Asthma in children
DR.R. NARASIMHAN
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Answers to some of the frequently asked questions on childhood asthma.
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ASTHMA is still a dreaded disease despite the awareness campaigns and dissemination of information on treatment strategies. There is fear if a child is diagnosed with asthma. The parents' worry extends from the child's participation in games to studies. Here are some of the frequently asked questions onchildhood asthma.
Can my child's asthma be cured?
Asthma is not a curable disease but an eminently controllable one. Most children grow out of their wheezing spells as they grow older. It is tempting to say that a child is cured of asthma. But it is not true. Asthma is known for its symptom-free periods, which can range from months to years. This phase of remission or disappearance of symptoms should not mean that the child does not need a follow up. This phase could be spontaneous or due to years of regular anti-inflammatory treatment. Asthma can reappear in the later years due to various factors.
Does symptom-free periods mean total control? Can we stop anti-inflammatory (steroid) inhalers?
No. All children with asthma have good and bad days. Optimum control of symptoms does not mean that inhalers can be stopped. On the other hand that is the right time to come down on the dosage and capitalise on the control achieved by continuing the dosage. Your doctor is the best person to decide on this.
Are allergy tests useful in children?
Opinion is divided on the use of allergy tests and hyposensitisation treatment in children. The general opinion is to avoid allergy tests in children, as it involves many injections and hyposensitisation treatment means too many injections over two to three years. Allergy tests do not cure but only reduce the intensity and frequency of attacks. This can be achieved with ease by inhalers without any need for painful injections.
Does asthma get worse with age?
Yes if the child is not prescribed a regular anti-inflammatory inhaler or if the child is more regular with a reliever inhaler or if the child is advised against using anti-inflammatory inhaler. The regular use of reliever inhaler results in fixed airway abnormality, which makes asthma attacks difficult to control. It is believed that regular treatment with anti-inflammatory inhalers would prevent worsening of asthma.
Is the aphorism "once an asthmatic always an asthmatic" true?
Asthma is a long-term disease and not a lifelong one, as it known for its symptom free periods. Some children remain symptom-free until they reach mid-teens or adulthood. So the aphorism is true with some reservations, as it is possible to achieve control in acute asthmatics with proper medication. Asthma-related complications are not related to age but to non-compliance with the treatment.
Are steroid inhalers safe in children?
They are safe. They can cause some side effects like hoarseness of voice that can be controlled by reducing the dosage or by rinsing the mouth regularly after use. Many parents are worried about the growth caused by steroids. The normal recommended dosages of steroids do not affect the strength and height of bones.
The author is a Senior Respiratory Physician, Apollo Hospitals, Chennai. E-mail: drrnarasimhan@gmail.com
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