WEDNESDAY, April 9, 2003 (HealthDayNews) -- While most people associate asthma with wheezing and shortness of breath, the disorder can show itself in other, less common ways, especially in small children.
That's the conclusion of a new study from Greece finding that, for some children, frequent throat clearing is the only apparent symptom of asthma. Results of the study appear as a research letter in the April 10 issue of the New England Journal of Medicine.
"Asthma can show up in many different ways," explains Dr. Michael Wasserman, a pediatrician at the Ochsner Clinic Foundation in New Orleans.
"Since kids often can't express what they're feeling, it's conceivable that if they feel a tightening in their chest, the only noticeable way they might react to that would be clearing the throat," says Dr. Phillip Korenblat, a spokesman for the American Academy of Allergy, Asthma and Immunology (AAAAI) and a professor of clinical medicine at Washington University School of Medicine in St. Louis.
Five million American children under 18 have asthma, according to the AAAAI. Symptoms of the lung disorder include wheezing, coughing, shortness of breath and a tight feeling in the chest. Now, the study says, doctors should look for constant clearing of the throat.
For the current research, researchers at the University of Crete asked parents of 2,609 children from 70 day care centers about their children's health. The average age of the children was 4.3 years old, and the group had slightly more boys than girls.
Almost 18 percent of the children had been diagnosed with asthma in the preceding 12 months. Almost 24 percent had been diagnosed with asthma more than 12 months before the start of the study.
The most common recurrent symptoms parents of all the children reported were coughing with a cold, coughing at night, coughing in the presence of smoke, coughing when laughing or crying, coughing from exercise, and vomiting. Only 5.5 percent of the parents said their children wheezed often.
Parents of 106 (4.1 percent) kids reported that their children frequently cleared their throats. From that group, 61 children had not been diagnosed with asthma. Thirty children out of the 61 were old enough to perform lung function tests that evaluate how well their lungs performed.
All 30 children showed signs of decreased lung function that improved significantly when asthma medications were given. The authors conclude that means the 30 youngsters had undiagnosed asthma. These children had shown no other signs of asthma, according to the study.
"What this study says to me is that children who have a habit of clearing their throat should have pulmonary function tests," says Korenblat. "Even if the first test comes back normal, it should be repeated after inhaling a bronchodilator [asthma medication]."
If the lung function improves by more than 12 percent after treatment, Korenblat says that means the child probably has mild asthma and should be treated for it.
Wasserman says it's reasonable to ask your doctor to check for asthma with a lung function test if a child is frequently clearing his throat. But he's not convinced that throat clearing is a symptom of asthma.
"It's plausible that clearing of the throat can represent a sign of asthma," he says. But he points out that throat clearing can also be a symptom of other medical problems, like allergies, which are a known trigger for asthma.
However, he adds, any symptom that persists for more than two to three weeks should be pointed out to your child's doctor.
More information
To learn more about asthma, visit the American Academy of Allergy, Asthma and Immunology, which also has some tips on living with childhood asthma.
