Bronchospasm occurs when the smooth muscles in the airways of your lungs tighten, making it difficult to breathe. It’s a common asthma symptom but can also happen in other conditions.
Since asthma and bronchospasm often occur together, it can be hard to tell the two apart.
But while bronchospasm is a common feature of asthma, it is not the same thing. Bronchospasm can also be triggered by conditions other than asthma.
So, while all people who have asthma experience bronchospasm, not all people with bronchospasm have asthma.
Your lungs are made up of a series of connecting tubes. The trachea (windpipe) leads to the bronchi, which branch off into smaller bronchioles. The air you breathe flows through these tubes, eventually passing oxygen into your bloodstream.
A circular layer of smooth muscle surrounds your bronchi and bronchioles. Bronchospasm happens when that smooth muscle tightens and constricts, making the airway tubes smaller.
During bronchospasm, air does not flow as well through your lungs. When this happens, you might wheeze, cough, feel short of breath, or notice chest tightness.
Bronchospasm in asthma
Asthma is a chronic condition caused by ongoing airway inflammation. In asthma, the airways may become chronically narrowed, blocked by mucus, and hypersensitive to environmental triggers. Because of this, people with asthma are prone to bronchospasm.
What’s the difference between bronchospasm and bronchoconstriction?
People often use the terms “bronchospasm” and “bronchoconstriction” interchangeably to refer to a narrowing of the airways that causes wheezing, coughing, tight chest, and shortness of breath.
However, doctors sometimes consider bronchospasm to be a more sudden narrowing in one area of the lungs, while bronchoconstriction is typically a more widespread, less sudden narrowing.
Bronchospasm has many causes, including short-term triggers and long-term diseases.
Because of their small airway size and anatomy, infants and young children are especially vulnerable to bronchospasm and wheezing. Viral infections, such as bronchiolitis, are a frequent cause of acute bronchospasm in this age group.
Other than asthma and viral infections, causes of bronchospasm include:
- other infections
- anaphylaxis
- irritants (allergens, strong smells, pollution, smoke)
- smoking or vaping
- cold temperatures
- exercise
- chronic obstructive pulmonary disease (COPD)
- certain medications
The right treatment for bronchospasm depends on its underlying cause. However, treatment usually includes an inhaled rapid-acting bronchodilator medication such as albuterol, levalbuterol, or formoterol.
Exercise-induced bronchospasm
If you receive a diagnosis of exercise-induced bronchospasm, your doctor may first recommend that you change your exercise routine by warming up, breathing through your nose, and avoiding cold, dry air.
If your symptoms continue, your doctor may prescribe an inhaled bronchodilator for you to use before exercise. They might also order tests to check for asthma.
Chronic conditions
People with chronic conditions such as asthma and COPD are prone to bronchospasm. Daily controller medicines such as inhaled steroids and long-acting bronchodilators can help prevent bronchospasm and reduce airway inflammation.
When bronchospasm does flare, treatment may include:
- inhaled bronchodilators
- inhaled, oral, or intravenous (IV) corticosteroids
- anticholinergics such as ipratropium and tiotropium
- antibiotics (for some COPD flares)
For serious flares requiring emergency room or hospital care, a doctor may recommend:
- oxygen therapy
- additional inhaled and IV medications
- mechanical breathing support
Anaphylaxis
Bronchospasm during anaphylaxis is usually part of a severe allergic reaction, which requires emergency treatment with:
- epinephrine injections
- IV fluids
- inhaled bronchodilators
- histamine blockers and corticosteroids
Bronchiolitis
Treatment may be different if your child’s doctor diagnoses viral bronchiolitis as the cause of first-time bronchospasm and wheezing.
Research has shown that many of the treatments listed above, including steroids and bronchodilators, are not helpful in acute bronchiolitis. The American Academy of Pediatrics recommends against their use.
Instead, doctors usually treat bronchiolitis first with:
- hydration
- suction and airway clearance
- oxygen, IV fluids, and other breathing supports (for severe cases in the emergency room or hospital)
Can inhalers cause bronchospasm?
Yes. Occasionally, the same bronchodilator inhalers used to treat bronchospasm (such as albuterol and levalbuterol) may unexpectedly cause bronchospasm themselves.
This unusual reaction is called paradoxical bronchospasm.
Common oral medications, such as certain pain relievers (aspirin, nonsteroidal anti-inflammatory drugs) and blood pressure medications (ACE inhibitors, beta-blockers), can also trigger bronchospasm.
If you notice increased wheezing, cough, or chest tightness in yourself or your child shortly after taking any medication, reach out to a doctor right away. Changes to your medication plan may be helpful.
Bronchospasm happens when the smooth muscle surrounding the airways in your lungs constricts and tightens, restricting airflow. This causes symptoms such as wheezing, coughing, chest tightness, and shortness of breath.
Bronchospasm is a key symptom of asthma, but it can also occur in people without asthma, such as infants with bronchiolitis, athletes, and older adults with COPD.
Treatment for bronchospasm depends on the underlying cause but usually includes an inhaled bronchodilator such as albuterol, levalbuterol, or formoterol. In some cases, lifestyle changes and preventive medications can also help.
Talk with a doctor if you or your child has symptoms of bronchospasm. A healthcare professional can determine a diagnosis and develop a treatment plan that works for you.