Is It Bronchitis or Asthma?

Doctor listening to patient's cough
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Sometimes I find bronchitis to be what I call a “wastebasket diagnosis.” What I mean by this is that sometimes your doctor does not know what you really have and just calls it bronchitis.

Other times, doctors who are suspicious of asthma will not want to “label” you as an asthmatic and will label the initial episodes of asthma-like symptoms as bronchitis. However, bronchitis is its own disorder and there is some overlap with asthma, which may explain some of the above-described confusion.

Symptoms

Your doctor has likely ruled out a more serious cause for your symptoms which could include wheezingchest tightnesscough, and shortness of breath. Additional symptoms might include a sore throat, increased sputum production that may be clear or colored, pain associated with chronically coughing, allergy and sinus congestion, chills, or body aches.

Fever is generally absent and would make a diagnosis of pneumonia or influenza more likely.

Young or old and throughout the entire year, but especially during cold and flu season, you may be impacted by bronchitis symptoms.

Bronchitis is most commonly caused by viruses such as influenza and the common cold, but can be caused by bacteria or inhaling dust and fumes. You are more likely to be affected if you:

  • Have a chronic respiratory condition like asthma or COPD
  • Smoke
  • Are over age 65
  • Have a weakened immune system

Acute Bronchitis

Acute Bronchitis occurs when there is an inflammation and swelling in the lungs occurring in a short period of time.

This commonly occurs following exposure the common cold or upper respiratory tract infection. Many patients refer to this as a “chest cold” and complain of a “post-viral cough” that is annoying for several weeks. Acutely patients complain of a cough, sore throat, and congestion. Treatment generally focuses on the relief of these

Chronic Bronchitis

The official definition of chronic bronchitis is a cough that occurs on most days of the month, 3 months of the year, for at least two years. This could also indicate poorly controlled asthma. In patients who are diagnosed with asthma later in life, it is not uncommon for them to be diagnosed with chronic bronchitis initially, especially if they lack some of the other classic symptoms. However, chronic bronchitis is very different from asthma and is more likely caused by smoking than being an allergic condition.

Treatment

If you have asthma and experience an episode of bronchitis, you need to follow your asthma action plan. Most asthmatics with a good plan will be able to manage symptoms at home and adjust their treatment accordingly.

In addition to following your asthma action plan, treatment of bronchitis can include:

  • Increasing fluid intake to prevent dehydration
  • Use of over the counter pain medications as directed by your doctor to relieve a headache, sore throat, or allergy symptoms
  • Humidified air to help improve congestion and runny nose
  • Over the counter cough suppressant and mucolytics to improve symptoms

Antibiotics are generally not needed since most bronchitis is due to a viral cause.

You need to seek care if you develop any of the following:

  • Parameters from your action plan tell you to seek care
  • You develop a fever
  • Cough that does not improve despite following your action plan or lasts more than 10 days
  • Develop a barking cough that makes it hard to speak or breathe
  • Cough up blood
  • Weight loss

Sources:

American Thoracic Society. What Is Chronic Obstructive Pulmonary Disease (COPD).

National Heart, Lung, and Blood Institute. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma.

Kuebler KK, Buchsel PC, Balkstra CR. Differentiating chronic obstructive pulmonary disease from asthma. J Am Acad Nurse Pract. 2008 Sep;20(9):445–54.