Asthma, the often ambiguous lung disease affecting nearly 7.1 million American children, is on the rise. In the last decade, the number of children with a chronic cough, wheezing and other symptoms commonly classified as “asthmatic” has almost consistently increased each year.

  The often muddled language of asthma may be one factor contributing to its steady rise.

“Asthma is a variety of diseases that have a common presentation of wheezing, shortness of breath, and can be presented from mild to extremely severe and can even lead to mortality,” said Dr. Andrew Colin, director of the division of pediatric pulmonology at the University of Miami Miller School of Medicine. “A lot of research going on tries to define the differences in presentations of various patients.”

Asthma can be loosely classified in four levels:

• Mild asthmatic: A shortness of breath when exercising.

• Moderate persistent level: Difficulty breathing at night or once every couple of months; throat may feel very tight.

•  Moderate severe asthmatics: People with this condition “use more healthcare facilities, they see doctors more and use medication on a chronic basis,” said Dr. Eduardo Oliveira, pulmonary critical care physician and chief of medicine at Cleveland Clinic Florida.

• Severe asthmatics: They exhibit symptoms on a daily basis and have visited the emergency room in the last three to four months as a result of their asthma. “Their lives are significantly affected by their asthma,” Oliveira said.

In children, however, asthma can be difficult to diagnose.

“When we talk about it in pediatrics much of the time we call asthma a lot of wheezing and conditions that are not truly asthma,” Colin said.

Often, the inability to communicate directly with the child results in a misdiagnosis. Using a parent as an intermediary may result in miscommunication of symptoms.

“Sometimes parents can’t even identify symptoms in their own children,” said Dr. Juan Martinez, director of the pediatric pulmonary division at Joe DiMaggio Children’s Hospital in Hollywood. “There is a discrepancy between what kids would say and what parents would say.”

The breathing pipes of an asthmatic patient are narrower and more constricted than the average person. The muscles lining those airways are more sensitive to environmental allergens.

“The main cause of asthma is inflammation,” Oliveira said.

Abnormal responses to certain materials may agitate the muscles in the airways, preventing air from circulating in and out of the body. Because an asthmatic patient is constantly wheezing, the muscles in their airways work harder and grow larger, contributing to the narrowing of the airways.

Genetics, Obesity and Hygiene

Asthma is a genetic disease. “There is an inheritance pattern to it,” Colin said. Those with a family history of asthma and allergies are more likely to contract the disorder.

“We have respiratory illness in our family and I had bronchitis as a child,” said Elaine Marquez, the mother of 7-year-old Daniel Marquez, one of Colin’s asthma patients.

      Environment also plays a large role in pediatric asthma. “We tend to see a bump in terms of childhood asthma during the toddler years. It is in association with daycare and school,” said Martinez. “Children acquire more germs in that environment.”