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The Medical Minute: Asthma differences in adults and children

As the winter cold season melts into seasonal spring allergies, many people may start to experience sneezing, wheezing and other breathing difficulties.

Sometimes, the trouble goes away after a few days, but if it lingers or recurs, asthma could be the culprit.

Dr. Joyce Green, a family medicine physician at Penn State Health Milton S. Hershey Medical Center, said the condition can develop in childhood or as an adult.

About 75 percent of cases are diagnosed before the age of 7. Many children would then experience remission around puberty but it can still come back later in adulthood. For some, they would develop asthma later in life.

“A big difference is how they experience their symptoms and also what triggers them,” Green said.

Children tend to have intermittent symptoms, including episodes of asthma that are triggered by something such as a cold, allergies or exercise. Children seem to be more susceptible to these.

Adults tend to have more persistent symptoms.  A lot of times they think it is just a cold that would not go away and would not think of it as asthma.

Certain types of asthma are typically diagnosed in adulthood. Some adults may develop occupational asthma, a condition triggered by irritants in their workplace. Aspirin-sensitive asthma is another type that is usually seen in adults.

Children are more likely than adults to have allergies alongside their asthma.

“If you have asthma and you are exposed to something you are allergic to, it can trigger an asthma attack,” Green explained. “Children are typically more sensitive to allergens and prone to asthma episodes because their airways are still developing.”

While symptoms are the same in children and adults – wheezing, cough, chest tightness, shortness of breath – children's asthma attacks are often caused by common triggers, while adult cases are sometimes trickier to tease apart and can be misdiagnosed.

In some cases, there is never a problem until the person gets a cold, then it causes persistent breathing difficulties that won't go away. That is when it's time to see the doctor.

A pulmonary function test is usually ordered to check for lung function abnormalities and will help confirm asthma and other lung conditions.

In children and adults, inhaled medication – used as needed or regularly, depending on the severity of asthma – is the typical treatment.

Green said it's also important to control the things that make asthma worse, whether those include irritants such as pollen, smoke, dust and mold or health conditions including allergies, obesity and acid reflux.

She doesn't recommend limiting activity because of the condition.

“It is important that you use recommended medications and follow up with your doctor to make sure your asthma is well controlled.”

“Some people with exercise-induced asthma have the misconception that they shouldn't participate in sports,” she said. “But many athletes live with asthma.”

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The Medical Minute is a weekly health news feature produced by Penn State Health Milton S. Hershey Medical Center. Articles feature the expertise of faculty physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.

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