Does Asthma Go Away?

Asthma Remission or Improvement

Does Asthma Ever Get Better
Does Asthma Ever Get Better. Pat Bass

Does asthma go away?

I am sometimes asked this by kids or their parents in my practice and less frequently by adults. Children with poor asthma control or frustrated adolescents want to know if they will continually have to deal with wheezing, chest tightness, cough, and shortness of breath. Other times parents or patients have noticed a significant decline in symptoms and wonder if they need to continue medication.

Do Kids Outgrow Asthma?

While scientists are not exactly sure why, as many as half of all kids with asthma see a significant improvement, or total elimination, of their asthma symptoms with increasing age.

It is nearly impossible to determine which kids will outgrow their asthma or have significant reduction in symptoms. However, symptoms can come back at any time so it is more appropriate to think of it as a ‘period of remission.’ In fact, many of these patients who appear to have outgrown their asthma will have a return of symptoms as an adult.

No Symptoms But Is Asthma Really Gone

While the asthma symptoms may have abated or significantly decreased, the underlying inflammation and other parts of the pathophysiology of asthma are still present. The only way to definitively tell if inflammation and mucus plugging are still present would be to do a biopsy.

Who Is Most Likely To Outgrow Asthma?

It might be easier to point out who is not likely to outgrow asthma.

While most wheezing in early life is due to viral respiratory infections such as the respiratory syncytial virus, differentiating viral illness from asthma can be difficult. Children who experience multiple wheezing episodes before age 3 and contain at least one of the following risk factors are at increased risk of continuing to wheeze:

  • Parent with asthma
  • Have a diagnosis of eczema

Or 2 of these symptoms:

  • Food allergy
  • Wheezing episodes not associated with colds
  • Elevated levels of eosinophils in the blood

Research at National Jewish Health found that only 6% of children followed for 9 years were considered in complete remission from asthma with no asthma activity meaning no asthma symptoms, medication use, or urgent care visits for asthma.

The following factors have been associated with increased likelihood a “period of remission” or improving asthma:

  • Boys are more likely than girls
  • Older the age at diagnosis
  • Wheezing only with a cold, but otherwise being symptom-free
  • Lower levels IgE and other biochemical indicators of asthma severity
  • Less sensitive or hyperresponsive lungs
  • Less severe asthma overall
  • Better FEV1
  • Decreased sensitization and exposure to allergens
  • No diagnosis of allergic diseases like eczema
  • Less need for rescue medication and fewer asthma attacks

Genetic testing has identified certain parts of our DNA that indicate patients likely to develop a more complicated or life long asthma course over and beyond having a family history of asthma.

While currently used in research studies, genetic testing may one day be able to predict what your asthma course may look like or whether an early wheezing episode increases the likelihood of lifelong asthma.

Final Thoughts

In response to the question does asthma go away, it seems that the correct answer is a wholehearted maybe!

It is important to be mindful of asthma as ignoring it is wrought with risk. However, if you or your child have experienced a significant improvement in symptoms you may want to talk with your doctor about decreasing or stopping medication. You may have been incorrectly diagnosed or you may be in a period of remission. Either way, talk with your doctor before making changes to your asthma action plan.

Sources

Covar RA et al. Predictors of Remitting, Periodic, and Persistent Childhood Asthma.

National Heart, Lung, and Blood Institute. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma.

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