While bronchitis symptoms, such as wheezing and shortness of breath, are similar to the symptoms of asthma, there are some important differences, namely in what causes those symptoms in each condition and how each are treated. Here’s what you need to know about both lung conditions. It gets tricky because there’s a type of bronchitis known as chronic bronchitis (a type of chronic obstructive pulmonary disease, or COPD), which, as the name implies, is a persistent condition that results from heavy exposure to cigarette smoke or other air pollutants, or frequent cases of acute respiratory infections. Chronic bronchitis can also result from uncontrolled asthma. And while asthma and bronchitis are two different conditions, they can also occur in some people simultaneously. “When asthma and acute bronchitis occur together, the condition might be termed ‘asthmatic bronchitis,’” explains John Carl, MD, a pulmonologist at the Cleveland Clinic in Ohio. Some physicians also use the term “asthmatic bronchitis” to refer 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. “While not 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 get in and out of the lungs. With bronchitis you may cough up phlegm or mucus and experience wheezing, shortness of breath, fatigue, chest pain, and a slight fever or chills. “The main symptom that tells you it’s acute bronchitis is a cough that persists for at least five days, although it can often last one to three weeks,” Dr. Shamiyeh adds. The cough is generally associated with phlegm production (sputum), which can be discolored or clear, he adds. In these cases, physicians may call the bronchitis “asthmatic bronchitis,” though that’s not a clinical term, Dr. Shamiyeh adds — and other physicians use “asthmatic bronchitis” when a case of acute bronchitis may cause asthma symptoms, like wheezing. People with asthma who get bronchitis are often 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 people who are nonasthmatic, Dr. Shamiyeh says. “Patients with asthma who get bronchitis may also be prescribed inhaled or oral steroids on a case by case basis.” Additionally, in some severe cases, acute bronchitis can cause asthma. That’s because acute bronchitis is caused by either a viral or bacterial infection, Dr. Castriotta explains. For most people, bronchitis goes away when the infection clears, but if not, it’s possible for that viral infection and acute bronchitis to turn into asthma, he says. “This is one of the ways in which adult-onset asthma develops,” he explains. The infection essentially causes changes in the airways that bring on the asthma symptoms. It’s worth noting that most cases of asthma are usually diagnosed in childhood, while most people with COPD are diagnosed after age 40 — and often after years of smoking or other long-term exposure to pollution, chemicals and secondhand smoke, Dr. Hanania adds. (4) Both asthma and COPD are chronic conditions, meaning that the damage cannot be reversed and the conditions cannot be cured, but both can be treated, says Dr. Hanania. “For those with asthma, it’s important to treat comorbidities and ensure proper use of inhalers. People with COPD should avoid smoking and exposure to triggers and use inhalers that contain bronchodilators,” he explains.
Don’t smoke, and avoid being around cigarette smoke.Get an annual flu shot.Get a pneumonia shot if you are older than 65, or if you’re younger than 65 with any condition that puts you at risk, like emphysema or other breathing problems, diabetes, or heart disease.
If you do come down with acute bronchitis, remember that most cases will clear up on their own — that goes for people with and without asthma. That means most people don’t need treatment for acute bronchitis, but to relieve symptoms, an OTC medication like acetaminophen (Tylenol) can help ease pain and discomfort, and a humidifier can assist with breathing. More serious cases of bronchitis may require additional medication, such as the types of inhalers often used in asthma attacks (like albuterol), steroid drugs, and sometimes even oxygen. Specifically, you should see a doctor about acute bronchitis if:
You can’t sleepYour cough lasts more than a couple of weeksYour fever lasts more than three days or is over 101 degrees FThe mucus you cough up is green or bloody (which could be a sign of pneumonia, for which you will need immediate medical care)You took your prescribed asthma medication but did not get any reliefYou are having difficulty breathingYou have a heart or lung condition and suspect you have bronchitis
Although bronchitis and asthma are two different lung conditions, they are closely related. Knowing the difference can help ensure you get the best treatment for the condition affecting you. With additional reporting by Jennifer Geddes.
