Managing childhood asthma

By Malcolm Blumenthal, M.D.

In the United States, asthma rates have been on the rise in recent decades. Asthma now affects 8 to 10 percent of people of all ages, with rates being slightly higher in children. It is the most common long-term disease in children and teens, and is the most common reason children miss school. Fortunately, because of advances in the understanding of what causes asthma and how it can be treated, there are more options than ever for helping a child with asthma lead a healthy, normal life.

Asthma is a persistent inflammation of the airways leading to the lungs that causes breathing problems. Symptoms include:

• coughing,
• wheezing, and
• shortness of breath

Most people with asthma breathe normally until a "trigger" causes an asthma attack and makes breathing difficult. Asthma triggers, which differ from person to person, include tobacco smoke, dust, pollen, pet dander, exercise, and cold air.

Controlling childhood asthma means avoiding triggers, monitoring symptoms, and using medications or seeking medical care when necessary. If your child has been diagnosed with asthma, your physician will develop an individualized asthma action plan to help your family manage the asthma effectively. This action plan describes how to monitor and treat asthma symptoms, including when to seek professional help or emergency care. Identifying what triggers an asthma attack for a child is an important component of managing asthma, because the first line of defense in controlling asthma is to limit exposure to triggers. If that means giving up a pet or staying indoors when it's cold outside, a child may find it difficult to cope with such limitations. Asthma also can be controlled by using either preventive or quick relief "rescue" medications.

New treatment approaches include medications that interfere with what causes an asthma episode before symptoms (such as wheezing) occur. Steroid medications now can be delivered (by inhalation) directly to the lungs where they are needed, avoiding the negative side effects (such as growth retardation) associated with steroids taken by mouth. Some newer "once-a-day" pills for asthma may be easier to take than inhaled medication; these may help people with asthma follow through on consistently taking their prescribed medicine.

Both genetic and environmental factors appear to play a role in the development of asthma. Researchers at the University of Minnesota are exploring the genetics of asthma to see what genes might be involved and how those genes may interact with each other or with environmental factors to increase the risk of developing the disease. By better understanding how asthma develops, better therapies that interrupt the mechanisms causing asthma could be designed. Work at the University of Minnesota's new Center for Lung Science and Health may eventually lead to better treatments for asthma and other lung diseases.

If your child has asthma, your physician may make specific recommendations, such as getting a flu shot for your son or daughter each winter. By following through on those recommendations, helping your child avoid known triggers, and sticking to his or her asthma action plan, you can keep your child's asthma well-controlled.

Note: Malcolm Blumenthal, M.D. is Professor of Medicine and Director of the Asthma and Allergy Program at the University of Minnesota.

Health Talk & You is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to http://www.healthtalk.umn.edu/. For comments or questions about Health Talk & You e-mail lafor016@umn.edu.