Our lungs have many small airways called as bronchi. Bronchi in the lungs branch into tiny airways that look like tree branches. Many respiratory conditions in children affect the bronchi like asthma. In this article we shall discuss what happens to our lungs in asthma.

What happens to the lungs during asthma attacks?
When we breathe normally, muscles around the airways are relaxed allowing the air to move in and out easily. During an asthma attack, three things happen in the bronchi. The muscles around the bronchi or airways tighten called bronchospasm leading to narrowing of the bronchi. In addition the lining of the airways becomes swollen (inflammation) and there is extra mucus (phlegm) in the airways. All these changes cause narrowing of the bronchi and increase in secretions from the airway lining, blocking the bronchi. This leads to difficulty in air moving in and out of the airways making it difficult for the child to breathe.

How does inflammation occur in asthma?
The airway changes in children with asthma can develop in response to infections, triggers and allergens. Viral respiratory infections are the most common reason for an asthma attack in children. Allergens could be indoor like dust mites, animal dander, cockroaches, fungal spores or outdoor like pollens. Interaction of the virus and allergens with the immune system leads to a complex reaction leading to a wide variety of inflammatory cells and mediators getting activated. This in-turn leads to extra mucus, swelling of the airway linings and bronchospasm.

Does inflammation of the lungs in asthma go away after an asthma attack is over?
With adequate treatment of asthma attack the changes of mucus secretion, swelling and bronchospasm improve. As asthma is a chronic (meaning present all the time) disease the inflammation inside the airways tends to persist even after the acute attack is over. During this stage symptoms could be less or minimal. Any further respiratory viral infections, allergen exposure or trigger lead to further asthma attacks.

Can asthma inflammation naturally disappear?
Asthma can naturally go away on its own, which is more likely for childhood asthma. The age by which this happens is variable. Many children who have outgrown their asthma may experience relapse later in life.

Can untreated asthma lead to irreversible changes in the airways?
In some children and adults with untreated or improperly treated asthma airway remodeling occurs. The airways become scarred and thickened; the changes are permanent and irreversible. With airway remodelling asthma medicines do not work as well.

If your child has asthma you need to consult a pediatric pulmonologist/allergist for proper diagnosis and management.