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Asthma in children

AT THE CHANGE of season, in April or in October, if you put your ear on the back of a person to hear the sound of his breathing, in one out of four persons you will probably hear a wheeze. This is more likely in children of the school going ages, though it can occur at all age, from infants to those in the older age groups.

The tendency to get a wheeze is on the increase more so in urban than in the rural areas, especially in the centre of the cities. Air pollution has played a definite role in this increase. Pollution from vehicular traffic has been a primary offender; more than any other source.

It has been found that the gasses emitted from vehicles exhausts contain more than the permitted levels of sulphur dioxide, nitrogen oxides etc., and damage the cells that line the respiratory passages, exposing the nerve endings. The damage to the living cells causes inflammation and the exposed nerve endings, which are highly sensitive, contract the surrounding muscles. Both result in a decrease in the calibre of the airways which leads to wheezing when air is breathed out.

All that wheezes is not asthma, is an old and true adage. Some children who wheeze have this condition because a respiratory virus infection (respiratory syncytial virus) which narrows down their airways because of inflammation. Such a wheeze may subside and disappear and never occur again. A wheeze in a child can also be because of a gland or a group of glands pressing upon the airways, thereby causing narrowing of the lumen. There are many other causes of a wheeze.

A wheeze, or cough and wheeze, or only cough that occurs again and again, and particularly at the change of season, is the one that is likely to be asthma.

Asthma in children should be diagnosed by a doctor, particularly a chest specialist, after ruling out other causes for a similar condition.

After the diagnosis is made it has to be medically treated. But more often it should be managed without drugs. This needs close cooperation between the patient, the parents, and the specialist doctor.

Asthma is usually an environmental problem in a person who is susceptible, i.e., genetically prone to it. It can be managed to the extent that in its worst form it is only a nuisance which does not interfere in the child's activities, both at home and at the school.