Definition and Overview

Bronchospasm refers to the sudden muscular contractions or constrictions of the bronchioles walls. A bronchiole serves as a passageway for air, which is inhaled through the nose or mouth and brought to the air sacs known as alveoli. When the bronchioles contracts or spasm, the individual will experience difficulty in breathing, which can range from very mild (barely noticeable) to severe. Severe bronchospasm can pose life-threatening risks to the patient.

Bronchospasm is usually of a temporary nature, making it an acute condition. It is typically due to an allergen- or substance-induced bronchioli activity and the inflammation of the lining of the lungs.

Aside from restricting the airways, bronchospasm also causes the bronchial glands to produce large amounts of mucus, which can be very sticky and difficult to expel. The sticky mucus also aggravates the constriction or inflammation of the bronchioles, effectively forming plugs in the airways. Once the mucus builds up in the bronchi, the lungs will become highly irritated, resulting in the individual coughing.

Constriction and obstruction of the bronchioles require the lungs to work harder to process and distribute oxygen to the rest of the body. As a result, the individual will experience labored breathing and exhaustion.

Cause of Condition

One of the most common causes of bronchospasm is asthma, which is a chronic inflammatory disease that affects the lower respiratory tract. This is a common disease that results in various symptoms that include bronchospasm and other types of airway obstruction.

For many asthma patients, bronchospasm and its accompanying symptoms can be worse at night, during the early morning (right after waking up), during exercise or strenuous activities, and when exposed to cold air.

Asthma and the constriction or obstruction of the bronchioles can be triggered when the patient is exposed to the following:

  • Dander from the fur, hair, skin, or feathers of pet animals
  • House dust
  • Pollen and mold
  • Cockroaches
  • Smoke from cigarettes or tobacco
  • Chemical fumes from hair and aerosol sprays, paint, and household cleaners
  • Changes in weather
  • Cold air


The following can also trigger bronchospasms in asthmatic patients:

  • Laughing or crying too hard, which can be classified as strong emotions
  • Sulfites from food and beverages
  • Having colds, flu, or rhinitis (which involves the inflammation of the membrane that lines the interior of the nose)
  • GERD, or gastroesophageal reflux disease, which involves stomach acid flowing back up to the patient’s throat
  • Strenuous activities like exercise


Other conditions can also cause bronchospasm, especially those affecting the lower respiratory tract, including the following:

  • Allergies. Allergens in the environment can trigger an autoimmune response, which involves the constriction of airways, including the bronchioles. Like with asthmatic patients, allergens can include pet dander, dust mites, mold, pollen, and other airborne particles. Eggs, milk, peanuts, walnuts, fish, shellfish, soy, and wheat are also common allergens that can cause bronchospasm. In some individuals, insect bites and stings, as well as some forms of medication (particularly penicillin) can also lead to the constriction of the bronchioles.
  • Pneumonia
  • COPD or Chronic Obstructive Pulmonary Disease
  • Emphysema


Risk factors for bronchospasm include the following:

  • Genetic factors, such as having family members who are asthmatic or allergic to certain airborne particles, food additives, and latex
  • Having infections in the upper respiratory tract
  • Being exposed to dry or cold air, air pollution, smoke, chemical fumes, or strong odors
  • Taking medication such as aspirin, antibiotics, or blood pressure medicine

Key Symptoms

Difficulty in breathing is the most common symptom of bronchospasm. This difficulty often occurs at night or early morning, or when the patient is engaged in strenuous activities, such as exercise.

Other symptoms include:

  • Wheezing, characterized by a whistling sound as the patient breathes
  • Shortness of breath
  • Dry cough, because the lining of the lungs are irritated and the mucus plugging the bronchioles cannot be easily expelled
  • Tightness and pressure in the chest
  • Shortness of breath
  • Hypoxia, or oxygen deprivation in certain parts of the body, characterized by a blue discoloration of the skin and extreme pain in or around the oxygen-deprived body part

Who to See and Types of Treatment Available

When experiencing shortness of breath and tightness and pressure in the chest, it is best to consult a family doctor or a general practitioner right away as these symptoms can also be signs of other types of conditions that might worsen over time.

In the case of bronchospasm, the doctor will determine the cause of the obstruction or constrictions. The main objective of the treatment is to open up the airways and address the inflammation that might be causing the narrowing of the passageways. The doctor will ask about allergies, asthma, and other pre-existing conditions, and may order diagnostic tests such as an x-ray or MRI to confirm the root cause of the condition.

For asthmatic patients, inhaled medications will be prescribed, such as bronchodilators (to quickly open up the constricted bronchioles) or corticosteroids. For severe attacks, systemic steroid medicines, which can be taken orally or through IV tubes, maybe recommended.

Beta2-adrenergic agonists are also often prescribed for bronchospasm and these include terbutaline, salbutamol, levosalbutamol, formoterol, and salmeterol. If the bronchiole constriction is caused by bacterial infections, the doctor will prescribe antibiotics to reduce the symptoms and treat the infection.

The doctor can also advise complete rest, increased liquid intake, and avoiding exposure to irritants and allergens.

References:

  • National Heart Lung and Blood Institute
  • British Thoracic Society
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