In recent years there has been a marked increase in the number of patients with bronchial asthma in children and even infancy. The course of bronchial asthma is chronic: it is accompanied by periods of exacerbations (attacks of shortness of breath) and relative well-being (interictal period).
It is possible to suspect the disease if your child had: – episodes of wheezing; – cough at night; – cough and wheezing, feeling of congestion in the chest after physical or emotional stress, during illness; – cough, wheezing after contact with a specific allergen (for example, contact with a cat); – if these symptoms were relieved by anti-asthma drugs. Diagnosis bronchial asthma usually comes after the first symptoms, so if you notice any of the above symptoms in your child, see your doctor right away.
The mechanism of development of the pathological process
In the bronchi of the person there are special muscles. Reduction (tension) of these muscles leads to a narrowing of the lumen of the bronchi, and their relaxation to expansion. This is a normal physiological process required by man. For example, during exercise, additional oxygen is required. A person needs to inhale as much air as possible. His breathing deepens, and his bronchi expand.
In case of bronchial asthma, the mechanism of timely adequate reduction of the muscles of the bronchi stops working. The essence of the disease lies in the fact that any irritant (allergen, exercise, psycho-emotional stress) spasm (narrowing) of the bronchi is out of time and out of place. In addition, due to concomitant allergic inflammation, the bronchial mucosa swells and a very thick, viscous “vitreous” sputum is secreted. This further aggravates the situation.
Causes of bronchial asthma
- Most children with asthma have a genetic predisposition to allergies: some of the relatives suffer from allergies. Often, a child who has had a seizure for the first time already has some allergic background (pollinosis, atopic dermatitis, food allergies, etc.). These diseases can develop in parallel.
- The trigger mechanism of the onset of the disease in most children is frequent colds, acute respiratory viral infections and bronchitis. Bacteria and viruses, affecting the walls of the bronchi, change their structure and, thus, facilitate the penetration of allergens into them. As a rule, the disease is preceded by a series of obstructive bronchitis. The diagnosis may also sound like “asthmatic bronchitis”, “bronchial obstruction”, “broncho-obstructive syndrome”. In principle, the mechanism for the development of obstructive syndrome is different from the mechanism for the development of asthma and, in fact, it is the same. Therefore, with frequent occurrence of bronchospasm (obstructive syndrome) during acute respiratory infections, the child can rightly be diagnosed with bronchial asthma. A pediatrician who has encountered a similar situation in his practice is obliged to send a child with frequent obstructive bronchitis to an allergist to confirm the diagnosis of asthma and conduct appropriate (free!) Treatment.
- The most common cause of an attack of bronchial asthma is the ingestion of a child of any allergen. For bronchial asthma Lead allergies to house dust (or rather to the mites and antigens of cockroaches contained in it), pollen, animal dander, food, fungal and drug allergens will be leading. In the first year of life, food allergies come to the fore, allergens enter the body through the intestines. Schoolchildren are dominated by pollen allergies (pollinosis) and house dust allergies: allergens penetrate through the respiratory tract.
- Various physical effects on the body (cooling, overheating, sudden changes in weather, physical exertion) and psycho-emotional stress (fear, stress, anxiety) can provoke asthma attacks. Sometimes asthma in a child can become a consequence of an unfavorable psychological situation in the family. Children, sometimes consciously, and sometimes unconsciously (subconsciously), can themselves cause seizures. So they try to draw attention to themselves or to any family problem, as if “blackmailing” adults.
- The deterioration of the environmental situation, atmospheric pollution by industrial emissions and vehicle exhaust gases leads to disruption of the child’s immune status and creates favorable conditions for the development of the disease. An important factor in the development of asthma is also tobacco smoke.
- Separately distinguish a special form – “aspirin” asthma. When it attacks of asthma occur on aspirin (acetylsalicylic acid). And aspirin is not in this case an allergen. The fact is that aspirin can provoke the release of some biologically active substances that cause the narrowing of the bronchi (bronchospasm). In the presence of aspirin bronchial asthma, aspirin, acetylsalicylic acid and all preparations containing them are strictly prohibited for a child. In addition, such patients should not eat food dyes, including drugs in colored capsules.
- The accompanying diseases of the digestive organs aggravate the course of asthma: intestinal dysbacteriosis, gastritis, gastroduodenitis, pancreatitis, liver diseases, biliary dyskinesia, constipation. Sometimes gastroesophageal reflux can be the cause of nighttime asthma attacks.
Some diseases that have arisen in childhood can be “outgrown”. One of them – bronchial asthma. Sometimes it happens that severe, accompanied by frequent agonizing attacks of early age asthma to the adolescent period passes without a trace. It is difficult to explain, but a fact known to medicine. True, such a wonderful self-healing does not always happen, at about 30-50%.
Symptoms of bronchial asthma
Sometimes precursors may precede an attack of bronchial asthma: anxiety, irritability, agitation, or, conversely, depression and drowsiness. A classic attack of bronchial asthma is as follows:
- The child has a feeling of lack of air, heaviness and congestion in the chest.
- Breathing is noisy, audible from a distance, with the characteristic difficulty of exhalation, accompanied by wheezing.
- The cough is agonizing, difficult to withdraw, thick sputum or sputum does not go away at all.
- Often the patient is in a forced position: sitting, leaning on his arms, shoulders raised and moved forward, his head retracted.
The severity of asthma is determined by the frequency of seizures and the possibility of their prevention with inhaled anti-asthma drugs without injections.
If the attack cannot be removed within a few hours, it means that the child has developed an asthmatic status. This is a dangerous condition that could end very sadly, even death.
Asthmatic status can provoke uncontrolled, excessively frequent use of bronchodilator drugs, mainly aerosol inhalers. Their incorrect use leads to the fact that the bronchi stop reacting to the medicine. Therefore, if it is impossible to remove the attack on their own, it is necessary to call an ambulance and urgently hospitalize the child.
The trouble of the disease also lies in the fact that due to frequent attacks, accompanied by respiratory failure, the brain of the child constantly suffers from a lack of oxygen and cannot develop normally. In addition, the constant fear of the threat of an attack is added. Originating at an early age, asthma leaves a definite imprint on the character of the child. Such children, as a rule, disinhibited, easily vulnerable, emotionally labile, can form various types of neurosis. With a long course, there is a lag in the physical, intellectual, sexual development of the child asthmatic compared with peers.
Treatment of bronchial asthma
The effectiveness of therapeutic measures depends on the timely cessation of the patient’s contact with the allergen: climate change, daily wet cleaning of the apartment, elimination of indoor flowers, domestic animals, an aquarium, wool carpets, etc. It is important to timely treat foci of chronic infection: (carious teeth, sinusitis, adenoids, tonsillitis, etc.) and diseases of the digestive system (intestinal dysbacteriosis, diseases of the liver and gallbladder, gastroesophageal reflux, etc.).
Diet. In the diet of a patient with bronchial asthma, it is necessary to exclude allergens that can provoke attacks, limit the consumption of carbohydrates (sugar, sweets, bakery products) and animal proteins. If a child has food allergies, you can recommend to parents to keep a food diary. For this, a record of what and when the child ate during the day is kept for several months. Comparing the information from the food diary with the beginning of the exacerbation of the disease, one can detect the dependence of the appearance of attacks on any food product.
Recommended diet for a patient with bronchial asthma: – Reduce the amount of sugar, pastry sweets, baking, salt. – Daily caloric intake should be about 2800 kcal. – Daily dairy products. – Soups: cereal, vegetable, beef on the second broth. – Butter: creamy, sunflower, olive. – Kashi: buckwheat, oatmeal, rice. – Fresh vegetables and fruits: colored in green (cucumbers, greens, green apples, etc.). – Meat: boiled lean beef. – Bread: white, otdobny. – Boiled potatoes.
Drug treatment. Modern traditional medicine offers a variety of drugs used for treatment of bronchial asthma. Conventionally, they can be divided into two groups: First aid means for relieving an attack. These drugs have a bronchodilator effect. In pediatric practice, salbutamol, ventalin and berotok are used in the form of inhalers, aminophylline in tablets or injections, as well as some other potent drugs.
Preventive drugs that relieve allergic inflammation. Experts call them “basic” necessary. There are several groups of them: antihistamine antiallergic drugs (suprastin, tavegil, claritin, etc.), membrane stabilizers (intal, tiled, ketotifen, etc.), hormonal drugs, antibiotics, etc. They are selected individually, taking into account the severity and peculiarities of bronchial asthma.
Unfortunately, the course of bronchial asthma is chronic, and in most cases the drugs offered for treatment give a temporary and unstable result. In addition, the side effects of these drugs are manifested: addiction, dysbacteriosis, allergic reactions, dysfunction of the gastrointestinal tract, liver, kidneys, metabolism, heart, tachycardia, increased pressure, etc. It happens that the child is afraid of having an attack and arbitrarily exceeds the dose of the bronchodilator drug dozens of times, which can provoke asthmatic status.
Treatment of bronchial asthma – A complex, time-consuming process that requires an integrated and individual approach. Doses of drugs, treatment, the duration of the medication is selected by the doctor. Do not try to treat the child yourself, consult a specialist.
Inhalers. Patients with bronchial asthma often use inhalers (the medicine is inhaled from the balloon-inhaler). The inhaled preparation can be in the form of an aerosol (gaseous state of matter) or in the form of the smallest powder. Inhalation drugs are administered by expanding bronchi, hormonal drugs, etc. However, when a sick child inhales the medicine from an inhaler can, only 10–20% of the medicine comes to his bronchi. Most of the drug settles in transit, on the back of the throat. In addition, children, especially small ones, do not understand instructions well and can inadequately and ineffectively inhale medicine from a can.
To improve the process of inhalation of the drug, special devices are used: spacers, turbuhalers, nebulizers, a “light breathing” system, etc. In children’s practice, their use is mandatory because it allows using smaller doses, has less costs and reduces the risk of side effects. Typically, such devices can be purchased at a pharmacy, often they are sold with a balloon inhaler or medicine for inhalation.
The spacer is an auxiliary device for inhalation, a chamber that serves as an intermediate reservoir for an aerosol medication. The drug from the canister inhaler enters the spacer and then is inhaled by the patient. Thus, you can take more than one breath, but several, until most of the medication gets into the lungs. Spacer increases the percentage of the drug in the lungs up to 30%. The spacer is applicable only for aerosol, but not for dry powder.
Turbuhaler, diskhalvr, cyclohaler – devices similar to spacers, but for powder inhalers.
Nebulizer is a technical device that translates medicine into an aerosol cloud. The paths of aerosol cloud formation are different; depending on this, ultrasonic and compressor (pneumatic, jet) nebulizers are distinguished. With the help of a nebulizer, long-term inhalation of solutions of medicinal substances with aerosols can be carried out.
The system of “light breathing” is activated by the breath of the patient. The inhaler is triggered automatically when the patient inhales, so there is no need to coordinate the inhalation and the moment of pressing the valve of the inhaler cartridge. Used with spacer. The rate of ejection of the drug in the “light breathing” system is 4 times lower than in conventional inhalers, and the aerosol cloud created does not strike the back of the pharynx. At the same time penetration into the respiratory tract increases by 2 times.
Phytotherapy. Herbal medicine plays a positive role in the prevention of attacks of bronchial asthma, lengthening the interictal period, reducing side effects from drugs. This method perfectly complements the traditional drug treatment, increasing its effectiveness.
Herbal medicine number 1 (for bronchial asthma):
wild rosemary grass – 5 parts, nettle leaves – 3 parts, mother-and-stepmother leaves – 2 parts.
Herbal medicine number 2 (for bronchial asthma):
the roots of licorice – 4 parts, the roots of elecampane – 4 parts,
the grass of wild rosemary of the marsh is 12 parts,
nettle leaves – 6 parts, coltsfoot leaves – 10 parts.
Terms of preparation of medicinal decoctions.
In an enamel pot for the night, pour 4 tbsp. l collect 1 liter of cold water, close the lid and leave to infuse. In the morning, simmer for 7-10 minutes from the beginning of boiling, insist 1-2 hours, squeeze. Take warm or hot, adding 1 tbsp. l milk, 5-6 times a day. The broth is not stored and daily prepare a new one.
Doses: children up to a year – 1 tbsp. l .; children 1-3 years old – 2 tbsp. l .; children 3-10 years – 3 tbsp. l .; children 10 – 12 years old – 50 ml; children over 12 years old – 1/2 cup and adults – 5-6 times a day.
Medicinal fitosby number 1 and number 2 alternate every 3-4 weeks. Take a long time.
Apple vinegar. Dilute 1 tbsp. l vinegar 10 tbsp. l water, drink 3 times a day after meals.
Tincture of garlic. Peel and chop 10 heads of garlic, pour 500 ml of vodka, close tightly and leave for 3 days in a dark place. Squeeze and filter. Take in the amount of 1 drop per year of life of the child 1 time per day, starting with 1 drop and gradually bringing to full volume.
For coughing and shortness of breath during obstructive bronchitis and during an attack of bronchial asthma, plants are used that have expectorant and phlegm-thinning effects. This is a dandelion, chamomile, St. John’s wort, plantain, horsetail, knotweed, yarrow, nettle, coltsfoot, calendula, licorice root. They can be used in the form of decoctions, tinctures, dry powder (tablets), poultices, lotions, etc.
After the process dies down, phytopreparations containing licorice root (glycyram, Lacrinate dietary supplement, liquorice root infusion, pertussin) are used for the rehabilitation of a patient with bronchial asthma, with a long course of at least one month.
Aromatherapy. Essential oils are shown only in micro doses. Apply essential oils of lavender, thyme, tea tree. Add to massage oil, rub the chest (5 drops of essential oil per 10 ml of base) or use the oil burner 10 minutes a day.
Physiotherapy treatment. The treatment uses physical therapy, breathing exercises, massage, acupuncture, hardening, mountain air treatment, spa treatment (especially useful highlands with discharged air, Priel-bar, Kislovodsk, the Southern Coast of Crimea), etc.
Homeopathic treatment. Homeopathy works great with treatment of bronchial asthma. It is only important to find a competent homeopathic physician who will individually select the treatment regimen for your child.
Work with a psychologist. As noted above, the disease leaves its mark on the nature of the child, so he needs the help of a psychologist or psychotherapist, as well as the creation of a favorable psychological atmosphere in the family.
In some cases, the child will need to consult a neurologist and prescription drugs that improve brain function.
Asthma schools. The experience of specialists has shown that parents know very little about bronchial asthma and the possibilities of modern medicine in its treatment. Many parents in their attempts to cure their child turn to various charlatans, sorcerers and psychics who promise “quick and complete recovery.” However, as we see, there is a huge choice of quite official safe and effective methods of therapy. In order to increase the awareness of patients in this field of medicine, special asthma schools have been created. There is training for sick children and their parents. Parents are told about the peculiarities of bronchial asthma, allergens, studying the principles of emergency care, rehabilitation, exercise therapy (physical therapy), massage, unconventional methods of treatment, affect the psychological aspects of the disease. Children learn to properly use inhalers, to adequately behave during an attack, psychologists work with them, etc.
Asthma schools help to improve the cooperation of doctors with young patients and their parents. Combating the disease by joint efforts in one direction helps to increase the effectiveness of treatment and significantly improve the quality of life.