The Effect of Asthma on Long-Term Health

Long Term Asthma Complications
Long Term Health Effects Of Asthma. Martin Barraud/OJO Images/Getty Images

Asthma is a chronic illness, meaning that it's never completely cured. Due to that, it's important that you try to be knowledgeable of the potential long-term consequences. While asthma cannot be cured, it can be managed. There are steps you can take to control asthma symptoms and limit its long-term effects. 

First of all, it's important to define asthma as a condition that consists of three major symptoms:

  • Increased mucus produced in the lungs.
  • Tightening of muscles that surround the small airways.
  • Swelling of the small airways.

Each of these components can affect your health in different ways.

Why Do Asthmatics Cough up More Mucus?

Cells in the lungs release chemicals (mediators known as cytokines) that lead to higher levels of mucous in the airway. The mucous can become lodged in the airway, contributing to the wheeze and cough that you feel when you have an asthma attack or develop asthma symptoms. These include shortness of breath, cough, chest tightness, or wheezing.

From a long-term perspective, this mucous can increase the chance that an infection like pneumonia may arise. Repeated infections can lead to complications including antibiotic resistance, in addition to scarring of the lungs themselves. Such scarring is irreversible and may lead to permanent lung damage.

In order to prevent the accumulation of mucous, it's important that you try to prevent asthma attacks.

This can best be accomplished through the use of controller medications and avoidance of triggers such as dust mites, pollen, and tobacco smoke.

These medications help prevent asthma attacks by controlling inflammation and decreasing mucous production. Some examples include inhalers like Advair, Symbicort, and Flovent.

Without the increased mucous, you can decrease the chance of pneumonia or bronchitis. Talk to your allergist or primary care doctor about your asthma, and discuss the potential use of a controller medication to prevent long-term damage.

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 poorly controlled. It's likely that you will need either a controller medication or an increased dose of your current medication.

Why Does Asthma Cause Chest Tightness and Wheezing?

This tightening of muscles around the airways is known in medical terms as bronchospasm. When this process is chronic, it can lead to a decrease in exercise tolerance. Over time, this can lead to higher rates of obesity, diabetes, high blood pressure, and other conditions that are associated with a sedentary lifestyle.

If you suffer from exercise-induced asthma, this process is easily well-controlled. When you have this type of asthma, use your albuterol inhaler 10 to 15 minutes before exercise — or during exercise, if needed. This usually takes care of your symptoms but does not necessarily mean that you will become a faster runner.

Other medications like Singulair or inhaled steroids can help you if the albuterol fails to control your symptoms adequately.

Your asthma should never get in the way of healthy exercise, and you should discuss any exercise-related asthma concerns with your allergist. Your goal is to reduce the impacts of asthma on your life and not let it prevent you from taking part in the activities that you want to.

What Is the Biggest Concern About Uncontrolled Asthma?

Although the increased mucous and muscle tightening are troublesome, chronic swelling of the airways is the most dangerous long-term effect of asthma.

A process known as airway remodeling can occur over many years, leading to eventual scarring of the lungs. This process results from the chronic and uncontrolled inflammation that can occur over time. If you fail to get good control over your asthma, the end result can be similar to COPD after many years.

In these cases, as with lung infections, the normal tissue of the lungs is replaced with scar tissue. Scar tissue does not work like normal lungs do, leaving patients with severe lung damage in some cases. Over many years, some of these patients experience significant disability as a result.

As with the increased mucous production, in the case of airway remodeling, achieving good asthma control is the best way to prevent long-term complications. 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 few asthma-related symptoms.

What Can I Do?

First, it's best to see your doctor and develop an asthma action plan. This is your road map to good asthma control. It tells you what you need to do every day as well as what you need to do when you develop symptoms. In addition, the plan tells you when and at what doses you should be taking your medication. The plan may change over time, so try to review it regularly with your doctor. 

It's also a good idea to identify your asthma triggers and monitor your symptoms. Both of these allow you to look at your action plan and see what steps need to be taken.

Sources:

Fahrenbach H, Wagner C, Wegmann M. Airway Remodeling in Asthma: What Really Matters. Cell Tissue Research. 2017;367(3):551-569. doi:10.1007/s00441-016-2566-8.

Gatheral TL, et al. Personalised Asthma Action Plans for Adults With Asthma. The Cochrane Database of Systematic Reviews. 2017;4:CD011859. doi: 10.1002/14651858.CD011859.pub2.

National Heart, Lung and Blood Institute. What is Asthma? 2014.

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