Most asthmatic children show no evidence of a chronic disease between attacks. It is, therefore, essential that the child be seen by a healthcare provider when symptoms are present. The patient’s medical history, physical examination and other diagnostic measures are the key components to making a proper diagnosis of asthma. Children are generally brought for medical care with one or more of the following commonly reported symptoms:
Wheezing is a whistling sound that results from narrowing of the airways.
Coughing occurs particularly at night when airways may be narrowed due to a decreased effort of breathing during sleep, as well as the presence of more mucus plugs that create an intrinsic need to cough and clear the blocked airways.
Chest tightness is caused by tightening of the muscles around the airway (called bronchospasm).
Shortness of breath is caused by faster breathing resulting from the compensation for the inefficiency of breathing through a narrowed airway, prolonged expiration and inappropriate exchange of oxygen and carbon dioxide.
The symptoms of asthma may not always correspond to the degree with which the airways have narrowed. It is critical, therefore, to have the child evaluated by a physician who can assemble the appropriate studies in order to determine the child’s severity of illness.
For children who develop severe asthma attacks, which are considered medical emergencies, treatment should never be attempted at home. When a child is having a severe attack, wheezing may be absent because the airway opening may be so minimal that wheezing is not even audible. Shortness of breath may become so severe that the child may begin to have trouble walking and talking. The child may sit hunched over to make breathing easier. Inhalation (breathing in) as well as exhalation (breathing out) become more difficult. Other symptoms due to increased respiratory effort include a low grade fever, sweating and fatigue from the increased work of breathing.
The child may develop abdominal pain as a result of the increased use of the diaphragm and abdominal muscles for breathing. Vomiting is common and may temporarily relieve the discomfort, but it may also indicate that the child has gastroesophageal reflux (GER). GER is a condition in which stomach contents move up into the esophagus.
Children may complain of stomach pain, heartburn and nausea. Excess burping and vomiting may also be present. GER provokes asthma and if left untreated can make asthma worse. The doctor can prescribe medication to block the stomach contacts from moving up towards the throat.
Remember all of these reported symptoms are to be used as a guide. Any breathing difficulties children experience must be reported to the child’s doctor immediately. A timely report of these symptoms will lead to an accurate diagnosis, the initiation of successful treatment and the avoidance of complications.