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Outgrowing Asthma, Part I

A patient asked me recently about the chances that

his 8-year-old son would outgrow his asthma. I told

him that this depended on what he meant by outgrow.

By the time they reach 18 years of age, up to half of

all asthmatic children will have no asthma symptoms

and require no regular asthma medication. The milder

the asthma is in childhood -- and the later the age of

onset -- the better the chances of becoming

asymptomatic.


These asymptomatic adolescents haven’t been cured

of their asthmatic airways, however. They remain

vulnerable to asthma attacks after age 20, often

triggered by respiratory infections or prolonged

exposure to allergens. It’s not uncommon for asthma

to return in early adulthood if a previously asthmatic

child moves in with someone who has a cat or a dust-

mite laden mattress. Studies show that about half of

asthmatic children who become asymptomatic in late

adolescence experience a return of asthma symptoms

sometime in their 20s.


Another way we know that asthma hasn’t really been

cured when it remits during adolescence is that their

lungs remain twitchy when tested with an inhaled drug

called methacholine. Even without asthma symptoms

or attacks, or the need for asthma medicine over many

years, the lungs of formerly asthmatic children are not

entirely normal. I’ll tell you more about this next time.


by Franklin Adkinson, M.D.

August 26, 2005