As with other diseases, there is not just one type of asthma. Depending on the trigger, how and when the asthma attack occurs, its treatment may vary. Bronchial asthma supports several types of classifications. Thus, different types of childhood asthma can be distinguished based on the level of control, the triggers, and the severity and frequency with which it appears.
Depending on the degree of airway obstruction (measured with spirometry), and the severity or severity, and frequency of presentation of symptoms, childhood asthma admits the following classification.
1. Mild asthma
In mild asthma, the attacks appear with a frequency not exceeding 1 or 2 per week, there is no interruption of night sleep, in the inter-crisis periods (as the name suggests, they are the periods of time that elapse from one crisis to another) the patient is asymptomatic and there is good tolerance to physical exercise.
Spirometry is usually normal or with minimal obstruction. Asthmatic attacks usually respond in less than 24 hours using bronchodilators only. Mild asthma is in turn divided into two subgroups: mild intermittent (they are occasional crises) or mild persistent (symptoms are frequent).
2. Moderate asthma
These patients frequently require a basic anti-inflammatory treatment, accompanied in asthmatic attacks by the regular use of bronchodilators. In the event of severe seizures, the need for systemic corticosteroids is possible. The attacks appear more frequently than 1 or 2 per week. Severe asthmatic attacks can occur although they are rare.
The need for urgent medical treatment is less than 3 times a year. Nocturnal asthma may appear 2 or 3 times a week, with repercussions on school life and in the inter-crisis periods the child may present with frequent dry cough and wheezing, and tolerance to physical exercise is decreased. Spirometry presents a clear obstructive pattern and the response of the bronchi after administration of a bronchodilator is positive.
3. Severe asthma
These patients require continuous treatment combining various drugs: brochodilators + systemic or inhaled corticosteroids at high doses + antileukotrienes. The attacks appear very frequently and are usually severe asthmatic attacks. Whistling in the chest or wheezing usually appears daily. The need for urgent medical treatment is more than 3 times a year. In some cases, these crises are accompanied by respiratory failure and even assisted respiration.
In the inter-crisis periods, the child presents a dry cough and continuous whistling, with a very poor tolerance to physical exercise, with almost daily interruption of night sleep and chest tightness on waking in the morning. School life is clearly affected and spirometry shows a clear obstructive pattern. If your child's symptoms get worse over time and appear regularly, be sure to see your pediatrician.
Based on the origin of the disease or triggers, childhood asthma can be:
1. Extrinsic asthma
Also called allergic asthma, it includes inhalant asthma (pollens, mites, animals, fungi, and occupational agents) and food, drug, and hymenopteran asthma attacks. Allergic asthma can, in turn, be divided into seasonal and perennial.
2. Intrinsic asthma
Collect the rest of the cases in which it is not possible to identify an allergic cause. Asthma associated with infectious processes, that induced by the existence of gastroesophageal reflux or that manifested by the sustained inhalation of irritating vapors are some examples. Among them are:
- Non-allergic asthma (Seizures are triggered by irritants, such as tobacco smoke, deodorants, paint ...), by respiratory infections, sudden changes in temperature or gastroesophageal reflux.
- Occupational asthma: Crises are triggered by exposure to chemicals in the place of study or residence.
- Exercise-induced asthma: it is triggered when the child exercises or increases his physical activity.
- Nocturnal asthma: it can appear in children with any type of asthma.
To treat asthma symptoms in children, it is necessary to know the types of asthma they may have. For each type of asthma there are different symptoms:
- Allergic asthma
When the child's breathing is altered and difficult when he is exposed to allergens such as pollen, mites or animal hair, in any season.
- Seasonal asthma
When the child has difficulty breathing or it plugs his nose or produces many nasal secretions, when he has contact with pollen, especially during the spring time.
- Non-allergic asthma
When symptoms appear or are triggered by irritants such as dust, respiratory infections, cold air, sudden changes in temperature, among others.
- Occupational asthma
When the child or adult is exposed to chemical substances such as plastic resins, wood or metal dust, etc.
- Asthma from exercise
Many children may feel short of breath when they increase their activity or physical effort. Physical exercise can cause a cough and consequently an asthmatic attack. These symptoms can appear during or after physical work.
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