Is It Bronchitis or Asthma?

Bronchitis and asthma are both common respiratory conditions that involve inflammation of the airways. They have overlapping symptoms, such as coughing and shortness of breath, and can occur simultaneously. Having asthma increases your chances of bronchitis.

Asthma is a chronic disease, while bronchitis can be acute or chronic.

A diagnosis of chronic bronchitis can occur in those with poorly controlled asthma, and it is not uncommon for patients who are diagnosed with asthma later in life to be initially diagnosed with bronchitis.

Symptoms

Asthma and bronchitis have four overlapping symptoms:

• Coughing
• Wheezing
• Shortness of breath
• Chest tightness

Asthma symptoms come and go over time and within the same day, whereas bronchitis symptoms are more consistent.

The most common bronchitis symptom is ongoing coughing with mucus. This is the case for both acute and chronic bronchitis. Asthma more commonly produces a chronic dry cough.

Acute bronchitis occurs when there is an inflammation and swelling in the lungs in a short period of time. This commonly occurs following exposure to viral illnesses, such as the common cold or flu. Asthma symptoms may also start or get worse with viral infections.

Coughing due to asthma may occur or worsen at night or early morning and may be triggered by exercise. Coughing in those with bronchitis is more consistent, but it may also get slightly worse at night or with exercise.

Additional symptoms of acute bronchitis can include:

• Coughing with sputum (mucus) that may be clear or colored
• Low fever
• Sore throat
• Pain associated with coughing
• Allergy and sinus congestion
• Chills or body aches

Many patients refer to acute bronchitis as a “chest cold” and complain of a “post-viral cough,” sore throat, and congestion that resolves in a few days to a few weeks.

Fever is generally low (100.5 to 102 degrees F) or absent in those with bronchitis. A higher fever would make a diagnosis of pneumonia, influenza, or COVID-19 more likely.

Chronic bronchitis is an inflammation of the bronchial tubes of the airways that produces a cough on most days of the month, at least three months of the year, and lasts for at least two years in a row.

A chronic bronchitis patient often experiences progressive symptoms and is unlikely to have a prolonged symptom-free period. On the other hand, asthma patients often experience waxing and waning of symptoms and can experience prolonged asymptomatic periods depending on their asthma control.

Causes

The causes of asthma are still unknown, but it is believed to be a mixture of genetic predisposition and environmental factors.

You are at an increased risk of developing asthma or having asthma symptoms worsen if you have:

• Family history of asthma, especially a parent with asthma
• Allergies
• Viral respiratory infections and wheezing as a child
• Exposure to cigarette smoke
• Occupational exposure to chemical irritants or industrial dusts
• Poor air quality from pollution (traffic pollution) or allergens (pollen, dust)
• Obesity

The most common type of asthma is allergic asthma that's triggered by allergens.

Symptoms of asthma occur or worsen with exposure to asthma triggers, including common allergens such as dust mites or pollen. While triggers vary from person to person, common ones include:

• Animal dander
• Dust mites
• Cockroaches
• Mold
• Pollen
• Tobacco smoke
• Extreme weather
• Exercise
• Stress
• Some medications, such as aspirin, nonsteroidal anti-inflammatories (NSAIDs), and beta-blockers

While chronic bronchitis and asthma can occur together, chronic bronchitis is more often caused by smoking cigarettes or heavy exposure to cigarette smoke.

Acute bronchitis is most commonly caused by viruses, but it can also be caused by bacteria or inhaling dust and fumes.

Chronic bronchitis leads to chronically irritated airways, decreased airflow, and scarring of the lungs. It is often part of chronic obstructive pulmonary disease (COPD), a chronic inflammatory disease of the lungs.

Among those with COPD, some may have symptoms more compatible with chronic bronchitis while others may have more symptoms of emphysema. Emphysema patients experience more problems with shortness of breath as opposed to a chronic cough.

Risk factors for acute or chronic bronchitis include:

• Smoking
• Exposure to secondhand smoke
• Exposure to environmental pollutants, such as industrial fumes
• Asthma
• COPD
• Family history of lung disease
• History of childhood respiratory diseases
• Gastroesophageal reflux disease (GERD)

Diagnosis

Chronic bronchitis is considered a diagnosis of exclusion, meaning that your doctor needs to make sure that your coughing symptoms are not being caused by another condition, such as asthma.

If you have symptoms of asthma or bronchitis, your doctor will ask you about your symptoms and your personal and family medical history and will do a physical exam, such as listening to your lungs.

Your doctor will also have you do pulmonary function tests (PFTs), such as measuring forced exploratory volume (FEV1) using a method called spirometry. This testing involves blowing into a device that measures the air volume of your exhales to assess airway obstruction.

If acute bronchitis is suspected, there may also be additional tests, such as blood or sputum tests to look for infections or chest X-rays to rule out pneumonia.

Pulmonary function tests are often performed before and after giving you a bronchodilator medication. If your lung tests significantly improve and indicate that airway obstruction resolved after being given the medication, you may be diagnosed with asthma. If airway obstruction mostly persists after being given the medication, chronic bronchitis may be suspected.

Although, diagnosis using PFTs can be complicated because some people with asthma can develop a more fixed airway obstruction that will only improve slightly with medications and there are people who have both asthma and chronic bronchitis.

Treatment

Most cases of acute bronchitis resolve on their own and acute bronchitis treatment generally focuses on the relief of symptoms.

Your doctor may recommend some of the following medications and remedies if you have acute bronchitis:

• Over-the-counter (OTC) cold medications, such as cough suppressants or mucolytics (breaks up and thins mucus)
• OTC pain relievers, such as ibuprofen
• Teaspoons of honey to ease throat irritation from coughing
• Using a humidifier or steam treatment
• Drinking lots of water
• Rest

If your acute bronchitis is caused by bacteria, you'll be prescribed antibiotics.

The overall treatment plan for asthma depends on asthma severity and symptom triggers, but the most commonly prescribed medications include:

• Short-acting beta-agonists (SABAs), known as rescue inhalers, that can address acute symptoms by widening airways quickly
• Inhaled corticosteroids, a long-term controller medication, that is taken daily to reduce inflammation and prevent symptoms over time, especially in those with persistent asthma that happens several times a week to up to multiple times a day

A rescue inhaler may be all that's needed for mild asthma or exercise-induced asthma that only happens during physical activity. 

Additional medications or environmental interventions, such as mold remediation or pest control, to address allergies may also be recommended if asthma is triggered by allergens.

Your physician will also help you develop an asthma action plan for recognizing asthma triggers and knowing what steps to take based on symptoms.

If you have asthma and experience an episode of bronchitis, you'll need to follow your asthma action plan and adjust treatment accordingly.

Seek medical care with any of the following:

• Parameters from your asthma action plan tell you to seek care
• Fever
• Cough does not improve despite following your action plan or lasts more than 10 days
• Barking cough that makes it hard to speak or breathe
• Coughing up blood
• Weight loss

In general, when asthma is well controlled and you are not experiencing symptoms your lung function will return to near normal.

If you have chronic bronchitis and COPD, on the other hand, your lung function will not return to normal because the lungs have been damaged. Still, symptoms can sometimes improve with a combination of treatments, including medications and lifestyle interventions, especially quitting smoking and/or avoiding smoke and pollutants whenever possible.

Treatments for chronic bronchitis include:

• Cough medications, such as cough suppressants or mucolytics
• Bronchodilator medications to help manage acute symptoms
• Inhaled or oral corticosteroids to decrease inflammation
• Smoking cessation medications, such as prescription Chantix (varenicline) or OTC nicotine replacement therapy
• Pulmonary rehabilitation, which involves involves working with a therapist to optimize control of your breathing and coughing and may include exercises
• Postural drainage and chest physiotherapy, which involves moving into positions that allows the mucus to drain
• Phosphodiesterase 4 inhibitors (PDE4 inhibitors) to decrease inflammation
• Oxygen therapy, which involves portable units to inhale supplemental oxygen
• Lung transplant surgery in the most severe cases

A Word From Verywell

If you're experiencing a chronic cough or shortness of breath, it's important to contact your healthcare provider who can help evaluate whether it might be asthma, bronchitis, or something else.

If you've already been diagnosed with asthma, chronic bronchitis, or both, stick to your treatment plan and notify your doctor if you experience any changes or worsening of symptoms. You may also want to consider joining an in-person or online community support group to connect with other people who have chronic lung conditions and to find resources that may help you feel supported or improve your quality of life.

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