Allergic asthma is the most common chronic disease of childhood. It often occurs in the first 5 age in children. Cough, wheezing, and shortness of breath are the most common findings. Today, although there is no cure to completely eliminate asthma, the disease can be completely controlled with various treatment methods.
Asthma is a chronic airway disease with recurrent cough, wheezing, and shortness of breath. The place where the disease affects in the lungs is the bronchi.
What is the incidence of Allergic Asthma?
The frequency of asthma and allergic diseases has increased significantly in developed countries in recent years. It affects one in every 4 children. It is also increasing in our country. It is seen in 5-10% of children.
What is the age of allergic asthma in children?
Asthma occurs in children at an early age. It occurs in one third of children in the first 1 year of a child and in 80% in 5 years.
What are the causes of allergic asthma?
Asthma is a disease that occurs with the interaction of personal and environmental factors. Approximately 60% genetics and 40% environmental conditions are considered to be effective in the occurrence of the disease. The most important of the personal causes of allergic asthma is genetics. Other than that, it is gender (male gender at early ages, female gender in adolescents and adults), and obesity. Environmental causes are indoor and outdoor allergens, air pollution, exposure to smoking, infections and diet.
What are the symptoms of allergic asthma?
An important point about allergic asthma is symptoms. The most important symptoms of asthma are cough, wheezing, shortness of breath and tightness in the chest. The findings are in repetitive character. Findings arise when the child is exposed to irritants such as allergen, viral respiratory infections, exercise, smoking or chemicals. Cough may be the only finding in some patients. Cough is usually dry and increases with exercise and at night and awakens from sleep. In patients who are not ill severely, the findings return to normal completely with treatment or spontaneously. The frequency of attacks varies depending on the patient and the environmental conditions.
What Should You Do If Your Child Has Allergic Asthma Symptoms?
Findings in asthma can be seen in also other diseases. For this reason, a child allergy specialist should be consulted in order to evaluate the child in the most appropriate way and to perform allergy tests in the healthiest way when necessary.
How to prepare when going to the doctor for allergic asthma?
It is useful to bring the medications you are using with you and the previous tests and x-rays. When going to a pediatric allergy specialist, it will be helpful to bring the medications you have used or are currently using, the previous tests and x-rays with you to evaluate the diagnosis and treatment of the patient. In addition, it will prevent re-testing if the tests are required.
If it won’t make a problem, do not use some drugs one week before you arrive.
If it is not particularly necessary, stop using allergy syrups, cough syrups, cold syrups 1 week before arrival. Because if the skin allergy tests are required, these drugs should be discontinued a week before. Breathing sprays and vapors, antipyretics and antibiotics containing only paracetamol do not affect the allergy test. However, if your child is ill and needs to use certain medicines, priority is the child’s improvement firsty. Allergy tests can be done after relief.
You do not need to bring your child hungry.
Families bring child hungry, thinking that it will be better for an allergy test or blood tests to be done. However, fasting or satiety is not important in the tests required for the diagnosis of allergic diseases. On the contrary, in allergy tests made on the skin, it will be better for the child to be full as the blood sugar may decrease due to stress.
How is asthma diagnosed?
Diagnosis of asthma in childhood is made with a detailed history, examination findings, and evaluation of laboratory tests together. History is very important in the diagnosis of asthma.
If a child has recurrent coughs, shortness of breath, wheezing symptoms, or prolonged coughs after viral respiratory infections, and if there is allergic disease in the parents or sibling such children should definitely be evaluated by an experienced pediatric allergy specialist for asthma.
What are the examination findings in the diagnosis of asthma?
The examination findings of the child with asthma vary according to the situation. If the disease is not active, examination findings may be completely normal. However, if the disease is active, an increase in the number of breaths, withdrawals in the chest can be detected, and wheezing may be heard.
What are the laboratory tests in the diagnosis of asthma?
Diagnosis of asthma is not made by laboratory tests alone, but tests are very important for both diagnosis and correct monitoring and treatment of the disease.
Allergy tests, pulmonary function tests, blood tests, chest radiography are performed when necessary. Some examinations performed when necessary for differential diagnosis may also be requested according to evaluations.
Allergy tests are very important in diagnosing allergic asthma.
Because it is necessary to determine whether the patient is sensitive to any allergen in order to be able to treat and monitor the disease in the best way. If there is an allergen sensitivity, measures should be taken to avoid that allergen and the treatment protocol should be arranged accordingly. If the desired control is not achieved despite the prevention and drug treatment, immunotherapy (allergy vaccine) can be made against that allergen.
The patient’s allergy can be detected from the blood or skin test. But the skin test is more sensitive and reliable. It is more economic and provides faster results. Results are obtained 20 minutes after it is done. Allergy testing made from the skin can be done from 1-2 months of age, but it is more convenient to make it after 2-3 years of age to diagnose allergic asthma. Because respiratory allergens often create sensitivity after those ages. However, house dust mites can be evaluated with allergy tests in patients deemed appropriate because especially in humid and temperate regions they cause earlier sensitization pollen.
Since allergy tests are very important in diagnosis and treatment, they should be performed by pediatric allergists.
In addition, immunotherapy (allergy vaccine) decision must be made by pediatric allergy specialists. Some medications should be discontinued one week before the allergy test made from the skin. Cough syrups, allergy and cold medicines that affect the test results should be discontinued one week before skin allergy test. However, if the patient is having an asthma attack or if he/she has high complaints due to viral respiratory infections and should use these drugs, it is appropriate to perform the skin allergy test after the patient has recovered.
How should treatment be done in asthma?
For the correct treatment of asthma, the patient should be evaluated in detail by the pediatric allergist experienced in this field, the severity of the disease should be determined, if there is an allergy, these should be included in the treatment program. In asthma, treatment consist the steps of education, prevention, drug therapy and immunotherapy (allergy vaccine) with allergy determined patients. In education, what kind of a disease is asthma, what to protect from, if an allergen sensitivity is detected, what should be done to avoid this should be explained. Since the use of asthma medicines is characteristic, families should be provided with information and education on how to use them according to the age of the child and the side effects of the medicines. Misuse of drugs is common and is one of the most important causes of treatment failure.
Control Measures
Control measures are very important in asthma. It is important to avoid allergens and triggers that the patient is sensitive to control the disease. The measures taken varies according to the allergen. Unnecessary measures can also put the family in stress and financial burden. It will be appropriate to get information from pediatric allergy specialists about what precautions to take.
One of the most important triggers in children with asthma is viral respiratory infections. For this, it is important to have flu shots, hand hygiene and avoiding crowded environments during epidemic periods. Antibiotics should not be used unnecessarily because these infections are viral.
Exposure to cigarette smoke should be avoided, especially there should be no smoking in the home. Children with asthma are sensitive to odors. For this reason, perfumes and cologne should be avoided, cleaning should be done with non-perfumed detergents and odorless cleaning materials should be preferred.
During periods of intense air pollution, should pay attention not to stay outside and not to open windows. Heaters that emit dirty gases should not be used inside the home. Obesity plays a role in triggering asthma with mechanical effect both on hormonal and the respiratory tract. Therefore, attention should be paid to the child’s weight gain. Appropriate sports should be encouraged, attention should be paid to avoid weight-bearing foods and a healthy diet.
Drug treatment in asthma
Drugs in the treatment of asthma does not eliminate the disease. Medicines ensure that the symptoms of the disease are kept under control. In the treatment of allergic asthma, two types of medication are used, such as attack treatment and preventive treatment.
Attack treatment in asthma
Relaxing drugs in children ,who have attacks and narrowed bronchi, provide enlargement in the bronchi, providing relief in cough and breath tightness. It should be used for 1-2 weeks only in periods of cough, wheezing and shortness of breath.
Preventive treatment in asthma
Various medications are used in the protective treatment of asthma. These treatments are used to control the symptoms caused by asthma in the lungs and to prevent damage to the respiratory tract. They are used for a long time. For this reason, it is very important to adjust the duration and dosage of the drugs by regularly monitoring by pediatric allergy specialists. Medicines containing cortisone are the most important drugs in the treatment of asthma. If given in the proper dosage and time, it will not be harmful.
Immunotherapy (Allergy Vaccine) Treatment in Allergic Asthma Treatment
In the treatment of allergic asthma, if the patient’s findings cannot be kept under control despite effective prevention and drug treatment, an allergy vaccine is an effective treatment in children if it is properly performed by an experienced pediatric allergy specialist. Allergy vaccines are two types, sublingual and subcutaneous injection vaccine. Sublingual vaccine can be administered after the age of 3, and subcutaneous injection vaccines after the age of 5. While sublingual vaccines had less side effects, subcutaneous injection vaccines were more effective.
Allergy vaccine treatment reduces or completely eliminates asthma symptoms. Accordingly, the need for medication also decreases and even disappears in some patients. Allergy vaccines contain only the allergen that the patient is sensitive to at appropriate concentrations. The vaccine duration is on average 4 years (3-5 years). Allergic reactions may develop in some patients while it is being done. The systemic reaction called anaphylaxis is very rare, and if this happens, the vaccine is terminated.
Are complementary and alternative treatments effective in the treatment of asthma?
In addition to the protection, drug therapy and allergy vaccine applied in the treatment of asthma, various applications called complementary and alternative therapy are performed. There are no conclusions regarding that complementary and alternative therapies such as acupuncture, bio-resonance, homeopathy, cave treatment and various herbal medicines are very beneficial scientifically.
What are the negative consequences if asthma is not treated?
If asthma is not properly treated and kept under control;
- Quality of life of the patient and family is impaired due to uncontrolled asthma
- Permanent damage to the respiratory tract may occur as a result of frequent attacks.
- Since much higher doses of drugs should be used to treat frequent attacks, the risk of side effects of drugs increases.
- As the disease is uncontrolled, life-threatening attacks can be seen.
As a result;
- Asthma is the most common chronic disease of childhood
- Asthma is most common in children between the ages of 0-5.
- Asthma is a disease that occurs with the interaction of personal and environmental factors. Heredity is the most important risk factor.
- The most important symptoms of asthma are cough, wheezing, shortness of breath and a feeling of tightness in the chest.
- The diagnosis of asthma is made by evaluating the history, examination and laboratory tests together.
- The most important examination to evaluate whether an asthmatic child is allergic is the skin allergy test.
- In asthma, treatment consist the steps of education, prevention, drug therapy and immunotherapy (allergy vaccine) with allergy determined patients.
