Bronchoconstriction

Medically reviewed by Deborah Weatherspoon, PhD, RN, CRNA on December 18, 2017Written by Diana Wells on December 18, 2017

Overview

Bronchoconstriction is a condition in which the smooth muscles of the bronchus contracts. The bronchus is the pathway that moves air to and from your lungs. This muscle contraction causes the bronchus to narrow and restrict the amount of air passing into and out of your lungs.

Bronchoconstriction usually occurs in asthma, emphysema, and other lung diseases. However, bronchoconstriction can also happen to those without any lung disease during intense exercise.

Causes of bronchoconstriction

The specific cause of bronchoconstriction isn’t known. However, some things are known triggers of bronchoconstriction as well as asthma. These triggers may include:

  • allergens
  • environmental pollutants
  • smoke
  • cold air
  • dry air
  • chemicals
  • respiratory infections
  • lung disease
  • stress

Another common trigger of bronchoconstriction is intense or strenuous exercise. When this condition happens to someone with asthma, it’s called exercise-induced asthma.

However, it can also sometimes occur in people who don’t have any type of lung disease. In this case, the bronchoconstriction only happens when these people are performing strenuous exercise. The condition is alleviated when the exercise is stopped. This is called exercise-induced bronchoconstriction (EIB).

The triggers of EIB may include those listed above for bronchoconstriction in general. But the primary trigger of EIB is endurance activities. This type of activity includes long periods of deep breathing. Some examples are:

  • long-distance running
  • long-distance swimming
  • long-distance bicycling
  • cross-country skiing

Athletes who exercise in cold weather are particularly prone to having EIB. For example, EIB has been found in about 50 percent of Olympic cross-country skiers. Although not clearly established, the change in temperature of the airway while breathing large amounts of cold air followed by the rewarming may be the cause. Dehydration from breathing dry air may also cause the release of inflammatory cells that cause swelling.

Symptoms of bronchoconstriction

The following are some of the symptoms of bronchoconstriction:

  • coughing
  • being short of breath
  • wheezing
  • tightness or pain in the chest
  • extreme tiredness during exercise (primarily EIB)
  • physical performance that is poorer than expected (EIB)
  • avoiding certain physical activities (usually applies to young children)

Treatment and management

The treatment plan for bronchoconstriction may depend on your specific triggers, the severity of your condition, as well as any other health conditions you may have. The following are some treatment options your doctor may recommend for you.

You may have to take certain medications regularly for management of ongoing symptoms. In some cases, you might only need them just before exercising or being exposed to a trigger. These medications may include:

  • albuterol (ProAir HFA)
  • short-acting beta agonists
  • inhaled corticosteroids
  • leukotriene modifiers (taken orally to block some types of inflammation)

There are also lifestyle changes that you can make that may help manage your condition. These lifestyle changes may include:

  • avoiding your triggers
  • warming up prior to any exercise
  • wearing a scarf or mask in cold weather
  • changing to a sport that doesn’t require endurance and extended periods of deep breathing, like football, baseball, sprinting, or wrestling (for EIB)
  • avoiding any intense exercise when you have a respiratory infection
  • eating a low-salt diet
  • incorporating fatty fish for omega-3s and fruits and vegetables high in vitamin c into your meals

Complications and associated conditions

If left untreated, bronchoconstriction can become life-threatening. For this reason, it’s important to follow your doctor’s treatment and management plans.

Bronchoconstriction may also cause airway remodeling. Airway remodeling occurs when a condition like bronchoconstriction changes the pattern of your airways, thickens them, or increases the amount of mucus produced there. Airway remodeling is still being studied, so it’s causes aren’t clear. It’s suggested such changes may be from the mechanical force of your bronchi constricting damaging tissue cells during repeated episodes of bronchoconstriction or other lung conditions.

Additional complications of EIB may include the following:

  • not enjoying favorite activities due to poor performance
  • avoiding exercise and missing the health benefits it provides

Some conditions that are associated with bronchoconstriction include:

When to see your doctor

You should see a doctor any time you have any symptoms of bronchoconstriction. It’s important to get the correct diagnosis because the symptoms can be similar to those of other medical conditions. The correct diagnosis can ensure proper treatment and management to avoid an emergency.

If you have any of the following symptoms, you should get immediate medical attention:

  • wheezing or shortness of breath that gets worse quickly
  • symptoms that don’t improve after using asthma medications
  • symptoms caused by intense exercise that don’t get better once you’ve stopped the activity

Outlook

With proper treatment, bronchoconstriction can be well-managed. However, without proper treatment, it can become life-threatening. It’s important to see your doctor any time you have any symptoms of bronchoconstriction even if you don’t have a lung condition. All bronchoconstriction should be treated and managed properly.

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