Bronchitis and Asthma are two common medical conditions related to our respiratory system and as most people find them quite confusing, today we thought of discussing those separately to give you a clear understanding on which is which.
What is Bronchitis?
Bronchitis is defined as an inflammation of the bronchial tube linings, which carry air from the atmosphere into and out of the lungs.
This can either occur as an acute or chronic condition depending on the time period of the signs and symptoms. Acute bronchitis will last for a few days. Patients recover without any residual effects, whereas repeated bouts of bronchitis can be referred to as Chronic bronchitis, which is one of the serious conditions associated with chronic obstructive pulmonary disease (COPD). This usually occurs due to a constant irritation or inflammation of the bronchial tube linings, mostly due to long term smoking. Chronic bronchitis is usually defined as a productive cough which lasts for at least 3 months, with repeated episodes for at least 2 consecutive years.
The major etiology for acute bronchitis includes viruses such as respiratory infections caused by Influenza and respiratory syncytial virus (RSV) where chronic bronchitis is caused by long term exposure to cigarette smoke. In some individuals, who are exposed to polluted air, dust, fumes and toxic gases in a chronic manner can later develop this condition which might give rise to severe complications like COPD.
Commonest risk factors
- Weak immunity and poor resistance to infections- HIV/AIDS, Diabetes Mellitus, chronic illnesses, extremities of age
- Chronic exposure to irritants like fumes, dust, chemicals, hair spray- Especially at the work place
- Gastric reflux-Repeated episodes of severe heartburn due gastro esophageal reflux disease can irritate the mucosa on throat, making it more vulnerable for an inflammation to occur.
Symptoms of Bronchitis
- A productive cough with clear, white, yellowish-gray or green sputum which might or might not bemixed with blood
- Fatigue and weakness
- Shortness of breath
- Mild fever with chills
- Chest pain or heaviness These symptoms can sometimes resolve spontaneously without the need of any medication, but it is important to seek medical advice,
- If the features last for more than three weeks
- Result in sleep disturbances
- Fever higher than 100.4 F (38 C)
- Accompanied by discoloured phlegm
- Hemoptysis (coughing out blood)
- Shortness of breath
Individuals with chronic bronchitis will sometimes need pulmonary rehabilitation to reduce the susceptibility to further infections and inflammation
An early diagnosis of Bronchitis, will prevent most of the life threatening complications. Therefore there are some mandatory investigations which should be carried out in suspected patients to confirm the diagnosis and find the etiology.
- Chest X-ray- Especially to exclude other conditions like Pneumonia which can cause similar symptoms and signs
- Sputum tests- To exclude whooping cough (pertussis) and allergies
- Pulmonary function test- To assess the function of respiratory system which will help in excluding Asthma or emphysema Acute bronchitis will usually resolve within 1-2 weeks even without medication, but some physicians will prescribe Antibiotics, Cough suppressants and anti-inflammatory agents to keep the air-ways open.
Individuals with chronic bronchitis will sometimes need pulmonary rehabilitation to reduce the susceptibility to further infections and inflammation. It will also help to ease breathing and maintain a proper functioning of the lungs.
Is this similar to Asthma?
Well, Asthma is defined as a chronic lung disease which causes inflammation thereby narrowing the airways, resulting in recurrent episodes of wheezing, chest tightness, sleep disturbances, shortness of breath and coughing (often occurs at night or early in the morning).
It can affect individuals of any age, but many identified cases have found to be initiated during childhood. Asthma, isn’t a condition which can be cured completely, but effectively managed symptomatically with proper and timely medication.
As far as the etiology is concerned, exposure to different irritants can easily trigger an inflammation of the airways which will release the chemical known as Histamine, resulting in bronchoconstriction and vasodilatation.
Commonest irritants to exacerbate Asthma
- Pollen grains, dust mites, spores, pet dander, cockroach waste
- Respiratory infections (common cold, flu)
- Strenuous physical activities (exercise-induced asthma)
- Cold air and humidity
- B blockers, aspirin, ibuprofen and Naproxen
- Emotional disturbances (stress)
- Certain foods and beverages (shrimp, tomatoes, potatoes, beer, wine)
- Gastro esophageal reflux disease (GERD)
Other risk factors
Positive family history, history of atopic dermatitis or allergic rhinitis, obesity, tobacco smoke, second hand smoking
Diagnosis of asthma
Your doctor will take measures to identify the triggering factors and exclude conditions which can produce similar signs and symptoms. Mandatory investigations in a clinically suspected individual include,
- Assessment of the lung function
- Spirometry and peak-flowmetry- to assess the severity of airway narrowing
- Methacholine challenge- A positive response to this chemical which is a known asthma trigger will confirm Asthma.
- Chest X-ray
- Sputum Eosinophil analysis
Treatment for Asthma depends on how severe the condition is and how it interferes with one’s day today activities
- Mild intermittent- Mild symptoms at least 2 days/week and 2 nights/month
- Mild persistent-Symptoms more than twice a week, but no more than once during a single day
- Moderate persistent-Symptoms once/day and more than one night/week
- Severe persistent-Symptoms throughout the day on most days and frequently at night
- Preventive- (inhaled corticosteroids, leukotriene modifiers, long acting B agonists) which provide a long-term relief on reducing the inflammation of airways and
- Quick-relief inhalers (bronchodilators-short acting B agonists, Ipratropium) which provide an immediate action causing a widening and opening up the airways.
In a nutshell
- Both Bronchitis and Asthma are inflammatory conditions of the lower respiratory tract, which could possibly result in a difficulty in breathing.
- Definition- Asthma is a chronic condition characterized by recurrent bouts of airway narrowing whereas Bronchitis is a short-term or acute illness, usually lasting 1-few weeks (in a long term basis).
- Individuals with asthma will often complain of a chest tightness, shortness of breath and wheezing whereas acute bronchitis will present with a hacking cough, with or without phlegm and Chronic bronchitis with a persistent cough and wheezing.