Asthma

At CHOC, we understand asthma is a long-term disease. Therefore, we specialize in providing support for kids with asthma at the CHOC Asthma Center.

What is asthma?

When your child has asthma, the airways of the lungs become sensitive to triggers (allergens and irritants). With exposure to triggers, the following changes occur:

• The lining of the airways becomes swollen and inflamed
• The muscles that surround the airways tighten
• More mucus production, leading to mucus plugs

All of these factors cause the airways to narrow. This makes it hard for air to go in and out of the lungs.

What causes asthma?

The exact cause of asthma is unknown, but believed to be partially inherited. The environment, infections and chemicals released by the body are also involved.

Exercise causes symptoms in many people with asthma, and can occur during, or shortly after, exercise. In some people, stress or strong emotions can cause asthma symptoms.

The following may be asthma triggers:

• Allergens: Pollens, grasses, trees, mold, pets, dust, cockroaches.
• Irritants: Strong odors (perfumes, household cleaners, cooking fumes, paints and varnishes), chemicals (gases, fumes), air pollution, changing weather conditions (temperature, barometric pressure, humidity and strong winds), smoke (inhaled or secondhand).
• Respiratory problems: Nasal allergies, sinus infections, cold or flu.
• Medicines: Aspirin, NSAIDs (nonsteroidal anti-inflammatory drugs) such as ibuprofen, indomethacin, naproxen.
• Other health conditions: GERD (gastroesophageal reflux), sleep apnea, overweight, depression.
• Other: Exercise, especially in cold weather, strong emotions that go along with crying or laughing.

Who is at risk?

It is most common in children and teens from ages 5 to 17, and those living in cities. Other factors include:

• Personal or family history of asthma or allergies
• Exposure to secondhand tobacco smoke
• Family history of asthma
• Children with allergies
• Exposure to secondhand and tobacco smoke.

What are the symptoms?

• Trouble breathing or shortness of breath
• Tightness in the chest
• Wheezing or a whistling sound when breathing
• Coughing
• Breathing becomes harder and may hurt
• Talking and sleeping may be difficult with severe symptoms.

How is asthma diagnosed?

To diagnose asthma and rule out other lung disorders, your doctor will rely on your child’s medical history, physical exam and other tests. An important test for the diagnosis and monitoring of asthma is spirometry.

A spirometer is a device that is used to determine how well the lungs are working. It measures the amount and speed of air exhaled.

Other tests may be necessary to check for conditions such as allergies.

What are the treatment options?

Your child’s doctor will figure out the best treatment based on:

• Child’s age
• Child’s overall health and medical history
• How sick your child is
• How well your child can handle specific medicines, procedures, or therapies

There is no cure for asthma, but can be controlled by avoiding triggers, taking medicines prescribed by your child’s doctor, monitoring symptoms, and knowing what to do if symptoms get worse.

CHOC experts recommend making an asthma action plan with your doctor. Learn more about understanding your child’s asthma and how to develop an asthma action plan by attending a free CHOC asthma education class.

There’s no single test for asthma, so it can be hard to diagnose the condition in a young child, says Dr. Galant, CHOC’s Asthma, Allergy and Immunology specialist, noting that symptoms are sometimes mistaken for another illness. “The most important diagnostic findings include a chronic or intermittent cough that comes on in the middle of the night and after exercise,” Dr. Galant says. “These kids also have wheezing and they respond to a bronchodilator, which opens the airways and stops the symptoms.” In addition, children with asthma often have allergies, eczema or a family history of asthma, says Dr. Galant.