What Exactly Is Asthmatic Bronchitis?
“Asthmatic bronchitis” is not an easy term to define. It’s used often enough, but the truth is, it’s not an official medical diagnosis.
“It’s really not a clear entity as a diagnosis,” Len Horovitz, MD, a pulmonologist with Lenox Hill Hospital in New York City, tells Health. The term may have originated decades ago when medical knowledge was less advanced and diagnoses less specific, he adds.
The term is also less and less in vogue, even among lay public, adds Jill Poole, MD, a professor of medicine and allergist at the University of Nebraska Medical Center.
Although considered two different conditions, asthma and bronchitis do have a lot of overlap. They both involve inflammation or swelling in the airways and, specifically, they both can affect the bronchial tubes, which tunnel air in and out of your lungs.
In both cases, “the underlying process is inflammation in the airway,” says Albert A. Rizzo, MD, chief medical officer for the American Lung Association. “That’s the common denominator.”
But that inflammation is caused by different things.
The most common type of asthma is allergic asthma. That’s when an allergy (say to pollen, mold, pet dander, or dozens of other things) causes the airways to narrow, which then triggers symptoms. “The classic symptoms of asthma are wheezing, chest tightness, shortness of breath, and cough, [although] you don’t have to have all four to have asthma,” says Dr. Poole. Asthma is diagnosed through lung function tests and is treatable, often with inhaled corticosteroids. People with allergic asthma may be able to prevent episodes by avoiding things they’re allergic to.
There are two types of bronchitis. Acute bronchitis can affect anyone and is usually caused by an infection with a virus (although bacteria can also cause bronchitis). Much like in asthma—though for a different reason—the bronchial tubes get narrower and cause symptoms, mainly a persistent cough, often producing mucus or sputum. Most cases of acute bronchitis go away on their own, although bacterial infections sometimes (but not always) need antibiotics to help send the bugs on their way.
Chronic bronchitis on the other hand is defined as a chronic cough with sputum that lasts at least two years, says Dr. Poole. It’s often found in people who are or have been smokers, or who have been exposed to other irritants. It’s somewhat treatable but not curable—and generally causes progressive lung damage.
Even though bronchitis and asthma are separate diseases, people with asthma can certainly get bronchitis—especially the acute form—just like anyone else. This is one way the term “asthmatic bronchitis” may be used. “Bronchitis activates their asthma,” says Dr. Horovitz.
Asthmatic bronchitis can also refer to the degree of symptoms with acute bronchitis. “If severe enough, [acute bronchitis] will have characteristics of asthma, like wheezing and chest tightness,” says Dr. Rizzo. “This is often called asthmatic bronchitis.”
It’s unclear if people with asthma are more prone to bronchitis, however. “You could argue that having asthma means your airways are inflamed and that the immune defenses in those airways are not optimal, which may predispose you to a bronchial infection,” says Dr. Rizzo. “It is also true that the use of inhaled steroids is very appropriate in asthma, and that the inhaled steroids may, too, alter the immune defenses in the airways thus increasing a risk for bronchial infection.” How well your asthma is controlled could also affect your risk of bronchitis, he adds.
Asthmatic bronchitis can also be taken to mean “symptoms of cough with sputum production as opposed to other asthma symptoms such as wheeze or shortness of breath,” Amber Oberle, MD, a medical instructor at Duke University Medical Center in Durham, North Carolina, tells Health.
The therapies for both bronchitis and asthma can also overlap. Treatments for allergic asthma often target the specific allergies, says Dr. Poole. Acute bronchitis usually just needs rest and time, while chronic bronchitis may require inhalers, sometimes the same inhalers that are used for asthma.
In the end, we are still learning about asthma, bronchitis, and other respiratory conditions. “It’s a moving target as to what’s causing them and the best treatment,” Dr. Rizzo says.
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