FACT SHEET ON ASTHMA

Asthma is a disease with coughing, wheezing and/or shortness of breath.
Asthma results from the tubes to the lungs getting inflamed and angry and full of mucous.
If the tubes are angry enough they can go into spasm and wheezing ( a whistling noise from the chest ) will occur. If the inflammation is allowed to continue, we believe that permanent "scarring" of the airways results (airway remodelling) with the tubes becoming more "twitchy".
Some medications open the tubes when they are in spasm (bronchodilators) to give quick short-term relief while others work more slowly to clear the inflammation (anti-inflammatories).
THE GOAL OF ASTHMA MANAGEMENT IS TO CLEAR THE INFLAMMATION AND MUCOUS THUS PREVENTING EPISODES AND AIRWAY REMODELLING.
There are three known causes of the inflammation:
1. Viral infections;
2. Allergy
3. Second hand cigarette smoke.
Children get a lot of colds especially in the winter. Young children can get a cold every three weeks. If it takes two weeks to clear the "chestiness", they are no sooner finished one cold when they get another and the problem snowballs.
Children under three or four years of age who are chesty with colds but not allergic have a good chance of outgrowing the problem.
Allergy is a second mechanism for inflaming the airways and creates problems even between the colds. Now the colds come on top of the mucous created by allergy. Children who are allergic have more trouble outgrowing the asthma. If the inflammation caused by allergy continues it creates permanent changes in the airways.
The allergies that are the most important for asthma are the year round ones such as allergy to dust mites, animal danders and cockroaches. Moulds and mildew are also important. Allergy control is important to reduce the inflammation in the airways.
Inhaled steroids are used to eliminate the inflammation and initially are used in high doses to clear the airways but then the dose is reduced to the least amount that will keep the airways clear. The asthma dictates the amount of medication. The need for a high level of inhaled steroid indicates asthma that can threaten. Then we also have to watch for side effects of the inhaled steroid e.g. slowing of growth. While we cannot cure asthma, good control will lead to the asthma becoming milder and help the child to outgrow it.
Other non-steroidal anti-inflammatory agents are not as powerful as inhaled steroid and there is evidence that early introduction of inhaled steroid to the treatment of asthma gives the best lungs. Abstract Agertoft and Pedersen have also published the results of a 12 year study examining growth in asthmatic children treated with inhaled steroid. They found that the children who achieved their predicted adult height were those treated with inhaled steroid and failure to achieve predicted adult height correlated with poor lung volumes. Click for Agertoft and Pedersen

Click the door for a longer discussion of asthma.
ASTHMA DISCUSSION

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