Is It Bronchitis or Asthma?

It can be difficult to know the difference between bronchitis and asthma, as they have a few similar symptoms.

However, there are also some important differences.

For example, acute bronchitis generally lasts just a few weeks, but asthma is a chronic condition that doesn’t completely go away once developed, though it can be managed under the care of a physician.

Although they share similar symptoms, bronchitis and asthma have different causes, treatments, and outlooks.

If you think you may be experiencing signs of asthma or bronchitis, it’s important to know how the two differ and when you should reach out to your provider for care.

Symptoms

Bronchitis and asthma both take place when the airways are inflamed, and as a result they can cause similar symptoms, including:

• Cough
• Chest tightness or pain
• Shortness of breath
• Wheezing

Bronchitis

Symptoms that can appear with bronchitis, but not asthma, include:  

• Slight fever
• Chills
• Body aches
• Sore throat
• Headache
• Fatigue
• Mucus production

Some people experience symptoms for just a few days or weeks, while others may have symptoms, like cough, that can last up to 90 days. 

Acute bronchitis is defined as lasting 90 days or less, whereas chronic bronchitis can last for months or years.

Most often, symptoms of chronic bronchitis will come and go, with some that flare up during the colder, wetter months of the year.

Asthma

As with many chronic conditions, symptoms of asthma can come and go.

In many cases, an external trigger, including pollen, cold weather, or exercise, can trigger an asthma attack.

Knowing which factors can make your asthma worse can help you to plan ahead to make sure you have your medication with you.

Still, not all asthma attacks are preventable.

For that reason, it’s important to tell your friends and family what they can do in case of an asthma attack.

Keep in mind that symptoms of asthma can also change over time, which is why it’s also important to stay in contact with your provider to report any changes you may experience.

Causes

Both bronchitis and asthma can be caused or triggered by environmental factors like allergens or pollution.

But there are additional possible causes unique to each condition.

Bronchitis

Acute bronchitis is generally caused by viruses, typically the same viruses that cause the cold and flu, but it can also be caused by bacteria.

The most common cause of chronic bronchitis is cigarette smoking, but environmental irritants and toxins can also contribute to the condition.

People at a higher risk of developing bronchitis include:

• Cigarette smokers
• People with compromised immune systems (including infants, young children, and the elderly)
• People who have work in close exposure to chemical irritants
• People who have acid reflux

Asthma

Unfortunately, researchers haven’t identified a single unifying cause of asthma.

Allergies, genetics, and environmental factors have all been shown to have an impact on whether or not a person develops the condition.

However, genetics may be the biggest risk factor. 

Other factors that can trigger asthma symptoms or an asthma attack include:

• Exercise, especially heavy or intense workouts
• Heartburn
• Smoking
• Sinusitis
• Other infections, including bronchitis
• Medications, especially aspirin
• Extreme changes in weather
• Stress and anxiety

Diagnosis

A physical exam of the lungs is involved in diagnosing both bronchitis and asthma.

But there are some additional methods that can be used to provide an accurate diagnosis for each.

Bronchitis

With acute bronchitis, a patient’s medical history and a physical exam of the lungs (including listening to the lungs with a stethoscope) is often all that’s needed for diagnosis.

But additional testing may be used when diagnosing chronic bronchitis, including:

• Chest x-ray
• Sample of phlegm, also known as sputum culture
• Pulmonary function testing (PFT), used to measure the volume and airflow of air in the lungs
• Pulse oximetry, used to measure the level of blood oxygen
• High resolution computed tomography (HRCT), a scan that can take high-resolution images of the lungs

Asthma

In addition to a review of a patient’s medical history and physical examination of the lungs, here are some of the tests used when diagnosing asthma:

• Lung function tests, such as peak flow test and spirometry
• FeNO test, used to determine how inflamed the lungs are and whether steroids can help to decrease the inflammation
• Allergy testing, if your doctor or allergist suspects allergens to be a trigger for your symptoms
• Methacholine challenge
• Chest x-rays and CT scans
• Sputum eosinophils
• Provocative testing, used to check for weather- or exercise-induced asthma

Treatment

Treatment options vary depending on whether you have bronchitis or asthma and the severity of the condition.

Bronchitis

Acute bronchitis generally clears up on its own, usually within 14 days.

If it doesn’t, your doctor may prescribe an antibiotic to help with breathing. 

Treatment of chronic bronchitis may include:

• Pulmonary rehabilitation: A breathing exercise program guided by a respiratory therapist.

• Oxygen therapy: An effective in-home or hospital treatment option for people with low levels of oxygen in their blood. In this treatment, oxygen can be delivered through oxygen concentrators, oxygen-gas cylinders, and liquid-oxygen devices.

• Medication: Your doctor may recommend steroid treatments or bronchodilator medications to help open narrowed passages in your lungs.

If you’re having trouble breathing at any point or unsure about which condition your symptoms indicate, reach out to your healthcare provider for care.

Asthma

Because asthma is a chronic condition, treatment is often an ongoing process and can include:

• Behavior modifications: Quitting smoking and avoiding environmental and allergenic triggers when possible.

• Quick-relief inhalers: Used to offer immediate relief during an asthma attack. Examples of quick-relief inhalers include albuterol (AccuNeb), prednisolone (Pediapred), and metaproterenol.

• Long-term medication: Used to treat symptoms and prevent future asthma attacks. Examples of long-term medications for asthma include formoterol and budesonide (Symbicort), omalizumab, and beclomethasone.

Working with your doctor can help determine which asthma treatment options will be most helpful for you and your asthma.

It’s important to note that the right treatment plan will depend on your age, the severity of your symptoms, and your unique triggers.

Keeping an asthma diary can help you and your doctor recognize triggers and make a specialized treatment plan.

Prevention

The best things you can do to prevent acute bronchitis are to practice good hygiene (including frequent hand washing and avoiding close contact with others who may be sick with the cold or flu) and speaking with a doctor as soon as you experience symptoms.

When left untreated, bronchitis can lead to pneumonia, a more serious illness.

For many people, asthma cannot be prevented, especially when symptoms are caused by predetermined factors like genetics and environment.

However, there are some lifestyle modifications that can help prevent to asthma attacks and lessen symptoms: 

• Quit smoking: If you’re a smoker, quitting is one of the best things you can do to reduce your symptoms and improve your lung health. 

• Breathing exercises: When used effectively, these exercises can reduce the amount of medication needed to manage your symptoms.

• Avoid known triggers: Including environmental or allergies

• Stress management techniques: Including yoga and mindfulness

• Certain natural supplements: Including vitamin D, caffeine, choline and magnesium.

• Clean your home regularly: If dust, pollen, or mold triggers your symptoms, cleaning your home regularly (and using an air purifier or air conditioner) can help.

• Avoid exposure to cold air: Covering your face when you’re exposed to cold air can help if weather changes exacerbate your asthma.

• Regular exercise: If needed, talk with your doctor about how you can get regular exercise safely, which can work to strengthen your heart and lungs and relieve asthma symptoms.

• Control heartburn and gastroesophageal reflux disease (GERD): If you suffer from frequent heartburn, talk to your provider about how to manage the condition, which can reduce asthma symptoms. 

When to See a Doctor

If you’re unsure whether or not your symptoms indicate bronchitis or asthma, reach out to a provider for care. 

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