Asthma Complications

Every single person who receives the diagnosis of asthma will receive a treatment plan from the doctor. A top recommendation is to have the asthma symptoms well managed. Why is it so important to have the symptoms under control? What can asthma lead to if not treated? It leads to a number of short and long-term complications. Let’s have in this article a review of the possible complications of asthma if left untreated.

Asthma complications affecting the lungs 

Doctors use special lung tests like spirometry to assess how well the lungs function.  While lung capacity is impaired during an asthma attack, lung function can be reduced even when a person is on asthma medication. If symptoms are not well controlled, lung function is more likely to deteriorate over time. The result: more severe shortness of breath, coughing, chest tightness, and wheezing. When an acute attack occurs, the lung functions further declines, putting that person at even greater risks and complications, which can be life-threatening.

  • Asthma causes specific changes in the airways. The airways  become more hyper responsive to various allergens and triggers from the environment. Due to chronic inflammation, the airways suffer remodeling and permanent changes in their structure, leading to tissue damage.  As the lung function further decreases, the wall of the airways becomes thicker, and there will be more mucus produced. 
  • Acute asthma attacks. If asthma is left untreated or it is poorly managed, the risk of asthma attacks is increased. Over one million visits to the emergency department occur each and every year due to complications of asthma.  Emergency care is needed. The asthma inhaler does not ameliorate the condition and a person experiences extreme shortness of breath, severe chest pain, difficulty walking and talking and bluish discoloration of the skin. Left untreated, acute attacks lead to life threatening, respiratory failure. 
  • Pneumonia. It is well known that asthma increases the risk of lung infections -or pneumonia because of previous lung damage caused by asthma. Pneumonia is a common cause of hospitalization in both children and adults with asthma. The flu (in adults) and respiratory syncytial virus (in children) are some of the most common causes of viral pneumonia, while pneumococcus is a leading cause of bacterial pneumonia. Typical symptoms of pneumonia include fever,difficulty breathing, chest pain, and rapid heartbeat. 

Ashma complications in children versus adults

In children, asthma can lead to many complications, including growth delays, various learning disabilities, trips to the emergency department, and missed days at school. Adults with asthma also may miss workdays, seek emergency care, and have an increased risk of developing depression and other mental-emotional issues. A 2008 survey found that roughly 60% of children had at least one day of asthma-related school absence and when added up, caused  10.5 million missed days of school. About 1 in 3 employed adults missed at least one workday due to asthma, which added up to over 14 million days of missed work. 

Both children and adults with asthma are more likely to develop obesity compared with people without asthma. Obesity further worsens asthma symptoms. 

Regardless of age, asthma interferes with day-to-day life, especially in cases of moderate persistent,  severe persistent asthma and of course, in case of acute attacks. Asthma symptoms often occur at night, interfering with sleep and causing fatigue the next day. Not being able to enjoy physical activity or spending time outdoors during allergy seasons can lead to a sedentary life, obesity, diabetes, high blood pressure, high cholesterol levels, stress, and depression. 

Complications  due to asthma treatment 

While asthma medications help prevent or manage symptoms, they can also cause side effects. Common asthma drug side effects include throat irritation and fungal infections (i.e. from inhaled medicine)to rapid heartbeats, anxiety, depression, sleeping problems like insomnia and nightmares, acid reflux. Steroid medication is associated with high blood pressure, osteoporosis, Cushing disease, cataracts, and other complications. 

Beyond all the above complications, asthma increases the risk of early death- especially if this condition is left untreated. While the asthma death rate has been declining over the years, there are still thousands of deaths each and every year in the US and some of these deaths can be prevented. 

In order to prevent all the complications and stay as healthy as possible, it is important to have regular follow up with the treating healthcare providers. Even better, consider having a medical team to monitor asthma including the family physician or pediatrician, lung specialist, as well as a dietician and physiotherapist for custom dietary and exercise plans.  If the symptoms are not well managed, the treatment plan has to be reviewed. If there are side effects from the medication, the dosage may need adjusted or switched to another drug. New therapies like monoclonal antibodies show promising results.

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