Asthma or Not? Cough in Children With Asthma

A cough is likely due to asthma if it refuses to go away over days, weeks or months, is worse at night or early in the morning, or if it comes and goes without notice.

A cough is even more likely due to asthma if the child also suffers from a chronic rough skin rash called eczema, or if a parent or other close relative has asthma.

Kids and adolescents can develop asthma at any age. So, no matter at what age such a cough began, the recognition that the child might have an underlying asthma condition is essential.

Sadly, many parents are reluctant to accept a diagnosis of asthma, a dilemma which leads to unnecessary pain and suffering, delay in treatment and even loss of life. For parents who can't come to term with their child having asthma, I have good news: a cough due to asthma quickly gets better with proper medications. Moreover, children can outgrow their asthma.

Why people suffer from asthma

People who suffer from asthma have sensitive, hyper-responsive lungs, in the same way that people who suffer from eczema have sensitive skin.

A sensitive lung can go into spasm or constriction at any time. Spasm narrows small air channels, limiting airflow within the lungs and suddenly making it difficult for people with asthma to breathe. During such an episode of asthma attack, patients can experience shortness of breath, wheezing, coughing, fast breathing, and chest tightness or discomfort.

Wheezing is a high-pitched musical sound taking place in the chest of someone who is experiencing an asthma attack. When loud, people nearby can hear it; but at other times it can only be heard by clinicians who listen to the chest with a stethoscope.

Asthma triggers

Catarrh or runny nose with its concomitant viral infection, cold weather, pets such as cats and dogs, dust, dirt, cockroaches, pollutants, paint fumes, perfumes, mold, grass, pollens and cigarette smoke can trigger already sensitive lungs into an episode of coughing and wheezing. Exercise, as well as emotions, also triggers a cough and shortness of breath in people with sensitive lungs.

Cough as a sign of asthma

Cough, a common problem, is one of the many signs of asthma. Parents and caregivers bring children to clinicians when their cough continues for many days and does not resolve with cough syrup. A cough is bothersome to children; it can prevent them from sleeping at night or during the day, can provoke them to vomit, can make them fearful of eating and even cause them to lose weight. When a cough and fever go together in a child, a more sinister illness such as pneumonia comes to mind.

Severity of asthma

When evaluating a child with asthma, it is important to assess the severity of the symptoms. Some children have the intermittent form of asthma, while others have the persistent form.

People with the irregular form of asthma experience symptoms once in a while. Those who have a persistent form experience degrees of symptoms more often, usually on a weekly basis or a daily basis, and sometimes even several times a day.

Examination of children with asthma

Clinicians look for signs of distress when presented with a child with an acute attack of asthma. The in-and-out pulling of chest muscles in a patient, or 'retraction', signals air-hunger and agony.

When there is no obvious wheezing, chest retraction or spontaneous coughing, I tend to ask the child, if they are old enough and comfortable, to cough out loud so that I can hear it

By the sound, one can often tell from where a cough is coming: from the throat, or pharynx, or from deep in the chest. The latter would mean that the lungs are the source of the problem, and therefore indicative of asthma. This distinction is important.

Respiratory rates, temperature, pulse rate and oxygen saturation are some of the vital signs obtained at the time of first examination.

Diagnosis of asthma

Clinicians can diagnose asthma in a patient who has a cough by listening to the chest with a stethoscope. A high-pitched musical sound, known as a wheeze, is suggestive of this condition. When a patient's symptoms are relieved with the use of a bronchodilator, such as albuterol, the diagnosis is all but certain.

Asthma medications

Drugs for asthma treatment, known as bronchodilators, are targeted to open up the narrowed airways so that air can get into the lungs. Another group of medications called 'inhaled steroids' reduces mucus production and inflammation in the small air channels. People with frequent asthma attacks should use both medications. Medical practitioners need to explain details of use.

Asthma control and prevention

Prevention is the key to containing asthma. People who have the condition should avoid known environmental triggers; some of the well-known allergens-dust, cats, dogs, smoke, roaches and so on have already been mentioned. Different asthmatics can have different triggers.

An asthma action plan is a set of steps which, when completed by medical practitioners, guides patients on the use of their medication before and during symptoms, and what to do when symptoms do not improve. There is also a section that tells users how to control things in their environment that make their asthma worse.

Why do people die from asthma?

Two years ago, the Center for Disease Control and Prevention, the CDC, in the USA reported 187 children under the age of 18 had died that year as a result of asthma.

My guess is that the numbers of children who die of asthma every day within the inner cities of underdeveloped countries such as Onitsha in Nigeria, where pollution is at every street corner and people breathe air mixed with smoke, dirt and dust, are countless.

Simple measures such as avoiding asthma triggers and prompt use of asthma medication would prevent many unnecessary deaths. Failure to recognize the illness is the most heartbreaking and obvious reason for the high numbers. Furthermore, lack of access to much-needed medication as well as a delay in seeking expert medical intervention is often to blame.



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