Dr. Ahmed Differentiating the symptoms of Allergic Bronchitis vs Asthma is difficult especially when you have repeated episodes of allergic bronchitis.
Asthma is a chronic condition that has episodes of exacerbations and disease-free periods. It classically has the following four symptoms:
- Wheezing or whistling sounds while breathing
- Shortness of breath
- Chest tightness, and
- Cough
Bronchitis is inflammation of the bronchi usually following a viral or bacterial infection or exposure to smoke. It is usually not seasonal or does not have a specific time to develop.
Bronchitis gets better in a few days and does not require long-term treatment. However, chronic bronchitis that occurs in patients with COPD is a long-term health problem with frequent exacerbations and flares.
Allergic bronchitis is a subtype of acute bronchitis that develops in patients who are allergic to external stimuli which can be dust, smoke, cold weather, pollen, mold, and workplace irritants such as fumes.
Allergic bronchitis can be viewed as bronchitis developing in patients with asthma or allergic rhinitis. It is also termed asthmatic bronchitis and is prevalent in patients with asthma who are chronic smokers.
These patients have symptoms of asthma along with phlegm production and partial improvement with bronchodilator therapy.
Pneumonia is inflammation or infection of the lungs. Unlike asthma, it does not come and go and does not have periods of flares or attacks. Pneumonia is usually a one-time infection that can be treated and cured.
Pneumonia can be associated with serious short-term as well as long-term complications if not treated on time.
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Differentiating Symptoms of Allergic Bronchitis vs Asthma:
Both Bronchitis and Asthma are conditions affecting the airways. They have similar symptoms and signs. There are subtle differences, however, they are not absolute.
It is very likely that a person with asthma is labeled as having Asthma and a person with allergic bronchitis is diagnosed with asthma.
Here are some of the differentiating symptoms of allergic bronchitis vs asthma:
Cough:
Cough is the hallmark of allergic bronchitis. Patients develop coughs when they are exposed to an allergen.
Patients with asthma may also have a cough, however, the cough usually is severe at night or in the early morning.
Some patients may not have a cough at all.
Phlegm:
Phlegm or sputum production is another hallmark of allergic bronchitis. Asthmatics may have a whitish mucoid sputum, especially in the early morning.
Sputum or phlegm production can increase during an acute attack of asthma or when there is superimposed bronchitis or pneumonia.
Patients with bronchitis have a foreign body sensation or mucus in their airways even if they can not expectorate it.
Fever:
Low-grade fever may accompany allergic bronchitis. However, asthmatics generally do not have a fever except during an infective exacerbation of asthma.
Fever is high-grade in patients with bronchitis caused by influenza or bacteria.
Duration of illness:
It takes 3 to 5 days for the symptoms of allergic bronchitis to resolve if treated. Phlegm production and fever usually settle within 3 to 5 days unless the disease is a complicated one.
Asthma is a chronic condition and the symptoms may take up to two weeks. However, improvement in the symptoms may be seen as early as 24 to 48 hours, especially when corticosteroids are given.
The symptoms of asthma such as wheezing and shortness of breath are usually partially improved with the treatment.
Patients have to continue treatment for a longer duration compared to patients with allergic bronchitis.
Recurrence:
Recurrence of symptoms can occur in both asthma and allergic bronchitis. However, asthmatics have more frequent exacerbations, usually two to three times a year, especially during winter.
Symptoms of allergic bronchitis may develop on exposure to the allergen.
Triggers:
Triggers of both asthma and allergic bronchitis are almost the same. However, in patients with non-allergic Asthma, obesity-associated asthma, and other variants of asthma, there may not be any triggers at all.
Chest tightness:
Chest tightness is one of the hallmarks of asthma. However, it can also occur in patients with allergic bronchitis.
Chest tightness without fever, cough, or phlegm production points to the diagnosis of asthma rather than allergic bronchitis.
Wheezing:
Wheezing can occur in patients with allergic bronchitis but it is the hallmark of asthma.
Wheezing in the absence of fever and phlegm production points to the diagnosis of asthma rather than allergic bronchitis.
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In Summary:
The symptoms of allergic bronchitis vs asthma overlap and is very difficult to diagnose the two based on symptoms and signs only.
Asthmatic bronchitis is another term for allergic bronchitis that is seen in patients with asthma who are chronic smokers and produce a lot of sputum [Ref].
Diurnal variation, recurrent symptoms of shortness of breath, wheezing, and chest tightness that improve with bronchodilators indicate the diagnosis of asthma.
On the other hand, fever, cough, phlegm production, and partial improvement with bronchodilator therapy indicate the diagnosis of allergic bronchitis.
Here is a table summarizing the differences between Allergic Bronchitis and Asthma:
Symptoms | Asthma | Bronchitis |
| Cough | Often dry and persistent | May start dry and become productive |
| Shortness of breath | Common during attacks | Typically worsens with physical activity |
| Wheezing | Common during attacks | May be present, especially with coughing |
| Chest tightness | Common during attacks | May be present |
| Fatigue | Common during attacks | Can be present |
| Fever | Not a typical symptom | Low-grade fever possible |
| Sputum production | Minimal to none | Common, often thick and discolored |
| Duration of symptoms | Can be intermittent and chronic | Acute or chronic |
| Triggers | Allergens, exercise, cold air | Viral or bacterial infections, irritants |
