Introduction

Childhood asthma is a common chronic respiratory condition affecting all age groups. It affects 10 -14% of school going children. However, there is evidence of asthma becoming more common and severe in younger age group children.

Asthma attacks can range from mild to life threatening. It is also one of the most common medical causes for hospital admission and emergency visits.

Asthma may occur in individuals with or without family history of asthma. The risk of developing asthma is higher in a child with strong family history of asthma and other allergic diseases such as eczema, allergic rhinitis and hay fever.

What is asthma?

Asthma is a chronic inflammatory disorder of the airways, which makes the airways :

• Red.
• Swollen.
• Produce more mucous.
• Hypersensitive.

When exposed to the irritants or trigger factors, the hypersensitive airways may become narrower and cause breathing difficulty. The severity of asthma changes with time depending on the exposure to trigger factors and asthma control.

What are the trigger factors?

A number of different triggers can cause asthma symptoms .Certain triggers are common to all people with asthma, but some are more individualized. Some of the triggers are:

• Infections especially viral respiratory infection.
• Smoking.
• Weather changes.
• Allergens such as those from pollen, house dust mites, moulds and pets.
• Exercise.
• Irritants such as perfumes, paint fumes and flour dust.
• Food and food additives.
• Medicines such as aspirin or other NSAIDs (painkiller).
• Emotion.
• Gastro-oesophageal reflux (reflux of stomach acid).

What are the symptoms of asthma?

The main symptoms are :

• Cough.
• Night Cough.
• Chest tightness.
• wheezing (noisy breathing-whistling sound).
• Breathlessness.

What are the signs of asthma?

• The child may have no physical sign during the attack free period.
• Barrel-shaped chest can be present in severe uncontrolled asthma.
• Evidence of allergic manifestations such as eczema and allergic rhinitis may support the asthma.

Signs are more obvious during an acute attack .The child may have :

• Audible wheeze.
• Difficult to exhale (breath out).
• Rapid breathing.
• Fast heart beat.

In severe attack, the child may have:

• Irritability.
• Lethargy.
• Anxiety.
• Clammy skin.
• Bluish discoloration of lips and fingers.
• Reduction in peak flow measurement from the predicted value or personnel best.

Goals of therapy

• To abolish and control asthma symptoms.
• To prevent asthma attack.
• To have good quality of life.
• To be able to participate in sports.
• To prevent irreversible lung damage.
• To prevent death.

What are the types of treatment for asthma?

Asthma medications consist of 3 types :

1. Preventer medications

These medications prevent asthma attack by controlling the process of inflammations in the airways. They reduce airways swelling and mucous production.

2. Reliever medications

These medications work by opening the narrowing airways by relaxing the airway muscle.

3. Controller medications

These act to relax the muscles of the airways and work over a long period of time by keeping the airways open. They are used in severe asthmatic cases in combination with preventer medications.

What can be done to control asthma?

• Avoid trigger factors.
• Use preventer medications regularly as prescribed by doctors.
• Use the asthma medication correctly.
• Recognise asthma symptoms and treat them early.
• Adhere to the asthma action plan given by the doctor.
• Follow-up regularly with your doctor.

Does asthma go away?

Asthma can be controlled but it cannot be cured. For some children, asthma improves during the teenage years, while others have symptoms that become more severe over time.

Many children appear to “outgrow” from their asthma, although the symptoms may re-appear later in life.

Support group

Asthma Society of Malaysia
Persatuan Asma Malaysia, P.O. Box 11
Jalan Sultan
46700 Petaling Jaya
Malaysia
Tel : +603-757 6641/603-290 5222
Fax : +603-757 6588
URL : www.ginasthma.com