Asthma Vs. Bronchitis: What's The Difference?

If you're like many people, you may be wondering how bronchitis vs. asthma stack up to one another in terms of their causes, symptoms, treatments, and preventative options.

While asthma and bronchitis are both considered "lung obstructive" conditions because they limit or block airflow in and out of the lungs, there are some key differences between them.

Bronchitis includes both acute and chronic varieties. Acute bronchitis lasts less than three weeks and is sometimes referred to as a chest cold. It is the most common of the two types and is marked by the production of mucus in the lungs and pulmonary (lung) inflammation. Many times acute bronchitis will go away on its own.

Chronic bronchitis is an inflammatory lung condition notable for airway constriction, a persistent cough, and phlegm production lasting more than three months and returning for at least two successive years. It is a type of chronic obstructive pulmonary disease (COPD). Though it is not curable, it can be successfully managed with the right treatments.

Asthma is also a long-term inflammatory lung disease that narrows the airways. It tends to come and go throughout a person's life. Unlike chronic and acute bronchitis, scientists aren't exactly sure what causes asthma, although children whose parents have the condition are at a higher risk of developing it.

According to 2020 data, over 4.2 million children¹ have asthma (while data² indicates childhood chronic cough is rare). Although there currently is no known cure for asthma, many treatment options are available to help you and your loved ones better manage the symptoms.

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What are the symptoms of bronchitis vs. asthma?

Because bronchitis and asthma are both conditions that obstruct the lungs, they have a few symptoms in common such as wheezing, chest tightness, coughing, and shortness of breath.

Some symptoms are unique to each condition. Let's look at how you can spot the difference between bronchitis and asthma symptoms.

Bronchitis

With acute bronchitis, you may experience a hacking type of cough with thick mucus production.

Some symptoms of chronic inflammation include:

  • Low-level fever and possible chills

  • Headache

  • Tiredness and body aches

  • Production of phlegm or thick mucus

For chronic bronchitis, triggers for these symptoms can be stress, cold air, environmental factors like excess pollen in the air, or chemical irritants from household or workplace products.

Asthma

Asthma's main symptoms usually center around moderate to intense episodes of breathing difficulties. These asthma attacks are often triggered by outside factors, including exercise, allergens, cold weather, stress, medicine such as aspirin, and environmental irritants and pollutants (including climate change). Some people with the condition also have trouble sleeping at night due to bouts of wheezing and difficulty breathing.

You can track your asthma symptoms to see if they are worsening by keeping track of how often you experience asthma attacks. It's also a good idea to jot down your triggers and use a peak flow meter³ to measure your airway constriction level.

What are the causes of bronchitis vs. asthma?

While asthma and bronchitis share a few symptoms in common, their underlying causes are often (though not always) different.

Bronchitis

Acute bronchitis is most commonly caused by a virus that infects your airways, such as a cold or flu virus, although sometimes bacteria can play a role.

The main cause of chronic bronchitis is cigarette smoking, and the majority of people affected by it are between the ages of 44-65.⁴ There are also other risk factors for the condition, such as:

  • Exposure to work chemicals or toxins

  • Environmental pollutants

  • Chemicals on food

  • Allergens like pollen or pet dander

  • Acid reflux, which can irritate lung tissue, causing it to swell

  • A genetic disorder is known as alpha-1 antitrypsin (AAT) deficiency⁵

  • A weakened immune system makes you susceptible to chronic airway inflammation

Asthma

Unlike chronic bronchitis, the exact cause of asthma is unknown. However, researchers believe the main risk factor is genetics. Rather than discovering a certain type of gene that causes the condition, evidence⁶ reveals that there are actually multiple genes interplaying with each other and with the environment to cause asthma.

In addition, other factors may increase your risk for developing asthma that overlaps with certain chronic bronchitis risks, including:

  • Allergies

  • Acid reflux

  • Smoking or being in an environment where people smoke

  • Exposure to environmental pollutants, toxins, and chemicals

Diagnosing bronchitis and asthma

About 25.2 million US adults have been diagnosed with asthma, compared to 9 million with chronic bronchitis.

Because both asthma and chronic bronchitis obstruct the lungs, your healthcare provider will use some of the same methods to diagnose them.

You can start by making an appointment to see your primary care physician if you have any of the symptoms listed above, especially wheezing, coughing, and difficulty breathing that lasts for more than three weeks.

If your physician suspects you have chronic bronchitis or asthma, you may be referred to a lung doctor, also known as a pulmonologist. They will likely begin the diagnostic process by listening to your lungs with a stethoscope.

You can also expect the focus during diagnosis to be on your symptoms, family history, lifestyle, and triggers. Some questions you may be asked include:

  • Have you had the flu or cold recently?

  • Do you smoke?

  • Do you have a family history of asthma?

  • What symptoms are you experiencing the most?

  • What usually triggers these symptoms?

  • How long have you been experiencing these symptoms?

  • Do you know if you're allergic to anything?

  • Have you had any exposure to chemicals or toxins at work?

Questions like these will help your healthcare provider get a baseline idea of your condition before they begin testing. 

Below are some common tests for chronic bronchitis and asthma.

Bronchitis

  • Spirometry test: During this test, you blow into a mouthpiece hooked up to a spirometer machine. It measures your lung airflow input and output and how fast you can exhale. Often, your age, gender, and even height are factored into your spirometry score when making a diagnosis.

  • Sputum testing. Sputum is another name for thick mucus or phlegm, and in some cases analyzing the makeup of the sputum can help determine what is causing your phlegm production and lung inflammation.

  • High-resolution computed tomography⁷ (HRCT). While a traditional chest x-ray is sometimes used to confirm a chronic bronchitis diagnosis, HRCT has proven more effective in recent years. They can help determine the severity and extent of chronic bronchitis and are used to confirm spirometry test results.

  • Lifestyle tests. Because people often know their own health better than anyone, tests are sometimes given to patients to find out their perceptions of their lifestyles, such as their smoking habits and overall health scorecard. These tests can be used in combination with other tests to help with diagnostic accuracy.

Asthma

Spirometry, HRCT, and lifestyle tests contribute to asthma diagnosis. Some complementary diagnostic tools used to determine if you have the condition include:

  • Provocation tests. These help pinpoint what may be triggering your lung obstruction symptoms. The three main types of provocation tests are:

  • Irritant tests. These determine if certain allergens, like pet dander or grass, may trigger your asthma attacks.

  • Exercise tests. During these tests, you'll do a short workout at a medical facility that's set up to monitor your lungs and airways. This helps determine if you have exercise-induced asthma, also known as exercise-induced bronchoconstriction (EIB).

  • Methacholine tests. People with asthma are more sensitive to methacholine, which causes airway constriction. The amount of airway constriction you have after methacholine is administered will help your doctor decide if you have asthma.

  • FeNO Test. A fractional exhaled nitric oxide (FeNO) test measures how much nitric oxide (NO) you breathe out to discover how much inflammation is in your lungs. Although it's not a stand-alone test, it can help confirm a diagnosis of asthma. FeNOs are also used post-diagnosis to track your lung inflammation to determine if your treatment plan is working for you or if adjustments need to be made.

Treatment options for bronchitis vs. asthma

Acute bronchitis

Acute bronchitis treatment is similar to the self-care routine you'd use for a common cold or the flu. Medical practitioners recommend that you rest up and get plenty of liquids. If your cough interferes with your ability to function, try throat lozenges or another over-the-counter cough suppressant.

You can also use a humidifier or breathe in the vapor from a bowl of steaming water to help clear out your congestion.

Treating acute bronchitis with antibiotics is not recommended because they won't work on viruses. Even when the condition is caused by bacteria, antibiotics can cause unwanted side effects and kill the "good" bacteria that are helping you fight the infection. Instead, contact your doctor if you need guidance on the best over-the-counter medications for acute bronchitis.

Chronic bronchitis

Chronic bronchitis treatments are prescribed by your healthcare provider and include several medications:

  • Beta-agonists help lung airways relax and open up

  • Corticosteroids to help decrease lung inflammation

  • Theophylline dilates the airways leading into the lungs

  • Phosphodiesterase inhibitors relax the smooth muscles around the lungs

  • Anticholinergics dilate the airways by preventing muscles from tightening around them

  • Antibiotics to clear up recurring respiratory infections

In addition, these breathing therapies may be part of a treatment plan to assist with chronic bronchitis symptoms:

  • Pulmonary rehabilitation exercise programs are used to help strengthen the lungs and reduce shortness of breath.

  • Oxygen therapy is employed for people with more advanced chronic bronchitis to ensure enough oxygen reaches the body.

  • Lung volume reduction surgery is sometimes recommended to remove pieces of the damaged lung and make breathing easier.

Asthma

Asthma treatments are broken down into:

  • Control medications for medium to long-term management of the condition

  • Rescue medications for when an asthma attack is imminent

Control medications can be inhalers, pills, allergy shots, or biologics, while rescue medications are typically inhalers.

Some of the same medications used to treat chronic bronchitis are also used for asthma control and rescue. For example, oral corticosteroids (steroids), theophylline, and long-term beta antagonists are used as control medications, while short-term beta antagonists are used in rescue inhalers.

In asthma, doctors may also prescribe leukotriene modifiers. These block chemicals called leukotrienes that the body releases in response to allergic triggers.

Prevention methods for bronchitis and asthma

The best ways to prevent acute bronchitis are to always wash your hands thoroughly, stay up to date on your vaccinations, use hand sanitizer, and isolate yourself from others if you (or they) are sick. Although prevention is ideal, it is curable and will go away on its own.

For chronic bronchitis, avoid smoking, as lifelong smokers have a 50%⁹ probability of developing COPD during their lifetime. Also, limit your exposure to environmental irritants, allergens, and pollutants that may trigger the condition.

If you think you may be at risk for non-smoking-related chronic bronchitis, get regular checkups and follow your doctor's recommendations for keeping your immune system in good shape.

Because of asthma's genetic component, it may be a challenge to completely prevent it. But learning your family history and avoiding common triggers (including smoking) are great ways to reduce the risk of asthma attacks. It's also ideal to be proactive and get tested for asthma if you already know it runs in your family so that a treatment plan can be put in place to manage your symptoms.

The lowdown

Understanding the key differences between acute bronchitis and asthma can help ensure you get the correct diagnosis from your healthcare provider so you can better manage your symptoms. By recognizing the triggers of each condition and learning the best prevention methods, you can reduce your risks of developing asthma and bronchitis and improve your quality of life once diagnosed.

  1. Most recent national asthma data | Centers for Disease Control and Prevention

  2. Diagnosis and management of chronic cough: Similarities and differences between children and adults (2020)

  3. Asthma and Allergy Foundation of America

  4. Chronic bronchitis: Where are we now? (2019)

  5. Alpha-1 antitrypsin deficiency-associated chronic obstructive pulmonary disease: A family perspective (2015)

  6. Genetics of asthma: An introduction for the clinician (2015)

  7. CT/HRCT scanning | Pulmonary Hypertension Association UK

  8. What is fractional exhaled nitric oxide (FeNO) testing? | NIH: National Heart, Lung, and Blood Institute

  9. Smoking and chronic obstructive pulmonary disease (COPD). Parallel epidemics of the 21st century (2009)

Other sources:

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