What Is Asthma

One of the most powerful natural asthma treatment may be found in your own kitchen! Sea salt and water intake is a potent alternative for asthma therapy. The next time you have an asthma attack, try putting a pinch of sea salt under your tongue, and drink a large glass of water. If this does not work immediately, do not panic. Try another of salt with another glass of warm water.

Sea salt is a very powerful natural antihistamine. It can also be used in an inhaler, without the harmful side effects of most medical drugs. Taking a pinch of sea salt along with the water helps to break up the mucus plugs in the lungs, get rid of the sticky phlegm and stop that persistent dry cough that mostly accompanies asthma attacks. It is also a natural antiseptic that helps your body to fight off germs and bacteria and helps to keep your body's electrolytes in a healthy balance.

Many people are also unknowingly suffering from dehydration. In today's hectic lifestyle, many people are not drinking enough water. To make matters worse, they routinely drink coffee and tea in place of pure water. Drinks like coffee and tea are diuretics which make your body lose even more water. When you do not drink enough water to properly hydrate your body, your air passages tend to close in an attempt to keep water from escaping as vapor. Drinking plenty of water throughout the day to keep your body hydrated will address this problem.

Begin drinking half of your body weight every day in ounces of water (recommended at least 8 glasses of water a day) and take a little bit of natural sea salt along with the water. Allow your body to get accustomed to this routine by making sure that you do not drink a whole gallon of water in one sitting. Split up the drinking throughout the day so that your body is able to properly absorb the water and you do not flood your system all at one time. This will keep your body hydrated throughout the day, and ward off asthma attacks naturally.

If you have been doing this routine daily, and the asthma condition has not improved, perhaps, it is time to look at other possible causes as well. Work related asthma is a common cause for many people, and warrants further investigation on your part.

Treatment may be described under three categories. Treatment of the acute attacks; treatment in between attacks; and treatment of status asthmaticus (Severe acute asthma).

Treatment of the acute attack

Sypathomimetic drungs
Acute asthma readily responds to sympathomimetic drugs. The time-honored drug used to be adrenaline 0.5 to 1ml of 1:1000 aqueous solution given subcutaneously. It promptly relieves bronchospams, brings about expectoration, opens up the airways, and terminates the paroxysm within minutes. Adverse side effects of sympathomimetic drugs include rise in blood pressure, tachycardia, palpitation, and precipitation of angina in those with coronary artery diseases. Aquaeous adrenaline is effective for 4 hours after which the dose may have to be repeated. Oily preparations with a longer duration of action are available. Hurts's method of administration is to deliver adrenaline subcutaneously in a does of 1 drop every minute till the bronchospasm is relieved. This helps in minimizing the dose to the optimum without causing unpleasant side effects. With the advent of safer drugs, the use of adrenaline has been reduced but still in some cases where other drugs fail, adrenaline may be necessary to give immediate relief.

Another sympathomimetic drug employed for the relief of the paroxysm is ephedrine in a dose of 25-50 mg orally every 6 hours, It is often combined with one of the xanthine derivatives. Its effect is slower but more sustained. In elderly subjects it produces urinary retention, which may precipitate prostratic symptoms. Other side effects include palpitation, excitement, and insomnia. Isoprenaline given in a dose of 20 mg subcutaneously, sublingually or as an aerosol (1/100 solution) is also effective in relieving bronchospasm during an acute attack. Sympathomimetic drugs should be used with caution in hypertensives and elderly subjects with coronary artery disease or urinary obstruction. Fatal arrhythmias may be precipitated by repeated doses of these drugs in those cases with status asthmaticus.

Beta-adrenergic agonists
Salbutamol is a selective beta-2-adrenergic agonist with less of cardiovascular side effects. It is commonly used orally in doses of 2-4 mg every 6-8 hours. It can be used parenterally in an intramuscular or intravenous dose or 500/ microgram. It is prompt in action and relatively safe. Several other beta-2-agonists such as terbutaline, isoetharine etc, are also available.

Methyl xanthines
Theophylline is the prototype of this group of drugs. Several later derivatives are available for oral use. Though the effects are not dramatic. Mild cases do respond to these drugs when given orally in doses of 150-200mg every 6 hours. Aminophylline is one of the ingredients of several commercial anti-asthmatic preparations along with ephedrine and phenobarbitone. The oral dose ranges from 200-300mg and it has to be given every 6 hours. The more effective route of administration of aminophylline is intravenous. The does is 240mg diluted in 20ml of 25% glucose and given intravenously over a period of 3-5 minutes. The effect is dramatic relief of the asthmatic paroxysm. This drug is particularly useful in cases unresponsive to or unsuitable for sympathomemetric drugs. It is one of the common drugs used in management of status asthmaticus. In patients with cardiovascular disease and in conditions where the possibility of left ventricular failure cannot be ruled out, this is the drug of choice. Adverse side effects are rare, but sometimes sudden vasomotor collapse or allergic manifestations may develop

Corticosteroids
These are indicated for the prompt relief of acute severe asthma and also as maintenance dosage in recurrent and chronic disease. For the acute attack, hydrocortisone,e in a dose of 100-200mg or its analogues (dexamethasone 4-8 mg or betamethasone 4-8 mg) are given intravenously as a bolus dose or in a slow drip. The effect is very obvious within 30-60 minutes. Oral preparations such as prednisolone or the other derivatives are preferred for maintenance dose. They are given for short periods to time over a period of exacerbation. The minimum effective dose is to be employed. Some cases may become steroid-dependent and the smallest dose required to be given for symptomatic relief can be determined by trial and error.

Aerosols of beclomethason are being increasingly used to abort or prevent an attack. This route of medication is convenient and the dosage can be kept to a minimum. The aerosol should be taken before bronchospasm is severe to ensure that the drug reaches the bronchi. Once severe bronchospasm develops, the patient cannot take an effective inspiration to deliver the drug at the site of action.

Anticholinergic agents
Atropine used to be given in asthma since it is effective in relieving bronchospasm but it seldom used now on account of its troublesome side effects. Another anticholinergic agent, ipratropium bromide is used at times as an aerosol with success in a dose of 36 mg 6 hours.

Prevention of recurrence
It is important to avoid known allergens which can be identified, especially in the case of some allergens like hose dust and pollen. Desensitization can be achieved by repeated challenges. Disodium cromoglycate administered as an inhalation in a dose of 20mg has the property of preventing mediator release from the mast cells. The inhalation has to be repeated every 6 hours. This drug should not be used during an acute attack since it may cause aggravation of the symptoms.

Respiration and other systemic infections should receive prompt attentions. The appropriate antibiotic should be selected based on microbiological tests. Tranquilisers, psycho-therapy or suggestion under hypnosis may be useful adjuncts in persons with prominent emotional everlay.

Management of acute severe asthma
Status asthmaticus has to be managed as a medical emergency. This condition is generally unresponsive to conventional drugs administered in the usual manner. Clinical assessment of the severity can be made from the intensity of dyspnea. Cyanosis and inability of the patient to speak uninterruptedly. Estimation of peak expiratory flow rate gives an objective assessment of the condition.

General measures:
These involve putting the patient to bed rest propped up with a back-rest; starting an intravenous infusion of normal saline. This aids in the administration of drugs and fluid replacement is essential to correct dehydration; and administering oxygen under supervision.
• Aminophylline is given as slow intravenous injection in a dose of 4-6mg/kg every 6 hours. Many cases get at least partial relief. Aminophylline can also be given as an intravenous infusion at the rate of 0.5-0.7mg/kg/hr.
• Corticosteriods should be given intravenously in high dosage. Hydrocortisone 100-300mg, betamethasone 8mg or dexamethasone 8mg are the preparations of choice. Sedatives which do not depress the respiratory centre are indicated if the patient is restless. Diazepam 5mg is suitable in most cases.

If the condition does not respond to treatment or the respiratory embarrassment is increasing, ventilation should be assisted. If the secretions are tenacious and difficult to be expectorated, throat suction or bronchoscopic aspiration may be required.

Indications for ventilatory assistance
1. Pa CO2 above 44mm Hg,
2. Pa O2 below 50mm Hg,
3. FEV1 or PEFR less than 10% of predicted value
4. extreme physical exhaustion, and
5. clouding of consciousness.

At least half the cases of asthma seem to be caused or aggravated by an allergy. The child may be sensitive to pollens or dust or to certain foods or drugs. Some asthma seem to result from infections of the organs of breathing (e.g colds), the child having become sensitive to the products of the germs causing the infection.

You know there is an asthma attack when you see your child sitting bolt upright in bed with his arms extended at his sides, pressing downward against the bed and his skin appears blue because he is not able to breathe the normal amount of air. You can hear wheezing and the large veins of his neck are conspicuous, his heart "pounds" at a rapid rate. What happens is that there is interference with the passage of air through the membrane-lined tubes which serve the lungs. These tubes become swollen and congested and there is more difficulty in expelling air from the lungs than drawing it in.

As parents, you may take some comfort in the knowledge that though such circumstances may be terrifying, children seldom die as a direct result. However when attacks are repeated time after time, the child's general health declines, possibly with permanent damage to lung tissues.

Immediate home treatments for toddler's mild attacks:

1) Try giving the child a hot drink of milk or plain hot water. This may relax the tissues in the air passages.

2) Steam inhalation accompanied by a hot foot bath may bring relief. If no mechanical vaporizer is available, you may conduct steam from a pan of boiling water through a paper cone. Care must be taken not to burn the face and to ensure a supply of fresh air.

3) If these remedies do not relieve the attack, call a physician or take him to the hospital.

Long range natural treatments for Infants:

From birth to 6 months, breast milk is the optimum food in order to prevent asthma. Full time breast feeding will build a strong immune system. Some of the special substances in breast milk are designed to protect your infant's intestinal tract from infection, enhance overall defenses and help the immune system strengthen and mature.

What not to take while breast-feeding:

- opiates
- tranquilizers
- aspirin
- cough syrups containing iodine
- caffeine
- alcohol
- chocolates
- aspartame
- nicotine (do not smoke)

Rub flaxseed oil or walnut oil into his skin. A teaspoon will anoint your infant's entire body. It contains a mixture of omega-3's and omega-6's to build the immune system.

Long range natural treatments for toddlers:

1) Avoid contact with the offending substances such as pollens, house dust, feather pillows and pets.

2) Extremes of cold and of humidity should be avoided.

3) Put your child on a low-sugar healthy diet.

4) If there is a history of antibiotics or cortisone use, check for yeast problem and treat this with yeast-elimination diet. (limit natural sugar including dried fruits, commercial fruit juices, malt and vinegar contained in pickles, catsup, mustard, mayonnaise and dressings. Keep your child on "safe foods" for five days then reintroduce gradually.

5) The following supplements have been found to play a definite role in asthma and if given daily may prevent attacks.

- Fatty acids (1/2 to 1 tbsp. cod-liver oil)
- Vitamin C (1 to 2 grams)
- Vitamin B-6 (100 to 200 mg

A question that I've heard a lot is "can milk induce asthma?"

The answer is that yes, milk can cause asthma problems in some people. I know this from research, as well as from first hand experience. On days when I'm having asthma problems a glass of cold milk or even a bowl of cereal can worsen my breathing problems.

The reason why milk causes asthma problems isn't so clear. Asthma experts have to possible theories. The first is that milk causes the creation of excess mucus in a person's airway. So someone with asthma, who already has problems breathing, milk can make the problem worse. The other theory is that many people have dairy allergies, so it's therefore a trigger of asthma attacks. Or it could be a mix of both for some people.

The problems don't stop with milk. They include other foods in the dairy group like butter, cheeses and yogurts.

If you have problems with milk and asthma, you have to be careful with what you eat and where you get it. Many restaurants put butter on their steaks. Many butchers slice meat and cheese on the same machine, so even if you're not getting cheese, you might have problems. It comes down to knowing what's on your food and what you're putting in your mouth.

The best solution is to no longer eat or drink the food item that's causing your problems. Of course, this is easier said than done, but in the long run it's worth it. On days when I'm having asthma problems, I switch to soy milk, which seems to not cause any problems for me.

You can also prevent the problems by taking allergy medicine.

Other Foods That Cause Asthma Problems

The bad news is that problems for asthmatics can extend throughout the whole grocery store.

Peanuts can be one of the most dangerous foods when it comes to causing breathing problems. Even a small bite can trigger a serious attack in some people.

Even foods made of wheat like certain breads and cereals can cause asthma problems in some people.

Another common problem food is fish. And even people with egg allergies can have problems with asthma.

The easiest solution is to find out what your allergic to and to avoid it as much as possible.

Asthma is a rising problem. Worldwide some 7 to 10% of he population suffer asthma with the prevalence in the United States and other Western Countries being higher than elsewhere. Last year 2009, 300 million people had asthma and 250,000 died from it.

My first experience of asthma came in infancy as I was teething and asthma punctuated my childhood with wheezing, shortness of breath and chest tightness being the major symptoms. Other asthma patients suffer with these symptoms as well as coughing.

Wheezing is perhaps the most noticeable sign of asthma - the mixture of whistles and other tones being quite like musical sounds from a barrel organ.

There can be many factors triggering asthma and wheezing. Viral and other infections may lead to wheezing, as can exposure to tobacco smoke or to pollution from the environment caused by traffic or from ozone.

Psychological stress may lead to asthma indirectly by altering immune response, and on the other hand exposure to pets, especially during the early years has been shown to reduce the risk of asthma, whether this is due to priming the immune system or the well known effect of pets to reduce stress is not clear.

As many as 50% of asthma patients turn to complementary medicine, using a variety of nutritional and manual therapies.

Amongst nutritional treatments vitamin C is the most well known and one of the most controversial. Amongst mineral therapies using the well known effect of magnesium as a relaxing agent is used in the form of tablets to relax the airways.

Manual or hands on therapies such as Osteopathic, Chiropractic manipulation or simple massage help to relax the rib cage and relax and destress the patient.

Although it is often the case that wheezing and asthma go hand in hand you can have asthma and have such chest tightness that little to no wheezing is heard. It is also true that wheezing may be due to an airways obstruction not caused by asthma.

The diagnosis of asthma is not simple and straightforward and indeed getting better by taking asthma medications is often the best diagnosis of asthma. Although asthma and wheezing are common there is no simple relationship between them. Wheezing probably means that the patient has asthma but check on their temperature too, check that they have not swallowed something accidentally and inhaled it and check with your health professional too, asthma can usually be well controlled but should not be taken for granted.

There is only one way to get asthma or a blocked nose and that is because you are breathing like an elephant. You are not an elephant, and your body will try to stop you from breathing so much.

Your nose may block up, and make your lungs get wheezy, and you may feel stuff in your lungs and want to cough.

If your child nose becomes completely blocked, then the Steps exercise should be done until it is clear enough to breathe through. Usually only one set is needed. The key is to ensure that breathing is only through the nose after the steps [like a mouse].

If the breathing is elephant-like ó the nose will just block up again. If it does, then repeat the steps. If it is only partially blocked, then ask the child to just breath like a mouse, and try to make it clear. With practice they will soon be able to unblock nose with just breathing.

If the symptoms of asthma occur, tightness, wheeze or cough occur ó remember the elephant and the mouse. Reinforce the statement with your child that the only way to get asthma is to first breathe like an........ [Elephant]. To make it go away you just breathe like a little mouse ..... [turn palm up] through your ........[point to nose!]

If your child begins to cough then you must teach them how to cough through their nose. Have a little practice with them. When they feel a tickle in their throat, instead of coughing with their mouth, they should firstly try to just ignore it, but if they have to then cough via nose. This is more like an 'AH-HRRM' or throat clearing before a speech.

At the same time reinforce again the mouse breathing. If you do not allow yourself to cough, then the urge to cough will simply go away. If you do allow the coughing cycle to start 'it will get worse and worse' as the deep breathing causes more and more CO2 to be lost will cause the production of more and more mucus.

To cough a lot you must breathe like a big..........Elephant. On occasions with smaller children, they may say to you that they cannot stop the cough. Here you must be firm if you want them to become free of the cycle. They are simply not allowed to cough. [Yell if you must, but it is usually better to do more closed mouth coughing practice.] Obviously also explain that they can cough if they are choking on something.

If you notice a post nasal drip, which is fluid running down the back of your throat, then the procedure is the same. Mouse breathing first, and if that does not stop it, then do steps until it has stopped.

Same applies to itchy nose and eyes. If you see your child doing the 'allergic salute', pushing on their nose because it is itchy, explains again that they have been breathing like a big ......elephant! Itchy eyes might be gently rinsed [eyes closed!] with cool clean water, followed by mouse breathing.

Finger Under the Nose

It is very useful to use your finger for feedback on the depth of your breathing. The more gentle and passive, the better. When you ask your child to check their breathing [even teenagers] ensure they use their finger under their noses. The other feedback is any noise created by breathing. If you or they can hear a 'wheeze' try and make it silent. If there is whistle because a nose is partially blocked, then they should breathe like a mouse so that it cannot be heard. In both of these cases if you reduce breathing depth you will soon stop the wheeze and unblock the nose. If it does not then a series of steps should be done.

Introduction

Asthma is a persistent lung infection that provokes and contracts breathing air. It causes chronic phases of whistling sound during breathing, chest stiffness, breathlessness, and coughing, which occurs usually in the night or early morning. This disease can affect all ages of people particularly begins in childhood.

The tubes which carrying air in and out of your lungs are know as airways. Those who are affected with asthma have swollen and irritated airways, which is very sensitive. Because of this reaction, muscles around it get stiff, and in turn airways become narrow which result into less air to your lungs. More swelling can make the situation awful, and airways become narrower. Airways cells sometimes make excess mucus that is a sticky liquid that is further narrowing the airways.

If Asthma symptoms are unusual then it is an asthma attack. In such a case, airways can close so much so that your important body organs will not get sufficient oxygen by which a person can lead to death.

Cause
Genetic and environmental aspects that manipulate its severity, which is confirmed by medical research, originate asthma.

Cure
Asthma is not a curable disease. If you feel well, still you are not cured and it can flash up at any moment. For comprehensive, flourishing and continuing treatment, you should proactively manage your disease. Sometimes the patients stop the medication when they feel well. This results in supplementary attacks afterwards.

Prevention
An inhaler known as "Fluticasone propionate metered dose inhaler" is used to avoid asthma attacks. Prevention of the expansion of asthma is unlike prevention of asthma incidents.

If symptoms continue, additional controller drugs are provided unless all symptoms are prohibited. With appropriate usage of drugs, you can reduce the risk and complications associated with Asthma.

Before discussing what causes asthma, I would like to first define what asthma is.

Bronchial asthma is a usually reversible disease of the lungs. This chronic and inflammatory disease involves the air passages in the lungs and affects about 25 million people in the United States. Intermittent episodes of wheezing (bronchospasm) can be alleviated by therapy (bronchodilators, corticosteroids). At times, the wheezing stops spontaneously without therapy. Asthma can be caused by extrinsic factors and internal factors (see below). It usually occurs in children and younger adults but can be seen in persons of any age.

Airway inflammation arises due to interaction of a multitude of cells, including:

• lymphocytes


• mast cells


• eosinophils


• neutrophils


• macrophages


• epithelial cells


• dendritic cells

and various mediators, including:

• chemokines


• cytokines


• leukotrienes


• nitric oxide


• immunoglobulins

The methods by which these factors interact with each other to activate inflammation and cause an asthma attack is presently under investigation and is partially, but not completely, understood. The results of this inflammation are constriction of bronchial smooth muscle, swelling or edema of the airways (including mucus in the airways), and hyperresponsiveness of the airways. The results of this situation are patient symptoms of wheezing, cough and shortness of breath.

Extrinsic (external) factors include:

• Allergies (allergens) are common in children and adults and are a common cause of asthma. These allergic reactions are often associated with IgE-related immunologic mechanisms. Some examples of allergens include inhaled materials (e.g. pollens), ingested materials (e.g. foods), and materials that cause problems when they contact the skin. Inhaled (environmental) allergens are some of the most common causes of asthma (e.g. aspirin).


• Occupational asthma occurs in about 10% of asthmatics and results fromexposure to offending dusts, gases, fumes, and vapors that are present in the workplace. These materials are high molecular-weight compounds and low molecular-weight compounds.

Examples of high molecular-weight compounds that cause asthma include animal products (e.g. veterinarians), seafood (e.g. oyster farmers), insects (e.g. entomologists), plants (e.g. bakers), biological enzymes (e.g. detergent industry workers), gums (e.g. printers), and latex (e.g. health care workers). Examples of low molecular-weight compounds that cause asthma include drugs (e.g. antibiotics), wood dust (e.g. saw-mill workers), diisocyanates (e.g. workers with polyurethane), epoxy compounds (e.g. epoxy resin workers), fluxes (e.g. aluminum solderers), and fixatives (e.g. hospital workers).

• Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs) can cause asthma in sensitive patients. This problem usually takes time to develop and is characterized by aspirin sensitivity, nasal polyps, and asthma.

What causes asthma: Intrinsic (internal) factors include:

• Respiratory infections, especially viral infections, are very common causes of exacerbations of asthma.


• Exercise can induce an asthmatic attack and is called exercise-induced asthma (EIA). Exercise usually induces an increase in respiratory rate and depth of breathing and increases the inhalation of atmospheric air which is cooler than the body temperature air in the lungs. This cooler air appears to stimulate receptors in the lung in susceptible patients to induce bronchospasm and an asthmatic attack.


• Genetic factors have been proposed as causes of asthma. The ADAM-33 gene sets on the short arm of chromosome 20 and has been significantly associated with asthma, being called the asthma gene. Four other asthma genes or gene complexes have been identified with the use of positional cloning.


• Emotional factors and in particular stress have been suspected to cause asthma, but the data to support this is not complete.

Drinking wine may not be a good idea for those with asthma. Experts say some brands may trigger the disease.

Adult asthmatics may not tolerate preservatives in wine and beer while children may be allergic to cow's milk, eggs, wheat, and peanuts.

This doesn't mean you should starve though. Bear in mind that only 2 percent of adults and 8 percent of children are truly allergic to a given food or additive. Of all the asthma triggers, food is the least important. To be on the safe side, observe what happens when you take a particular food. If that food triggers an attack, by all means avoid it.

Keeping fit can put you at risk for asthma. This can happen in about 85 percent of asthmatics. Exercise-induced asthma (EIA) is usually triggered by physical activity and may begin a few minutes after you start exercising. Symptoms resolve within 20 to 30 minutes.

Exercise, however, shouldn't be avoided since it has many benefits. Aside from keeping you fit, it helps your lungs. To avoid EIA, choose an exercise that's right for you. If you can't tolerate running, try swimming.

Warm up before exercising. Begin with short workouts and gradually increase them. Don't exercise in cold weather. If you must, wear a scarf around your nose and mouth. And don't forget to take a bronchodilator before exercising to prevent an attack.

Asthmatic airways are also sensitive to viral infections like the common cold. Asthma can likewise be aggravated by bronchitis (the inflammation of the bronchial tubes), sinusitis, rhinitis (the inflammation of the nasal passages), tonsillitis, and nasal polyps (fluid-filled sacs in the nose).

Be alert for warning signs like a runny nose, cough, sore throat, headache, muscle aches and pains. See a doctor if you have any of these problems. He or she may prescribe medicines to prevent asthma from developing. You may also need to increase your asthma medications, especially inhaled steroids, to prevent an attack.

Since asthma triggers are found everywhere, where can an asthmatic go? It does seem that triggers are all around us but remember that asthmatics have different triggers. What triggers an attack in one person may not harm another.

So the rule of thumb is to know your triggers and do your best to avoid them. Once you know what's causing your problem and prepare for it, you can do anything without ever worrying about asthma. Above all, don't forget to take your medicines. They've been prescribed to prevent attacks and will help you live a normal life.

Can asthma be cured? The answer lies in the sixth part of our series. Don't miss it!

Since obesity is bad for asthmatics, keep your weight down to a healthy level. You can do this with the help of Zyroxin, a safe and natural supplement that will maximize your weight loss through its unique fat-burning ingredients.

There is a lot of controversy and debate regarding the point whether tonsils should be removed or not in a person suffering from asthma. Different doctors have different opinions in this matter. Some advocate tonsillectomy (removal of tonsils) while others do not. It is therefore important to understand the role of tonsils in the human body so that adequate judgement can be made in this regard.

Tonsils make the first line of defence in the human body. They are present on either side of the pharynx. Pharynx is the middle portion of the throat. Why tonsils make the first line of defence is because they try to trap any germs and foreign bodies that may enter the body through the mouth and the nose. After trapping them the tonsils also produce protective antibodies with the help of their lymphatic cell structure that forms the main body of the tonsils. These antibodies circulate in the blood and fight the foreign organisms that somehow pass into the blood stream. So tonsils on one hand act as a mechanical guard and on the other hand they act on the molecular level also to protect the body. The antibody forming tissue is present in other parts of the body too but tonsils are first line of defence of the human system.

The body of a child is exposed to many different kinds of germs for the first time. The body is not used to these germs and needs to be protected against them. The tonsils work vigorously and in some children get abnormally enlarged in the process. If a child suffers from cough and wheezing his breathing is as it is strained. If this is due to some allergic reactions it may be accompanied with sore throat and fever as well. If the allergy persists or may subside and reappear again and again the tonsils too get infected while protecting the body.

In such a scenario the infected tonsils may need to be removed as their infection may be adversely having an impact on the body repeatedly. Also their enlarged size may be straining the breathing further in a child who is already suffering with asthma. So the children who suffer with asthma may be recommended a removal of tonsils if the asthma is of extrinsic type and is caused by allergens.

Sometimes in the children who suffer from intrinsic asthma too this may be recommended as the body becomes weakened and is susceptible to attacks from various organisms. But this is controversial because tonsils are the first line of defence and removing them may not be such a good thing to do, at least in theory. But in practice the tonsils may be a cause for many infections and it is best to get rid of the source of infections.

Some of the views regarding the question of removal of tonsils are:

1 The tonsils act at the site and later as a source of infection in the body. Their removal would influence the course of asthma favourably and even prevent its occurrence in a susceptible individual.

2 The tonsils prevent the spread of infection from the nose and throat into the bronchi and the lungs so their removal would create situations of mild asthma developing into severe one. In susceptible individuals symptoms of asthma may even precipitate due to tonsillectomy.

3 The presence or absence of tonsils actually does not make any difference over the allergic state of an individual. So technically removal of tonsils cannot precipitate the symptoms of asthma according to this view.

With reference to the varied views mentioned above it seems that the most appropriate path for the surgery for the removal of tonsils would not only be an individual choice but also may mean that a certain individual needs to be studied for previous history of infections, process of treatment and pathway of recovering from the infections before any decisions can be taken.

If there is evidence of recurring infections of throat and the infections seem to be localised in the tonsils then this may be the only option provided there are no other serious complications. Children in the younger stages are more susceptible to repeated infections of throat and the chest so to understand that the infections are localised to the tonsil area is very important before taking the decision of tonsillectomy.

Another point to be thoroughly understood is that removal of infected tonsils may have no effect whatsoever over the condition of asthma of the child. The removal of tonsils may have effect on the associated conditions of aggravation of the symptoms because of the effect that the associated allergens may be having on the situation.

This is also true only to the extrinsic type of asthma, but it shall have none or very little effect on the intrinsic type of asthma. Some doctors feel that the benefits associated with tonsillectomy are most evident in the first year of surgery and later they dissipate and after some time there remains no difference between the asthmatic children who underwent surgery and the asthmatic children who did not undergo any surgery.