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Audio Playerhttps://healthymomsmagazine.net/wp-content/uploads/2016/08/Asthma-Update-2016-1.mp3

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 Introduction

Ever wonder what asthma is and why so lots of children have it?  Understanding and treatment of this chronic condition in children has really come a long way in the past few decades and I thought I would bring you some of the current information I have recently learned about the common condition called asthma.  I hope after listening to today’s discussion, you will be able to recognize the common symptoms of asthma and have some understanding of what is going on in an asthmatic child‘s lungs so stay tuned to this crucial edition of portable functional Pediatrics!

Musical Intro

For those of you who are new to portable functional Pediatrics, I am your host, Dr. Paul Smolen, a board certified pediatrician who has practiced in Charlotte NC for the past 34 years. I think 34 years of middle of the night care for asthmatic children qualifies me as something of an expert so with that said, let’s get into today’s topic.

What is Asthma?

Let’s start with the question, what is asthma?  Many parents are shocked when I tell them that everyone, whether they are asthmatic or not, are capable of having the physiologic actions that asthmatics do during an asthma attack. You heard me right; any individual can have a bronchiole attack just like asthmatics do, even children and adults who don’t have asthma. Bronchospasm or tightening of one’s bronchioles is actually a protective reflex that everyone’s lungs are capable of in action to irritants. Wheezing, the high pitched sound coming from the lungs during an asthma attack, is the hallmark of bronchospasm. It is a protective reflex to keep smoke and toxic chemicals from injuring our lungs. Bronchospasm protects a child‘s lungs. we all have this reflex that some describe as a loaded gun response, waiting for something to pull the activate to start.  For non-asthmatic children, that “Something” is normally a severe case of smoke inhalation, inhaling strong heat like in a fire, or exposure to toxic chemicals.  It takes a lot to pull a non-asthmatic’s trigger. but not in asthmatic children; for them the activate is normally pulled by just a cold virus or rolling in the lawn on a great spring day or running up and down a soccer field on a cool fall morning. In these children, the reflex has gone haywire, and the activate is pulled for nearly no reason. So you can see, asthma is a condition of heightened bronchial responsiveness, that I like to call twitchy bronchioles.  Low threshold of irritation combined with recurrent episodes that are reversible with medicine… you got a diagnosis of asthma.

Súvisiace, ako neošetrená reaktivita potravy ovplyvňuje celé telo

Why so much allergy and asthma today?

But why is this disease becoming a lot more common? fewer children in America are growing up around cigarette smoke, the air is cleaner than it was when I was a child, a lot more kids have air conditioning and central heat, and power plants are putting out far less particulates than in previous generations, so why is the incidence of asthma climbing. The short answer is, no one knows but here are some of the theories:

The hygiene hypothesis-Lack of microbial life in a child’s gut is the root cause of allergy. This lack of germs stems from repeated courses of antibiotics, a lack of playing in dirt, not growing up around animals microbes, dishwashers that essentially sterilize what we eat, excellent clean food that may have been even irradiated, antibacterial soaps and gels, and a lack of cultured bacteria rich foods are among some of the reasons that seem to support this theory.

Acetaminophen- there is evidence that children who take this drug seems to be a lot more prone to allergies and asthma. Yes, Tylenol. We have talked about this before in previous podcasts. *** how this happens, I am not sure but research does seem to make a link that may be causal or just associated with something else these children do.

Obesity and processed food, especially highly processed food found at fast food restaurants cause inflammation to ramp up in a child’s body and may be part of starting the inflammation in a child’s bronchioles. very theoretical but there is some evidence that supports this theory. ***

Vitamin D deficiency-Here is another popular theory. childhood has come indoors and we all know that it is outdoors, under the influence of ultraviolet light, that a child’s body makes vitamin D. It’s absence somehow turns on inflammation again, the root cause of asthma and allergies.***

And finally, early severe viral infections with RSV and genetic aspects clearly have a strong influence on whether a child develops asthma and allergies. Asthma. and maybe some of these genetic aspects are gene expression changes from things that our ancestors experienced; the so-called epigenetics.

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Recent Research:

So now that you know what asthma is and some of the theories about why its incidence is increasing, let’s look at what recent recent research tells us about asthma?

Attacks are a lot of frequently triggered by everyday viral illness, a lot of frequently rhinovirus, the ordinary cold virus.

After a viral illness, a child’s bronchioles are hyper responsive for  7-12 weeks. That’s longer than we previously thought.  Unfortunately, a lot of young children will get another viral health problem before the 7-12 weeks go by so you can see how young infants have wheezing episodes nearly continuously for the first years of life.

While death from asthma is relatively rare, 1/3 of children who die from asthma only had mild disease before their severe attack. Their pediatrician didn’t feel that they had severe asthma before they had a fatal asthma attack.  I find this revelation particularly frightening.

Severe attacks normally require the inflammation stopping effect oral systemic steroids but research has found that often one dose of a steroid called decadron, also known as dexamethasone, can abort an attack as well as the standard five days of oral prednisolone.

Increasing the preventative dose of inhaled steroid controller to 4X the preventative dose can often abort an asthma attack and obviate the need for oral steroids.

And finally, research tells us that if a child is not doing well with their asthma, the most common reason for their poor control is that the child and their family’s are not abiding by giving the the child their medications. It’s not that the medications don’t work; they are often not being taken for various reasons. Managing a chronic condition like asthma is tough for families and frank denial of the existence of the health problem can be very strong, especially in teens.

I think in the next decade we are going to start really understanding what triggers asthma and we are going to learn how to stop lots of children from ever developing it. basic science research is closing in on the answers at a rapid rate. A child’s lungs, especially as they are growing, are very outstanding and delicate structures. stopping and controlling asthma needs to be a very high priority for both doctors, parents, and really all of society considering that it is the most common chronic health problem that children experience.

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Well, always, thanks for joining me for today’s pedcast. If you take pleasure in hearing about what is new in pediatrics with podcasts, take a moment to subscribe to portable functional Pediatrics on iTunes or at my website, www.docsmo.com. got a comment, share your thoughts and experiences with my listeners. Together, we can make children healthier. I know we can. This is Dr. Paul Smolen, noting that is doesn’t seem fair, that every child isn’t able to get a breath of fresh air. Let’s change that. dobudúcna.

Outro:

Smo Notes:

Asthma Facts

http://www.aafa.org/page/asthma-facts.aspx

Why is the incidence of allergy and asthma increasing?

https://www.aaaai.org/conditions-and-treatments/library/allergy-library/prevalence-of-allergies-and-asthma

Link to this post:Asthma update 2016 (Pedcast)

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