequate care and support for affected children, improving their quality of life, and reducing the disease burden.

What should you know about the diagnosis of asthma in children?

Diagnosing asthma in children is challenging, as it can be misunderstood with other diseases with similar symptoms, leading to both overdiagnosis and underdiagnosis. Clinical assessment is usually the primary diagnostic tool, although pulmonary function tests and allergy tests may also be used. Your child may need to undergo Lung function tests, bronchoprovocation testing, and exhaled nitric oxide testing to confirm the diagnosis. Positive immediate hypersensitivity skin tests (IgE) are typical in patients with asthma, and atopy is the most robust predictor of wheezing progression to asthma. 

Things you must know about asthma treatment in children

A comprehensive approach that includes both medication and non-medication interventions, disease education and awareness, and asthma self-care is vital in effective management. The treatment plan for asthma includes educating the patient, avoiding triggers, and using drug therapy to enable the patient to function normally without being limited by asthma symptoms.

Awareness and Education - 

The doctor advises the patients and their caregivers on recognizing and preventing triggers and the purpose of prescribed medications. The healthcare provider also emphasizes that adherence to treatment and monitoring are essential in managing asthma. 

Environmental control measures for asthma prevention may include:

• Removing carpets.

• Washing bedding and clothing weekly in hot water.

• Using specially designed covers for mattresses and pillows.

• Removing stuffed animals.

• Keeping pets outdoors.

Compliance remains a significant issue in managing pediatric asthma, with several factors contributing to this problem. Compliance issues include medication dosing frequency, the risk of asthma side effects, and medication effects. To manage these issues, your doctor may prescribe Inhalation devices, such as spacers and dry powder inhalers, for your child.

Pharmacologic treatment -

Your doctor may opt for a stepwise approach to pharmacologically manage asthma diagnosis, beginning with the most aggressive therapy necessary to achieve control. Asthma treatment aims to minimize symptoms, reduce asthma episodes, and maintain normal activities without adverse medication side effects. 

Your doctor may prescribe -

• A daily dose of Long-term control medications to maintain asthma control and prevent exacerbations 

• Quick-relief medications as acute asthma treatment and exercise-induced asthma treatment.

Collaborating with your child's healthcare provider is vital to formulate a written asthma action plan, particularly if your child has severe asthma. The plan helps in various ways, such as recognizing the need to adjust long-term control medicines, assessing treatment effectiveness, identifying signs of an asthma attack, knowing when to call a healthcare provider, and knowing when to seek emergency help. The asthma action plan may categorize asthma into zones based on symptoms and peak flow measurements such as green, yellow, and red, representing well-controlled, partly controlled, and poorly controlled symptoms. This categorization helps track your child's asthma. Children can sometimes use a peak flow meter to measure breathing ability, but they need to be coordinated and understanding. 

It is important to note that symptoms and triggers may change over time, and the healthcare provider may adjust the medication accordingly. If symptoms are under control, the provider might lower doses or stop the medication; if they are not, the provider might increase, change, or add medicines. This process is known as step-down or step-up treatment.

Tips for Asthma Management

Here are some lifestyle changes and home remedies for asthma cure to help reduce your child's exposure to asthma triggers and prevent asthma attacks:

• If you live in a damp climate, use a dehumidifier to keep the air dry.

• Get your heating and air conditioning system checked annually by a professional, and change filters regularly according to the manufacturer's instructions. Installing a filter that can trap small particles in your ventilation system is advisable.

• If your child is allergic to pet dander, avoid pets with fur or feathers, and keep them out of your child's room. Regularly bathing or grooming them can also reduce dander.

• Use air conditioning to reduce the amount of pollen, dust mites, and indoor humidity. If you don't have air conditioning, keep your windows closed during the pollen season.

• Remove or reduce dust by using dustproof covers for pillows, mattresses, and box springs, and consider removing carpeting and installing hard flooring. Use washable curtains and blinds.

• Clean your home regularly to remove dust and allergens.

• If your child's asthma is worsened by cold, dry air, have them wear a face mask outside.

Conclusion

Managing childhood asthma requires thoroughly understanding the condition and its triggers. Diagnosis can be challenging, as several other conditions can cause similar symptoms. However, working with a healthcare provider to create a written asthma action plan can help identify and manage symptoms effectively. Treatment options for childhood asthma include long-term control medications, quick-relief medications, environmental controls, and lifestyle changes. It's important to remember that treatment plans may need to be adjusted over time as a child's symptoms and triggers change, but with proper management, most children with asthma can achieve good control of their symptoms. Children with asthma can lead healthy, active lives by working closely with a healthcare provider and closely monitoring symptoms.