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Controlling Severe Asthma

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Asthmatic Bronchitis

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What is asthmatic bronchitis?

Asthmatic bronchitis refers to the incidence of acute bronchitis in a person with asthma. Acute bronchitis is a respiratory disease that causes inflammation in the bronchi, the passageways that move air into and out of the lungs. This inflammation results in respiratory congestion and shortness of breath. Asthma is a disorder that causes inflammation of the airways, leading to shortness of breath, chronic cough, chest tightness, and wheezing.

Acute bronchitis is a common respiratory disorder in the United States. Infants, young children, and elderly people have the highest risk of developing acute bronchitis. Acute bronchitis is commonly caused by upper respiratory viral infections. If you have asthma, your risk of acute bronchitis is increased because of an increased sensitivity to airway irritation and inflammation. Your risk of acute bronchitis is also increased if you smoke or are exposed to air pollution.

The signs and symptoms of asthmatic bronchitis vary among individuals, depending on the severity of the infection. Treatment for asthmatic bronchitis includes antibiotics, bronchodilators, anti-inflammatory drugs, and pulmonary hygiene techniques such as chest percussion (medical treatment in which a respiratory therapist pounds gently on the patient’s chest) and postural drainage (medical treatment in which the patient is placed in a slightly inverted position to promote the expectoration of sputum).

Healthy lifestyle practices, including good hand washing, drinking plenty of fluids, following a well-balanced diet, getting plenty of rest, and avoid smoking, can help prevent or improve asthmatic bronchitis.

Seek immediate medical care (call 911) if you have severe difficulty breathing, which may be combined with pale or blue lips, fast heart rate, and chest pressure.

Seek prompt medical care if you are being treated for asthmatic bronchitis but mild symptoms recur or are persistent.

What are the symptoms of asthmatic bronchitis?

Symptoms of asthmatic bronchitis are related to inflammation of the lung airways and can vary in intensity among individuals.

Common symptoms of asthmatic bronchitis

You may experience asthmatic bronchitis symptoms daily or just once in a while. At times any of these asthma symptoms can be severe:

  • Chest pain or pressure

  • Dry, nonproductive cough (wet, productive coughing suggests infection)

  • Fatigue

  • Fever

  • Shortness of breath or rapid breathing (tachypnea)

  • Wheezing (whistling sound made with breathing)

Serious symptoms that might indicate a life-threatening condition

In some cases, asthmatic bronchitis can be life threatening. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bluish coloration of the lips or fingernails

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

What causes asthmatic bronchitis?

Asthmatic bronchitis refers to the occurrence of acute bronchitis in conjunction with asthma (disorder that affects the lungs and is characterized by airway constriction that leads to shortness of breath, chest tightness, and wheezing). Acute bronchitis is a respiratory disease that causes inflammation in the bronchi, the passageways that move air into and out of the lungs. The inflammation results in respiratory congestion and shortness of breath. The most common cause of asthmatic bronchitis is an upper viral respiratory infection.

What are the risk factors for asthmatic bronchitis?

A number of factors that occur in conjunction with asthma increase the risk of bronchitis. Not all people with asthma who are exposed to risk factors will get asthmatic bronchitis. Risk factors or triggers for asthmatic bronchitis include:

  • Air pollution
  • Allergies
  • Animal dander
  • Dust
  • Jobs associated with livestock, grain, textiles, and coal mining
  • Pollen
  • Preexisting lung disease
  • Smoke
  • Upper respiratory infections

Reducing your risk of asthmatic bronchitis

You may be able to lower your risk of asthmatic bronchitis by:

  • Getting pneumococcal or annual flu vaccines

  • Practicing good hygiene by always washing your hands to prevent the spread of infection

  • Refraining from smoking and avoiding secondhand smoke

  • Taking all medicine as prescribed, even if you do not have symptoms

How is asthmatic bronchitis treated?

Treatment for asthmatic bronchitis begins with seeking medical care from your health care provider. The goal of treatment for asthmatic bronchitis is to reduce asthma-related bronchospasm and reduce congestion caused by the acute bronchitis. Asthma medications include long-term asthma control medications to prevent asthma attacks, which is especially important in the case of acute bronchitis. Short-term asthma medications are given in the event of an asthma attack. Acute bronchitis is not normally treated with antibiotics, since the most common cause is a viral infection. Expectorants can help thin mucus in the airways, making it easier to cough up mucus.

Long-term asthma control medications

Long-term asthma control medications are inhaled or taken orally each day to control and prevent symptoms. Generally, the most effective long-term control medications are inhaled corticosteroids. Long-term control medications include:

  • Biologics, such as omalizumab (Xolair), which is an injectable antibody used to control asthma symptoms in people with allergy-induced asthma whose symptoms are not controlled by inhaled corticosteroids. Xolair suppresses an inflammatory process of your immune system, so another name for this type of biologic is immunomodulator. It is injected on a periodic basis in your doctor’s office.
  • Inhaled corticosteroids, such as budesonide (Pulmicort Flexhaler, Pulmicort Respules), flunisolide (Aerobid Aerosol), fluticasone propionate (Flovent HFA), and triamcinolone acetonide (Azmacort Inhalation Aerosol)
  • Leukotriene modifier medications such as montelukast (Singulair)
  • Long acting beta-agonist medications, such as salmeterol (Serevent Diskus) and formoterol (Foradil)

Quick-relief asthma medications

“Rescue” or quick-relief medications treat acute symptoms and are generally inhaled through a device called an inhaler. Rescue medications are used on the spot when you feel a sudden onset of asthma symptoms. Fast-acting asthma medications include short-acting beta agonists (bronchodilators), such as albuterol sulfate (ProAir, Proventil, Ventolin, AccuNeb inhalation solution) and levalbuterol (Xopenex).

Treatment options for acute bronchitis

Options for the treatment of acute bronchitis in individuals who have asthma include:

  • Analgesics, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), naproxen (Aleve), and aspirin (for adults only)
  • Antibiotic therapy is given only if the infection is likely caused by bacteria
  • Bronchodilators via a nebulizer or metered-dose inhaler if wheezing if present
  • Chest physical therapy (CPT) or postural drainage to promote coughing up mucus
  • Humidifier to increase moisture in the air
  • If you are a smoker, treatment to help you quit smoking
  • Increased hydration to thin mucus
  • Oxygen therapy

What you can do to improve your asthmatic bronchitis

In addition to reducing your exposure to asthmatic bronchitis triggers, you can also improve asthmatic bronchitis by:

  • Drinking plenty of fluids
  • Getting plenty of rest
  • Taking all medications as prescribed

What are the potential complications of asthmatic bronchitis?

Complications of untreated or poorly controlled asthmatic bronchitis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of asthmatic bronchitis include:

  • Chronic obstructive pulmonary disease (COPD), including emphysema and chronic bronchitis
  • Frequent respiratory infections
  • Pneumonia
  • Pulmonary hypertension (high blood pressure in the arteries of the lungs)
  • Respiratory failure
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 19
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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