Bronchial asthma is a common inflammatory disease of the bronchi, in children most often of an allergic nature. The first signs of asthma usually appear in children under 5 years of age, and do not always disappear with age, but manifest symptoms of varying intensity periodically during life.
In 34% of all patients with asthma for the first time, this disease manifests itself up to 10 years. But in 80% of this number by adolescence, all manifestations of the disease disappear. In 1/5 of patients from childhood, asthma returns after 45 years.
Up to 10 years, the probability of an asthmatic attack depends largely on heredity:
- if 1 parent is sick – the risk is 30%;
- when both parents are sick, the risk of the disease is 75%.
For asthma, seasonality is important. Up to 40% of exacerbations are caused by pollen from flowering plants. Boys are ill with this disease 2-3 times more often than girls.
The probability of getting sick increases in case of:
- genetic predisposition – the most significant factor, including the regulation of the immune response (IgE synthesis), as well as the regulation of the synthesis of the enzyme that triggers the inflammatory mediators;
- hypersensitivity (sensitization) of the body to allergens – allergization at an early age, for example, house dust mite, drugs, passive smoking;
- actions of external factors triggering bronchial hyperreactivity – to inducers of inflammation include:
- respiratory infections;
- sharp inhalation of cold air;
- physical or emotional stress;
- hormonal disorders;
- time of day – exacerbations are more often noted in the early morning or at night;
- the irritating effect of the rejection of food from the esophagus during gastroesophageal reflux;
- passive smoking during intrauterine development and after birth;
- change in meteorological conditions.
Inflammation of the bronchi, triggering a violation of the conductivity of the bronchial tree and a spasm of smooth muscle fibers of the bronchi (bronchospasm) are causes of asthma in children.
Forms of the disease
All forms of asthma manifest in children with wheezing (wheezing) breathing, and the appearance of this symptom should be considered as a reason to be examined by a pulmonologist.
- Atopic (allergic) form – develops as a result of inhalation contact with allergens.
- Non-atopic form – an attack is triggered by bronchospasm, a factor provoked by non-allergic origin – stress, cold air, exercise, stress.
- Mixed – which combines the signs of an allergic and non-allergic form of the disease.
- Asthmatic status – or life-threatening condition, acute form, accompanied by obstruction of the small bronchi, dumb light.
According to the severity of the disease in children and adults are classified equally. On the classification of asthma in children, as well as how to treat exacerbation, can be found in the article Bronchial asthma – what is it.
The peculiarity of asthma attacks in childhood is that the severity of the disease is not determined by the duration of the attack or disease itself. Life threatening condition can develop in childhood in a very short time.
This is due to the fact that in children, especially up to 3 years old, asthma symptoms appear during bronchial edema and are due to the fact that the diameter of the bronchi at this age is less than in adults.
Even a slight swelling of the airways causes a persistent constriction. In adults, bronchial obstruction is more caused by bronchospasm than by edema of the inner lining of the bronchi.
Bronchial asthma in children develops rapidly, the first signs may occur against the background of complete health. But more often, the symptoms of the beginning bronchial obstruction are combined with chronic or allergic rhinitis, atopic dermatitis, eczema.
In children, the atopic form of bronchial asthma is more common, and the non-allergic form may develop in response to aspirin. When treating aspirin in a short time, symptoms of aspirin asthma can develop – a disease that is difficult to treat.
Predisposition to aspirin asthma is hereditary. If the family has patients with this disease, then the symptoms of intolerance to aspirin should be expected in the child.
External signs of the disease
The child gradually develops certain external signs of the disease – the chest is deformed with the formation of a protrusion of the sternum, a so-called keeled chest is created.
A sign of asthma is scant sputum, which is rarely separated without exacerbations. This symptom occurs in 70% of cases only during an attack.
A diagnostic symptom of bronchial asthma in children is frequent (more than 50 breaths / minute) wheezing, tightness, and heaviness in the chest.
A moderate asthma attack is accompanied by symptoms:
- already at the usual conversation, shortness of breath appears in babies, infants refuse to eat;
- it is difficult for the patient to speak in long sentences, he speaks in separate phrases, words;
- he is excited, when breathing noticeably, as supraclavicular fossae sink, intercostal muscles are strained;
- pulse above 120 beats per minute;
- Frequent breathing of the breath reaches 30-50 breaths per minute.
If the patient’s condition worsens, from an excited state, he becomes inhibited, the pulse dramatically decreases, these signs mean that a life-threatening condition has arisen.
With these symptoms, parents should be careful. If the patient suddenly calms down, then such calm may be a manifestation of impaired consciousness due to lack of oxygen.
The most common form of bronchial asthma in children is allergic, associated with atopy (increased IgE synthesis in response to an allergen), increased bronchial reactivity, which is expressed by a predisposition to bronchospasm, mucus hypersecretion, edema – bronchial obstruction.
Symptoms of bronchial asthma in children first appear usually at night. The child wakes up from lack of air with a heavy feeling in the chest.
- The kid wants to get up, he needs fresh air. He takes a characteristic posture, rests his hands on his knees, the table, any surface nearby, which helps him, leaning, to push the air out of their lungs, since this requires considerable effort. At the same time, the shoulders go up, the rib cage expands markedly.
- The veins in the neck swell; when breathing, you can see how the respiratory muscles are connected, the exhalation is difficult and elongated.
- The skin turns pale.
- Acrocyanosis develops – cyanosis of the skin due to deterioration of blood supply, the most pronounced symptom is in the area of the nasolabial triangle, fingers, feet.
- Night attack lasts up to 3-4 hours, after which the patient falls asleep.
Aura before the attack
Before an attack, a condition called an aura may occur. By the appearance of such symptoms in a child as a sudden sneezing, hives on the skin, runny nose, he is able to understand that he has an attack of bronchial asthma, and children over 7 years old – use an inhaler on their own.
- Aura is sometimes accompanied by itching, sore throat, headache, causeless fear, panic.
- Symptoms of incipient aggravation are sometimes limited to cough with scanty vitreous sputum, while the cough tremors themselves are accompanied by dry wheezing.
When signs of aura appear, a child older than 6–7 can independently take steps to prevent or reduce the exacerbation of bronchial asthma.
Otherwise, the attack develops:
- breathing becomes hard;
- palpitations increase;
- integuments get bluish tint.
If a child’s speech slows down, drowsiness occurs, cyanosis and asphyxiation increase, you should seek medical help immediately.
Bronchial asthma of non-allergic origin may develop as a reflex cough reaction to bronchospasm. Cold air, which he inhaled sharply during the walk, can cause bronchospasm, unexpected strong excitement, joyous or fearful.
In these cases, you need to try to calm, distract him, as bronchospasm, as well as panic, fear of the beginning exacerbation, trigger the mechanism of the disease. Mustard plaster on caviar, a few sips of warm water can be distracting maneuvers.
When can we suggest asthma
Parents should show the child to a pulmonologist if they notice that:
- the baby, when walking in cool weather, has difficulty breathing, shortness of breath appears when talking in the usual walking step;
- while playing with pets, starts coughing, difficulty in talking;
- reacts with violent sneezing, coughing for dry cleaning of the apartment.
Bronchial asthma is a disease that is well treated with attention. But, in order to prevent the deterioration of the child’s condition, the danger of illness cannot be underestimated. Parents should follow the recommendations of the pulmonologist, do not overestimate their own experience, and promptly seek help in emergency situations.
Is it possible to treat bronchial asthma in children with folk remedies and what every parent should know – read in our article Folk remedies for bronchial asthma.