Although asthma is an airway disease that can occur at any age, it is more common in children and people with a personal or family history of allergies. In the former case, affects more than 10%, As per the studies done on its incidence in the country.
asthma It is one of the main non-communicable diseases (NCDs), affecting children and adults. The swelling and narrowing of the tiny airways in the lungs cause your asthma symptoms, According to the World Health Organisation, that can manifest as cough, wheezing, shortness of breath and chest tightness. Difficulty in breathing may increase.
“My son coughs all night, many nights, several times a year”; “The girl is agitated for no reason and whistling sounds are heard when she breathes”; “Teachers told me that he sits at recess, he doesn’t play with his classmates because he gets breathless right away.” These statements by mothers and fathers may or may not refer to symptoms of asthma, but – in the face of a virus and a respiratory infection – it is important to differentiate between cases of asthma, as it is a chronic disease whose management is different. : It requires learning and some remedial measures.
Its manifestations vary from person to person and can vary throughout life in the same patient., “Asthma, like many other chronic diseases, cannot be cured, but optimal control can be achieved, which is the key to living a good quality life. People with asthma can lead normal lives even in the most severe cases, so it will always be important to make an adequate diagnosis, which also considers the origin of asthma, triggering factors and the severity of the condition. Adherence to the treatment prescribed by the treating health professional”, explained Dr. Jorge Maspero, Medical Director of Fundación CIDEA, Specialist in Allergy and Clinical Immunology.
how to detect asthma
Below is a series of factors that must be taken into account in order to fully understand whether you are experiencing a picture of asthma and determine how to prevent complications and better control the disease. how it presents in each patient.
1. Symptoms and severity of episodes: It is necessary to establish how they occur, in their onset and in their development, duration, intensity, hourly variation and pattern (continuous or seasonal); Frequency, attendance on duty, hospitalization, need and response to medication.
“One of the great aims of asthma management, especially in severe cases, is the prevention of exacerbations, which are conditions that often require immediate medical attention. Early recognition of the presence and worsening of symptoms by the patient and their family will allow early medical intervention, stop the progression of the crisis and reduce the likelihood of hospitalisation”, Dr Veronica, Pediatrician at Hospital Garrahan Giubergia told.
2. Development of the disease: This is related to age of onset, progressive character or not, previous and current diagnosis and treatment.
“The diagnosis of asthma is fundamentally clinical and is confirmed by spirometry and bronchodilator testing. Diagnosis is more complicated in young children (preschoolers), as lung function tests such as spirometry are more difficult to perform. However, in children aged 6 years it is achieved in the same way as in adults”, explained Giubergia.
Some children with asthma reach adulthood without a diagnosis, although many times asthma symptoms begin during the first years of life. About 4 in 10 children who wheeze due to a respiratory infection are eventually diagnosed with asthma in later years.
On the other hand, determining the severity of asthma in each patient is important. Long-term follow-up of children with asthma between the ages of 7 and 10 confirms that the severity of their condition persists over time: those who develop severe asthma in their early school years are more likely to develop severe asthma in adulthood. I also have severe asthma. ,
By definition, severe asthma is one that cannot be controlled despite adequate therapy adherence at the maximum dose or that, even when controlled, worsens upon reduction of high-dose therapy; It affects 5 to 10% of cases”, explained Dr. Maspero.
3. Triggering or aggravating factors: It is necessary to establish whether episodes are triggered by respiratory infection, environmental allergens (mites, animal epithelia, fungal spores or pollen) or exposure to environmental pollutants (tobacco smoke or other pollutants), association with environmental changes (travel, other Habitat), emotional factors (crying, laughing), food and additives, medications (aspirin), gastroesophageal reflux and factors such as cold air, exercise, or weather changes. This is relevant regardless of whether the residence is urban or rural, house or apartment; Geographical location and temperature. Bedroom details (type of mattress, pillow, rugs, stuffed animals, books). Pets (cat, dog, etc.). Family smoking (number of smokers, frequency, if they smoke indoors).
As Maspero suggested, “There are various etiological agents, such as indoor allergens, mites, animal epithelia, fungi or pollen, that affect exacerbations. Allergic sensitivities of the patient and environmental influences, which are variable in many cases, should be evaluated, which should be agreed upon with the specialist.
4. Effect of disease: This pathology can cause difficulties in the patient such as absenteeism from school, reluctance to participate in sports, sleep, growth, development and behavioral disorders, and can lead to changes in routine, loss of work hours, and economic costs to the family. can make an impact. That’s why it’s also important to understand what menstruation is like without seizures, whether you have symptoms, tolerance to exercise, need for occasional or frequent medication, etc.
“When children cannot run or play with their peers, it is essential to address the impact on their lives; How much a sleepless night due to symptoms affects the child and their entire family and the fear that breathing difficulties will worsen and they will have to go to the ER. This is why it is so important to find ways to best control the disease, to deal with its effects on different stages of life”, acknowledged the doctor.
5. Learning: Information about the disease, its severity, involvement of the family and the patient himself, together with the health professional, in establishing and monitoring an asthma control plan, including appropriate administration of medications, and how to act in specific crises is important. guidelines on
The expert added, “Children who cannot control their disease with usual treatment will be at risk of presenting a high number of crises, may require hospitalization and repeated courses of systemic corticosteroids, which in sum may pose a long-term health risk.” ,
As far as treatment is concerned, the news is encouraging. Medicine is increasingly becoming better therapeutic options that contribute to improving the health and quality of life of patients and their families. A few days ago, the indication for this purpose of the biologic dupilumab, present in our country since 2019, was presented for children.
“For a population that had limited therapeutic options, it is a significant advance to have innovative therapies that manage to more effectively control the pathophysiology of severe asthma, but also with a better safety profile. It is good news that science continues to progress and we can count on medical innovations like this in the country”, concluded Maspero.