How to treat severe asthma in a 10-year-old boy?

Question

Hi doctor,

My son is 10 years old. He has been suffering from a cough, chest pain, and shortness of breath for the past week. He was diagnosed with asthma at an early age. How do you keep asthma under control? He is prescribed medications. He is taking it, but there is not much control. What are other treatment options available for this uncontrolled asthma?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I understand your concern.

As you already described, your son is suffering from bronchial asthma, key to its treatment is the use of inhaled medications. For adequate asthma control, appropriate inhalers with the right dose are to be used with appropriate technique, and they should be used regularly. Investigations to be done for newly diagnosed bronchial asthma:

1. Complete blood count.

2. Serum total IgE.

3. Chest x-ray.

4. Pulmonary function test (spirometry pre and post bronchodilator).

Causes for repeated exacerbation include:

1. Presence of comorbid conditions like allergic rhinitis, acid reflux, and obesity.

2. Incorrect inhaler technique or if inhaler is not being used regularly.

3. If incorrect inhaled medicines are being used.

4. Fungal sensitization and hypersensitivity.

The following advice is to be followed, for uncontrolled bronchial asthma:

1. Start regularly using the inhaler Budetrol two puffs twice daily with a spacer followed by mouthwash. Inhalers are to be used daily without any break for at least six months. No dose is to be skipped until advised by a pulmonologist.

2. The spacer device is to be attached to the inhaler. It is a must to use spacer.

3. Consult a pulmonologist either physically or virtually regularly.

4. Take vaccinations appropriate for the age if not taken already.

5. Control of co-morbid conditions, if any.

Get the investigation advised and follow up after one week, will then evaluate if your asthma is controlled or not and if it requires any further kind of treatment. Take care to follow up with an investigation or earlier if further queries are there.

I hope this information will help you.

Thanks.