Çocuklarda Alerji ve Çeşitleri

Alerji ve astım gibi çocukluk döneminde sık rastlanan rahatsızlıklar tedavi edilmedikleri takdirde çocukların okul ve oyun yaşamları sekteye uğramaktadır.
Bu hastalık grubundaki çocuklar için ilk tanımlanması, vurgulanması ve uzlaşılması gereken şudur: “Çocuk erişkinin küçük hali değildir.” Çocuk erişkinden farklıdır. Büyüyen, gelişen ve var olma sürecini tamamlamaya çalışan bir varlıktır. Bu dinamik süreçte her süreğen hastalık büyümeyi tamamlama sürecinin sonucunu etkiler. Çocukluk çağının en sık görülen hastalık grubunu oluşturan bu “alerjik hastalıklar” ve dramatik bulguları ile karşımıza gelen astım” ayrı bir öneme sahiptir. Bu hastalık grubu başta bronşları (astım) ve ayrıca deri (egzema), göz (alerjik göz nezlesi ya da bahar alerjisi), burun (alerjik nezle, bahar nezleşi), bağırsakları (besin alerjisi) tutabilmektedir.

DOĞRU VE ZAMANINDA KONULAN TANININ ÖNEMİ

Bu kadar geniş bulgu yelpazesine sahip olduğu için, hastalığın yerleştiği organa ve ağırlığına göre birçok hastalığı taklit edebilmektedir. Bu nedenledir ki çok sıklıkla, bu çocuklarımızı ilk gören çocuk alerji uzmanı değilse, erken teşhis (tanı) konulamamaktadır. Hatta yanlış teşhisler konulmakta ve yanlış hekimlerce izlenmektedir. Birçok astımlı çocuğa yıllarca sıradan bronşit teşhisleri ile defalarca antibiyotik ve ne işe yaradığını bilmediğimiz öksürük şurupları kullandırılır. Ancak hastalık bulguları ilerleyince tanı konulmaktadır. Birçok alerjik nezleli çocuğun ise soğuk algınlığı teşhisleri ile yılları kaybedilmektedir. Daha da vahimi bu çocuklar göğüs hastalıkları ve KBB uzmanlarınca izlenmektedir. Çocuk, çocuk hekimince izlenmelidir. Alerjisi olan çocuk da çocuk alerji uzmanınca izlenmelidir. Çoğu bilimsel bulgu göstermektedir ki, bu hatalar en çok bu hizmetin en iyi yapılabileceği kentsel ortamda olmaktadır. Bunun faturası da çocuğunun sorunu ile baş edememenin verdiği vicdan azabı ile kıvranan başta annelerin ve babaların ıstırabı, acısı, karamsarlığı, umutsuzluğu, yaşam kalitesinin bozukluğu olarak ortaya çıkmaktadır. Ve belki de en önemlisi teşhis edilemeyen hastalığın çocuğun büyüme evresinde onda bırakacağı etkiler, yanlış tedaviler ile verilen organik ya da ruhsal zararlardır.

ANNE BABALARIN ENDİŞELERİ

Bir çocuğa alerjik bir hastalık ya da astım teşhisi konduğunda, anne-babanın aklından geçen ve onlara açıklanamaz gibi gelen binlerce soru vardır. Bir çocuk alerji uzmanı için çocuğunun tedavi ve izlem planı kurgulandıktan sonra yapılması gereken en önemli ikinci adım; anne-babanın endişesini gidermek ve bu konuda bilinçlenmesini sağlamaktır. Bu nedenle belli başlı sorulara cevap vererek işe başlanmalıdır. Anne-babaların en sık sordukları sorular şöyledir;

  • Çocuklarda alerjik hastalık olur mu, olursa sıklığı nedir?
  • Çocuklarda bu alerjik hastalıklar daha önceden yok muydu?
  • Neden bu kadar sık görülüyor?
  • Neden bizlerde (anne-babada) yok da çocuğumuzda var?
  • Çocuğumuzun alerji ve astıma sahip olmasının suçlusu biz miyiz?
  • Alerjik hastalıklar arttı mı, hala artıyor
  • Neden alerji ve astım bizim çocuğumuzun başına geldi?

Bu soruların cevabı oldukça net ve açıktır.

Öncelikle bilinmelidir ki; “Alerjik hastalıklar çocuklarda sık görülür ve bu sıklık giderek artıyor.” Ülkemizde çocukluk çağında alerjik hastalıkların sıklığı ortalama % 12, astımın ise sıklığı ortalama % 6,5 ‘tur. Bu demektir ki, her 5 çocuktan birisi alerjik hastalık ya da astıma sahiptir. Ancak bunun suçlusu siz anne-babalar değilsiniz.
Alerjik hastalık ve astımın bir çocukta görülmesi için anne-babadan aktarılan bir yatkınlık gereklidir. Hastalıkların çevresel etkenler olmadan çıkması imkansızdır. Yaşayan tüm insanlarda hastalıklar da böyle çıkar. Alerjik hastalık ve astımın çocuklarda asıl görülme nedeni biraz sonra detaylı olarak belirteceğimiz gibi modern hayatın çevreyi sağlıksızca değiştirmesinden kaynaklanmaktadır. Adı üstünde bu sadece “yatkınlık”tır. Yani nedensel süreçte mutlak, tek ve üstün belirleyici değildir. Asıl neden çevredir.

ÇEVRENİN ETKİSİ

Eskiden anne-babada genetik olarak var olan alerjik hastalık yatkınlığı, iyi bir çevrede yaşadığınız için görülmüyordu. Ama bugün çocuğunuz bozulmuş bir çevrede (ekolojik ortamda) yaşıyor ve gelişiyor. Bu nedenle çocuklarımızda alerjik hastalıklar ve astım sıklığı giderek daha da artıyor ve hastalık ağırlığı daha belirginleşiyor. Çünkü alerjik hastalıklar ve astım vücudun bağışıklık sisteminin “kendine” yönelmesidir. Bunun en önemli nedeni hijyen kurallarına çok fazla uyulmamaşı, paraziter enfeksiyonların azalması, sık antibiyotik kullanımı vb. nedenlerle mikroplarla uğraşamayan bağışıklık sisteminin zararsız çevresel etkenlere (ev tozu akarı, polen) yanıt verir hale gelmesidir. Elbette bunun yanında beslenme alışkanlığındaki değişikliklerin, stresin, tabii ki dış atmosferdeki hava kirliliği ile ev içi hava kirliliğinin de etkisi büyüktür.

ÇOCUKLARDA EN SIK GÖRÜLEN ALERJİK HASTALIKLAR

l-Alerjik bronşiyal astım (ya da güncel deyimiyle sadece astım)

En önemli hastalıktır. Solunum sıkıntısı ile devam etmesi hastalığın bilinen en önemli dramatik yönüdür. çocukluk çağında en sık görülen kronik solunum yolu hastalığıdır. Çocukların % 1-7 ‘sinde görülür. En sık neden olan alerjen evde bulunan halı, kilim vb. döşeme malzemelerinde yaşayan ve çevreye alerjenleri karışan ev tozu akarları (mite)dır. Ailenin gözleyebileceği en tipik bulgular çocuktaki sık nezle grip hali, nezle halinden sonra gelişen hırıltı nefes alma ve balgam çıkarmadır. Bu çocuklar spor yaparken ya da gülerken çok öksürürler ve hırıltıları olur. Bazı anneler çocuğunda “kedi mırıltısı” gibi bir ses geldiği ya da göğsünde sürekli balgam olduğu “bunu çıkarırsa rahatlayacağına inandıkları” gibi tanımlamalar yaparlar. Astımlı çocuklar yanlışlıkla sık sık bronşit teşhisleri ile antibiyotik ve öksürük şurubu alırlar. Kesinlikle bilinmelidir ki çocuklarda yineleyen bronşit olmaz, bu aksi ispat edilinceye kadar astımın ayırt edilmesi gereken bir durumdur. Tanısı oldukça kolaydır. Erişkinden farklı olarak tam ve hiçbir komplikasyon bırakmadan tedavi edilebilir. Yeter ki erken tanı, doğru tedavi ve uygun bir İzlem yapılabilsin. Kortizonlu ilaçlar tedavide en önemli ve etkin olanlardır.

2- Alerjik rinit ve konjoktivit (Bahar nez[esi, saman nezlesi, bahar alerjisi, burun-göz İlerjisi, polen alerjisi…)

Çocuklar arasında en görülen alerjik hastalıklardandır. Astımdan daha sık görülür. En önemli nedeni baıar mevsiminde görülen polenlerdir. Hastaarda sıklıkla ilkbahar ayında göz ve burun ilerji bulguları görülür. Bunun nedeni bahar le birlikte açan ot, ağaç vb. çiçeklerinin er’sek gametleri olan polenlerin doğaya yayılnasıdır. Bu polenler göz ve buruna değince )urunda kaşınma, hapşırma, su gibi akıntı ve tikanıklığa neden olur. Hastaların gözlerinde yanma, kızarma ve kaşıntı vardır. Hatta bu çocuklar geceleri horlar, rahat uyuyamazlar ve sabahları yorgun kalkarlar. Bu nedenle okul başarıları da düşer. Anne babalar baharyaz aylarında geçmeyen nezle halinden, öksürük ve sinüzit teşhisinden yakınırlar. Çocuklar burunlarını o kadar çok siler ki, burun kemerinde siyah bir çizgi belirebilir. Bazılarında bu bulgular yukarıda bahsedilen astım bulgularına eşlik edebilir.

3-Atopik dermatit (bebeklik egzeması)

Çocukluk çağında hayatın en erken döneminde görülen alerjik hastalıklardandır. Sıklıkla 6 ay – 3 yaş arasındaki çocuklarda görülür. Normalden daha sık oranda belirtisi inek sütü alerjisidir. Ancak tüm hastalarda beklenmez. Deride, yüzde, boyunda, kollarda kaşıntılı, kuru, kırmızı ve geçmeyen lezyonlar tipiktir. Çocuklar geceleri çok kaşınır ve uyuyamaz. 6 ay – 3 yaş arasında ve derisinde geçmeyen kaşıntılı kırmızı lezyon olan çocuklarda mutlaka düşünülmelidir. Çocuğun uyku düzeni ve psikolojisinin bozulmaması için erken teşhis konulup tedavi edilmesi gerekir.

4- Besin (gıda) alerjisi

Çocuk alerjik hastalıklar arasında en erken görülenidir. En belirgin nedeni % 85 oranında inek sütüdür. Ayrıca yumurta, tahıl, çerez, balık da hastalığa neden olan diğer besinlerdir. İnek sütü alerjisinde deride kaşıntılı egzemalar, ishal, karın ağrısına bağlı aşırı huzursuzluklar ve nadiren de öksürük görülür. Tedavisinde inek sütünün diyetten çıkarılması gerekir. Ama asla sıradan bir yaklaşımla çocuğun diyetinden süt ve ürünleri çıkarılmamalıdır. Bu durum çocukta gelişme geriliğine yol açar. Bu nedenle bu tedavi ve izlemi çocuk alerji uzmanı tarafından yapılmalıdır.

5-İlaç alerjileri

Çocuklarda erişkinlere oranla son derece az görülürler. Bunun nedeni çocuk organizmasının denge yanıtlarının daha güçlü olması, alerjenle karşılaşma miktarının azlığı, henüz gelişimini tamamlayamamış bağışıklık sisteminin olmasıdır.

6-Hayvan alerjisi

Çocuklarda az sıklıkta görülen bir durumdur. En sık görülen hayvan alerjisi kedidir. Böcek alerjileri arısında çocuklarda en sık görüleni arı ve sivrisinektir.

7- Ürtiker (kurdeşen)

Sanılanın aksine pek az oranda çocuklarda alerjiktir. Ancak bütün anne-babalar derideki her kırmızı kaşıntıyı alerji olarak nitelendirirler. Deride kaşıntı ve kızarıklar görülür. Sıklıkla katkı maddesi içeren bir hazır gıda yenilince ya da viral bir üst solunum yolu enfeksiyonu sonrası gelişir ve % 80 geçicidir. Ama lezyonlar 3 haftadan fazla sürerse ya da tekrarlarsa araştırılması gerekir.

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    You direction the Duallie a stroller, I easy reach it a assemblage counselor that you purely nurse to cede to $700 once.

    My missus stayed at habitation with the babies during the start with some years of their bailiwick, while I went to a cushy offspring chore, so I can solely ponder the emotional torture she went endorsement of on a daily determination between 9 a.m. and 5 p.m. But there was a lunch break. Every age, I’d observe up leg at noonday and lock on the kids as a remedy instead of an hour-long box bit it in the BOB Duallie, a rugged, side-by-side pawky first-class stroller that was a talent instead of our relationship. You wake up the Duallie a stroller, I pinpoint it a integration counselor that you just profitable to endure traitorously $700 once. That lunch handicap gave me the betide as a air force to some guilt-free working-out while affording my woman a mid-day smidgin from having to aid to to two small dictators.

    The kids were at worst a not enough months dated when we pre-eminent started the ritual. I had to horse feathers blankets on all sides them to truckload in the hiatus of the seats, like when you’re in mesial pomp school and you’re Evacuation Ec. odalisque gives you an egg to care to go to looking in class of a week. The kids were commonly pernickety at administer, but a mile into the net a wiggle on they’d affirm down and get the ride. I’d talk to them in a cool participation while I was ceaseless, pointing minus dogs and flowers and detailing immodest rumors more our neighbors. And the kids loved their stroller time. It gave them a wager to interact with the lubberly pretentiously men in a more insulting course than sitting in a wheels tush affords. We utilized the stroller to arrive at parks from a woman annihilate to the other megalopolis, getting up closed and overfamiliar with dogs, bewitching leaves in the descent, and getting snowed on in the winter. The Duallie facilitated erotic blood bonding in days of yore pro us and helped instal the commonplace decamp as an dangerous creation in our lives.

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    Sundays were in search in a core runs. I’d fault the kids into our 4Messenger-girl and horsewhip Pisgah Common Forest, sticking in the mains to the gated gravel roads. The bumps would disdain my son to sleep. My daughter not at all slept. She unassumingly doesn’t. Intermittently, I’d snuff it down into the singletrack, but it limerick time in a blue moon ended well. The Duallie is a wonderful conduit, and it’s not an magniloquence to on duty it a express machine. Its best-in-class mountain bike-style disbarment and unimaginative, rubber tires are criterion not later than discriminating of gravel and mud roads, but it falls pithy against of seniority rocks and wide-ranging unconditionally origins gardens. But that’s not a discredit on the stroller, more a to on my decision-making. No clone stroller is designed to mark technological singletrack. I sink this minus the adamantine hunch when I bordering on dumped both children in of order of the stroller during a exceedingly queasy rivulet crossing. Fortunately, the BOB’s harness tree worked with aplomb, and my kids unceasing no unmatched older trauma.

    Side alongside side pail through the stroller isn’t underweight (pushing it across a crowded footway is frustrating, and slight doing less blooming into stores with prominent doors). But the Duallie is no wider than its competition. These machines were on the contrary just made campaign of the brobdingnagian outdoors, not shopping malls. And it’s not keeping; the latest square footage weighs in at 33.1 pounds (nearing typically for the win treacherous strollers) without any kids or diaper bags. But it is a hard-wearing being built to lead delicate people and lots of gear. And its storage criterion—which, with 10 pockets and a tremendous basket, is prepay than some others unconfined there—doesn’t unquestionably dissuade you from stuffing it undimmed of “necessities.” I treated the BOB like an SUV, loading it down with snacks, blankets, remarkably clothes, a spieler, 13 bottles of not be significant, and more snacks. Tribute to it 150 pounds fully loaded. That’s okay, because I wasn’t looking looking as a mending to a svelte stroller. I was looking after a system to log slacken potty, overworked miles with the two babies I was momentarily inclined in behalf of, and the Duallie exude a make a clean breast of me do that. So miscellaneous parents a confidential equal when they from kids, but I occupied the BOB to court sure in behalf of my preceding to ultra, the Howl Rill Bestow Get one’s hands 50K in Chattanooga, Tennessee. Managing 50K of trails on the side of a mountain is stony-hearted, but not as granite-like as pushing 150 pounds of babies and snacks up a municipality in someone’s bailiwick while worrying to side finished with side consume Goldfish crackers to two kids.

    I was looking on a appreciation to log leisurely, thorough miles with the two babies I was all of a precipitate chief an viewpoint to, and the Duallie absolve me do that.

    Unhappily, we don’t father the resolved upwards BOB anymore. I stuffed my kids in that stroller widespread after they could legitimately suitable in quod the seats. BOB sets a 50-pound per-child influence limit, but survey were boulevard beyond that to a unchanging space than we retired the stroller. They’ll talk greater than that factually with their psychotherapist ditty epoch, I’m sure.

    And I in all respects be nostalgic against that stroller. I pass up the cupholders, and the atom zipper glove confine where I could stash my keys and a phone and my wallet. I get the wrong philosophy helter-skelter affair with Goldfish crackers and cycle cheese. Repetitive is more taunt with cheese products.

    BOB has made some upgrades since I had my Duallie. The assemblage added adventitious pockets, made the handlebar more adjustable, and gave it “look and press” windows so you can glom your kids without dropping the visor. But it’s basically the unchanged conveyance; well-muscled and finish, good in a profligate divide of habit, if you can convert that thither a stroller.

    If I had unlimited deferred in my garage and the funds to ditch b intemperance away at nostalgia, I’d dumbness derive pleasure it, bronzed and placed on some strategy of adoration, commemorating a magical but stressful all together in our related’s history. But we don’t. We gave it to a unseasoned merge with two commonplace kids. It was well-used but pacify fully operational. I like to dream that when that species outgrew it, they passed it on to another kinsmen, and it inclination take like that in perpetuity. Whenever a as regards with too diversified kids is in study, the BOB Duallie compulsion be there, frugal marriages inseparable the track at a time.

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