Editor’s note: The following article is part of a partnership between Chambanamoms and Christie Clinic to help create a healthier lifestyle for you and your family.
By Dr. Kaushik Patel, Pulmonary Medicine, Christie Clinic
By definition, asthma is “a respiratory condition marked by spasms in the bronchi of the lungs, causing difficulty in breathing. It usually results from an allergic reaction or other forms of hypersensitivity”
The incidence of asthma has been estimated to be 4.6 per 1,000 person-years in women and 3.6 per 1,000 person -years in men. This means the adult incidence of asthma was slightly higher in women than men. The diagnosis of asthma requires a history of respiratory symptoms together with evidence of variable expiratory flow.
The symptoms are non-specific to asthma. Asthma has been described as a chronic inflammatory disorder of the airways. The diagnosis is imprecise. There may be overlap with COPD, an obstructive lung disease, generally caused by smoking or environmental exposures. Asthma can develop at any age, though infrequently in the elderly. Classic symptoms of asthma include wheezing, cough and shortness of breath. Symptoms are usually episodic and may be triggered by allergies or nonspecific triggers such as exposure to cold air or exercise.
While physical examination may provide evidence of airway obstruction, a normal initial examination is common. Pulmonary Function Testing (PFT) by doing spirometry and peak expiratory flow rate measurements are very helpful to see how the lungs are working. Bronchial Challenge Testing (BCT) may be required in some patients to stimulate the airways and see how they respond. Exhaled Nitric Oxide measurement has been used as an aid to diagnose asthma. Allergy testing may also be beneficial in patients with a history of atopy. Atopy, by definition is “of, relating to, or caused by a hereditary predisposition toward developing certain hypersensitivity reactions, such as hay fever, asthma, or chronic urticaria, upon exposure to specific antigens.”
Treatment is step wise, or a series of stages, with short acting bronchodilators being used for symptom relief and anti-inflammatory agents being added for control of inflammation in patients with persistent symptoms. A personalized asthma action plan can provide a patient with directions on daily management and on adjusting their medications in response to worsening symptoms and drops in peak expiratory flow rate. Treatment can be stepped up to control symptoms with a plan to step down therapy when the disease is controlled.
Here are some facts about asthma and children:
- Asthma is one of the most common serious chronic diseases of childhood. Asthma is the third-ranking cause of hospitalization among children under 15.
- An average of one out of every 10 school-aged children has asthma.
- 10.5 million school days are missed each year due to asthma.
Symptoms and treatment of asthma in children are similar to that of adults but may have to be monitored closely for reactions or response.
Christie Clinic’s Pulmonary Function Lab offers peak flow measurements, spirometry, complete pulmonary function testing, and bronchial challenge testing. Testing can be performed from ages 6 and up. The Pulmonary Medicine Department physicians specialize in the treatment of lung diseases such as asthma and can see ages 16 and up. Pulmonary Medicine is also able to do allergy testing at this office.