Bronchial Asthma In Children. Diagnosis And The Principles Of Treatment
Bronchial asthma is an allergic disease, which is based on chronic inflammation in the respiratory tract and bronchi’s hyperactivity to the impact of various incentives. The disease is characterized by recurrent episodes of bronchial obstruction, partially or completely reversible, accompanied by fits of coughing, wheezing and by tightness in chest.
The increase in prevalence of asthma in all age groups is considered to be due to the following factors:
• The impact of air pollutants inside homes, due to the peculiarities of modern building materials and recycling of air (nitrogen dioxide, cigarette smoke, etc.) and an increase of different allergens (dust mites, cockroaches, fungi, and animal hair).
• The incidence of acute respiratory viral infection in early childhood.
• The syndrome of respiratory disorders, bronchopulmonary dysplasia, etc.
• Smoking in the family; smoking while pregnancy or nursing pregnant affects the lungs of the protembryo or infant.
The development of bronchial asthma in children is due to genetic predisposition and the environmental factors. There are three main groups of factors that contribute to the development of the disease:
• Predisposing factors (genetic burden to allergic diseases, atopy, and bronchial hyperactivity).
• Etiological agents/sensitizing factors (allergens, viral infections, drugs).
• Aggravation factors (or so-called triggers) that promote inflammation in bronchi and/or provoke the development of acute bronchoconstriction (allergens, viral and bacterial infections, cold air, cigarette smoke, emotional stress, physical stress, weather conditions, etc.).
Basic principles of bronchial asthma treatment:
• Education of sick children and their parents: they must know the purpose of medication, possible ways of achieving them and the methods of the disease control.
• Identification and removal (elimination) of the factors, provoking exacerbation of the disease.
• Appointment of special hypoallergenic diet.
• Rational use of drugs (bronchial spasmolytic) that prevent the exacerbation of the disease and improve the symptoms during the recrudescence.
• Specific immunotherapy.
• Remedial treatment of non-drug methods and means, including therapeutic resorts (facilities) or treatment centers.
• Regular dispensary observation with curative therapy correction.
Primary prevention includes creation of a productive environmental situation, leading healthy life-style, elimination of non-irritating environmental factors (chemicals, cigarette smoke, etc.). Early detection of atopy and the causalgic allergens, including food, prevention of the development of viral infections, treatment of atopic dermatitis, allergic rhinitis, etc. are very important compounds of primary prevention of the disease. Reduction of allergen exposure, leading to subsidence of inflammation in bronchi and their hyperactivity, belongs to secondary prevention.
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