Asthma Management Helps Kids

This Article was published in The Republican and on Wednesday, June 20, 2012, 9:30 AM

Written by Judith Kelliher – The Republican

The Photo: Dr. Jonathan Bayuk, an allergist and clinical immunologist, shows 10-year-old Connor Twarog, of Williamsburg, how an inhaler, used to deliver medicine to relief asthma symptoms, is operated in the allergist’s office in Northampton.

With this year’s warmer weather, airborne pollen counts have risen and those can lead to triggering asthma attacks in anyone with the chronic lung disease, particularly children, says Dr. Jonathan Bayuk, an area allergist and clinical immunologist.

Pollen is just one of many triggers that can bring on attacks in young asthma-sufferers. There are a host of others, such as viral infections, exercise, dust mites, mold and stress, which in children can lead to lungs and airways becoming more easily inflamed, Bayuk said.

In other words, these kinds of events are probably just minor annoyances in people without asthma, but can be very pesky or downright dangerous for those who suffer from it.

While childhood and adult asthma are essentially the same disease — and there is no known cause or definitive cure for it — one difference is that in the younger population it is the most common chronic disease. And while it can affect a child’s activity level due to symptoms such as shortness of breath, it can be managed effectively and symptoms kept in check, Bayuk said.

Asthma can develop at any age but it is more common to see it developing in children because their immune systems are much more dynamic, he said, noting that childhood asthma does not mean it will continue in all affected children when they reach adulthood.

“Airways are smaller in children so the presentations can be more dramatic and scarier because of the coughing and wheezing and they can’t always tell you how they feel,” said Bayuk, who works at Hampden County Physician Associates in their Springfield, Northampton and Westfield offices.

In simple terms, Bayuk said, asthma is a “tightening of the airways and a creation of mucus in the lungs.” There are a variety of asthma symptoms, including shortness of breath, a chronic cough, wheezing, chest tightening and exercise intolerance.

But not all symptoms mean a diagnosis of asthma, especially for children, said Bayuk, who treats a number of families — children and parents — as asthma sufferers. Children under age 3 can display symptoms of wheezing, for example, but that could be attributed to a viral infection and not asthma, he said.

In terms of treating the disease, mild cases can sometimes settle on their own, while most children with asthma rely on medications to manage episodes. Besides medications, monitoring a child’s environment for the triggers that lead to attacks is very important, Bayuk said. The good news, he said, is that with proper treatment, most children can remain active like their non-asthmatic counterparts.

Guidelines on asthma from the National Institutes of Health recommend that the goal of therapy is to use the least amount of medicine possible to treat the disease. While Bayuk agrees with that goal, he notes that it is important to increase the amount of the dose, and how often it is administered, if the asthma worsens.

As the asthma is controlled, parents in collaboration with their health care providers should then reduce the amount of medication, he said.

There are a number of asthma medications that either provide quick relief or act as a longer-term treatment. A drug such as albuterol (inhaled) could be effective in providing immediate relief by relaxing the airway muscles for someone with “mild intermittent” asthma, Bayuk said. Unlike quick-relief treatment, longer term drugs such as corticosteroids work to decrease how often attacks occur and lessen how bad they get, he said.

There may also be a role for allergy shots in some patients, he added.

A recent editorial in the scientific journal Pediatrics warns that the use of the pain reliever acetaminophen may increase the risk of developing asthma in children. While the editorial draws a possible link between the drug and asthma, Bayuk said more studies need to be conducted to reach a more firm conclusion. But such a claim does give rise to the importance of parents keeping on top of information about the drugs used to treat their children, he said.

“The most important thing is to educate the patients, and for parents to educate their children. They’re the ones managing this,” Bayuk said. “The goal is to keep people healthy and live a full life.”