Is It Asthma, Bronchitis, or Both?

当您或亲人患有哮喘时，“呼吸轻松”一词具有全新的含义。Wheezing, coughing,气促恐惧和担心ty that can accompany asthma attacks are probably all too familiar. But things get even more complicated if you have asthma and come down with a case of acute bronchitis.

尽管bronchitis symptoms, such as wheezing and shortness of breath, are similar to thesymptoms of asthma, there are some important differences, namely in what causes those symptoms in each condition and how each are treated. Here’s what you need to know about both lung conditions.

急性支气管炎是由病毒或细菌感染引起的，这通常是由感冒或流感引起的，通常持续约一到三周，然后自行清理。哮喘是一种慢性疾病，其特征是气道长期发炎，被认为是由于某些遗传基因而导致的，在婴儿期或童年期间或您接触的环境中患有呼吸道感染。（（1,2)

It gets tricky because there’s a type of bronchitis known as慢性支气管炎（（a type of chronic obstructive pulmonary disease, or COPD), which, as the name would imply, is a chronic condition that results from heavy exposure to cigarette smoke or other air pollutants, or frequent cases of acute respiratory infections. Chronic bronchitis can also result from uncontrolled asthma.

尽管哮喘和支气管炎是两种不同的疾病，但它们也可以同时发生。“当哮喘和急性支气管炎一起出现时，病情可能被称为'哮喘性支气管炎'。”John Carl, MD, a pulmonologist at the Cleveland Clinic in Ohio.

一些医生还使用“哮喘性支气管炎”一词来指代COPD和some asthma component, addsNicola Hanania, MD，肺部，重症监护和医学副教授bob ios下载 departments at Baylor College of Medicine in Houston.

哮喘是一种使气道变窄并产生过量粘液的疾病，这会导致呼吸急促，咳嗽和喘息。您可能还会感到胸部紧绷或疼痛，并在驱除呼吸时听到吹口哨的声音。（（3)

“While not all patients have the three telltale asthma symptoms (wheezing, shortness of breath,咳嗽), the most ‘classic’ one is probably wheezing, which is a high-pitched whistling sound created by obstructed bronchial passages,” explainsJames Shamiyeh, MD, a pulmonologist and medical director of the Heart Lung Vascular Institute at the University of Tennessee Medical Center in Knoxville.

支气管炎是由于大型气道的炎症引起的，这意味着比平时更少的空气能够进出肺部。有支气管炎，您可能会咳嗽phlegmor mucus and experience wheezing, shortness of breath, fatigue, chest pain, and a slight fever or chills.

“The main symptom that tells you it’s acute bronchitis is a cough that persists for at least five days, although it can often last one to three weeks,” Dr. Shamiyeh adds. The cough is generally associated with phlegm production (痰), which can be discolored or clear, he adds.

It's particularly concerning when people who already have asthma develop acute bronchitis, explains Richard Castriotta, MD, professor of medicine and associate director of the division of pulmonary, critical care, and sleep medicine at McGovern Medical School at the University of Texas in Houston. "It makes their asthma much worse."

In these cases, physicians may call the bronchitis “asthmatic bronchitis,” though that’s not a clinical term, Shamiyeh adds — and other physicians use “asthmatic bronchitis” when a case of acute bronchitis may cause asthma symptoms, like wheezing.

People with asthma who get bronchitis are often treated withinhalersthat dilate the bronchial tubes (to make breathing easier), and over-the-counter (OTC) painkillers and cold medication for other upper respiratory cold symptoms, similar to treatment for acute bronchitis in people who are nonasthmatic, Shamiyeh says. “Patients with asthma who get bronchitis may also be prescribed inhaled or oral steroids on a case by case basis.”

Additionally, in some severe cases, acute bronchitis can cause asthma. That’s because acute bronchitis is caused by either a viral or bacterial infection, Dr. Castriotta explains. For most people, bronchitis goes away when the infection clears, but if not, it’s possible for that viral infection and acute bronchitis to turn into asthma, he says. "This is one of the ways in which adult-onset asthma develops," he explains. The infection essentially causes changes in the airways that bring on the asthma symptoms.

此外,医生有时使用术语“眼疲劳matic bronchitis” when referring to people with COPD who have mild asthma symptoms, or when it’s difficult to differentiate the two condition, Dr. Hanania adds.

It’s worth noting that most cases of asthma are usually diagnosed in childhood, while most people with COPD are diagnosed after age 40 — and often after years of smoking or other long-term exposure to pollution, chemicals and secondhand smoke, Hanania adds. (4)

Hanania说，哮喘和COPD都是慢性疾病，这意味着损害无法逆转，并且条件无法治愈，但两者都可以治疗。“对于患有哮喘的人，重要的是要治疗合并症并确保适当使用吸入器。患有COPD的人应避免吸烟并暴露于触发因素，并使用含有支气管扩张剂的吸入器。”他解释说。

Here are some steps you can take to预防支气管炎对于患有哮喘的人以及那些没有哮喘的人：

• Don't smoke, and avoid being around cigarette smoke.
• 获得一年一度的flu shot.
• 得到肺炎如果您的年龄超过65岁，或者您的年龄较小，或者您年轻的年龄超过65岁，任何使您处于危险之中的情况，例如emphysema或其他呼吸问题，糖尿病或心脏病。

If you do come down with acute bronchitis, remember that most cases will clear up on their own — that goes for people with and without asthma. That means most people don’t need treatment for acute bronchitis, but to relieve symptoms, OTC medication, such asTylenol (acetaminophen), can help ease pain and discomfort, and a humidifier can assist with breathing. More serious cases of bronchitis may require additional medication, such as the types of inhalers often used in asthma attacks (likeAlbuterol), steroid drugs, and sometimes even oxygen.

Specifically, you should see a doctor about acute bronchitis if:

• 你无法入睡
• Your cough lasts more than a couple of weeks
• Your fever lasts more than three days or is over 101 degrees F
• 你咳嗽的粘液是绿色或血腥的（这可能是sign of pneumonia, for which you will need immediate medical care)
• You took your prescribedasthma medication但没有得到任何缓解
• You are having difficulty breathing
• 您有心脏或肺部状况，怀疑您患有支气管炎

Although bronchitis and asthma are two different lung conditions, they're they are closely related. Knowing the difference can help ensure you get the best treatment for the condition affecting you.

With additional reporting by Jennifer Geddes.