Asthma in Children (cont.)
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Asthma Causes: Allergies and Exercise
Although an estimated 75%-85% of people with asthma have some type of allergy, the allergy isn't always the primary cause of asthma. Even if allergies are not your child's primary triggers for asthma (asthma may be triggered by colds, the flu, or exercise for example), allergies can still make symptoms worse.
Children inherit the tendency to have allergies from their parents. People with allergies make too much "allergic antibody," which is called immunoglobulin E (IgE). The IgE antibody recognizes small quantities of allergens and causes allergic reactions to these usually harmless particles. Allergic reactions occur when IgE antibody triggers certain cells (called mast cells) to release a substance called histamine. Histamine occurs in the body naturally, but it is released inappropriately and at too high an amount in people with allergies. The released histamine is what causes the sneezing, runny nose, and watery eyes associated with some allergies. In a child with asthma, histamine can also trigger asthma symptoms and flares.
An allergist can usually identify any allergies a child may have. Once identified, the best treatment is to avoid exposure to allergens whenever possible. When avoidance isn't possible, antihistamine medications may be prescribed to block the release of histamine in the body and stop allergy symptoms. Nasal steroids can be prescribed to block allergic inflammation in the nose. In some cases, an allergist can prescribe immunotherapy, which is a series of allergy shots that gradually make the body unresponsive to specific allergens.
Children who have exercise-induced asthma develop asthma symptoms after vigorous activity, such as running, swimming, or biking. For some children, exercise is the only thing that triggers asthma; for other children, exercise as well as other factors trigger symptoms. Young children with exercise-induced asthma may have subtle symptoms such as coughing or undue breathlessness after physical activity during play. Not every type or intensity of exercise causes symptoms in children with exercise-induced asthma. With the right medicine, most children with exercise-induced asthma can play sports like any other child. In fact, over 10% of Olympic athletes have exercise-induced asthma they've learned to control.
If exercise is a child's only asthma trigger, the doctor may prescribe a medication that the child takes before exercising to prevent airways from tightening up. Of course, asthma flares can still occur. Parents (or older children) must carry the proper "rescue" medication (such as inhalers) to all games and activities, and the child's school nurse, coaches, scout leaders, and teachers must be informed of the child's asthma. Make sure the child will be able to take the medication at school as needed.
Girish Sharma, MD
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