Bronchitis or Asthma

Asthma and bronchitis are both airway inflammatory conditions. Although they are similar in many ways, they are different diseases with different treatment. It is important to get the correct diagnosis. The similarities and differences are described below.

Bronchitis can be acute or chronic. Acute bronchitis lasts for about three weeks.1 Chronic bronchitis lasts for three months or more within a two-year period.2 Chronic bronchitis is a form of COPD (chronic obstructive pulmonary disease).

Causes

Viral infections are the most common cause of acute bronchitis. Cigarette smoking is the main cause of chronic bronchitis.2 The causes of asthma are not well understood. Cigarette smoke can play a role in asthma for some people. However, there are many other factors, including genetics, early life exposures, and contact with allergens, irritants, and viruses.3

Symptoms

Cough is the main symptom of bronchitis and is also a typical asthma symptom. In fact, acute bronchitis and asthma are the first and second most common causes of cough, respectively.1,4 Unlike a cold or pneumonia, acute bronchitis does not usually cause a runny and stuffy nose or fever.1 People with asthma often have other breathing symptoms as well, such as wheezing, chest tightness, and shortness of breath. However, cough can be the only asthma symptom for some people.

Airway obstruction

Asthma and chronic bronchitis are both obstructive lung diseases. Having an obstructive lung disease means that air has a hard time getting out of your lungs. An important difference between asthma and chronic bronchitis is whether medications can open up the airways (“reversibility”). In people with asthma, the airway obstruction is reversible. Their lung function improves after taking a bronchodilator medication, such as albuterol. People with COPD have irreversible airway obstruction. Their lung function does not improve after taking albuterol. Lung function is measured with spirometry.5

Triggers

Both asthma and bronchitis flare-up at times.6 Viruses, air pollution, and cigarette smoke trigger flare ups of both conditions. Dozens of other factors can trigger asthma as well.

Treatment

Treatment for acute bronchitis is very different from chronic bronchitis. There is some overlap in the medications used to treat chronic bronchitis and asthma.

Acute bronchitis.

Acute bronchitis is usually caused by a virus and gets better on its own. Adults with acute bronchitis can take a cough suppressant.1 These can be prescription or over-the-counter. Children younger than six years old should not use cough and cold medications. Antibiotics and asthma medications are often prescribed for acute bronchitis, but are not usually effective or recommended.1 In particular, beta-agonists are helpful only for people with wheezy bronchitis.

Chronic bronchitis.

The treatment for chronic bronchitis depends on how severe it is. The types of medications typically used for chronic bronchitis are:6

  • Anticholinergics: Prevent the muscles around the large airways from tightening.7
  • Beta-agonists: Relax the muscles that surround the airways, helping the airways to open up.
  • Corticosteroids: Reduce inflammation.
  • Phosphodiesterase inhibitor: Decreases swelling in the lungs.8
  • Theophylline: Relaxes the airways and allows them to open up.

Asthma

Inhaled corticosteroids and beta-agonists are the mainstays of asthma treatment. Other medications, such as leukotriene modifiers, omalizumab, oral corticosteroids, and theophylline, are used as alternatives or add-on medications. The US Food and Drug Administration has not approved any anticholinergic medications to treat asthma. They are sometimes used to treat asthma anyway.

Cure

Acute bronchitis usually clears up on its own.1 Chronic bronchitis and asthma can be managed and treated, so that you can breathe more easily. Unfortunately, there is no cure for these conditions.

Written by: Sarah O'Brien | Last Reviewed: May 2016.
View References