In most cases, asthma is caused by allergies. It manifests itself in the form of inflammation of the airways, in which acute bronchospasm is accompanied by an increase in mucus secretion.
Disease symptoms
Every parent should know how asthma can manifest itself. Signs in a child are usually pronounced. The baby begins bronchospasm, which doctors call bronchial obstruction. This is expressed as follows. The child begins paroxysmal dry cough. Over time, viscous sputum begins to stand out.
You can understand that an obstruction has begun by breathing. If in a he althy child the duration of inhalation and exhalation is approximately the same, then with the development of an asthmatic attack, shortness of breath appears. It is characterized by a short inhale and a long exhale. In this case, the patient has wheezing, which is heard from afar.
There are also so-called first signs of asthma in children, which are observed even before the onset of an attack. So, the baby starts coughing, nasal congestion and itchy skin are observed.
When having an attack, older children may complain aboutfeeling of lack of air, squeezing in the chest area. Sleep is disturbed in babies, they become whiny, irritable, lethargic.
Provoking factors
To prevent the development of the disease, you need to know what exactly can lead to problems. Experts include air pollution, changes in atmospheric pressure, flowering of allergenic plants, and even an unfavorable psychological atmosphere in the house as provoking factors.
If you have people with hereditary allergic diseases in your family, then you first need to find out how asthma can manifest itself in a child. The symptoms must be known in order not to miss the onset of problems. Also at risk are children with exudative catarrhal diathesis.
Allergen that leads to bronchospasm can be plant pollen, certain foods, tobacco smoke, drugs, household dust. The reaction can start from inhaling cold air or from physical exertion.
At the first contact, the body seems to get acquainted with a foreign substance, but at subsequent “meetings” it already begins to react violently. The immune system produces antibodies, and they, in turn, release biologically active substances, which cause asthma in children to develop. Signs and symptoms of shortness of breath, a persistent cough, and difficulty breathing are hard to miss.
Characteristic features of the disease in infants
All babies before an asthma attackthe so-called prodromal period is noted. At this time, you can notice deviations from the respiratory system. Liquid mucus begins to stand out from the nose, itching appears and the constant sneezing associated with it, dry cough. The doctor can listen to single dry rales, see swollen tonsils. These are the first signs of asthma in a child under one year old.
Also, the disease affects the nervous system. The baby becomes restless, irritable, his sleep deteriorates. Violations are also observed on the part of the digestive system - constipation may begin or loose stools may appear.
Asthma develops in babies, usually on the background of respiratory diseases. Only in exceptional cases, its appearance can be due to stress. In this case, the symptoms of asthma in infants appear gradually. This is due to the fact that swelling of the bronchial mucosa and hyperemia are growing at a slow pace.
The attack itself can last from several minutes to several days. It will be accompanied by wheezing that can be heard even at a considerable distance, expiratory shortness of breath.
It is worth noting that sometimes the first signs of asthma in children under one year old go unnoticed. They can appear sporadically without any regularity, at different times. At the same time, they can pass on their own, without any therapy. And in the period between attacks, parents do not notice any deviations.
Preschool children
It is also not always possible to suspect the development of the disease in older children. Signs of asthma in a child at 2 years old can be blurred. For example, atthey can become more frequent and become intermittent breathing during sleep. It also happens during physical exertion.
The characteristic manifestations of the disease also include frequent sneezing, periodic coughing, restless sleep. Often children do not even notice that they are coughing in their sleep. This happens reflexively. If the child sleeps separately, then the parents may not even hear the cough. Therefore, it is necessary to observe the child, if the kindergarten teacher speaks, then the baby coughs during sleep.
Preschoolers cannot always describe their feelings, so parents should monitor their condition. For example, signs of asthma in a 5-year-old child may appear during active games. It is necessary to consult a doctor if, after a short run, the baby begins to cough. Active movement can cause pain in the chest, a feeling of squeezing.
Signs of asthma in schoolchildren
The older the child, the more detailed and accurate he can describe his condition. Therefore, it is already a little easier to determine the disease in schoolchildren. But this can only be done if you know what signs of asthma in children can be.
As in preschool children, in school-age children, the disease is indicated by coughing during sleep and after physical exertion. Patients can talk about the pressing feeling that has appeared in the chest area. In addition, having caught the connection between physical activity and emerging discomfort, children try to run as little as possible, avoiding any active games. Even in the absencecomplaints should be monitored for students who refuse to attend physical education classes, try not to run, sit quietly during breaks.
When a child has a coughing fit, it is difficult for him to sit upright. He tries to alleviate his condition, bends, hunchbacks, leans forward. You may also notice excessive pallor. Preschoolers and children of primary school age may become frightened and even cry during an attack.
Adolescence
As a rule, by the age of 12-14, the diagnosis is already established. At this age, it is important to teach your child to recognize when asthma starts. Signs in a child, as a rule, are always similar. He should always have with him a special inhaler prescribed by a doctor. Parents are obliged to ensure that the medicine does not run out of the bottle and change the used container in time.
Symptoms of the disease in children of middle and senior school age are not particularly different from those found in toddlers. But adolescents are already able to control the disease, which means they can prevent an exacerbation.
It's worth noting that despite the fact that many people have attacks while exercising, teens with asthma need to be physically active. Just before the loads, you need to take the medicine prescribed by the doctor and monitor your breathing. It should be even and rhythmic.
Seizures can be triggered by allergens. But teenagers should already know which substances provoke the disease. If possible, they should avoid them. If allergic attacks provoke seasonal plants, thenit is necessary to take medications on a regular basis that block their development.
Remission often begins at this age. All signs of asthma disappear, and parents decide that their child has simply "outgrown" the disease. But in fact, bronchial hyperreactivity persists. If a teenager encounters several provoking factors, then the disease may return. Sometimes it happens in adulthood. Quite often there are situations in which asthma disappears in adolescence and reappears in the elderly.
Diagnosis
To accurately determine whether a child has asthma, it is not enough to know the first signs and main symptoms of this disease. Shortness of breath, rapid and difficult breathing, obsessive cough can also appear with obstructive bronchitis. Therefore, without consulting doctors can not do. First of all, you need to visit a pediatrician. He will already give a direction for all the necessary tests and refer you to an allergist. If necessary, you may also need to consult a pulmonologist.
In addition to general blood and urine tests, sputum can also be taken for analysis. In asthma, it is found to have an increased content of eosinophils, Kurschmann spirals (mucus from the respiratory tract), Charcot-Leiden crystals (lysophospholipase released from eosinophils), Creole bodies (an accumulation of epithelial cells).
To establish a diagnosis, the doctor must deal with the details of the baby's life. He needs to know how and when the seizures start. Even according to this description, sometimes a specialistit becomes clear what exactly is the allergen for the baby. It is also important for the doctor to know how the child reacts to bronchodilators. Asthma will be indicated by a temporary improvement in the background of their use.
Diagnosis consists in conducting special tests. One of the most common are skin allergy tests. For these purposes, potential allergens are applied to slightly scratched areas of the forearm. After 20 minutes, the doctor evaluates the results. They look at exactly which areas of the skin turned red the most.
This allows you to identify the allergen, but does not make it possible to understand whether the work of the respiratory system is disturbed. Parents themselves can determine this, knowing the signs of bronchial asthma. The cough form in children requires a more thorough diagnosis. To determine the working volume of the lungs, a special examination is carried out - spirometry. It is used to assess the degree of impaired functioning of the respiratory system.
To do this, measure the volume of exhalation-inhalation made with effort and the total capacity of the lungs. For the first time, these measurements are taken without any drugs. Then the examination is repeated after taking bronchodilator medications. If the lung volume increases by more than 12%, then the sample is considered positive.
Also evaluate bronchial hyperreactivity after exercise. If the forced expiratory volume decreases by 20%, this indicates that the small patient has asthma. The signs in a child, however, can be so pronounced that such a detailedsurvey.
Clinical manifestations
It should be understood that in infants it is often impossible to make a diagnosis due to the fact that an obstructive syndrome occurs with bronchitis. In a few days, they develop a cough, symptoms appear, indicating respiratory disorders, and wheezing wheezing is heard. As a rule, treatment consists not only in taking brocholytics, but also antibiotics, antihistamines. With subsequent SARS, symptoms of pulmonary obstruction may appear.
Signs of asthma in infants are quite vague, so special attention is paid to the history, asking parents about the onset of the disease and physical examination.
The very course of the disease can be divided into 3 conditional stages:
- Directly attack. Acute suffocation develops due to difficult entry. It is preceded by a pre-seizure stage, which can last from several minutes to 3 days.
- The period of exacerbation. It is characterized by shortness of breath, the appearance of periodic whistles, an obsessive cough and difficulty in expectorating sputum. At this time, acute attacks may periodically recur.
- Remission. The period is different in that the child can lead a normal life, he does not have any complaints. Remission can be complete, incomplete (determined by indicators of external respiration) or pharmacological (preserved when taking certain medications).
It is important to be able to recognize the early signs of asthma in children so as not toprevent the development of an acute attack. If it was not possible to prevent it, then the parents and the immediate environment of the child should know what needs to be done. It is also important to understand that attacks are distinguished by the severity of bronchospasm.
The safest is the mild degree. With such an attack, a spasmodic cough begins, breathing is slightly difficult. At the same time, the general well-being of the child remains good, speech is not disturbed.
In a moderate attack, the symptoms are more pronounced. The child's he alth worsens, he becomes capricious and restless. The cough is paroxysmal in nature, thick viscous sputum is difficult to pass. Breathing is noisy and wheezing, shortness of breath is present. The skin at the same time turns pale, the lips become bluish. Children may only speak in single words or short phrases.
A severe attack is characterized by the appearance of shortness of breath, which is heard at a distance. The heartbeat in babies quickens, cold sweat appears on the forehead, general cyanosis of the skin is observed, the lips are blue. Symptoms of asthma in children aged 6 years and older are characterized by the fact that the patient cannot speak, he is able to pronounce only a few short words. Toddlers, as a rule, cannot explain their condition, they only cry and express anxiety in all available ways.
The most severe cases are called status asthmaticus. This is a condition in which a severe attack of the disease cannot be stopped for 6 or more hours. Atchild develops drug resistance.
Features of the course of the disease
It is important to know how asthma can manifest itself before an attack begins. Signs in a child may be: capriciousness, irritability, tearfulness, headache, obsessive dry cough.
In most cases, attacks begin in the evening or at night. Initially, there is a cough, noisy breathing, shortness of breath. Children are often frightened, start crying, tossing about in bed. The initial manifestations of asthma in children are often expressed in the form of broncho-obstructive syndrome in acute respiratory infections. Also, against the background of colds, an attack of asthmatic bronchitis can begin. It is characterized by shortness of breath, in which breathing is difficult, and a wet cough.
Atopic bronchial asthma is characterized by the rapid development of an attack. Timely use of bronchospasmolytics allows it to stop. But with an infectious-allergic form, attacks develop slowly, symptoms increase gradually. It is far from immediately possible to stop an attack by taking bronchospasmolytics.
After normalization of the condition, sputum begins to be coughed up, shortness of breath disappears. In some cases, the condition improves only after vomiting.
Parents' actions
Regardless of the age of a child who has been diagnosed with asthma, his relatives should monitor to prevent the development of attacks and reduce their frequency. To do this, it is necessary to strictly follow all the recommendations of doctors, drink prescribed drugs andavoid potential allergens.
In kindergarten, all teachers, a nurse, a music worker should be aware of the situation. It is also important to give them a list of allergens that are the reason that asthma begins in a child. It is also advisable to report the symptoms of the onset of an attack to them. In this case, they will be able to send the child to a he alth worker or call the parents in a timely manner.
If caregivers know what a child is allergic to, they can help avoid contact with these substances. For example, you can replace flowers in a preschool if some of them provoke the onset of an attack. Also, educators are able to monitor the nutrition of the baby. Of course, even two-year-old crumbs need to be explained that they should not eat. But not always children can control it themselves.
At school, teachers should also be aware of the child's problems. First of all, it is necessary to tell the class teacher that the child has asthma. In children, signs and symptoms may appear gradually. For example, if there was contact with an allergen at school, then the child may sleep restlessly at night, cough during rest, his breathing may become confused. In this case, it is necessary to ask the baby in detail about what he did during the day, what he ate and in what rooms he was.
Physical education teachers should also be warned. But if the doctor sees the need, he will refer the child to the commission, where he can be given partial or complete exemption from physical activity at school.
But keep in mind: the child must be gradually accustomed toactive lifestyle. Asthma is not a hindrance to most sports. Even some Olympic champions suffered from this disease in childhood. It is important to simply teach the child to monitor their condition and be able to recognize the first signs of bronchial asthma. Children should have a good defense mechanism. You just need to explain to the child that it is important to stop and restore breathing even if there is a slight discomfort.
Treatment tactics
It is impossible to figure out on your own what to do if the first signs of asthma appear. Treatment should be prescribed by an allergist, sometimes complex work and the involvement of a pulmonologist are required. Equally important is the correct behavior of parents. There is no need to panic, but there is no need to be inactive either. It is necessary to have a conversation with the baby, discuss the possible causes of the development of the disease, tell what can and cannot be done.
How to deal with a condition such as asthma in children? Treatment (Komarovsky, by the way, claims that it is simply necessary) consists in the use of medications to prevent the development of an attack and put the patient into a state of remission.
You can stop the condition with the help of glucocorticosteroids. First, you need to use fast-acting inhalers. Therapy should be supportive. If it is not possible to achieve the desired effect with Nedocromil or cromoglycic acid, then inhalations are made with glucocorticosteroids.
Therapy should be directed at:
- elimination of clinical manifestations;
- improved breathing function;
- reduced need for bronchodilators;
- Preventing the development of life-threatening conditions.
