Determining an Asthma Attack vs. Allergy Attack
- Saturday, August 8, 2009, 3:08
- Asthma
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- Alois:
- Well, my child is an asthmatic and she has serious coughing attacks instead of the typical wheezing. I would like to know, how can I tell if she’s having an asthma attack or allergy attack, compared to a cold?
- Dr. Ayars:
- First of all, how old is your child?
- Alois:
- She’s 8.
- Dr. Ayars:
- Well, I’ll tell you what, an 8-year old is a lot easier question than if you told me it was a 2-year old. In the younger age group, it can be very difficult to tell the difference between a cough from bronchitis, or a cough from post nasal drip versus asthma. Obviously, if they get to the point where they’re overtly wheezing and making whistling sounds, it may be easier to decide that they probably have asthma as well. And of course, the biggest thing to bring out asthma is the common cold, because it inflames the lining of the lungs or the bronchial tubes and you get bronchus spasm if you’re so predisposed to asthma. In infants, it can be a very difficult diagnosis and it may take a very astute physician to examine the patient to have a good idea. It’s a little easier in an 8-year old, and the reason is, you can talk to them. Several things you can ask a child, of course, is if they’re short of breath or they have tightness in the chest. You could try to listen for wheezing and if you had a home stethoscope, that would be helpful, because most of the time when you have wheezing it’s going to be asthma. The other thing that you can do is have a peak flow meter.And then you will know from previous experience what their normal base line is and you can see whether they’ve fallen. Of course, this requires that the child can give a very good effort, because if they only kind of give a half effort, it won’t be representative of what their actual status is. So sometimes it’s very difficult to tell. The other problem is, is there is what is called cough variant asthma, and those individuals cough a lot but don’t have a lot of wheezing or shortness of breath, and that can make it very tough to distinguish from a cold. So, what I would do with your child is I would recommend having a peak flow meter at home, you might even consider getting a stethoscope, although most patients don’t have that, and listen for wheezing and observe whether their peak flows have diminished. The other thing that can be very helpful is, if you’re not certain, is give them the bronchodilator that you have, and assuming that you have one, use it and see if it increases their peak flows. And if so, that’s very strong supportive evidence that they may well indeed have asthma.
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