Recurrent sinusitis in children and a cold that refuses to go away could be early warning signs of asthma and allergy to the polluted air that constricts the airways, said doctors on World Asthma Day on Tuesday.
“Most parents take sinusitis casually, but it triggers asthma in about 70% of the cases. If left untreated, it causes inflammation of the lungs but if treated, asthma can stay under control,” said Dr Vivek Nangia, director, department of pulmonology and infectious diseases, Fortis Hospital.
Though pollution tops the list, dust, pollen and change in weather also cause asthma.
The symptoms could be as mild as chest pain, nausea, prolonged cold and cough to the severe ones such as wheezing, shortness of breath and bronchitis. Some children experience occasional mild symptoms but there are many who may experience severe episodes.
The symptoms may vary from child to child, and it also depends on the age. In infants one may notice slow feeding or shortness of breath during feeds.
Toddlers with asthmatic symptoms may avoid going out to play as they would get tired easily and start coughing when performing any physical activity.
In older children the change in weather usually triggers an allergic reaction, resulting in cough that worsens at night.
Sooner the treatment starts the better it is to improve the breathing pattern, to reduce flare-ups and also to control symptoms, doctors say
“Treatment takes place in two parts—treating the asthma episode and maintenance therapy, using inhalers and tablets. Once the symptoms get better, the child needs to be put on preventive treatment that requires observation and to avoid triggering factors,” said Dr Nangia.
However, doctors warn against misdiagnosis as the symptoms can be similar to certain types of viral infections. Labelling a child asthmatic can be quite detrimental for his or her growth. Therefore, one has to be sure about the symptoms.
“Unless there are recurrent symptoms—at least three episodes of spasmodic cough unassociated with any viral infection, we don’t confirm asthma. We prefer to call it hyperactive airway disease as a lot of them become alright as they grow up,” said Dr JS Bhasin, head of paediatric department, BLK Super Specialty Hospital.
The history of the child and her family is important while diagnosing the disease.
Before the age of five, doctors prefer clinical examination and observe the child’s response to therapy as a means of diagnosis. For older children, there is pulmonary function test in which a child is supposed to blow through a particular machine and readings are recorded.
The best way to handle asthmatic children is to control the symptoms by avoiding irritants.
“Delhi air is the biggest irritant and so are the dust mites inside the house. People should take measures such as going for wet-mopping and avoid carpets. The material for curtains and sofas should be such that doesn’t attract dust. Smoking in front of an asthmatic child is an absolute no,” said Dr Bhasin.
It is also not advisable to have pets in a house if the child has asthma. Pets are best avoided, if you must keep one then ensure that the child has least contact with the pet.
“Like diabetes or hypertension, asthma symptoms can be controlled by therapy. Inhaler is the first line of treatment and has less side-effects. As long as the symptoms stay under control, there is no need to worry,” said Dr Nangia.