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Outgrowing Asthma: Is Remission Possible?

WebMD discusses how common asthma is in children and which kids are more likely to outgrow it.

If my child no longer has asthma symptoms, could it be that he was misdiagnosed with the disease?

Perhaps. Rachelefsky says a lot of children diagnosed with asthma don’t have it and many asthmatics go undiagnosed.

“Spirometry is standard, but many physicians in primary care practices don’t have a spirometer. They diagnose sinusitis as asthma and mistake asthma for esophageal reflux,” he says.

But for children under the age of 2, it is difficult to do spirometry to test for asthma. When a child is that young, providing a diagnosis “is an imperfect science,” says Reynolds J. Panettieri Jr., a pulmonologist with the University of Pennsylvania.

“If you have true asthma, you don’t outgrow it,” so young children who are wheezing from a viral infection that hangs around for a long time may not have asthma but “twitchy” or hypersensitive airways that are a holdover from the virus, he says.

Johnson says, even if a child is too young for standard testing, “It’s better to err on the side of caution and treat kids whether they have asthma or not. The benefits are great,” he says.

Why do more boys outgrow asthma than girls?

Although a recent study found that boys were more likely than girls to outgrow asthma, Rachelefsky says there isn’t enough research to make any conclusions about gender and the progression of asthma.

Panettieri says more girls develop asthma after the onset of puberty; boys develop it before.

“It’s not that boys outgrow it, but now there are more women with it,” he says.

Some studies have suggested that hormonal differences may factor in to a higher prevalence of adult asthma in women.

If a child has asthma and goes into remission, are they more susceptible to respiratory issues later in life?

Usually, says Johnson.

An asthmatic may have more breathing trouble with colds as adults, “and that’s why it’s so important for patients to understand what uncontrolled asthma is, so in the future they know how to seek treatment,” he says.

Is there any way of altering the course of asthma in young children?

“It’s not really the case that intervention changes the course of asthma. But medicines have gotten so safe that we can pretty much neutralize symptoms indefinitely in the majority of people with asthma,” Johnson says. Uncontrolled asthma leads to emergency room visits, absenteeism from school, and missed opportunities for social and athletic interchange, he says.

Rachelefsky adds, “The goal of asthma treatment is control of the disease to allow someone to have a normal life, knowing that it may not prevent the natural history of the disease. People should concentrate on the right diagnosis and treatment.”

Reviewed on August 13, 2009

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