The Cough That Won’t Go Away
majority of coughs stem from a viral upper respiratory infection,
and therefore will get better with time, a chronic cough shouldn't
be overlooked. We never want to over-diagnose asthma, but we don’t
want to miss it either. Doctors will make the diagnosis based
on family history, present illnesses, physical examinations, and
sometimes laboratory data and ancillary tests.
Asthma is a type of sensitivity. A child with asthma has hyper-reactive
airways, meaning that certain stimuli (dust, cigarette smoke,
mold, cats, cockroaches, etc.) will trigger a reaction in the
lungs. We've known for a while now that the reaction involved
a constriction of the lung’s bronchioles, or small airways,
causing sufferers to feel a tightening of their chest and to have
difficulty breathing. But there is also an inflammatory component
to asthma, and this contributes greatly to the disease process.
run together, and people with asthma will often also have dry
skin, eczema, and/or allergies. Sometimes
a baby will develop all three at an early age. Researchers are
investigating ways to prevent what’s called the “atopic
march." Perhaps in the near future we can actually prevent
asthma from coming out in a child with a strong family history
of it, if he is already showing signs of eczema and allergies.
a child for asthma, family history is important, as the condition
often (but not always) runs in the family. But a physical exam
is even more important, as doctors need to listen for wheezing
in the lower airways. Sometimes, however, you can have a normal
lung exam and still have asthma. Conversely, a young child (usually
less than 1 year old) can have certain viruses that cause wheezing,
so not all wheezing indicates asthma.
There is a
test for asthma called spirometry, or pulmonary function tests,
but these tests require effort from your child, so it usually
can’t be performed until he is at least 5 years old. For
the younger child, your doctor will have to make a clinical diagnosis
based on whether his cough is “tight,” non-productive,
or lingering. Other signs of asthma may be a nighttime cough,
or coughing from exercise.
causes of a chronic cough include sinusitis, post-nasal drip,
viruses, pertussis (whooping cough), walking pneumonia, and acid
reflux. It is normal for a common cold to leave behind a mild
cough for up to 14 days, but if your
child is suffering with a cough for more than 2 weeks, he should
be re-evaluated. Sometimes an x-ray may be necessary.
treated with bronchodilators, medicines that open the lungs. Albuterol
is the most common (also called Proventil, Ventolin, Proair, Maxair)
and is given orally, inhaled in a pump, or from a nebulizer machine.
The oral method has the most side effects. The pump needs to be
used in conjunction with a spacer device in order to get the medicine
to the lungs. And the nebulizer can be used at any age, but takes
a good 15 minutes to set up, administer, and clean.
that are anti-inflammatory include Singulair (a mild medicine
that is not a steroid and can actually help with allergies as
well) and steroid-based medicines such as Pulmicort, Flovent,
and Advair. Scientific studies show that only a trace amount of
steroid medicine is absorbed into a child’s system if the
pump or nebulizer is used correctly; your doctor will discuss
the risks and benefits of each medicine they prescribe.
including Robitussin, Dimetap, Sudafed, Triaminic, Tylenol, and
Motrin, are not effective for asthma, and you run the risk of
encountering side effects or overdose. So please stay away from
is left untreated, it will progress and can get quite serious—even
deadly. If your child ever exhibits any signs of respiratory distress—their
chest wall or stomach is going in and out too rapidly—go
to the emergency room immediately. When it comes to trouble breathing,
a doctor needs to conduct a face-to-face assessment immediately.
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