What is asthma?
Asthma is a chronic disorder that causes spasm of the airway leading to narrowing of the air passage and attacks of cough, wheeze and breathlessness. The spasm may occur due to exposure to allergens, chemical irritants, smoke, cold air and exercise.

What is the incidence of asthma?
Asthma tends to affect about 10% of children globally. Why certain patients are susceptible to asthma is still not known.
Asthma due to allergy may also be associated with eczema, allergic rhinitis and allergic conjunctivitis. Also, allergic predisposition tends to run in families with inheritance between 40-60%. Thus, though allergic predisposition may be inherited, its manifestations may differ between parent and child.

What is the outcome of asthma in childhood?
Wheezing in the 1st 3 years on life is usually benign and is due to small airways in early life. As the airways grow, these children may become less prone to wheezing during viral infections. However, asthma due to allergic inheritance may persist later in life. Also severe asthma may also persist in adult life.

How does asthma present in a child?
In children, rather than wheezing and breathlessness, cough is the predominant symptom. Cough may recurrent and may get aggravated during sleep and exercise.

How is childhood asthma diagnosed?
Asthma in children is mainly a clinical diagnosis. Following symptoms may be suggestive of asthma:

• Recurrent episodes of wheezing
• Recurrent cough – more troublesome at night
• Cough or wheeze after exercise
• Breathing problems during a particular season
• Cough or wheeze after exposure to dust, smoke, perfume, animal fur
• Child’s cold frequently affecting the chest and takes more than 10 days to resolve
• Symptoms relieved with nebulization.

Your doctor may look for wheeze, signs of respiratory distress, associated allergic conditions such as eczema, rhinitis and hay fever. The child’s lung function may be estimated by an instrument called spirometry or peak expiratory flow meter that will measure the peak expiratory flow rate (PEFR). PEFR increases by >15% in children with asthma after treatment with bronchodilators.

However there are certain conditions that may mimic asthma such as reflux, cardiac diseases, cystic fibrosis, immunodeficiency, sinusitis and even a foreign body aspiration. But these can be ruled out by associated symptoms and clinical examination.

Last updated on 15-12-2003