It can be difficult to diagnose asthma. Your child's doctor will consider the nature and frequency of symptoms and may ask for tests to rule out other conditions and identify the most likely cause of the symptoms.
There are several childhood conditions that can have symptoms similar to those caused by asthma. To further complicate the situation, these conditions are usually coexisting with asthma. Therefore, the child's doctor should determine if the child's symptoms are triggered by asthma, a condition that is not asthma, or by asthma and another condition.
Some of the conditions that generate symptoms similar to asthma are:
• Rhinitis
• Sinusitis
• Reflux of stomach acid or gastroesophageal reflux disease
• Abnormalities of the respiratory tract
• Vocal cord dysfunction
• Infections of the respiratory system, such as bronchiolitis and respiratory syncytial virus
The doctor will ask for a detailed description of the symptoms and the child's health. The child may also need medical tests.
In children over the age of five, doctors diagnose asthma with the same tests that are used to identify the disease in adults. Pulmonary function tests (spirometry) measure how much air the child can exhale and at what speed. The pulmonary function test can be performed with the child resting, after exercise or after taking asthma medication.
In younger children, the diagnosis can be difficult because lung function tests are not accurate before five years of age. The doctor will only rely on the detailed information that you and your child provide about the symptoms. Sometimes, a diagnosis cannot be made until months or even years after observing the symptoms.
If you suspect that your child has asthma, it is important that you consult a doctor as soon as possible. Early diagnosis and appropriate treatment can prevent interruptions in daily activities, such as sleeping, playing sports and attending school. It could also prevent dangerous or possibly fatal asthma attacks.
Allergy tests for allergic asthma
If the child seems to have asthma caused by allergies, the doctor may perform an allergy skin test. During a skin test, the skin is pricked with extracts of substances that usually cause allergies (such as animal dander, mold or mites) and is observed if signs of an allergic reaction develop.
Treatment
The goal of asthma treatment is to control the symptoms all the time. Well-controlled asthma means that your child:
• Does not have symptoms or has minimal symptoms
• Does not have asthma outbreaks or has minimal outbreaks
• No limitations of physical activity or exercise
• Uses the minimum possible of fast relief (rescue) inhalers, such as albuterol
• Presents few or minimal side effects of medication
The treatment of asthma includes the prevention of symptoms and the treatment of an asthma attack in progress. The right medication for your child depends on a number of issues, including age, symptoms, asthma triggers, and what seems to work best to keep asthma under control.
Long-term control medications
Long-term preventive control medications reduce the inflammation of the airways that produces the symptoms that the child presents. In most cases, it is necessary to take these medications every day.
Types of medications for long-term control include:
Combined inhalers. These medications contain an inhaled corticosteroid along with a long-acting beta agonist. These include fluticasone and salmeterol (Advair Diskus, Advair HFA), budesonide and formoterol (Symbicort), fluticason, and mometasone and formoterol (Dulera inhaler).
Inhaled corticosteroids. These medications include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex), ciclesonide (Alvesco), beclomethasone (Qvar) and others. Your child may need to take these medications for several days to several weeks before they provide maximum benefit.
The use of these drugs in the long term has been associated with slower growth in children, but the effect is not of great significance. In most cases, the benefits of good asthma control are more important than the risks of any possible side effects.
Modifiers of leukotrienes. These oral medications include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo). They help prevent asthma symptoms for up to 24 hours.
Rarely, these medications have been linked to psychological reactions, such as nervousness, aggression, hallucinations, depression and suicidal thoughts. Contact the doctor immediately if your child has any unusual reaction.