Asthma
Asthma is a condition characterized by recurring episodes of airway narrowing and obstruction, which can be triggered by allergens, viral infections, or physical activity. It is one of the most common causes of chronic cough in childhood.
Episodes typically involve recurrent coughing and wheezing, with normal, symptom-free intervals in between. Nighttime coughing is often a feature. Shortness of breath is frequently observed as the main symptom.
During an attack, the child may use accessory respiratory muscles to breathe, and wheezing or whistling sounds may be audible externally.
Diagnosis is based on a history of recurrent cough and wheezing episodes, a family history of asthma (especially in first-degree relatives), findings from pulmonary function tests, and physical examination findings during attacks.
Risk factors include a history of atopic dermatitis in infancy, parental asthma, allergen sensitivity, wheezing episodes unrelated to colds, a diagnosis of allergic rhinitis, confirmed food allergies, and eosinophilia in blood counts.
The treatment goal is to control daytime and nighttime symptoms and allow the child to return to normal activity. Preventing attacks and maintaining normal pulmonary function test results are key aims.
Acute Tonsillitis/Pharyngitis
Tonsillopharyngitis is one of the most commonly diagnosed conditions in pediatric outpatient clinics and hospitals. Enclosed environments and climate changes are contributing factors. Streptococcal pharyngitis, commonly known as “strep throat,” is rare under the age of three due to the lack of developed receptors for the bacteria. It is most commonly seen in school-aged children.
About 75–80% of all cases are viral and do not require antibiotics.
Proper clinical evaluation is essential. Rapid tests or cultures should be performed, and antibiotic treatment should only be started when necessary.
Cough
Causes of cough vary widely by age group.
- In newborns, it may be due to swallowing dysfunction, fistulas, gastroesophageal reflux, or even heart failure.
- In preschoolers, recurrent upper respiratory tract infections, asthma, reflux, passive smoke exposure, and atypical infections are more common.
- In school-aged children, recurrent upper respiratory tract infections, asthma, postnasal drip, sinusitis, and smoke exposure are prominent causes.
A cough lasting longer than 3 weeks is defined as chronic cough. In such cases, the child should be evaluated, and appropriate tests should be performed.
It is also important to note that not every cough requires antibiotics.
Constipation
Constipation is a common issue in children. Nearly half of the cases have a family history of constipation. Constipation may be indicated by having fewer than three bowel movements per week, hard stools, and soiling of underwear due to stool retention.
Constipation can be classified as acute or chronic.
- Acute constipation often occurs due to dietary or environmental changes and is commonly accompanied by abdominal pain.
- Chronic constipation lasts more than a month and, if untreated, may lead to fecal incontinence.
Bowel movement frequency varies significantly by age. In functional constipation, early toilet training and poor hygiene in school bathrooms are often contributing factors. Children may adopt various postures or behaviors to avoid defecation.
Otitis Media
Acute otitis media (middle ear infection) is a frequent childhood illness. Symptoms include fever, ear pain, and irritability. Damage to the eardrum and ear discharge may occur during the course of the infection.
Three episodes in six months or four in a year are defined as recurrent otitis media. This condition may lead to hearing problems or delayed speech development.
Often developing after upper respiratory infections, otitis media usually resolves on its own. However, close monitoring is needed to prevent potential complications.
Henoch-Schönlein Purpura (HSP)
Henoch-Schönlein Purpura (HSP) is the most common vasculitis of childhood. It involves inflammation of small blood vessels, which are found throughout the body. Because of this, multiple organs—particularly the kidneys and intestines—can be affected in the early stages, leading to damage or bleeding.
The appearance of red, non-blanching skin rashes should prompt an immediate evaluation by a specialist. Close monitoring and appropriate treatment are essential.
Even after the acute phase, kidney involvement may occur years later, so long-term follow-up by a pediatric nephrologist is crucial.
Familial Mediterranean Fever (FMF)
Familial Mediterranean Fever is a condition characterized by episodes involving two or more of the following: fever, abdominal pain, chest pain, joint pain, or swelling. These attacks usually last longer than six hours, and the patient has no symptoms or abnormal lab findings between episodes.
A family history of recurrent abdominal pain should raise suspicion, and evaluation by a specialist is advised.
Without proper treatment and follow-up, FMF can lead to amyloidosis—a condition involving protein accumulation that damages organs, especially the kidneys. Controlling the disease before reaching this stage is essential.