Airway
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Eosinophilic airway inflammation
Reversible airflow obstruction due to smooth muscle constriction
Airway bacterial infection
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ICS
Salbutamol
Ipratropium
?Tiotropium
Antibiotics
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Fewer and less severe wheeze attacks
Improved quality of life
Less severe wheeze attacks
Improved quality of life
Eradication of infection
Fewer and less severe wheeze attacks
Improved quality of life
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Extra-pulmonary
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Obesity
Gastro-oesophageal reflux
Unsafe swallow
Rhinitis
Eczema
Food allergy
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Weight reduction
May be coincidental
PPI
Thicken feeds
Antihistamine
Nasal steroids
Emollients
Topical steroids
Avoidance
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Restore normal BMI
Fewer wheeze attacks and better quality of life
Fewer wheeze attacks and better quality of life
Improved symptoms
Rash and itching resolved
No allergic reactions
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Social/
Environmental
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Nicotine exposure (tobacco or vapes)
Exposure to allergens to which child sensitised
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Refer to smoking cessation clinic
Allergen avoidance, including pet removal
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Exposure ceases, fewer attacks and better quality of life
Exposure ceases, fewer attacks and better quality of life
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