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Podcast: Portable Practical Pediatrics
Episode:

Asthma Update 2016 (Pedcast)
Category: Kids & family
Duration: 00:00:00
Publish Date: 2016-07-30 08:49:22
Description: Topic introduction   Ever wonder what asthma is and why so many children have it?  Understanding and treatment of this chronic condition in children has really come a long way in the past few decades and I thought I would bring you some of the latest information I have recently learned about the common condition called asthma.  I hope after listening to today’s discussion, you will be able to recognize the common symptoms of asthma and have some understanding of what is going on in an asthmatic child's lungs so stay tuned to this important edition of Portable Practical Pediatrics! Musical Intro For those of you who are new to Portable Practical Pediatrics, I am your host, Dr. Paul Smolen, a board certified pediatrician who has practiced in Charlotte NC for the past 34 years. I think 34 years of middle of the night care for asthmatic children qualifies me as something of an expert so with that said, let's get into today's topic. What is Asthma? Let's start with the question, what is asthma?  Many parents are surprised when I tell them that everyone, whether they are asthmatic or not, are capable of having the physiologic responses that asthmatics do during an asthma attack. You heard me right; anyone can have a bronchiole attack just like asthmatics do, even children and adults who don't have asthma. Bronchospasm or tightening of one's bronchioles is actually a protective reflex that everyone's lungs are capable of in response to irritants. Wheezing, the high pitched sound coming from the lungs during an asthma attack, is the hallmark of bronchospasm. It is a protective reflex to keep smoke and toxic chemicals from injuring our lungs. Bronchospasm protects a child's lungs. We all have this reflex that some describe as a loaded gun response, waiting for something to pull the trigger to start.  For non-asthmatic children, that "Something" is usually a serious case of smoke inhalation, inhaling strong heat like in a fire, or exposure to toxic chemicals.  It takes a lot to pull a non-asthmatic's trigger. But not in asthmatic children; for them the trigger is usually pulled by just a cold virus or rolling in the grass on a nice spring day or running up and down a soccer field on a cool fall morning. In these children, the reflex has gone haywire, and the trigger is pulled for almost no reason. So you can see, asthma is a condition of heightened bronchial responsiveness, that I like to call twitchy bronchioles.  Low threshold of irritation combined with recurrent episodes that are reversible with medicine... you got a diagnosis of asthma. Why is Asthma Becoming More Common in Children? But why is this disease becoming more common? Fewer children in America are growing up around cigarette smoke, the air is cleaner than it was when I was a child, more kids have air conditioning and central heat, and power plants are putting out far less particulates than in previous generations, so why is the incidence of asthma climbing. The short answer is, no one knows but here are some of the theories: The Hygiene hypothesis-Lack of microbial life in a child's gut is the root cause of allergy. This lack of germs stems from repeated courses of antibiotics, a lack of playing in dirt, not growing up around animals microbes, dishwashers that essentially sterilize what we eat, pristine clean food that may have been even irradiated, antibacterial soaps and gels, and a lack of cultured bacteria rich foods are among some of the reasons that seem to support this theory. Acetaminophen- there is evidence that children who take this drug seems to be more prone to allergies and asthma. Yes, Tylenol. We have talked about this before in previous podcasts. http://www.docsmo.com/fever-friend-or-foe-pedcast/ How this happens, I am unsure but research does seem to make a link that may be causal or just associated with something else these children do. Obesity and processed food, especially highly processed food found at fast food restauran...
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