Certain respiratory problems serve as signals that reactive airway disease is present. A dry, tight cough that cause for no apparent reason or in patterns (such as during the night or after exertion) may be the only sign. In more intense episodes, overt wheezing may be audible from across the room. Some sounds that resemble wheezing, however, can actually arise from upper-airway infections such as croup, and a physician’s exam may be necessary to make the distinction.
If the airways are particularly tight, the child may show more obvious signs of distress: rapid respirations, labored breathing with minimal exertion or when at rest, such as noticeable use of muscles in the rib cage and neck with each breath. In severe cases, he may be unable to walk or talk, the skin may be pale or even dusky, and abdominal pain or even vomiting may occur. A child who is extremely short of breath should be seen by a physician immediately or taken to an emergency room. Depending on the severity of the symptoms and the patterns of wheezing your child is showing a variety of tests may be performed. Your child’s doctor may ask you to obtain a peak flow meter, which measures the maximum rate of airflow your child can generate at a given time and can be used as a guide to adjust medications. This simple test can be extremely useful in keeping track of your child’s progress on a day-to-day (or hour-to-hour) basis. A chest X-ray may be needed to rule out an underlying infection. Allergy testing may be appropriate to determine what is triggering wheezing episodes.