Bronchial Asthma

What is asthma?
Asthma is a chronic disease of the tubes that carry air to the lungs ( airways or bronchi ). These airways become irritated, inflamed and narrowed.
With asthma, breathing is sometimes difficult due to these changes in the lungs:

  • Swelling of the lining in the airways
  • Tightening of the muscles around the airways (a spasm)
  • Extra mucus in the airway

In patients with asthma, the airways are always irritated and inflamed, even though symptoms are not always present. The degree and severity of airway inflammation varies over time. Asthma is not contagious. It is a chronic disease which can be controlled with daily medications. Although asthma is a chronic disease, anyone with asthma can have an acute (sudden) attack of symptoms.

Symptoms of asthma attack :

  • Repeated coughing
  • Whistling sounds called “wheezing”
  • Complaints like “My chest feels tight” or “My chest hurts”
  • Activity decreased from the normal level
  • Fast breathing
  • Increased work of breathing

Some asthma attacks are mild. Some asthma attacks get very serious.

What causes an asthma attack?
Even if your child has no symptoms, being asthmatic means that there is almost always some inflammation/swelling in the airways. Triggers can cause inflammation to increase, which may cause asthma symptoms to worsen causing asthma attacks (also called flare-ups or exacerbations). Every child has different and specific triggers.

Asthma triggers:
Factors that may trigger or worsen asthma symptom include viral infections, allergens (e.g., house dust mite, pollens, cockroaches, pets, molds), tobacco smoke, strong smells and sprays, exercise, cold air, some drugs, laughter and stress. These responses are more likely when asthma is uncontrolled.

How can I reduce asthma attacks?

  • Follow your asthma plan given to you by your child’s doctor.
  • Give medicines as directed.
  • Keep your child away from smoke and known triggers, if possible.

Consult your doctor if your child gets a cold or allergies.

What should I do during an attack?

  • Stay calm and review the doctor’s instructions.
  • Give rescue medications prescribed by the doctor as directed.
  • Offer your child frequent drinks of water or juice. Fluids help the mucus stay moist and loose.
  • If your child is coughing, encourage him/her to cough up the mucus and spit it out in order to clear the airway.
  • Have your child rest quietly.

Seek Emergency help from the doctor

  • If your child continues to wheeze, breathe fast and hard, or cough, even though rescue medications have been given.
  • If your child cannot take fluids by mouth.
  • If your child repeatedly coughs until vomiting.
  • If your child becomes sweaty or complains of chest pain.
  • If your child lips or fingernails turn bluish.
  • If it is hard to talk or to walk.
  • If your infant/young child’s chest sinks in or the nose opens wide while breathing.

What should I do between the attacks?
Give your child the controller medications prescribed by the doctor and try to avoid asthma triggers.

Asthma medicines
There are 2 types of asthma medicines:

  • Quick-relief medicines (“relievers”) are the rescue medicines used to stop asthma attacks.
  • Preventive medicines (“controllers”) are used every day to protect the lungs and keep asthma attacks from starting.

Asthma medicines can be taken in different ways . When asthma medicine is breathed in (inhaled), it goes right to the airways in the lungs where it is needed. Inhaled medicines come in many shapes as sprays or powders. Some asthma medicines are taken orally.

Controller medicines for asthma are safe to use every day.
The child can not become addicted to preventive medicines for asthma even if he use them for many years.
Controller medicines make the inflammation of the airways in the lungs go away.
The doctor may tell you to give preventive medicine every day

  • If your child coughs, wheezes, or has a tight chest more than twice a week
  • If your child wakes up at night because of asthma
  • If your child has many asthma attacks
  • If your child has to use quick-relief medicine more than twice a week to stop asthma attacks.

Asthma may get better or it may get worse over the time. Your doctor may need to change asthma medicines or change their doses. Children with asthma should be reviewed regularly by their doctors as advised. Do not change the dose or stop the preventive medicine until the doctor tells you.

When asthma is under good control, patients can:

  • Avoid troublesome symptoms during day and night
  • Need little or no reliever medication
  • Have normal active lives
  • Play, go to school and sleep well at night
  • Avoid serious asthma flare-ups (exacerbations, or attacks)
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