Focus on Conditions: Pediatric Asthma

What is Pediatric Asthma?

Asthma is a chronic (long-lasting) inflammatory disease of the airways causing the airways to occasionally narrow. Its symptoms include coughing, rapid noisy breathing in and out, chest congestion, tightness, discomfort, wheezing and shortness of breath sometimes to the point requiring the child to gasp for air. Asthma has a profound affect on the infant and child with over 3 million visits to the doctor and 200,000 hospitalizations yearly. Attendance at school is also affected with numerous lost school days.

What are the causes?

In infancy and childhood irritants known as allergens and viruses cause inflammation and obstruction to air flow through the lungs resulting in early pediatric asthma. Early allergic sensitization and the diagnosis of asthma go hand in hand. More than half of all children begin to have asthma issues before the age of 3 years and 80% start before age 6 years. Approximately 60-70% of individuals with asthma, including 3 million children with asthma have an underlying allergic issue and 90% of children with asthma also have allergies.

What are the triggers?

The most common asthma triggers include: grass, tree, and weed pollens, airborne mold spores, dust mites, foods as well as food preservatives, animals, cigarette smoke, cold air, exercise, gastro-esophageal reflux, medication allergy and viruses.

How can I control Asthma?

Asthma and allergy control is of utmost importance. Asthma control begins in the: home; school; office; and the automobile. One must control the indoor air quality, such as Dust Mites (bare floors, throw rugs, vacuum 1-2 times per week), animal dander (choose a pet without fur or feathers, keep out of the bedroom), mold spores (reduce moisture, use dehumidifiers, limit indoor house plants, fix all leaks and clean excessively damp, moldy areas), pollens (use air conditioning in the warm weather, keep windows and doors closed) and smoke, especially second hand cigarette, cigar and pipe smoke.

What about the treatment?

Treatment of asthma begins by eliminating the most common triggers causing inflammation and swelling of the airways. If the airways are already irritated / inflamed they will be more sensitive to the above allergens and the asthma symptoms will increase. One must avoid / eliminate the asthma triggers so the child experiences less coughing, wheezing, shortness of breath, and is not awakening during the night with breathing problems. A child should not require emergency medications more than 2 times a week and can run around without coughing and having difficulty breathing.

How do I know if it's Asthma?

To establish a diagnosis of asthma a clinician should obtain a detailed family, social and medical history (including wheezing-coughing-difficulty breathing-chest tightness-exercise difficulty), physical examination, pulmonary function studies (spirometry) in children 5 years and older and baseline chest x-ray. Referral to an asthma specialist should be considered if signs and symptoms are not typical or if there are problems with the diagnosis or if additional testing is required.

Risk Assessment

http://carat.asthmarisk.org/RiskProfile/assessment.asp

CHSLI physician contacts:

St. Catherine of Siena Medical Center:
Louis E. Guida, Jr. MD FCCP, FAAP, FAAAAI, FACAAI
Allergy, Asthma, Pediatric Pulmonary, Cystic Fibrosis
631-665-2700 / 631-321-2100

St. Charles Hospital:
Louis E. Guida, Jr. MD FCCP, FAAP, FAAAAI, FACAAI
Allergy, Asthma, Pediatric Pulmonary, Cystic Fibrosis
631-665-2700 / 631-321-2100

Good Samaritan Hospital Medical Center:
Louis E. Guida, Jr. MD FCCP, FAAP, FAAAAI, FACAAI
Allergy, Asthma, Pediatric Pulmonary, Cystic Fibrosis
631-665-2700 / 631-321-2100

Mercy Medical Center:
Stanley Goldstein, MD
516-536-7336