A bronchospasm is the sudden tightening of the tubes that feed air into the lungs, called the bronchi. This happens because the tubes are lined with muscle cells that can contract (tense up) and relax, depending on signals they receive from the outside world and from within the body.
Bronchospasms are often described as a sudden feeling of breathlessness, accompanied by tightness in the chest.1 People who are having a bronchospasm may feel like they cannot get enough air. This can be very distressing, especially in younger patients.
Severe bronchospasms may be life-threatening, and so knowing the signs and symptoms, as well as potential causes can be crucial to ensuring that a person gets the help they need. This, along with potential remedies, will be discussed further.
What is a bronchospasm?
A bronchospasm is when the muscle cells that line the airway suddenly contract. This makes the airways narrower and tighter, meaning that less air can flow in. This can cause people to experience a restriction in the amount of oxygen the body receives, which can be dangerous, especially if brain cells do not receive enough oxygen.
The muscle cells may contract for a variety of reasons, whether this be due to illness, exercise, medications or irritants or allergens in the air. Whatever the reason, it is important to identify the trigger so that the appropriate treatment can be given.
Symptoms of a bronchospasm
As mentioned above, a bronchospasm can feel like a sudden tightness in the chest. The person affected may find it hard to breathe properly and may feel breathless. However, there are some other symptoms associated with bronchospasms:2
- Coughing
- Wheezing
- Pressure or tightness in the chestShortness of breath
In some cases, there may also be excess mucus (which is similar to the phlegm that people cough up when they have a chesty cough).3 This can exacerbate the feelings of breathlessness.
What causes a bronchospasm?
Bronchospasms may be caused by a variety of external factors that may signal to the muscle cells to contract, including:2
- Asthma
- Chronic obstructive pulmonary disease
- Emphysema
- Infections of the upper respiratory system
- Smoke – this is an irritant
- Certain fragrances – these may be allergens
- Strenuous exercise – this may cause exercise induced asthma
- Dust – this is an allergen
- Pollen – this is an allergen
- Certain medications, such as aspirin, antibiotics and beta blockers
Bronchospasms may also occur when patients are under general anaesthetic, which is when a person is completely unconscious in surgery. This may be because the breathing tube irritates the lining of the airway.
In the majority of these cases, there is some underlying mechanism that causes the muscle cells of the airways to be slightly overactive – whether that be genetic, biological or environmental – and this is what can cause such a severe reaction to these external factors 1. This is why it is important to work with a doctor to identify the trigger and resolve it as soon as possible.
Contraction of the muscle cells may also cause the immune system to respond, which can cause the airways to become inflamed. This can worsen symptoms.
Diagnosing bronchospasms
Bronchospasms are usually considered a symptom, rather than an illness. Nonetheless, they may be formally diagnosed in the following ways:2
- Scans such as x-rays (which can find chest infections) and CT scans (which can show any problems in the lungs themselves)
- Pulmonary function tests – these will help to measure the ‘power’ your lungs have in them
- Assessing triggers – this can help to find the allergen, pollutant, or other factor that causes a bronchospasm
Who gets bronchospasms?
Bronchospasms can happen to a wide variety of people. This includes asthmatics, people with chronic obstructive pulmonary disease or emphysema, and people who are allergic or otherwise sensitive to particles and pollutants in the air.
Asthmatics are particularly susceptible to bronchospasms, as this is a major part of asthma. It is estimated that 9% of asthmatic patients experience bronchospasms during an operation.4 This may be due to the breathing tube irritating the airway, which can potentially cause a major complication. Thus, it is always important to disclose any pre-existing health conditions, like asthma, to a doctor before having surgery.
Children may also experience bronchospasms, especially children who have an underlying health condition, like asthma. However, in children, complications are more likely to arise3 as their airways are naturally smaller. For this reason, it is important to contact a doctor immediately if a child is suspected of having a bronchospasm.
Treatment and home remedies
Once a person is diagnosed with bronchospasms, they may be given any of the following treatments to help them settle and prevent another:1, 2
- Bronchodilators – these are drugs such as salbutamol which are designed to help the airways open up, allowing patients to breathe easier
- This is a popular treatment method for asthma and is the drug in an inhaler
- Corticosteroids – these are drugs such as prednisone which are designed to reduce inflammation and help the airways open up
- Anti-cholinergic drugs – these are drugs that act to open up the airway by relaxing the nervous system
There are no home remedies that are able to effectively treat bronchospasms. It’s important to seek medical attention if you or a loved one are at risk of bronchospasms to ensure one of the above medications are available for you to use in the event that you do suffer one.
If the trigger for a bronchospasm is something that is ingested (eaten), such as a certain medicine or a particular food, then avoiding this will help to prevent bronchospasms.
How to prevent bronchospasms
The best way to prevent bronchospasms is to identify what triggers them and a doctor can help with this.
It is also important to try and avoid things that may increase the risk of airway irritation:
- Strenuous exercise – try to increase the intensity gradually and make sure that you are not over-exerting yourself
- Smoking and vaping can irritate the airways and cause lung damage that can lead to bronchospasms and generally affect breathing
- Try to stay warm – cold air can increase the risk of a bronchospasm
When to seek medical advice
If you or a loved one is at risk of developing bronchospasms, it is important to see a doctor. Furthermore, if you or a loved one notice that you become breathless or experience chest tightness, seeking advice from a doctor can lead to investigations which ultimately result in finding treatment options.
Lastly, if you or a loved one has a bronchospasm that is not relieved by any of the medications listed above, it is important to get emergency help as bronchospasms may be severe and life-threatening.
Summary
Bronchospasms are involuntary contractions of the bronchi, leading to breathlessness and chest tightness. They arise from muscle cells in the airway constricting, limiting airflow and oxygen. Triggers include asthma, allergies, medications, irritants like smoke, and intense exercise. Asthmatics, those with respiratory conditions, and children are especially prone. Diagnosis often entails scans and identifying triggers. Main symptoms encompass chest tightness, coughing, and wheezing. While bronchospasms are primarily symptomatic rather than a disease, treatments like bronchodilators and corticosteroids are available. It's crucial to identify triggers for prevention, and severe symptoms necessitate immediate medical attention due to potential life-threatening consequences.
References
- Bronchospasm—Adult | Winchester Hospital [Internet]. www.winchesterhospital.org. Available from: https://www.winchesterhospital.org/health-library/article?id=874035
- Bronchospasm - What You Need to Know [Internet]. Drugs.com. [cited 2022 Oct 28]. Available from: https://www.drugs.com/cg/bronchospasm.html#diagnosis
- Gordon R. Asthma [Internet]. FDA; 2003 [cited 2022 Oct 28]. Available from: http://www.fda.gov/fdac/features/2003/203_asthma.html
- Gropper MA. Miller’s anesthesia. 9th ed. Amsterdam: Elsevier; 2019.