Understanding the Importance of Long-Term Treatment Through the "Nature of Asthma" and the "Current State of Asthma Care"

To everyone who has been diagnosed with bronchial asthma (asthma) at a hospital and has started treatment.
"How long will I need treatment?" Have you received an explanation?

Asthma treatment is not just about "suppressing symptoms in the moment"; it is extremely important for "reducing future health risks."

By continuing treatment even after symptoms are controlled, you can prevent "asthma attacks" that threaten your daily life and life itself, prevent "decline in respiratory function" that leads to persistent suffering, and ensure you do not struggle with the disease in the future.

In this article, we will explain the nature of asthma, as well as what can and cannot be achieved through treatment. Learn the theory of asthma treatment and apply it to your daily care!

◆ Asthma is not a "disease that heals quickly"

Asthma is not a disease that heals naturally like a cold. It is a long-lasting disease (chronic illness) that is fundamentally rooted in constitutional characteristics such as allergic predisposition and genetic factors.

In the airways (air passages) of people with this constitution, a defensive reaction to foreign substances called inflammation continues abnormally long. When stimuli such as dust, pollen, or a cold are added to this, the cells of the airways react hypersensitively, causing symptoms like coughing and difficulty breathing.

◆ The goal is "remission," not "complete cure"

In recent years, by correctly using asthma medications such as inhaled corticosteroids, many people have been able to live their daily lives without hindrance.

Previously, many people suffered from emergency visits or hospitalizations due to severe symptoms (asthma attacks), or were troubled by daily shortness of breath due to declining respiratory function, but such cases have decreased significantly today.

In other words, we are now in an era where "controlling symptoms" and "reducing future health risks" in asthma treatment are fully achievable.

However, with current medicine, it is not possible to reverse the constitution that causes asthma. The best we can do is to calm the airway inflammation caused by that constitution. There is also a treatment aimed at improving the constitution called allergen immunotherapy, but it is not yet powerful enough to completely cure asthma.

In other words, once you have developed asthma, you must face treatment with the premise that you cannot escape the constitution that makes you prone to asthma symptoms.

It is difficult to "stop medication and be completely cured (healing)." However, it is fully possible to aim for a "state where symptoms rarely occur with the minimum necessary medication (remission)." Maintaining this "remission" for a long time is an important goal to aim for in current asthma treatment.

◆ Do not neglect it by "thinking you are cured"

When symptoms settle down after starting treatment, there are not a few people who say at the outpatient clinic, "I don't need medicine anymore, right?" or "I'm not using medicine anymore." Certainly, it is troublesome to keep using medicine every day when you are not having any trouble.

However, what I want you to remember here is that the constitution that causes asthma has not changed. If you stop treatment, the airway inflammation rooted in that constitution will flare up, and there is a risk that symptoms will recur with even minor stimuli.

You might think, "I can just use medicine again whenever it recurs," but that is not acceptable. Because asthma progresses if left untreated.

If left untreated for a long time, the airway inflammation continues, and eventually, the structure of the airways itself changes (remodeling). Once that happens, symptoms become easier to appear than before, and asthma attacks become more likely to occur.

In fact, past studies have pointed out that carelessly stopping inhaled corticosteroids or not using them for a long period is a risk factor for worsening asthma symptoms and asthma death.

Even today, when inhaled corticosteroids are widespread, many patients visit respiratory outpatient clinics saying, "I was told I had asthma over 10 years ago, but I only used medicine a little when I had symptoms."

In such cases, airway remodeling has often already progressed, and it can be quite difficult to control symptoms.

Airways that have undergone remodeling cannot be returned to their original state.That is precisely why continuing treatment even when there are no symptoms is the key to lowering future risks.

◆ Summary: Protect your future self by continuing treatment

As described, in order to live well with asthma, it is important to firmly understand

• The nature of asthma as a "chronic airway disease rooted in constitution"
• The limitations of modern medicine that "it is difficult to stop medication and be completely cured"

and aim for a life where you are not troubled by asthma symptoms in the future by continuing treatment even when there are no symptoms.

Continuing treatment for a long time may be difficult to do alone. Make a reliable healthcare professional your ally and continue treatment comfortably while consulting with them.


<References>
Ministry of Health, Labour and Welfare. Self-Care Navi for Adult Asthma. Japan Allergy Association. December 2010. https://www.jaanet.org/allergy/pdf/allergy_asthma01.pdf, (Accessed April 21, 2025)

Thomas et al. asthma remission: what is it and how can it be achieved? Eur Respir J 2022; 60: 2102583.

Suissa et al. Low-dose inhaled corticosteroids and the prevention of death from asthma. N Engl J Med 2000; 343: 332-6.