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Is It Asthma, Bronchitis, or Both?

The phrase “breathing easy” assumes an entirely new meaning whenever you or a family member has asthma. Wheezing, coughing, shortness of breath, driving a car, and anxiety that can accompany asthma attacks are likely all too familiar. But things get even harder in the event that you have asthma and fall with a case of acute bronchitis.

While bronchitis symptoms, such as wheezing and shortness of breath, are similar to the outward indications of asthma, there are a few important differences, namely in what causes those symptoms in each condition and how each is treated. Here are things you need to learn about both lung conditions.

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Differences Between Asthma and Bronchitis | Buy Ziverdo Kit

Acute bronchitis is caused by a viral or bacterial infection, meaning it typically results from a cool or the flu and lasts about someone to three weeks before clearing on its own. Asthma is really a chronic condition characterized by the airways being inflamed and is thought to either result from certain inherited genes, having respiratory infections during infancy or childhood, or the environment you’re exposed to.

It gets tricky because there’s a form of bronchitis known as chronic bronchitis (a form of chronic obstructive pulmonary disease, or COPD), which, as the name implies, is really a persistent condition that results from heavy contact with cigarette smoke or other air pollutants, or frequent cases of acute respiratory infections. Chronic bronchitis may also result from uncontrolled asthma.

And while asthma and bronchitis are two different conditions, they can also occur in a few people simultaneously. “When asthma and acute bronchitis occur together, the problem could be termed ‘asthmatic bronchitis,’ ” explains John Carl, MD, a pulmonologist at the Cleveland Clinic in Ohio.

Some physicians also utilize the term “asthmatic bronchitis” to make reference to people who have COPD and some asthma component, adds Nicola Hanania, MD, professor of medicine in the pulmonary department at Baylor College of Medicine in Houston.

How to Tell if It’s Bronchitis or Asthma

Asthma is really a condition that narrows the airways and makes excess mucus, which in turn causes shortness of breath, coughing, and wheezing. You could also feel tightness or pain in the chest and hear a whistling sound when expelling breath. 

“Without all patients have the three telltale asthma symptoms [wheezing, shortness of breath, cough, the most ‘classic one is probably wheezing, which is a high-pitched whistling sound created by obstructed bronchial passages,” explains James Shamiyeh, MD, a pulmonologist and medical director of the Heart Lung Vascular Institute at the University of Tennessee Medical Center in Knoxville.

Bronchitis results from inflammation of the large airways, which means that less air than usual is able to be in and from the lungs. With bronchitis, you might cough up phlegm or mucus and experience wheezing, shortness of breath, fatigue, chest pain, and a small fever or chills.

“The key symptom that lets you know it’s acute bronchitis is really a cough that persists for at least five days, although it can often last someone to three weeks,” Dr. Shamiyeh adds. The cough is generally associated with phlegm production (sputum), which may be discolored or clear, he adds.

When It’s Asthma and Acute Bronchitis

It’s particularly concerning when people who currently have asthma develop acute bronchitis, explains Richard Castriotta, MD, professor of clinical medicine at the Keck School of Medicine at the University of Southern California. “It makes their asthma much worse.”

In these cases, physicians may call bronchitis “asthmatic bronchitis,” though that’s not a scientific term, Dr. Shamiyeh adds — and other physicians use “asthmatic bronchitis” each time a case of acute bronchitis could cause asthma symptoms, like wheezing.

Individuals with asthma who get bronchitis in many cases are treated with inhalers that dilate the bronchial tubes (to make breathing easier), and over-the-counter (OTC) painkillers and cold medication for other upper respiratory cold symptoms, similar to treatment for acute bronchitis in individuals who are nonasthmatic, Dr. Shamiyeh says. “Patients with asthma who get bronchitis are often prescribed inhaled or oral steroids on a case-by-case basis.”

Additionally, in a few severe cases, acute bronchitis could cause asthma. That’s because acute bronchitis is brought on by the viral or bacterial infection, Dr. Castriotta explains. For most of us, bronchitis goes away completely when the infection clears, but if not, it’s possible for that viral infection and acute bronchitis to develop into asthma, he says. “That is one of many ways by which adult-onset asthma develops,” he explains. The infection essentially causes changes in the airways that bring on asthma symptoms.

When It’s Asthma and Chronic Bronchitis

Additionally, doctors sometimes utilize the term “asthmatic bronchitis” when referring to people with COPD who’ve mild asthma symptoms, or when it’s difficult to differentiate the two conditions, Dr. Hanania says.

It’s worth noting that many cases of asthma are generally diagnosed in childhood, while most people with COPD are diagnosed after age 40 — and often after years of smoking or another long-term contact with pollution, chemicals, and secondhand smoke, Dr. Hanania adds. 

Both asthma and COPD are chronic conditions, and thus the damage cannot be reversed and the conditions cannot be cured, but both may be treated, says Dr. Hanania. “For those with asthma, it’s very important to treat comorbidities and ensure proper use of inhalers. People with COPD should avoid smoking and contact with triggers and use inhalers that contain bronchodilators,” he explains.

John Oliver
John Oliver
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