Ask an Expert: What Happens If Asthma Is Not Controlled Properly?

People who suffer from asthma can undergo a range of symptom experiences, from mild symptoms that minimally impact daily activities to severe symptoms that put them at risk of hospitalization or death.

If following a healthcare provider's advice, asthma can be relatively easy to control, Jurairat J. Molina, M.D., allergist and medical board expert for Verywell Health, tells Verywell. But if a person faces barriers to care or does not understand their treatment protocol, asthma can easily get out of control, too.

According to the American Lung Association (ALA), a person experiencing controlled asthma should use an inhaler fewer than three times a week, sleep through the night without waking up due to asthma symptoms, and be able to participate in daily activities and exercise with few to no symptoms. Symptoms can include shortness of breath, chest tightness, and coughing.

A person who experiences uncontrolled asthma may have a combination of frequent daytime symptoms, waking up at night due to symptoms, using quick-relief medicines (like an inhaler) to quell symptoms, or limiting their activity because of their symptoms.

Uncontrolled asthma is not the same as severe asthma, which can occur when a person responds poorly to some asthma medications. It impacts between 5% and 10% of people with asthma, according to the ALA.

Dr. Molina discusses what can happen if asthma goes unchecked, and what steps people can take to get their condition under control.

Verywell Health: Physically, what can happen to the body if asthma is not controlled?

Dr. Molina: Asthma is an inflammation. It’s a chronic condition, and it’s an inflammation of the airways. If left untreated or [if] inappropriately treated, then that inflammation could turn into a scarring in the lung tissues, and it could cause, later on in life, what we call severe uncontrolled asthma. You could have problems with recurrent bronchitis [and] pneumonia, and that increases your risk of hospitalization or death later on if left untreated.

Verywell Health: What is the public health impact of uncontrolled asthma?

Dr. Molina: There are a lot of people suffering from asthma. And that can be a big public health issue if people aren’t being appropriately treated or [have] uncontrolled asthma.

People with uncontrolled asthma [can] end up in emergency rooms, urgent care, [or] get admitted to the hospital, and that would impact public health or healthcare expenses. That would translate into billions of dollars in healthcare expenses, if people are not treated appropriately or [have] uncontrolled asthma.

Verywell Health: What are some reasons asthma goes uncontrolled or untreated?

Dr. Molina: The reason that people have uncontrolled asthma is because sometimes the disease itself is viewed as “just something that I deal with when I have an attack; I don’t have to take the medication on a regular basis.” And that is not true.

Asthma is a chronic disease that needs preventive treatment. You should take medication on a regular basis, as opposed to just going to an urgent care or emergency room or seeing your physician when you have an asthma attack. Each time when you have a flare-up or asthma attack, it causes more inflammation in your lungs and down the road you could have a worse outcome or severe consequences.

Verywell Health: How can providers help patients control their asthma?

Dr. Molina: Health literacy [the degree to which individuals are able to obtain, understand, and use basic health information in order to make informed health decisions] is something I think all providers should be sensitive to.

As mentioned above, some people have the perception that they don’t have to take medication regularly, or they don’t have a good understanding of what would be the long-term consequences of asthma if they don’t take medication as instructed or follow medical advice. And that individual usually ends up with an uncontrolled asthma or develops other complications of asthma because of inappropriate treatment.

Providers shouldn’t assume that their patient’s going to walk out of the appointment understanding everything that’s been explained. Sometimes, providers need to use a different approach, or work with a multidisciplinary team. Sometimes they need to have a nurse call the patient a couple days later just to make sure that they go pick up the medication, they understand the instructions, or if they have any other questions regarding the treatment plan or the medication they have to take.

Verywell Health: Do any groups of people suffer the consequences of asthma more than others?

Dr. Molina: There are several barriers to care of asthma from race [to] sex [to] age to behavior.

In terms of consequences, we already know that people who are Black have a high risk of asthma death: They have 3 times the mortality rate and 2 times the hospitalization rate because of their genetic background. On top of that, socioeconomic factors—income, education level, employment, insurance, or to what extent a person considers health a priority—can impact their asthma outcomes.

Verywell Health: How can asthma be controlled to reduce consequences?

Dr. Molina: Asthma is not difficult to treat. Once we identify a person has asthma and put them on an asthma regimen—and if a person follows your instruction or takes it appropriately—usually asthma is fairly well controlled.