Bronchial Asthma in Children: Understanding, Manifestations, Testing, Treatment, and Prevention

Created by Doctor Alex in Respiratory Health, 5 months ago

Bronchial asthma is a chronic inflammatory disease that affects the airways, causing intermittent obstruction and various respiratory symptoms. In children, asthma is particularly common, with recurrent wheezing episodes being a prominent feature. 

This article aims to provide a comprehensive overview of bronchial asthma in children, including its manifestations, testing methods, treatment options, and preventive measures.

bronchial asthma in children understanding

Understanding Bronchial Asthma: Bronchial asthma is characterized by chronic inflammation of the airways, leading to recurrent episodes of wheezing, shortness of breath, chest tightness, and persistent cough. These symptoms often occur in a pattern, with exacerbations commonly happening at night and early in the morning. Children under the age of 5 are frequently affected by this condition, experiencing repetitive wheezing episodes.

Manifestations of Bronchial Asthma: 

Appearance Features:

  • Intermittent Transient Wheezing: Wheezing occurs sporadically, often triggered by viruses, weather changes, seasonal allergies, and other factors. There may be no wheezing between episodes, and the onset of wheezing typically begins before the age of 3.
  • Persistent Wheezing: Wheezing symptoms persist beyond 6 years of age, appearing intermittently as described above.
Typical Asthma:
  • Upper Respiratory Tract Infection: Asthma attacks are often initiated by an upper respiratory tract infection, accompanied by symptoms like a runny nose.
  • Nocturnal and Morning Wheezing: Asthma attacks predominantly occur during the middle of the night and in the early morning hours, accompanied by wheezing sounds.
  • Examination Findings: Lung auscultation reveals the presence of crackles and rales.
Atypical Asthma: In this form of asthma, there is inflammation of the upper respiratory tract, along with wheezing. Lung examination reveals the presence of rales and crackles.

Testing: Various tests can aid in the diagnosis and evaluation of bronchial asthma in children, including:

  • Blood Count: Eosinophilia is commonly observed. In the case of superinfection, an increase in white blood cell count and neutrophils may be present.
  • Chest X-ray: Pulmonary emphysema may be visible on chest X-ray images.
Causes of Bronchial Asthma:
  • Viral Infections: The most common cause of acute asthma cases (approximately 85%) is viral infections caused by pathogens such as Rhinovirus, Coronavirus, Influenza virus, and RSV (Respiratory Syncytial Virus).
  • Other Triggers: Environmental factors such as dust, house mites, pollen, pets, mold, and cigarette smoke can contribute to asthma. Additionally, certain foods like eggs, cow's milk, soybeans, fish, and shrimp can act as triggers. Other factors, including gastroesophageal reflux disease, fever, and dehydration, may also play a role.
  • Family History: Children with a family history of asthma or allergies are more susceptible to developing asthma.
  • bronchial asthma in children understanding

Treatment of Bronchial Asthma: The management of bronchial asthma in children involves various treatment approaches based on the severity of symptoms:
  • Mild Asthma Attacks: Inhaling bronchodilators such as Ventolin or Salbutamol, along with nasal cleaning and airway clearance, is recommended.
  • Moderate Asthma: Combination therapy involving inhaled bronchodilators (e.g., Ventolin) and nebulized corticosteroids (e.g., Fluticasone propionate or Budesonide) is commonly used.

  • Severe Asthma Attacks: In cases of severe asthma attacks, nebulization and supplemental oxygen may be necessary. Antibiotics may also be prescribed if there is evidence of superinfection.

  • Malignant Asthma: Malignant asthma requires emergency hospitalization and intensive treatment. It may involve intravenous administration of bronchodilators and corticosteroids. In severe cases, intubation and mechanical ventilation may be required.

  • bronchial asthma in children understanding

Prevention of Bronchial Asthma:

Preventive measures can help reduce the frequency and severity of asthma attacks in children. The specific preventive strategies depend on the underlying causes of asthma:

Viral Infections: It is essential to isolate children with respiratory infections to prevent the spread of viruses to healthy children.

Environmental Factors: Minimizing exposure to common triggers such as dust, house mites, pollen, pets, mold, and cigarette smoke can help prevent asthma exacerbations.

Dietary Considerations: Identifying and avoiding specific food triggers like eggs, cow's milk, soybeans, fish, and shrimp can be beneficial for children with asthma.

Other Triggers: Managing comorbid conditions such as gastroesophageal reflux disease and ensuring adequate hydration and fever control can contribute to asthma prevention.

Family History: Children with a family history of asthma or allergies should receive regular medical monitoring and follow preventive treatment plans.

bronchial asthma in children understanding

In terms of preventive treatment, inhaled medications play a fundamental role in managing asthma in children of all ages, as recommended by the Global Initiative for Asthma (GINA). These include:

Inhaled Corticosteroids: Fluticasone propionate (Flixotide) and Salmeterol/fluticasone propionate (Seretide) are commonly prescribed.

Oral Medications: Montelukast Na (Singulair, Montelukast) may be prescribed in certain cases.

bronchial asthma in children understanding


Bronchial asthma is a chronic condition that significantly impacts the lives of children, causing recurrent respiratory symptoms and potentially affecting their daily activities. Understanding the manifestations, conducting appropriate testing, and implementing effective treatment and preventive measures are crucial in managing bronchial asthma in children. By following a comprehensive approach, healthcare providers and caregivers can help children with asthma lead healthier lives with improved symptom control and reduced asthma exacerbations.

Answered by Doctor Alex, 5 months ago