What Is Asthma in Children and How Severe Is the Condition?

Severe Asthma in Children: A Complex Condition Under Scrutiny

Severe asthma represents a significant challenge in the field of pediatric pulmonology and is addressed with great attention by the Italian Society for Pediatric Respiratory Diseases (SIMRI), which has dedicated a specific section on its website (www.simri.it) to this complex pediatric condition. The SIMRI section on severe asthma is a key resource for physicians, researchers, patients, and families, as it offers detailed information, scientific updates, and guidelines for managing this disease.


Definition and Impact of Severe Asthma on Children’s Health

Asthma is a very common chronic respiratory disease that affects the airways, namely the bronchi, which are the anatomical structures that carry air to the lungs. Children with asthma typically have inflamed bronchi. Asthma presents with persistent symptoms such as:

  • Coughing

  • Wheezing and shortness of breath

  • Chest tightness

Asthma symptoms may be recurrent, but sometimes they do not appear for weeks or even months. Nevertheless, asthma requires daily care and treatment in order to reduce the risk of acute attacks.


Why Do Children Suffer from Asthma?

Asthma often begins in childhood. Identifying the exact cause of asthma is difficult. However, we know that certain children are more susceptible to developing the condition if they:

  • Have a family history of asthma, atopic dermatitis, or allergies

  • Suffer from atopic dermatitis or allergies themselves

  • Had bronchiolitis as infants, a common respiratory infection in early childhood

  • Were born prematurely and/or with low birth weight

In addition, a low-quality lifestyle, poor diet, and lack of cleanliness or hygiene in living environments may contribute to the increasing number of children affected by asthma compared to the past.

Smoking during pregnancy and exposing children to passive smoke during their early years are also known to increase the risk of developing asthma.


Symptoms of Asthma in Children: What Triggers Them?

Due to the nature of the disease, the airways of a child with asthma are highly sensitive. Since the bronchi are inflamed, they can overreact to various stimuli, which may further irritate and inflame the airways. A trigger is any stimulus that provokes asthma symptoms by irritating the airways. Several asthma triggers are known—these include:

  • Animal dander

  • High pollen levels

  • Air pollution

  • Dust mites

  • Excessive stress

  • Respiratory infections

Recognizing these triggers is essential in finding ways to avoid them. In any case, the best way to deal with asthma triggers is to always take the prescribed therapy, even in the absence of acute symptoms.

How Severe Is Asthma?

The severity of asthma varies from child to child. A child with severe asthma—which is the chronic form affecting about 5% of all children with asthma—may experience continuous and difficult-to-control symptoms. However, most children with asthma are able to manage the condition well by taking their prescribed daily medication or using rescue medication as needed when symptoms occur. Having a written asthma action plan helps simplify symptom management. Still, while some asthma attacks can be managed at home, others require hospital care. It’s important to remember that certain asthma attacks can be life-threatening, so it is essential to contact your healthcare provider if symptoms worsen.


Does Asthma Get Worse Over Time?

Frequent asthma attacks can worsen the condition over time by making the airways more inflamed and narrower. In such cases, asthma symptoms are more likely to intensify and occur more often. The best way to prevent asthma from worsening is to take the prescribed therapy consistently. Quitting smoking during pregnancy and avoiding exposure to smoke in shared environments with the child will reduce the risk of frequent attacks and long-term worsening of asthma. If you notice that your child’s symptoms are getting worse, consult your healthcare provider as soon as possible to reassess the treatment plan.


Does Asthma Go Away on Its Own?

Asthma is a chronic condition. In some cases, symptoms may improve or disappear with age. However, even if a child seems to “outgrow” asthma, the symptoms may return later in life, possibly triggered by factors such as workplace environments, pollution, or hormonal changes like menopause.


Is There a Cure for Asthma?

There is no cure for asthma, but there are proven and tested medications that can control its symptoms. This means that most children with asthma can lead normal lives as long as they adhere to their prescribed treatment.

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