The Long-Term Effects of Asthma

Many focus on the immediate symptoms caused by asthma and managing them day to day. But those same issues—shortness of breath, coughing, chest tightness, and wheezing—can also lead to long-term asthma effects, including exercise intolerance, recurrent infections, and permanent narrowing of the bronchial tubes. This can effect your breathing, your overall health, and your quality of life.

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

Man coughing while sitting at desk across from bank employee
 

Reduced Exercise Tolerance

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

Bronchoconstriction is often caused 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:

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

According to research, those with severe asthma engage in considerably less physical activity than the average person. For instance, compared to the general population, those with severe asthma may take approximately 31.4% fewer steps per day and engage in 47.5% fewer minutes of combined moderate and vigorously intensive activity.

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

Complications related to asthma symptoms are especially a concern for those with severe asthma, a designation given to 5% to 10% of the total asthma population.

Increased Risk of Infection

With all types of asthma, the tissue in your airways becomes inflamed when exposed to irritants that cause an asthma attack. This response is the body's way of trying to protect the tissue, but it restricts the passage of air 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.

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 will be during an asthma attack. You should not ignore an increase in mucus or assume that it is "just to be expected."

From a long-term perspective, like inflammation, 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

One of the long-term complications of uncontrolled asthma is airway remodeling, which is the permanent narrowing of the bronchial tubes. If you fail to 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 constriction of the airways damage airways over time and lead to structural changes; these cause a 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, in addition to 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.

If you don't feel that your symptoms are adequately controlled with your current management plan, or you start to experience new symptoms, be sure to speak with your doctor; treatment may need to be modified over time to be most effective.

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, doctors do not usually consider this a cure 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:

Male children are also more likely to go into remission.

A Word From Verywell

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

Keep in mind: If you have symptoms more than two days per week, use your rescue inhaler more than two times per week, or wake up at night three times per month, your asthma is not well controlled. You should work with your doctor to limit the attacks, protect your lungs, ensure you are able to exercise safely, and reduce the short- and long-term impact of asthma on your life.

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