Recurrent Upper Respiratory Tract Infections in Children
Recurrent Upper Respiratory Tract Infections in Children and its Ayurvedic treatment:
Definition and Introduction of Upper Respiratory Tract Infections:
Upper respiratory tract infection (URTI) is a nonspecific term used to describe acute infections involving the nose, para-nasal sinuses, pharynx, and larynx. There are no standardized criteria laid down in any authentic textbooks of medicine or pathology regarding the number of episodes that are essential to coin the term ‘Recurrent Upper Respiratory Tract Infections’ (RURTI). It is well described in various textbooks of paediatrics that 8-12 episodes of URTIs per year are common in children and more than that was considered as RURTI.
Upper Respiratory Tract Infections (URTIs) includes: Common cold, influenza, strep throat, acute bronchitis, pharyngitis, sinusitis, tonsillitis, laryngotracheitis and epiglottitis.
Common Cold: The common cold (medically known as infectious naso-pharyngitis) is the most common upper respiratory tract infection. More than 200 viruses can cause colds, the most common being the rhinovirus, which causes more infections in humans than any other microorganism. Symptoms of a common cold (nasal congestion, muscles aches, fatigue, and fever) are mild. A cold nearly always starts with throat irritation and stuffiness in the nose. Within hours, full-blown cold symptoms usually develop, which can include sneezing, mild sore throat, low-grade fever, minor headaches, muscle aches, and coughing. In children, fever may be as high as 103 degrees F for one or two days; it should go down after that and be normal by the fifth day. Nasal discharge is usually clear and runny the first one to three days; it then thickens and becomes yellow to greenish. A runny nose usually lasts two to seven days, although coughing and nasal discharge can persist for more than two weeks.
Influenza (Flu): Influenza, commonly called the ‘flu’, is always caused by a virus. The symptoms usually always include headache, muscle aches, fatigue, and high fever. Influenza may also cause a cough (which is usually dry but can be severe) and sometimes a runny nose and sore throat.
Strep Throat: Sore throat during a cold is very common and usually mild and in nearly all such cases is caused by a virus. The symptoms of the more serious so-called strep throat, which is caused by the group A Streptococcal bacteria, include a sudden onset of severe sore throat, difficulty in swallowing, and fever. The patient may also have a headache, stomach pain, and vomiting. Only about half of patients with strep throat have such clear-cut symptoms, however. Furthermore, half of people who have these symptoms do not actually have strep throat. Strep throat is most likely to occur in late winter and early spring and is not usually accompanied by a cough or nasal congestion.
Acute Bronchitis: Acute bronchitis is an infection in the passages that carry air from the throat to the lung causing a cough that produces phlegm. In such cases, the airway tubes have become inflamed and collected mucus. In 95% of cases, acute bronchitis is caused by a virus and is spread from person to person through coughing. In some cases other tiny microbes called Mycoplasma or Chlamydia may be responsible. The cough usually lasts for about a week to ten days but in about half of patients coughing can last for up to three weeks and 25% of patients continue to cough for over month.
Pharyngitis: Pharyngitis is an inflammatory process of the pharynx, hypopharynx, uvula, and tonsils that can be caused by viral or bacterial infection and occasionally both.
Sinusitis: Sinusitis is the infection of the para-nasal sinuses weather it may be acute or chronic. It usually takes place as a bacterial complication of a viral URTI. Predisposing factors include nasal infections, dental infections, trauma, neighboring infections like chronic tonsillitis and adenoids, lowered resistance and chill, atmospheric pollution. In children adenoids may play a role in the etiology. Only maxillary sinuses and ethmoidal sinuses may be affected, oedema of the face and eyelids may occur more often.
Tonsillitis: Acute tonsillitis is one of the most common infections encountered in everyday practice. It occurs more frequently up to the age of 15 years. The tonsils become congested and swollen, secretions increase and become tenacious, movements of palate become impeded due to pain and jugulodigastric nodes get enlarged and tender. Raw sensation in the throat, pain in throat, refusal to eat, voice becomes thick and muffled, malaise, fever, headache etc. are the common symptoms.
Laryngotracheitis: This severe infection occurs in children, where their resistance is low and infection is virulent. The child happens to be toxic because of the severity of infection and dyspnoea due to generalized edema of the entire tracheo bronchial tree. There is marked congestion and oedema of the entire respiratory tract, extending from larynx to the trachea or bronchi. This interferes with the pulmonary function. Tenacious secretion and crushing may be present.
Epiglottitis: Epiglottitis is a life-threatening disease observed most frequently in children aged 1 – 6 years, often during the fall and winter. Although less common, it also can affect adults. It leads to sudden airway obstruction and other complications, including septic arthritis, meningitis, emphysema and mediastinitis.
Why URTI Incidence Is More Common in Paediatric Age Group?
The reasons behind it includes –
- Anatomical and physiological considerations: Small narrow airways hypertrophied lymphoid tissues, underdeveloped / undeveloped para-nasal sinuses, mucus hyper secretion and peculiarities of Eustachian tube.
- Immunological considerations: First exposure, Young cells and Immature immunological defences
- Social factors: Improper foods / food habits and chances of more exposure at school/ day care centre
What Are The Treatments for the Common Cold in Allopath Medicine?
- Hot beverage
- Nasal wash
- Nasal strips
- Nasal decongestants
- Zinc preparations
- Nasal spray
- Steroids and
What is the Treatment for More Severe Upper Respiratory Tract Infections?
General Guidelines Regarding Antibiotics:
In spite of strong warnings by experts that colds and their symptoms never require antibiotics, many physicians feel pressured by patients or parents into prescribing antibiotics for mild upper respiratory tract infections. One disturbing study reported that antibiotics are prescribed for nearly half of children who go to the doctor for a common cold. In people with colds, even the presence of a persistent cough or greenish, thick mucus does not indicate the need for antibiotics if there are no other symptoms of infection. Experts estimate that outside the hospital only half of the antibiotics prescribed for sore throats, 20% of prescriptions for bronchitis, and virtually no antibiotics for colds are necessary. Antibiotics may be required in children and elderly patients with medical conditions that put them at high risk for complications of respiratory infections. They are also used for some cases of sinusitis and ear infections.
Other possible indications for antibiotics are described below.
Prescribing antibiotics to so many people who do not require antibiotics is raising great concern among health professionals. Increasingly, physicians are reporting strains of common bacteria that are no longer eliminated using many standard antibiotics. As of yet, the average person is not endangered by this problem. The risk is greatest in hospitals and nursing homes, but it is still not high. Nevertheless, it is important for patients and parents of children with mild upper respiratory tract infections to understand that although antibiotics may bring a sense of security, they provide no significant benefit and overuse can contribute to the growing problem of resistant bacteria.
On a positive note, new developments in antibiotics are helping to forestall the growing problem of bacterial resistance. One innovative approach involves creating antibiotics that have the capacity to either self-destruct or regenerate themselves.
Ayurvedic treatment for Recurrent Upper Respiratory Tract Infections in Children:
‘Kaumarabhritya’ (Ayurvedic paediatrics), one of the eight major branches of Ayurveda, especially deals with the problems related with infants and children. It is a unique peculiarity of Ayurveda that Ayurvedic paediatrics start well before conception. It deals with antenatal, perinatal and postnatal care along with the different aspects of child health and diseases. A large number of single and compound formulations are available in the Ayurvedic classics for the treatment of common ailments like respiratory infections.
How can upper respiratory infections be prevented?
Hygiene: Everyone should always wash his or her hands before eating and after going outside. Ordinary soap is sufficient; antibacterial soaps add little more protection, particularly against bacteria.
Daily Habits: One should follow the ‘Ayurvedic lifestyle’ described on the home page of this website for better prevention against the recurrent upper respiratory tract infections.
Vaccines: Child has to be timely vaccinated and even should undergo ‘Suvarna-prashan Sanskar’ (Ayurvedic vaccination programme).
Treatment of RURTI in Ayurveda:
In the treatment of RURTI, a long list of do’s and don’ts is mentioned by different Ayurvedic classics.
- Remain in a place devoid of wind
- Cover head with thick and warm cloths
- Food: Which having Laghu(light in digestion) and Snigdha properties, not too liquid, jangala mamsa( chicken, meat of goat, meat of dear), jaggery, luke warm milk added with turmeric powder and slight salt, trikatu powder (combination of dry ginger powder, black pepper & long pepper), pomegranate, Light hot beverages like tea added with ginger, boiled rice and moong dal added with ‘trikatu’ powder, old wines, gargling by luke warm water added with salt
- Some Unique Ayurvedic formulations for treatment of URTI: 1) Dashmoola kwath (Decoction made by a unique combination of ten different herbal plants described in Ayurveda known as ‘dashmoola’), 2) Pathyadi kwath 3) Abhayadi kwath 4) Tab. Shatyadi 5) Tab. Khadiradi 6) Tab. Lavangadi 7) Cap. Breeth free (Organic india pharma) 8) Sitopaladi powder mixed with honey 9) Trikatu powder mixed with honey 10) Talisadi powder mixed with honey 11) Balchaturbhadra powder mixed with honey 12) Syrup Kanakasav 13) Syrup Dashmoolarishta 14) Syrup Cofseal (Organic india pharma) 15) Chyavanprash (Organic india pharma)
- Cold water, cold beverages
- Exposure to cold
- Habit of excessive eating
- Anger, stress, sorrow
- Suppression of natural urges
- Newly prepared wines
- Excess sleep and bath