Persistent cough could indicate underlying issues that could prove harmful to your child’s health in the long term if neglected, says experts from the Post Graduate Institute of Medical Education and Research (PGIMER).
Shalini Kelkar was worried. It was late at night, but her five-year-old child Arti was unable to relax and rest because of persistent coughing. A strange phenomenon, this cough announced its presence only at night, almost every night for several weeks.
Despite administering a variety of cough syrups and cough tablets and antibiotic courses, Shalini failed to regain control of the situation and provide relief to her little one. However, Shalini and Arti are not alone, undergoing this traumatic ordeal night after night.
A child catching a cold is a common enough occurrence, but doctors say that a persistent cough can be indicative of a much bigger respiratory problem like asthma.
“Asthma is a common long-term condition that can be effectively controlled in most children,” says Dr Shailesh Mehta, Senior Pediatric Consultant Mother and Child Care Clinic, Chandigarh.
“The severity of asthma symptoms varies between children, however most children will have mild asthma. Asthma affects the airways, the small tubes known as the bronchi, which carry air in and out of the lungs. Children diagnosed with asthma tend to seem more prone to suffering from cough and cold since the airways of their lungs are more sensitive than normal,” says the paediatric.
According to doctors from the PGI, when an asthmatic child comes into contact with something that irritates their lungs, known as a trigger, their airways narrow, the lining swells, the muscles around them tighten, and there is an increase in the production of sticky mucus or phlegm. This makes it difficult to breathe and causes symptoms such as wheezing, coughing, shortness of breath, and tightness in the chest.
Asthma can easily be managed by using inhalers that deliver medication directly to the lungs and provide relief from symptoms within minutes, allowing the child to lead a normal life.
Asthma often runs in families and a child is more likely to have asthma if one or both parents have the condition. However, the exact cause of asthma is not yet fully understood. An upper respiratory tract infection, such as a cold or flu is the most common trigger of an asthma attack. Other common triggers include exercise, especially in cold weather, an allergy to and contact with house dust mites, animal fur, grass and tree pollen, exposure to air pollution, especially tobacco smoke, among others.
Getting an asthma diagnosis by your doctor is very easy; it’s just by simple and accurate history and by accurate clinical examination. That, however, is the easy part. The problem, doctors say, is not with the diagnosis of asthma, but is with social acceptance.
Asthma has widespread prevalence, with nearly 300 million people suffering globally. The WHO estimates prevalence of asthma in India at 30 million, and Shalini Kelkar’s child is one of them. In advanced countries, asthmatics live better lives with inhalation therapy. Yet many Indian parents don’t accept the diagnosis of asthma for their child and refrain from using inhalers, thereby prolonging their children’s suffering.
Dr Mehta says, “Many people treat symptoms like frequent coughing, early morning coughing, breathlessness, and wheezing with cough medicines or over-the-counter drugs. Also, there is immense fear associated with the word ‘asthma’ and word ‘inhalers’.
Due to this doctors have to use other, elusive terms like ‘allergic bronchitis’ or ‘wheezing bronchitis’. If diagnosis of asthma is not told to the patient, it leaves the serious discussion on asthma lost. This unfound fear has led to majority of the population opting for oral medications like tablets and syrups whereas globally, asthma is being treated with inhalers.”
The focus of asthma management has shifted from emergency management, when symptoms are acute, to control-based management, aimed at long-term treatment. According to experts, inhalation therapy is the most preferred treatment for adult and paediatric asthma.
Inhaled asthma medications provide almost instant relief and are safe for long term use. They do not cause side effects as the drugs reach the lungs directly and are not absorbed in general circulation, as compared to oral drugs and injections which get absorbed and reach all organs and can cause side effects.
Chest physicians emphasise that since asthma is a condition that affects the lungs, the medication must also be in the form that can be easily inhaled in the lungs. Just like a skin ointment is prescribed for a skin infection, asthma must be treated appropriately with an inhaler.
“A combination of reliever, in case of an emergency attacks, and preventer, regularly to prevent future attacks, can act locally and effectively manage asthma,” he said.
Most commonly, asthma symptoms are dismissed as a simple cough and are not treated properly and in time. With prompt detection and timely treatment, asthma can be managed well and the child can lead a normal life.