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Asthm in children: do children outgrow asthma?

No clear answer is available. The long-term prospects of treatment and cure of childhood asthma is now a major concern. It has often been suggested that childhood asthma will disappear when the child becomes an adult. Medical and scientific evidence is less optimistic. It has been estimated that asthma disappears in 30 to 50 per cent of children in adolescence, but often reappears in adult life.

Almost two-thirds of children with asthma continue to suffer from the disorder through puberty and adulthood. While many can go into a permanent or partial remission, some still have twitchy or sensitive lungs. Moreover, even when asthma symptoms have disappeared, the functioning of the lungs remains altered, or airway hyperresponsiveness, or cough persists. This means that they may wheeze when they get a bad chest cold, or exercise in cold air. In one study in England, two-thirds of the three hundred childhood asthmatics were still symptomatic when they were twenty-one years old.

The growth of the lungs appear to be relatively normal in most children with asthma, but it can be less than normal or impaired throughout childhood and adolescence in those with severe and persistent symptoms.

The prognosis or the long-term outlook of asthma appears to be worse when the child has eczema or a family history of eczema. Wheezing in the first year of life is not a prognostic indicator for asthma, or for more severe asthma later in childhood. It should also be noted that 5 to 10 per cent of children with less severe asthma develop severe asthma in later life.

Childhood asthma should never be neglected in the hope that the child will simply grow out of it. Children with mild asthma are likely to have a good prognosis while children with moderate or severe asthma will probably continue to have some degree of airway hyperresponsiveness and may be at risk of having long term asthma.