Understanding Adolescence
Teen takes
Dr. S. YAMUNA
|
Adolescents manage to remain healthy most of the time. But sometimes they do suffer from respiratory ailments.
|
During adolescence, boys and girls generally remain healthy. Their major concerns centre on body image. This column looks at how the respiratory system may cause problems.
Allergic Rhinitis
Sneezing, running nose, nasal block, itchy nose, itchy eyes, excessive tears, coughing and red eyes are a common group of symptoms which are present in a significant number of boys and girls in the early hours of the day. This is allergic rhinitis. This begins in adolescence. Girls are more afflicted than boys. Young adults with allergic rhinitis have recurrent sneezes, thin nasal secretions, sometimes mouth breathing and dark areas under the eyes. Some of them show irritability, poor concentration and temper tantrums. Treatment of allergic rhinitis improves the psychosocial difficulties.
Treatment includes avoidance of allergen, if known, use of antihistamines, decongestants, and topical nasal steroids as spray. If left untreated, allergic rhinitis can lead to Eustachian tube block, sinusitis, secondary bacterial infection, and nasal polyps. Nasal drops to relieve nasal block should be used only under medical supervision. Overuse can result in rhinitis medicamentosa.
Sinusitis
To improve the vocal resonance, our facial bones have air filled spaces lined by mucous membrane. These spaces are called air sinuses. We have frontal, maxillary, sphenoid and ethmoid sinuses in our skull. All the sinuses are in communication with the nasal airway. When the drainage of these sinuses is blocked as in rhinitis, the sinuses can get inflamed and thus result in sinusitis.
Running nose and nasal block, which continues beyond seven to 10 days, suggests the diagnosis of sinusitis. Metallic taste, nocturnal cough, fever, excessive tiredness, headache, pain over the upper canines and lateral incisors, pain behind the eyes which is increased by eye movement, or deep boring pain in the head on nasal blowing are some of the symptoms of sinusitis.
Sinusitis should be treated promptly. If not, it can lead to infection of the tissues surrounding eyes, facial bone infection, brain abscess and meningitis. If the symptoms continue beyond six weeks, the adolescent would develop chronic sinusitis, which is responsible for loss of man-hours, school absenteeism and scholastic backwardness.
Treatment includes rest, hydration (six to eight glasses of water per day), painkillers, antibiotics, topical corticosteroids as nasal sprays, and others. Continuation of nasal corticosteroids under medical supervision provides long-term relief from symptoms.
Bronchial asthma
Asthma is the most common chronic respiratory disorder of the adolescents. Though asthma has its onset in childhood, it either worsens or improves during adolescence. Asthma is due to hyper responsiveness of the airway to precipitants, which result in airway narrowing and breathing difficulty. Allergens like pollen, house dust mite, animal dander from pets, certain foods, cold drinks, cigarette smoking, perfumes, some drugs like aspirin, viral respiratory tract infection, cold air and exercise can bring on an attack of airway narrowing in susceptible teenagers.
Symptoms include sudden onset of shortness of breath, wheezing, choking feeling, tightness of chest, cough and feeling of suffocation. When such symptoms happen twice a week it is moderate asthma, when the symptoms happen every day it is severe asthma. Symptoms more often begin at nights or early mornings.
Inhalers form the mainstay of treatment. Relievers are bronchodilators delivered by inhalers to relieve the attack by releasing the airway narrowing. Preventors are corticosteroids to reduce the swelling and inflammation of the airway. Relievers should be used only during an acute attack. Preventors can be used long term to prevent further attacks. If the teenager finds difficulty in coordinating inspiration, he or she can use a spacer.
In exercise-induced asthma, the airway narrowing begins within 5 to 15 minutes after initiating physical exercise. The symptoms resolve spontaneously within 15 to 30 minutes after stopping exercise. Use of appropriate inhaler 15 minutes before exercise helps adolescents in continuing their athletic pursuits without attracting negative attention from peers.
Using the preventor regularly helps in maintaining a healthy state. Preventors should be stopped only on medical advice. When an adolescent goes on camps he or she ought to take a new inhaler. Use of inhaler and preventing an attack is better than experiencing an acute attack before peers. Prevention of symptoms improves the growth and self esteem of the young adult.
The author is a Consultant Paediatrician and Adolescent Physician at Apollo Hospitals and Child and Adolescent Clinic, Chennai.
Printer friendly
page
Send this article to Friends by
E-Mail
Quest
