question-icon

Suggest treatment for bronchial asthma in a child

default
Posted on Mon, 28 Sep 2015
Question: Sir I want to know below things:
1.     Is reliever and preventer both give simultaneously. Are we give only preventor also.
2.     He is taking medicine for at least one year, then after again decease rise. Will he recover from this decease, chances are not.
3.     Recommended medicines are ok or not.
4.     Any test you recommend
5.     What is allergy test. Is it available in XXXXXXX XXXXXXX
doctor
Answered by Dr. Archana Verma (2 hours later)
Brief Answer:
Take only preventer therapy for control of bronchial asthma

Detailed Answer:
Hi

Welcome to the HCM

I have gone through your question and understand your concerns but don't worry. Childhood asthma if controlled properly with good compliance can make life near normal in children.
Preventer drugs are given for maintainance therapy. Relievers such as salbair are given only during acute exacerbations. If the relievers are used very often, then preventer drugs needs to be stepped up. Any step down should be planned only after complete control of all the symptoms for atleast 6 months. Also, step down or decrease in preventer drugs should be very gradual. Only 25-50% of the doses are reduced every 3 months during step down. You may discuss this approach in detail with your pediatrician.
So, the answers to your questions are as follows:
1. Give only preventer therapy on regular basis. Use relievers only during exacerbation of symptoms. If the child is symptomatic very often then step up of budecort or change to budecort+formetrol combination therapy after discussing with your treating pediatrician.
2. Yes, he can recover with proper therapy and compliance. So do not lose hope.
3. Medicines are fine but doses needs to be adjusted as per your child's frequency of day time and night time symptoms.
4. No specific tests are indicated for proved case of bronchial asthma. Try to find out the allergens to which your child is sensitive and avoid them such as smoke, pollens, dust etc.
5. Allergy test won't be of much use at this stage.

You may go for breathing exercises with the help of physiotherapist to improve his lung function along with medicines for long lasting effects. It's advisable.
Hopefully this will help you. I would be happy to help you in any further questions.

Take care
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
default
Follow up: Dr. Archana Verma (4 days later)

My child is generally suffer in night after 3 AM. Symptoms start with coughing. Slowly slowly it increase then he fill tighten in chest , neck and itching on chest. Start biting teeth .Then wheezing sound comes.
In day time generally he not attacked. And he fill batter.
Why he generally attacked after 3 AM. How his body know the time is 3 AM now start.
There is any side effect of puff in long life.

Any suggestion regarding his diet and what kind of things we take in his food so his immunity power become increase
doctor
Answered by Dr. Archana Verma (2 hours later)
Brief Answer:
Night symptoms are due to circadian rhythm

Detailed Answer:
Hi
Most asthma cases show worsening of symptoms in early morning around 4-6 am. This happens due to circadian rhythm of circulating hormones such as epinephrine, cortisol and melatonin and neural mechanism such as cholinergic tone. All these act together on already hypersensitive airways to narrow them down further leading to worsening of symptoms as seen in your child.

Since the most important part of treatment is to stop further airway damage and speed up the repair so that child's lungs improve well, so a proper round the clock preventer therapy is given. It controls the inflammation going on in the lungs.

There is no major side effects of long term use if asthma is controlled well and therapy is properly stepped down. If a child is given oral steroids or high dose of inhaled steroids persistently, then it may affect his growth.

Diet should include foods rich in vitamins especially citrus fruits which are good source of vitamin C. Plenty of fluids and breathing exercises are useful. Avoid obesity by regular balanced diet and exercise.

Hopefully this will be of help.
Take care
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
Answered by
Dr.
Dr. Archana Verma

Pediatrician

Practicing since :2006

Answered : 1129 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for bronchial asthma in a child

Brief Answer: Take only preventer therapy for control of bronchial asthma Detailed Answer: Hi Welcome to the HCM I have gone through your question and understand your concerns but don't worry. Childhood asthma if controlled properly with good compliance can make life near normal in children. Preventer drugs are given for maintainance therapy. Relievers such as salbair are given only during acute exacerbations. If the relievers are used very often, then preventer drugs needs to be stepped up. Any step down should be planned only after complete control of all the symptoms for atleast 6 months. Also, step down or decrease in preventer drugs should be very gradual. Only 25-50% of the doses are reduced every 3 months during step down. You may discuss this approach in detail with your pediatrician. So, the answers to your questions are as follows: 1. Give only preventer therapy on regular basis. Use relievers only during exacerbation of symptoms. If the child is symptomatic very often then step up of budecort or change to budecort+formetrol combination therapy after discussing with your treating pediatrician. 2. Yes, he can recover with proper therapy and compliance. So do not lose hope. 3. Medicines are fine but doses needs to be adjusted as per your child's frequency of day time and night time symptoms. 4. No specific tests are indicated for proved case of bronchial asthma. Try to find out the allergens to which your child is sensitive and avoid them such as smoke, pollens, dust etc. 5. Allergy test won't be of much use at this stage. You may go for breathing exercises with the help of physiotherapist to improve his lung function along with medicines for long lasting effects. It's advisable. Hopefully this will help you. I would be happy to help you in any further questions. Take care