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Catherine Meunier is a family medicine physician and genetic counsellor who was trained in Montreal, Canada. Her areas of particular interest are pediatrics and women’s health. She is the mother of a 5 year old son and a 2 1/2 year old daughter and has been living in Tokyo for the last 9 months.

My son has recently been diagnosed with asthma, please tell me more about asthma.

A dry nighttime cough is often suggestive of an asthma condition.

Asthma is the most common chronic lung disease in children and adolescents, affecting between 5 to 15% of this age group. Commonly, in young children, viral respiratory infections lead to inflammation of the lower airways and their subsequent narrowing (bronchoconstriction). In older children, allergies, pollutants, cigarette smoke, exercise and cold air are the most common trigger factors.

Typical symptoms may include a dry nighttime cough, whistling sounds, or difficulty breathing during exercise and cold exposure. Classically, as a consequence of airway narrowing, wheezing is heard on expiration.

Most often, the diagnosis does not necessitate further tests unless the problem occurs often or is severe. If necessary, special breathing tests can confirm the diagnosis and help evaluate the effectiveness of the treatments.

Allergy tests are often prescribed to identify common intolerances such as dust, mold, feathers and pets. Once these trigger factors are identified, special attention should be paid to the child’s bedroom environment.

Asthma, in most instances, is a reversible condition, which responds to two major types of medications. The first class, bronchodilators, rapidly decreases the constriction of the >airways and helps to alleviate symptoms. The second class, >anti-inflammatories, treats the underlying cause of the bronchoconstriction. This class of medication takes up to several days to take full effect and often needs to be taken in anticipation of an asthma attack.

Close attention should be paid if you suspect that your child may have asthma, as asthma can be fatal. Rigorous monitoring by physicians, understanding of the disease, and close adherence to treatment are critical. Most children will improve with age, probably because of the decrease in respiratory infections. Long-term studies tend to indicate that 50% of children diagnosed with asthma will have a remission, 40% will improve, and 10% will have chronic, severe problems. During an asthma attack, should prompt administration of medications fail to improve the symptoms, medical assistance should be rapidly sought. Asthma attacks often worsen at night. Treatment should be started as early in the day as possible when symptoms first appear, or if an upper respiratory infection develops in susceptible children.