An Overview of Bronchospasm

A potentially life-threatening airway constriction

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Bronchospasms occur when your airways constrict, or narrow, causing you to have difficulty breathing. When this occurs, your chest will feel tight and you will likely start coughing frequently. If your airways constrict too much, you will be unable to breathe in deep enough and will face a medical emergency from oxygen levels being too low.

If you've ever been in a home with old water pipes, you can hear a high-pitched noise as water flows through them. This high-pitched noise is caused by narrow pipes. Like narrow water pipes, when your airways constrict during a bronchospasm, you will hear a whistling noise when you breathe, known as a wheeze.

Your respiratory system is one of the most important functions of your body, yet you don't typically think about it because it's controlled by autonomic (involuntary) functions. How deep or shallow you breathe, as well as how fast you breathe, are much of the time not controlled by you unless you are practicing breathing techniques for relaxation.

Mechanisms

In order to exchange oxygen and carbon dioxide, your body uses three mechanisms:

  • Ventilation: The mechanical act of breathing in and out, which brings oxygen into the lungs and carbon dioxide out of the lungs
  • Diffusion: The function of carbon dioxide and oxygen being exchanged at the alveoli (functional part of the lung exchange process) and pulmonary capillaries
  • Perfusion: Pumping the blood throughout your body with fresh oxygen

Bronchospasm interferes with these mechanisms, preventing your respiratory system from working properly.

Symptoms

Experiencing symptoms of bronchospasm can be very stressful and frightening, as you will feel like you are not getting enough breath. For this reason, you will usually need to seek emergency medical attention.

Common symptoms that may be associated with bronchospasms include:

Fatigue and exhaustion are other less-common and more subtle symptoms that may be associated with bronchospasm. Because these symptoms can be frightening, it is good to have a clear medical plan for prevention and treatment if you have any of these symptoms.

Causes

There are many causes of bronchospasm that can be associated with other diseases. The first time you are worked up for bronchospasm-associated shortness of breath or wheezing, you may not have ever considered that you would experience this disorder.

Common Causes

Asthma may also be a major contributor and risk factor for you to develop bronchospasm. However, just because you have asthma does not mean that you will develop bronchospasms.

If you experience a bronchospasm during surgery, your anesthesiologist or nurse anesthetist will be properly trained to manage your airway. You may require additional monitoring during the post-operation period if you had a bronchospasm during your surgery.

What is Bronchoconstriction?

Diagnosis

Under most circumstances, the diagnosis of bronchospasm will be determined by medical examination. When you are being seen by a medical professional, they will put a pulse oximeter on your finger to estimate the saturation of your blood cells with oxygen on your finger (although it could be a toe or taped to your forehead). Unless you have another underlying disease that restricts oxygen transfer in your lungs, your pulse oximeter reading should be greater than 90 percent.

If they are unable to get adequate readings, they can directly check your oxygen amount in your arteries by drawing blood from an artery in your wrist. This test is known as an arterial blood gas. The wrist is a sensitive area and will sting a little when being drawn from. Because the blood is being drawn from an artery, which has high pressure, they will apply pressure with gauze and apply a pressure dressing until the artery has time to heal.

If your physician is concerned about other causes of wheezing or shortness of breath, you may get an X-ray. Other, more extensive testing is typically not required during an acute episode of bronchospasm. However, you may be referred to a pulmonologist for further evaluations including a CT scan, pulmonary function testing, or exercise testing to further identify the cause of your bronchospasms or symptoms.

Future episodes of bronchospasm may not require much in the way of testing other than monitoring your oxygen levels to ensure your safety.

Treatment

Treatment of bronchospasm usually starts with inhaled medications known as short-acting beta2-agonists. Ventolin or Proventil (albuterol) are common medications that may be used if you are having difficulty breathing or shortness of breath. Albuterol helps to open up your airways.

If you have high blood pressure and are on beta-blockers like Lopressor (metoprolol), or Inderal (propanolol), you will want to let your physician know, as it will block some of the effects of albuterol. You should also have a rescue-inhaler to help delay emergencies, giving you time to seek medical attention if you have a repeat episode of bronchospasm.

If you have underlying asthma, you will also likely be given a corticosteroid like dexamethasone to help reduce any inflammation involved in narrowing your airways. Following an asthma exacerbation, your doctor will also likely provide you with a prednisone taper over several days to help reduce your risk for a recurrence.

If you are suffering from hypoxia and you are unable to maintain your oxygen levels (even with supplemental oxygen) due to severe constriction of your airways, you can have a breathing tube placed (known as intubation) to protect your airway and maintain appropriate oxygen levels.

How Inhaled Corticosteroids Work as Treatment Options

Coping

Experiencing a bronchospasm can be very scary for you. The number one thing you can do to cope with having bronchospasms is to reduce their occurrence.

Working closely with your pulmonologist, and sometimes an otolaryngologist, you will be able to develop a plan of care that reduces your risk for having repeat bronchospasms. If you have environmental risk factors, such as smoking, allergies, or fragrances that are shown to exacerbate bronchospasms, then eliminating these substances from around you will be key to reducing your risk.

If you suffer from bronchospasms due to asthma, being adequately treated with both long-term and short-term inhalers or nebulizers will help you to avoid subsequent bronchospasms.

Alternative Therapies

There are several groups that suggest that using breathing retraining techniques can be useful in reducing bronchospasms. One technique, in particular, has had successful results in three out of four studies.

The Buteyko breathing technique was founded by Russian physician Konstantine Buteyko. He proposed that in asthmatics, worsening shortness of breath was caused by hyperventilation. His technique is thought to cause hypoventilation, which increases your carbon dioxide levels in your blood, which may have a bronchodilation effect to help minimize your shortness of breath.

Buteyko Technique

The Buteyko breathing retraining exercise consists of the following steps:

  1. Several shallow breaths (through the nose) for 10 seconds
  2. Exhale all air after the 10 seconds is up
  3. Pinch your nose to prevent inhaling for 3 to 5 seconds (or until you feel the first feelings of being air hungry)
  4. Repeat for several minutes on a daily basis

It is reported that using the Buteyko breathing retraining exercises can reduce your need for albuterol. People involved in these studies also reported an improvement in their quality of life in relation to asthma. There are several other techniques, such as the Papworth breathing technique and Pink City Lung Exerciser. However, these are not as well studied as the Buteyko method.

Yoga and acupuncture are two other alternative therapies that have limited information related to their efficacy in bronchospasm, though it is believed by some to help reduce symptoms related to asthma. If you are a practitioner of yoga, you may notice that pranayama yoga breathing techniques are fairly similar to the Buteyko breathing retraining and you may receive similar benefits.

Many different herbs and oils are thought to have bronchodilatory effects. However, there is limited research showing long-term effects of eating or inhaling these. While there are many small studies that look at herbal and oil use for a variety of ailments, they are not sufficiently studied to make any recommendations.

You should not use herbs and/or oils as alternative therapy without consulting with your physician first.

A Word From Verywell

You may not always know that you are susceptible to having bronchospasms before your first one. Seek emergency help if you are having shortness of breath or difficulty breathing. Following your first incidence, it is important to develop a plan of care with your doctor to help reduce your risks of having subsequent episodes of bronchospasm. You may find that alternative therapies such as breathing retraining or yoga may add supplemental help in controlling your symptoms.

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Article Sources
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