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Can Asthma Go Into Remission

Childhood Asthma Risk Factors

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The perinatal period has been implicated in the development of childhood asthma. Several cohort studies have unveiled risk factors for the development of asthma in offspring, with factors that span from genetic and environmental risk factors to features such as child’s sex and presence of atopy.

Genetic Risk Factors

Environmental Risk Factors

Environmental perinatal risk factors are also important to consider for childhood asthma. Maternal tobacco smoking during pregnancy has been shown to increase the risk of childhood asthma . Maternal diet in pregnancy has also been implicated as an asthma risk factor with reports of maternal diets higher in vitamin E, zinc, and polyunsaturated fatty acids as protective against the development of childhood asthma . In contrast, high sugar intake in the maternal diet during pregnancy has been associated with increased risk of asthma in offspring . Other maternal dietary factors have been studied but with less conclusive results including the intake of vitamin D, vitamin C, and a Mediterranean diet. Other perinatal risk factors for childhood asthma that have been reported are neonatal jaundice, maternal preeclampsia, and cesarean section delivery, all which have been associated with higher risk of childhood asthma development .

Ultimately gene-environment interactions are critical for the development of asthma in a child .

Natal Risk Factors

Sex

Family History

Medical History

Medication Exposure

Consider Immunotherapy Or Allergy Shots

If you have allergic asthma, immunotherapy , may help. These shots consist of small amounts of the substances youre allergic to, with gradual increases over the course of several months .

Allergy shots may be especially helpful for children with seasonal allergies, and it can help them build up immunity so they dont experience as severe of symptoms as adults.

However, its still possible for other triggers to cause asthma symptoms despite taking allergy shots.

Theres no cure for asthma. Once you have this chronic condition, you may have asthma symptoms for life. However, the severity of your symptoms varies based on:

  • genetics

Characteristics Of Study Subjects

We surveyed the parents of 35,682 children from 94 elementary and middle schools. A total of 10,305 subjects were excluded because of inadequate demographic information, being older than 60 years of age or missing responses to the key question . Among those with age and sex data, the distributions of age and sex were not statistically different between those included in the final analysis and those who excluded. Data from 25,377 subjects were satisfactory, with a response rate of 71.1%. Among these participants, 886 cases of asthma were identified. Due to potential confounding with chronic obstructive pulmonary disease and heart failure among those who answered with an onset age of 41 years or older, the analysis was carried out only to the age of 40.

Figure 2

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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
  • No diagnosis of allergic diseases like eczema
  • Less need for rescue medication and fewer asthma attacks

Can You Outgrow Asthma

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Can you really outgrow asthma? Many asthmatics and parents of asthma sufferers have asked this question. There have been many cases of individuals who were diagnosed with asthma as children and then saw their symptoms decrease and even disappear entirely as they reached young adulthood.

But did these individuals actually outgrow the condition or is there another answer for their seemingly miraculous recovery?

The simple answer is that, despite evidence to the contrary, it is not possible to outgrow asthma. Asthma is a chronic, lifelong condition. Even if symptoms seem to taper off, the underlying condition of the lungs that caused them still exists and it can still lead to an attack at any time. But that doesnt mean that all asthma sufferers have to give up hope.

So how do you explain those individuals who used to suffer from regular asthma attacks and then just stopped experiencing symptoms altogether? There could be several possible explanations.

The most likely is that they never actually had asthma to begin with. Because the symptoms of asthma can be closely related to those of other allergy-related conditions, it could be that what a doctor thought was asthma was really some other kind of allergy that spontaneously improved as the immune system matured.

Wishing you the best of health

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How The Treatment Goals Are Attained

Unfortunately, there is no magic bullet for asthma. While treatment can control symptoms safely and effectively for most patients most of the time, it is not a simple matter of the doctor writing a prescription and the patient taking the medication. Successful treatment of asthma is likely to require several steps on the part of physician. These include:

  • Confirmation of the diagnosis
  • Characterization of the asthma with regard to:
  • Chronicity
  • Severity
  • Identification of triggers
  • Identification of the components of airway obstruction
  • Development of a plan to identify the least treatment that is safe and effective
  • Teach implementation of that plan
  • The diagnosis of asthma is suspected when a patient has a history of recurrent or chronic shortness of breath, labored breathing, or cough in the absence of any other obvious reason. The diagnosis is confirmed by obtaining evidence that there is airway obstruction that reverses either spontaneously or as a result of treatment with anti-asthmatic measures. The procedures used to make the diagnosis include a careful history, measurement of pulmonary function , and therapeutic trials of medication.

    Triggers of asthma, those identifiable factors that commonly worsen symptoms include:

    • Viral respiratory infections
    • Airborne allergens
    • Inhaled irritants
    • Cold air
    • Exertion

    Patients with an intermittent pattern of asthma require only intervention measures.

    Why Does Someone Get It

    Over 10% of people have some history of asthma. It often runs in families. The heritable nature of asthma is not well understood, however, and geneticists cannot define the precise manner in which it is passed from parents to children. All we can say is that families with asthma are more likely to have children with asthma. Although there appears to be an inherited predisposition to develop asthma, severity varies considerably among asthmatics, even among members in the same family. If asthma is present in both parents, the likelihood of a child having asthma is even greater, but even then not all of the children will have asthma. Even among identical twins, both do not necessarily have asthma, although this is more likely than if they were just siblings or nonidentical twins. This suggests that there is some additional factor that we do not yet fully understand, other than inheritance, that influences the development of asthma.

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    Q: What Is Allergy Immunotherapy And How Does It Work

    Dr. Z: Allergen immunotherapy comes in the form of allergy shots or allergy drops, called sublingual allergen immunotherapy because you put the drops under your tongue. Each dose contains a small amount of the allergen and it works by allowing the body to build up immunity to it over time. Ultimately, the allergy gets switched off and you no longer experience symptoms.

    Can Asthma Go Away

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    For many people, asthma is a long-term condition, especially if you developed it as an adult. In children, it sometimes goes away or improves tremendously once they become teenagers. However, theres always the chance that it may recur at some point in their adult lives, so its always better to think of it as being in remission for that period.

    It is impossible to determine which children will have a considerable reduction in their symptoms or completely outgrow their asthma. Nonetheless, just because the symptoms appear to have gone or minimized doesnt mean that the underlying mucosal plugging and inflammation is no longer present. The only way to definitively tell that its gone for good would be to do a biopsy.

    To be clear, if you develop asthma as an adult, the chances of it going away are slim to none. Children, on the other hand, are the most likely to have their asthma completely disappear. Even then, it depends on whether or not theyre predisposed to the following risk factors:

  • Theyve had multiple wheezing episodes before the age of three
  • At least one parent has asthma
  • They have an eczema diagnosis
  • The eosinophil level in their blood is elevated
  • They have a food allergy
  • They have wheezing episodes that arent triggered by colds
  • If the child has risk-factor , has either or , in addition to any two symptoms from , , or , their chances of having asthma well into adulthood are significantly higher.

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    Does Asthma Cause Permanent Damage

    The airway obstruction of asthma is generally completely reversible and usually does not cause permanent damage to the lungs, heart, or other organs. However, severe acute episodes of asthma can be associated with life threatening events and even fatalities. Survival of severe life threatening events can be associated with damage from lack of oxygen during the severe exacerbation, and lack of oxygen to the brain can cause loss of consciousness and brain damage.

    Chronic asthma with ongoing airway inflammation may also be associated with what is called “remodeling” of the airways. This describes permanent changes occurring in the tissues surrounding the airways that results in permanent narrowing of airways. The potential for this emphasizes the importance of monitoring pulmonary function in patients with asthma at regular intervals, particularly those with a chronic pattern of asthma.

    Can Asthma Go Away:

    The simple answer to the fact that if you’d ever had asthma at any age, can it go away is: No.

    Asthma is a chronic condition that affects how the airways work which can then lead to difficulty in breathing and the fact is it cannot be cured however, it can be managed with medication and lifestyle changes.

    Asthma is a chronic sickness:

    resulting in asthma returning whenever even after quite a while without indications.

    This means asthma doesn’t disappear once you’ve had it and you are constantly in danger of having an asthma attack.

    A few groups of people think individuals grow out of childhood asthma but that is not true as it is usually a case of a wrong diagnosis of asthma like bronchitis which goes away and people from a wrong diagnosis tend to believe that they got cured from asthma which is never the case.

    An asthmatic person usually has more symptoms during colder months when there is more outdoor air pollution and an increase in indoor air pollution caused by burning wood or other fuels for heating in the home.

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    Children Do Not Outgrow Their Asthma

    Its also a misconception that all children outgrow their asthma.

    According to the American College of Allergy, Asthma & Immunology, children may experience remission from asthma as adults, but about one-third of children with asthma will have symptoms as adults.

    A 2014 study found that its possible to experience a second peak of symptoms later in adulthood.

    An Expert Consensus Framework For Asthma Remission As A Treatment Goal

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    • Andrew Menzies-GowCorrespondenceCorresponding author: Andrew Menzies-Gow, PhD, Department of Respiratory Medicine, Royal Brompton Hospital, Sydney St, London SW3 6NP, United Kingdom.
    • Mona BafadhelAffiliationsRespiratory Medicine Unit and Oxford Biomedical Research Centre, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
    • Thomas B. CasaleAffiliationsDepartment of Internal Medicine, Division of Allergy and Immunology, Morsani College of Medicine, University of South Florida, Tampa, Fla
    • General Practitioners Research Institute, Groningen, The NetherlandsObservational and Pragmatic Research Institute, SingaporeGroningen Research Institute for Asthma and COPD , University Medical Center Groningen, Groningen, The Netherlands
    • Ian D. PavordAffiliationsRespiratory Medicine Unit and Oxford Biomedical Research Centre, Nuffield Department of Medicine, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
    • Stanley J. SzeflerAffiliationsBreathing Institute, Childrens Hospital Colorado and Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colo
    • Prescott G. WoodruffAffiliations

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    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.

    Respiratory System Pathologies: Common Diseases And Disorders

    There are two types of respiratory diseases and disorders: infectious and chronic. Pulmonary infections are most commonly bacterial or viral. In the viral type, a pathogen replicates inside a cell and causes a disease, such as the flu. Chronic diseases, such as asthma, are persistent and long-lasting. They can relapse and the patient can go into remission, only to suffer symptoms again at a later time.

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    How To Stay Healthy As You Age

    Aging does not occur only at the organ level.

    People become older at the cellular level, too, Wechsler said. This is associated with worsening immunity the lungs respond less well. Its called immunosenescence, the gradual deterioration of the immune system.

    Increased inflammation also can contribute to the aging process, he said. Older people start having higher levels of cytokines, such as interleukin 1 and 6.

    People can boost their immune systems as they age.

    We know the detrimental effects of obesity, and that exercise helps, Wechsler said. Exercise could be a possibility to help an aging immune system.

    There are no specific methods for boosting the immune system, said Mathur, adding that staying healthy in general is important.

    Maintain a good diet and stay away from obesity, he said. We do know that good nutrition, including intake of vitamin D, is important for good immune function. The main interventions to specifically help with managing asthma are the regular use of appropriate inhaler medications, and keeping up with recommended vaccinations, especially yearly flu vaccine and the series of pneumonia vaccines.

    Why Do Asthma Symptoms Disappear For Some Kids And Not Others

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    Some working theories:

    • As a child gets bigger, so do the airways in their lungs. Inflammation of airways, an asthma hallmark, could go on unnoticed, Johnson says.
    • Children who wheeze only when they have a cold or other upper respiratory virus tend to improve with time, he says.
    • Children who are sensitive to allergens from a young age tend not to improve, Rachelefsky says. His observation is backed up by findings from a nine-year study of more than 1,000 asthmatic children that found fewer allergy-related antibodies in those who became symptom-free.
    • Children with eczema, a skin disorder characterized by itchy rash, or a family history of asthma are likelier to have lasting asthma symptoms.
    • The more severe the asthma past the age of 5, the likelier symptoms will continue, with or without allergies, Rachelefsky says.

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    Asthma Isnt An Excuse Not To Work Out

    • Warm up and cool down before exercising. This will help you lungs get acclimated to the air.
    • Avoid working out during cold weather. If you do, cover your mouth and nose.
    • Avoid working out when you have a cold or viral infection.
    • Always use your inhaler or prescribed medication before you work out.

    You shouldnt use EIB as an excuse not to work out and get exercise. Its likely possible as long as you work with your doctor, find a regimen that works for you and take any medication as necessary, said EXPERT. Dr. Navitha Ramesh is a pulmonologist at Geisinger Wyoming Valley. To schedule an appointment, call 800-275-6401.

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    Who Should Treat This Particular Aspect Of Asthma Or Allergies

    Many older patients are treated for asthma by their internist or family physician however, if your asthma symptoms are not under control within three to six months, or if you have severe persistent asthma, or if you are having asthma episodes that need emergency treatment, it may be time to see an asthma specialist. Allergists/Immunologists or pulmonologists are specialists who treat asthma. Those who have completed training in those specialties are usually called board-certified or board-eligible.

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    Second Stage: Mild Persistent Asthma

    Although this stage is still relatively mild, asthma is beginning to become more noticeable and starting to interfere with your quality of life.

    Symptoms. In mild persistent asthma, daytime symptoms are occurring 3 to 6 times a week. Nighttime symptoms interfere with sleep nearly every week, or 3 to 4 times a month. Flare-ups are more severe and may affect activity levels.

    Lung function tests. As with intermittent asthma, the FEV1 is 80% or more above normal values. Peak flow readings show less than 20-30% variability.

    Treatment. A low dose inhaled steroid will be used as a controller medication to prevent and control symptoms. Less common alternatives might include cromolyn, a leukotriene receptor antagonist , or theophylline. The doctor will also prescribe a quick-relief inhaler for flare-ups.

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