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Sunday, November 23, 2014
Asthma is a very common illness diagnosed in roughly 5 percent to 10 percent of children. It is the result of chronic inflammation of the airways. Symptoms occur when these irritated airways become "triggered" by one of a number of factors (colds being an especially common trigger). Once triggered, the airways launch into a complicated response of muscle constriction, swelling of the airway wall, and mucus overproduction. These changes cause symptoms that can range from persistent cough, to frank wheezing, to severe difficulty getting air.
Diagnosis is based on recognizing an asthma "pattern" in a patient rather than on a single test. Typical symptoms brought on by typical triggers that are responsive to typical medications are part of that pattern. (Note, though, that albuterol alone will not always "fix" matters in a more persistent flare up. Albuterol only relaxes the muscle constriction; it does nothing for the airway swelling or mucus production.)
Breathing tests that show abnormal airway function can also support the diagnosis. However, they are not perfect tests because many asthmatics will have totally normal breathing tests when they are well.
Most children with asthma can be successfully treated by their primary care doctor. The most common reason to see a specialist is for consultation about asthma that won't come under control. That is, the patient keeps having symptoms despite what's already been prescribed. This situation raises questions of whether a more effective treatment plan is available, or whether a different problem is involved that has yet to be addressed.
Asthma treatment is most successful when it is a team project between patients, families, and physicians. When there is doubt about the diagnosis, it is hard to get everyone on the same page. It can be helpful to have a specialist involved in this situation to help clarify the diagnosis and help get everyone on track together.
This article is a NetWellness exclusive.
Last Reviewed: Aug 11, 2014
Elizabeth D Allen, MD
Clinical Associate Professor of Pediatrics
College of Medicine
The Ohio State University