Is It Asthma or Chronic Bronchitis?

Chronic bronchitis is an ongoing condition characterized by a cough that occurs on most days of the month, at least three months out of the year, and lasts for at least two years. It is considered a diagnosis of exclusion meaning that your healthcare provider needs to make sure that your coughing symptoms are not being caused by another condition like asthma. Symptoms are caused by inflammation and irritation of the airways in the lung.

A woman coughing on her couch
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COPD or chronic obstructive pulmonary disease is often used to describe a person with chronic bronchitis, emphysema, or a mixture of both.Two people may both have COPD, but one person may have symptoms more compatible with chronic bronchitis while the other person may have more symptoms of emphysema. Emphysema patients experience more problems with shortness of breath as opposed to a chronic cough.

Additional symptoms of chronic bronchitis can include:

  • Increased mucus production
  • An irritating cough that is often worse in the am
  • Irritated airways
  • Decreased airflow
  • Scarring of the lungs

Symptoms are generally progressive and patients may notice each episode of coughing and mucus production following a viral infection last longer and takes longer to recover from.

If you are not sure if you have chronic bronchitis or asthma, answering the following five questions may help you determine the most likely cause:

Did You Have Symptoms of Allergies or Asthma as a Child?

While asthma can be diagnosed in patients in their forties, most asthmatics are diagnosed in early childhood or adolescence. In fact, studies demonstrate that primary care doctors will often label older patients with asthma when in fact they have COPD, emphysema or chronic bronchitis.Whether this may result from social stigma placed on tobacco-related disorders or some other reason is unclear.

What Makes My Symptoms Worse?

Symptoms of asthma worsen with exposure to triggers. While triggers vary from person to person, worsening asthma symptoms following exposure to any of the following are more likely to indicate asthma:

  •  Tobacco smoke
  •  Animal dander
  •  Dust mites
  •  Cockroaches
  •  Mold
  •  Pollen
  •  Extreme weather
  •  Exercise
  •  Stress
  •  Some medications

Chronic bronchitis, on the other hand, is not impacted by any of these. Respiratory tract infections are more likely to cause increased symptoms.

Do I Smoke Now or Did I Smoke in the Past?

While chronic bronchitis and asthma can occur together, chronic bronchitis is much more common in smokers, former smokers and people with heavy exposure to environmental tobacco smoke.

Am I Ever Symptom-Free?

As is implied in the definition of chronic bronchitis, the condition requires regular symptoms over a long period of time. 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. Importantly, asthmatics can experience prolonged asymptomatic periods depending on their asthma control.

Does My Lung Function Return to Normal Between Exacerbations?

In both asthma and chronic bronchitis, your healthcare provider will measure pulmonary function tests such as spirometry and FEV1. When asthma is well controlled and you are not experiencing symptoms your lung function will be near normal. A chronic bronchitis patient’s lung function will not return to normal with treatment.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Celli BR, Macnee W. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J. 2004;23(6):932-46. doi:10.1183/09031936.04.00014304

  2. Gentry S, Gentry B. Chronic Obstructive Pulmonary Disease: Diagnosis and Management. Am Fam Physician. 2017;95(7):433-441.

  3. Tinkelman DG, Price DB, Nordyke RJ, Halbert RJ. Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over. J Asthma. 2006;43(1):75-80. doi:10.1080/02770900500448738

  4. Kuebler KK, Buchsel PC, Balkstra CR. Differentiating chronic obstructive pulmonary disease from asthma. J Am Acad Nurse Pract. 2008;20(9):445-54. doi:10.1111/j.1745-7599.2008.00332.x

Additional Reading
  • National Heart, Lung, and Blood Institute. Expert Panel Report 3 (EPR3): Guidelines for the Diagnosis and Management of Asthma Accessed on May 23, 2015.

By Pat Bass, MD
Dr. Bass is a board-certified internist, pediatrician, and a Fellow of the American Academy of Pediatrics and the American College of Physicians.