The Long-Term Effects of Asthma

If you have asthma, you know about the immediate symptoms and how to manage them day to day. You may not know that those same issues—shortness of breath, coughing, chest tightness, and wheezing—can also lead to long-term health effects, including:

• Exercise intolerance
• Recurrent infections
• Permanent narrowing of the bronchial tubes

These long-term effects of asthma can affect your breathing, overall health, and quality of life.

While asthma can never be completely cured, managing it well is important not only so feel your best today, but also in the years to come.

Reduced Exercise Tolerance

Wheezing, coughing, chest tightness, and shortness of breath all are brought on by narrowing bronchi and bronchioles due to the tightening of smooth muscles that surround these airways. This is known as bronchoconstriction.

Bronchoconstriction is often brought on by exercise. In exercise-induced asthma (also known as exercise-induced bronchoconstriction), airways constrict as a direct result of physical activity. This reaction can often be managed with medication, including:

• Short-acting beta agonists (SABAs)
• Long-acting beta agonists (LABAs)

However, when bronchoconstriction is chronic—which occurs in severe asthma—it can lead to a decrease in exercise tolerance.

According to research, people with severe asthma engage in considerably less physical activity than the average person. For instance, they take more than 31% fewer steps per day and engage in 47.5% fewer minutes of moderately or vigorously intensive activity.

Over time, a lack of activity can lead to higher rates of obesity, diabetes, high blood pressure, and other conditions associated with a sedentary lifestyle.

Increased Risk of Infection

With all types of asthma, exposure to irritants inflames your airway tissues, causing an asthma attack. It's your body's way of protecting the tissue, but it restricts air passage in and out of the lungs and makes breathing difficult. Chest tightness and wheezing are signs of inflammation.

Inhaled corticosteroids are often used to control inflammation in asthma. However, continual inflammation can increase the risk of lung infections because it allows infectious material to become trapped in the lungs.

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Lung Scarring

Bronchoconstriction and lung inflammation both cause increased production of mucus, which is created by cells in the lungs that release chemicals known as cytokines.

The mucus can become lodged in the airway; the more severe the accumulation, the tighter your airway becomes and the more pronounced wheezing and coughing are during asthma attacks. Don't ignore an increase in mucus or assume that it's "just to be expected."

Long-term perspective, excess mucus can also increase your chance of infections like pneumonia. Repeated infections can then lead to complications including antibiotic resistance and scarring of the lungs.

Scarring is irreversible and may lead to permanent lung damage.

Airway Remodeling

A long-term complication of uncontrolled asthma is airway remodeling, which is permanent narrowing of the bronchial tubes. If you don't get good control over your asthma, this condition—which mimics chronic obstructive pulmonary diseases (COPD)—can develop over many years.

Airway remodeling is a complication associated with all types of asthma severity, and it has been shown to affect both large and small airways. Repeated bouts of inflammation and airway constriction damage airways over time and lead to structural changes, resulting in progressive loss of lung function.

The best way to prevent remodeling is to achieve good asthma control. This means having rescue medications available when necessary besides your asthma-controller medication. Proper use of asthma medications should allow you to live an active, healthy lifestyle, with fewer asthma-related symptoms.

Remission and Progression

Asthma is a progressive disease. The extent to and rate at which it progresses differs for each individual. As such, so does the risk of long-term effects. Management plays a critical role in all of this.

While some children and adults may see a significant decrease in symptoms with treatment and time, asthma attacks always remain a possibility. For many others, there is no period of remission. Instead, symptoms may continue to worsen.

Regardless of the level of severity of your asthma, sticking to your prescribed treatment plan is an essential part of controlling your condition and working to prevent long-term asthma complications. This will involve proper medication, the elimination of certain triggers, and monitoring of your asthma.

Can You Outgrow Asthma?

Some children with asthma stop having symptoms when they mature. By adolescence, 16% to 60% of children diagnosed with asthma seem to be in remission.

However, healthcare providers don't usually consider asthma "cured" since, even after years of living symptom-free, you could suffer an asthma attack at any time.

The wide range of remission statistics shows that studies have been inconsistent in their design, and more research is needed to fully understand how and why some children seem to "get over" asthma.

In some studies, children who were more likely to go into remission had asthma characterized as:

• Episodic asthma (versus persistent asthma)
• Mild initial asthma severity
• Fewer allergies and allergy symptoms
• Less atopic dermatitis

Male children are also more likely to go into remission.

If your childhood asthma appears to have gone away, it may still be a good idea to avoid triggers, especially allergy triggers, as they could cause symptoms to reappear.

Little to no research has followed adults who appear to have outgrown their childhood asthma, so there's no clear picture of whether or not this reduces the risk of long-term health effects.

A Word From Verywell

By developing an asthma action plan and working with your healthcare provider to find the right medications, you can take control of asthma and limit its long-term effects. 

Keep in mind that your asthma is not well controlled if:

• You have symptoms more than two days per week
• You use your rescue inhaler more than two times per week
• Asthma symptoms wake you up more than two times per month

Work with your healthcare provider to limit the attacks, protect your lungs, ensure you're able to exercise safely, and reduce the short- and long-term impact of asthma on your life.