Asthma is a condition that causes the airways to your lungs to become inflamed and swollen, making it difficult to breathe — and because it makes it more difficult for you to exhale, it’s known as an obstructive lung disease.
Another group of lung diseases called restrictive lung diseases happen when your lungs don’t get enough oxygen when you inhale. Restrictive lung diseases include conditions such as pulmonary fibrosis.
While obstructive and restrictive lung diseases have many similarities, they have different causes, treatments, and outlooks.
Read on to learn more about the difference between the two and how you can manage an obstructive lung disease like asthma.
Lung diseases fall into two different groups: obstructive lung diseases and restrictive lung diseases.
Lung diseases in either group can cause symptoms such as difficulty breathing, coughing, and shallow breathing. But while obstructive lung diseases make it difficult for you to breathe out, restrictive lung diseases make it difficult for you to breathe in.
| Obstructive lung diseases | Restrictive lung diseases | |
| Definition | Make it difficult to exhale | Make it difficult to inhale |
| Causes | Caused by something blocking your airways, such as inflammation and swelling | Happens when your lungs don’t fill with enough air when you breathe in |
| Examples | Asthma, COPD | Pulmonary fibrosis, ARDS |
| Symptoms | A feeling of fullness in the lungs, mucus production, wheezing, symptoms that worsen with activity | A feeling of not being able to get enough air, anxiety from not being able to get enough air |
| Short- or Long-Term | Most are long-term (chronic) conditions | Can be chronic, short-term (acute), or result from injuries |
| Treatment | Opens airways | Varies widely depending on the underlying cause |
Obstructive lung diseases
Obstructive lung diseases make it harder for you to exhale air.
People with obstructive lung diseases breathe air out with slow and shallow breaths. An obstruction or blockage in your airways causes obstructive lung diseases. Often, this obstruction occurs when your inflammation and swelling narrow your airways.
For instance, asthma attacks occur when your airways become inflamed and filled with mucus. This obstructs your airways, making it difficult to breathe and leading to the symptoms of an asthma attack.
Other obstructive lung conditions include:
- bronchiectasis
- emphysema
- chronic bronchitis
- chronic obstructive pulmonary disease (COPD)
- cystic fibrosis
Symptoms of obstructive lung diseases can vary depending on the specific condition and the severity. But some symptoms are shared by all obstructive lung diseases, including:
- a feeling of fullness in the lungs
- difficulty breathing
- shallow breaths
- shortness of breath
- coughing
- wheezing
- spitting or coughing up mucus
- symptoms that get worse with activity
Restrictive lung diseases
Restrictive lung diseases make it hard to inhale enough air to fill your lungs. This can occur for a few different reasons.
Sometimes, your lungs themselves become restricted by an illness such as pneumonia. This is called an intrinsic restrictive lung disease.
In other cases, injuries or conditions of surrounding parts of your body make it difficult to breathe fully. For instance, a fractured rib can disrupt your normal breathing. This type of restrictive lung disease is called an extrinsic restrictive lung disease.
Conditions that impact your nervous system, such as muscular dystrophy, can also make it hard for your body to make the movements needed to take full breaths. This is known as a neurological restrictive condition.
Examples of intrinsic restrictive lung diseases include:
- adult respiratory distress syndrome (ARDS)
- tuberculosis
- sarcoidosis
- pulmonary fibrosis
Some conditions that can increase your risk of extrinsic restrictive lung diseases include:
Conditions that can lead to neurological restrictive lung diseases include:
The exact symptoms of a restrictive lung disease depend on:
- the type of restrictive lung disease
- the condition itself
- the severity of the condition
For instance, people with extrinsic restrictive lung diseases might frequently change positions to make breathing easier. Common symptoms of all restrictive lung diseases include:
- a feeling of not being able to get enough air
- anxiety or panic related to breathing difficulties
- shortness of breath
- coughing
- difficulty breathing
- shallow breaths
The first step to a diagnosis of any type of lung disease is a conversation with a doctor or specialist. They’ll go over your medical history and your symptoms.
It’s important for a doctor to know:
- how long you’ve been having trouble breathing
- if anything makes your symptoms better or worse
- if you have any additional symptoms
During a physical exam, the doctor will listen to your breathing and note any irregularities.
They might order some tests, including pulmonary function tests that determine if your breathing difficulty is obstructive or restrictive, for confirmation. These tests can also help diagnose certain conditions and can be indicators of how severe they are.
Common pulmonary function tests include:
- Spirometry measures how much air you inhale and exhale as well as how quickly you’re able to breathe it back out.
- Lung plethysmography measures how much air is left in your lungs after you exhale.
- Diffusing capacity (DLCO) measures how well oxygen and carbon monoxide can diffuse between the blood vessels in your lungs and small air sacs in your lungs called alveoli. DLCO also helps aid in determining the severity of obstructive and restrictive disease as well as pulmonary vascular disease.
Sometimes pulmonary function tests will be enough to confirm a diagnosis. Doctors might order other tests if they need more information to determine what’s causing your breathing difficulties. Other tests may include:
- Imaging tests. X-rays or CT scans can help doctors see your lungs and airways up close and spot injuries, inflammation, and other conditions.
- Lab tests. Arterial blood gas tests measure the oxygen content of your blood and help determine the severity of your lung disease.
- Bronchoscopy. Bronchoscopy uses a small tube to insert a tiny camera into your airways to get an up-close look at possible blockages.
Obstructive lung conditions like asthma are generally treated with medications that open your airways and reduce inflammation.
Your exact treatments will depend on the severity of your asthma or other obstructive lung disease and on how well you respond to initial treatments.
Since most obstructive lung diseases are chronic, treatments will not cure your condition, but they will help you better manage your symptoms.
Medical treatments
You might be prescribed oral medications to help manage your asthma, including the temporary use of antibiotics or antivirals to help relieve any swelling and inflammation in your airways.
In some cases, you might also be prescribed a class of medication called biologics. These drugs are designed to help control inflammatory responses in your body and are often prescribed for asthma that has not responded to other treatments.
At-home treatments
Many of the medications you take for asthma are inhaled through an inhaler. Your asthma treatment plan will likely include treatments for attacks and for managing symptoms long-term, such as:
- Corticosteroids and other anti-inflammatories. Taking anti-inflammatory medications with an inhaler over a long period can help relieve swelling and reduce mucus.
- Anticholinergics. These are used alongside anti-inflammatories to help stop your airway muscles from tightening.
- Bronchodilators. These medications relax tightened airway muscles and can be taken during an asthma attack or long-term for asthma management.
Lifestyle treatments
Some lifestyle changes can help reduce your asthma symptoms, including:
- quitting smoking, if you smoke
- avoiding allergens
- achieving or maintaining a moderate weight
- increasing fruits, vegetables, and whole grains in your diet
- getting regular physical activity
A
Talk with a doctor about the best lifestyle changes and treatments for your asthma.
Asthma is an obstructive lung condition caused by inflammation of your airways that makes it difficult to breathe.
The first step to getting treatment for your asthma is getting a diagnosis. Once your asthma diagnosis has been confirmed, you can begin treatment to help reduce inflammation and manage your asthma.