In most cases, the cause of bronchial asthma is allergy. It manifests itself in the form of airway inflammation, in which acute bronchospasm is accompanied by an increase in mucus secretion.
Symptoms of the disease
Every parent should know how asthma can occur. Symptoms in a child are usually pronounced. The baby begins bronchospasm, which doctors call bronchial obstruction. It is expressed as follows. The child begins a paroxysmal dry cough. Over time, viscous sputum begins to stand out.
You can understand that obstruction has begun by breathing. If in a healthy child the duration of inspiration and expiration is approximately the same, then with the development of an asthmatic attack, shortness of breath appears. It is characterized by a short breath and a long exhale. In this case, the patient has wheezing, which is heard from afar.
There are also the so-called first signs of asthma in children, which are observed even before the onset of the attack. So, the baby begins to cough, there is a stuffy nose and itchy skin.
With an attack, older children may complain of a feeling of lack of air, squeezing in the chest area. In children, sleep is disturbed, they become tearful, irritable, lethargic.
Provocative factors
To prevent the development of the disease, you need to know what exactly can lead to problems. Experts include air pollution, atmospheric pressure drops, flowering of allergic plants and even an unfavorable psychological atmosphere in the house as provoking factors.
If you have people with hereditary allergic diseases in your family, you first need to find out how asthma can manifest in a child. Symptoms must be known in order not to miss the onset of problems. Also at risk are children with exudative-catarrhal diathesis.
Allergen, which leads to bronchospasm, can become plant pollen, certain foods, tobacco smoke, drugs, household dust. The reaction may begin by inhaling cold air or from physical exertion.
At the first contact, the body seems to get acquainted with a foreign substance, but at subsequent “meetings” it already begins to react violently. The immune system produces antibodies, and they, in turn, release biologically active substances, which cause asthma to develop in children. Signs and symptoms in the form of shortness of breath, obsessive cough and shortness of breath are difficult to miss.
Characteristic features of the disease in infants
All babies have a so-called prodromal period before an asthma attack . At this time, you can notice deviations from the respiratory system. From the nose, liquid mucus begins to stand out, itching appears and the constant sneezing associated with it, a dry cough. The doctor can listen to single dry rales, see swollen tonsils. These are the first signs of asthma in a child under one year old.
Also, the disease affects the nervous system. The baby becomes restless, irritable, his sleep spoils. Disturbances are also observed from the digestive system - constipation may occur or loose stools may appear.
Asthma develops in babies, usually against a background of respiratory diseases. Only in exceptional cases can its appearance be caused by stress. At the same time, signs of asthma in infants appear gradually. This is due to the fact that swelling of the mucous membrane of the bronchi and hyperemia increase at a slow pace.
The attack itself can last from several minutes to several days. It will be accompanied by wheezing, which is heard even at a considerable distance, expiratory shortness of breath.
It is worth noting that sometimes the first signs of asthma that appear in children up to a year go unnoticed. They can occur occasionally without any regularity, at different times. At the same time, they can pass by themselves, without any therapy. And in the period between attacks, parents do not notice any deviations.
Preschool children
Suspecting the development of the disease in older children is also not always possible. Signs of asthma in a child of 2 years may be blurred. For example, their breathing may become more frequent and intermittent during sleep. It also occurs during physical exertion.
The characteristic manifestations of the disease also include frequent sneezing, periodic coughing, and restless sleep. Often children do not even notice that they cough in a dream. This happens reflexively. If the child sleeps separately, then the parents may not even hear a cough. Therefore, it is necessary to observe the child, if the kindergarten teacher says, the baby coughs during sleep.
Preschoolers can not always describe their feelings, so parents should monitor their condition. For example, signs of asthma in a 5-year-old child can occur during active games. It is necessary to consult a doctor if, after a short run, the baby begins to cough. Active movement can cause chest pain, squeezing.
Signs of asthma in schoolchildren
The older the child, the more detailed and more accurate he can describe his condition. Therefore, to determine the disease in schoolchildren is already a little easier. But this can only be done if you know what signs of asthma in children can be.
As in preschoolers, in school-age children, the disease is evidenced by coughing in a dream and after exercise. Patients can tell about a pressing feeling in the chest area. In addition, having caught the connection between physical activity and the emerging discomfort, children try to run as little as possible, avoiding any active games. Even in the absence of complaints, it is necessary to monitor students who refuse to attend physical education classes, try not to run, and sit quietly at breaks.
If a child begins to cough, it is hard for him to sit upright. He tries to alleviate his condition, bends, stoops, moves forward. You can also notice excessive pallor. Preschoolers and primary school children during an attack can be frightened and even cry.
Adolescence
As a rule, by the age of 12-14 the diagnosis is already established. At this age, it is important to teach your child to recognize when asthma begins. Symptoms in a child, as a rule, are always similar. He should always have with him a special inhaler prescribed by a doctor. Parents must ensure that the medicine does not end in it, and change the used container in time.
Symptoms of the disease in children of middle and senior school age are not particularly different from those found in babies. But adolescents are already able to control the disease, which means they can prevent an exacerbation.
It is worth noting: despite the fact that many people have seizures during sports, adolescents with asthma need physical activity. Just before exercise, you need to take the medicine prescribed by your doctor and monitor your breathing. It should be smooth and rhythmic.
Attacks can cause allergens. But adolescents should already know which substances provoke the disease. If possible, they should avoid them. If allergic attacks provoke seasonal plants, then it is necessary to take medications on a regular basis that block their development.
Often at this age, the process of remission begins. All signs of asthma disappear, and parents decide that their child simply "outgrew" the disease. But in fact, bronchial hyperreactivity persists. If a teenager is faced with several provoking factors, then the disease may return. Sometimes this happens in adulthood. Quite often there are situations in which asthma disappears in adolescence and reappears in the elderly.
Diagnostics
To accurately determine whether a child has asthma, it is not enough to know the first signs and main symptoms of this disease. Shortness of breath, rapid and labored breathing, an obsessive cough can also occur with obstructive bronchitis. Therefore, you can not do without consulting doctors. First of all, you need to visit a pediatrician. He will already give a referral to all the necessary tests and refer you to an allergist. If necessary, a pulmonologist consultation may also be needed.
In addition to general blood and urine tests, sputum can also be taken for analysis. In asthma, an increased content of eosinophils, Kurshmann spirals (mucus from the respiratory tract), Charcot-Leiden crystals (lysophospholipase released from eosinophils), and Creole bodies (accumulation of epithelial cells) are found in it.
To establish a diagnosis, the doctor must deal with the details of the baby's life. He needs to know how and when attacks begin. Even by such a description, sometimes it becomes clear to a specialist what exactly is an allergen for a baby. It is also important for the doctor to know how the child reacts to bronchodilators. Asthma will be evidenced by a temporary improvement in the state of their use.
Diagnosis is to conduct special tests. One of the most common are skin allergy tests. For these purposes, potential allergens are applied to slightly scratched areas of the forearm. After 20 minutes, the doctor evaluates the results. They look at which particular areas the skin turned red most.
This allows you to identify an allergen, but does not allow you to understand whether the respiratory system is disrupted. Parents themselves can determine this, knowing the signs of bronchial asthma. The cough form in children requires a more thorough diagnosis. To determine the working volume of the lungs, a special examination is performed - spirometry. With its help, the degree of impaired functioning of the respiratory system is assessed.
To do this, measure the volume made with exhalation-inspiration and the total capacity of the lungs. For the first time, these measurements are done without any drugs. Then the examination is repeated after taking bronchodilator drugs. If the lung volume increases by more than 12%, then the sample is considered positive.
The bronchial hyperreactivity after exercise is also evaluated. If the forced expiratory volume decreases by 20%, this indicates that the small patient has asthma. The signs of a child, however, can be so pronounced that they do not always prescribe such a detailed examination.
Clinical manifestations
It should be understood that in infants it is often impossible to make a diagnosis due to the fact that obstructive syndrome occurs with bronchitis. In a few days, they develop a cough, symptoms appear that indicate respiratory failure, wheezing is heard. As a rule, treatment consists not only in taking brocholytics, but also antibiotics, antihistamines. With subsequent ARVI, symptoms of lung obstruction may appear.
The signs of asthma in infants are quite blurred, so special attention is paid to the anamnesis, the questioning of parents about the onset of the development of diseases and physical examination.
The course of the disease itself can be divided into 3 conditional stages:
- Directly attack. Acute choking develops due to obstructed entry. It is preceded by an entrepreneurial stage, which can last from several minutes to 3 days.
- The period of exacerbation. It is characterized by difficulty breathing, the appearance of periodic whistles, an obsessive cough and difficulty in sputum discharge. At this time, acute attacks may recur periodically.
- Remission. The period is different in that the child can lead a normal lifestyle, he does not have any complaints. Remission can be complete, incomplete (determined by indicators of external respiration) or pharmacological (preserved when taking certain medications).
It is important to be able to determine the first signs of asthma in children in order to prevent the development of an acute attack. If it was not possible to prevent it, then the parents and the immediate environment of the child should know what needs to be done. It is also important to understand that seizures are distinguished by the severity of bronchospasm.
The safest is a mild degree. With such an attack, a spastic cough begins, breathing is slightly difficult. The overall well-being of the child remains good, speech is not disturbed.
With a moderate attack, the symptoms are more pronounced. The child’s well-being worsens, he becomes moody and restless. The cough is paroxysmal in nature, a thick, viscous, difficult-to-discharge sputum is secreted. The breath is noisy and wheezing, shortness of breath is present. The skin turns pale, the lips acquire a bluish tint. Children can only speak in single words or short sentences.
A severe attack is characterized by the appearance of shortness of breath, which is heard from a distance. The heartbeat in babies becomes more frequent, cold sweat appears on the forehead, there is a general cyanosis of the skin, lips are blue. Signs of asthma in children 6 years of age and older are characterized by the fact that the patient cannot speak, he is able to pronounce only a few short words. Toddlers, as a rule, cannot explain their condition, they just cry and express concern in all available ways.
The most severe cases are called asthmatic status. This is a condition in which a severe attack of the disease cannot be stopped for 6 or more hours. The child develops resistance to prescribed medications.
Features of the course of the disease
It is important to know how asthma can occur before starting an attack. Symptoms in a child may be: moodiness, irritability, tearfulness, headache, persistent dry cough.
In most cases, seizures begin in the evening or at night. Initially, there is a cough, noisy breathing, shortness of breath. Children often get scared, start to cry, rush about in bed. The initial manifestations of asthma in infants are often expressed in the form of bronchial obstructive syndrome in acute respiratory infections. Also, against the background of colds, an attack of asthmatic bronchitis can begin. It is characterized by shortness of breath, which makes breathing difficult, and a wet cough.
Atopic bronchial asthma is characterized by the rapid development of an attack. Timely use of bronchospasmolytics allows you to stop it. But with an infectious-allergic form, seizures develop slowly, symptoms gradually increase. It is not immediately possible to stop the attack by taking bronchospasmolytics.
After normalization, the sputum begins to cough, shortness of breath passes. In some cases, the condition improves only after vomiting.
Parent Actions
Regardless of the age of the child with asthma, his relatives should be careful to prevent the development of seizures and reduce their frequency. For this, it is necessary to strictly comply with all the recommendations of doctors, drink prescribed drugs and avoid potential allergens.
In kindergarten, all educators, a nurse, a music worker should be aware of the situation. It is also important to give them a list of allergens that are causing asthma in a child. Symptoms of the onset of an attack should also be reported. In this case, they will be able to timely send the child to a medical professional or call the parents.
If educators know what the child is allergic to, they can help avoid contact with these substances. For example, you can replace flowers in a kindergarten if some of them provoke the onset of an attack. Also, educators can monitor the baby’s nutrition. Of course, even two-year-old crumbs need to be explained that they should not be eaten. But not always children can control it themselves.
At school, educators should also be aware of the problems of the child. First of all, you need to tell the class teacher that the child has asthma. In children, signs and symptoms may appear gradually. For example, if the school had contact with an allergen, then the child may sleep restlessly at night, cough during rest, his breathing may become confused. In this case, it is necessary to ask the baby in detail about what he did during the day, what he ate and in what rooms he was.
Physical education teachers need to be warned. But if the doctor sees the need for it, he will send the child to a commission where they can give him a partial or complete release from physical exertion at school.
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Treatment tactics
It is impossible to independently figure out what to do if the first signs of asthma appear. An allergist should prescribe treatment, sometimes complex work and the involvement of a pulmonologist are required. The correct behavior of parents is also important. There is no need to panic, but inaction should also not be. It is necessary to have a conversation with the baby, discuss the possible causes of the development of the disease, tell what can be done and what cannot.
How to deal with a condition such as bronchial asthma in children? Treatment (Komarovsky, incidentally, claims that it is simply necessary) consists in the use of medications to prevent the development of an attack and the patient is in remission.
You can stop the condition using glucocorticosteroids. First you need to use high-speed inhalation agents. Therapy should be supportive. If it is not possible to achieve the desired effect with the help of Nedocromil or cromoglicic acid, inhalations with glucocorticosteroids are made.
Therapy should be aimed at:
- elimination of clinical manifestations;
- improvement of respiratory function;
- reducing the need for bronchodilators;
- Prevention of life-threatening conditions.