What Does A Bronchospasm Feel Like

Have you ever experienced tightness in your chest that makes it harder to catch a breath? Or perhaps you are unable to carry out your daily activities due to constant wheezing, tiredness, and chronic cough? 

If the answer is "yes," then you might have experienced an episode of bronchospasm. 

In the respiratory system, bronchospasm particularly affects the tiny airways in your lungs called bronchi. It happens when the muscles that line the bronchi abnormally contract, causing the narrowing of the airways. Hence, it results in difficulty breathing. 

Bronchial spasms can be terrifying and might be triggered by a number of factors, such as an allergic reaction or an underlying respiratory problem like asthma, bronchitis, or chronic obstructive pulmonary disease (COPD). However, fortunately, bronchospasm can be managed and, most of the time, it is treatable.

What is bronchospasm

The bronchi are the primary passageways responsible for distributing air throughout the lungs. Under normal bodily function, the muscles surrounding the bronchial inner lining are thin and smooth, which facilitates effortless air movement. Any respiratory issue or airway hyper-reactivity can trigger these smooth muscles to constrict and narrow the airways.

Eventually, this limits the amount of oxygen supply that the body requires. This abnormal muscular contraction is known as bronchospasm or bronchial spasm and may manifest mild to severe breathing difficulties.

Sign and symptoms

Bronchospasm can be very scary and may come suddenly. The signs are fairly related to the severity of how much narrowing and restricted airflow is observed. The most common noticeable symptoms are: 

• Chest tightness - feeling pressure or pain in the chest and back
• Shortness of breath
• Light-headedness
• Feeling fatigued for no apparent reason
• Getting tired after physical activity
• Cough
• Wheezing
• Sore throat
• Nasal congestion
• Fever

Causes and risk factors

Bronchospasm typically occurs when bronchial tubes get inflamed and irritated. Several reasons can  induce the condition, which vary from person to person.

Depending on the cause of bronchospasm, the bronchial glands may produce more mucus, contributing to further irritation, narrowing, and airway obstruction. The following are the common causes contributing to bronchospasm:

• Asthma: 

Asthma is a pulmonary condition that primarily affects the lungs. It is one of the most common causes of bronchial spasms. Asthma attacks happen when airway inflammation induces bronchial muscular constriction. This deprives the body tissues of the oxygen supply they need. Sometimes, allergy-induced asthma also triggers excessive bronchospasm when an allergic substance is inhaled, resulting in hyperresponsiveness of smooth muscles.

• Underlying respiratory issues: 

Patients with respiratory problems such as bronchitis, bronchiolitis, and COPD are more prone to bronchial spasms. Acute bronchitis is a common complication that may give rise to airway constriction on a temporary basis. However, some progressive COPDs, such as chronic bronchitis and emphysema, can impair respiratory ability and make normal breathing difficult. 

• Physical exercise: 

Strenuous exercise without following a warm-up can obstruct the airways, which makes it harder to maintain breathing during physical exertion. This type of airway narrowing is often referred to as exercise-induced bronchospasm (EIB) or exercise-induced bronchoconstriction.

Although EIB and exercise-induced asthma (EIA) are used interchangeably. Studies have broadened an aspect that EIA is termed when asthma patients perform exercise that exacerbates their asthma. While EIB is considered in people who don't have a history of asthma.¹

• Allergen:

A study showed that air pollution and weather fluctuations increase the allergenic pollen in the environment, which leads to significant chances of bronchospasm in patients with respiratory tract problems.²

• Other causes include:
  • Bacterial, viral, and fungal infections in the respiratory passageways
  • Smoking or vaping
  • Exposure to chemicals, strong fumes, and other irritants
  • Usage of general anesthesia during surgical procedures

The following are the known risk factors that may give rise to bronchial spasms: 

• Personal or having a family history of respiratory diseases, allergies, or hypersensitivity to food additives
• Dust mites, pollen, air pollutants
• Cold temperatures
• Adults over 65 years of age or young children
• Weakened immune system
• Exposure to second-hand smoking
• Medications antibiotics, NSAIDs, or blood pressure medicines

Diagnosis

The doctors may perform several examinations to assess your lung health capacity and point out triggers for bronchial spasm diagnosis:

• Physical exam - Healthcare providers may ask about your current health and related medical history. They may use a stethoscope to identify wheezing and other symptoms
• Chest X-rays
• CT scans
• Lung volume assessment
• Pulse oximetry - This device measures the amount of oxygen in your blood by placing it on your finger or ear
• Spirometry. This test helps to measure the force of air by  breathing in and out of a given tube
• Lung diffusion capacity - This test will determine how well oxygen is diffused between your lungs and the circulatory blood
• Arterial blood gas tests - This determines the blood pH and the amounts of oxygen and carbon dioxide present in your blood
• Eucapnic voluntary hyperventilation - Doctors may conduct this breathing test to check for exercise-induced bronchospasm

How does it feel having bronchospasm

Bronchospasm can be really uncomfortable. You may feel as if you aren't getting enough air, making it difficult to take deep breaths. People may start to wheeze while exhaling air, which is typically followed by a cough. These symptoms cause irritation and inflammation that may induce further mucus production, manifesting in narrowed airways. If bronchospasm progresses, people may start to experience tightness in the chest and back, shortness of breath, and sometimes fever symptoms develop as well.

Is bronchospasm common?

Bronchospasm is quite common among the general population. However, they are found to be more evident in adults over 65 years of age and in younger children since they have unique lung mechanics in comparison to young adults and middle aged individuals. As a result, they are more susceptible to bronchial spasm symptoms.³

Bronchospasm is usually associated with different respiratory illnesses such as COPD (chronic bronchitis), asthma, and lung infections.

What to do when you have bronchospasm?

If you have already been diagnosed with bronchospasm, then your doctor may have prescribed you a short-acting bronchodilator. However, if you are experiencing it for the very first time, then it is advised to get treatment from nearby emergency centers.

Being prone to bronchospasm can be terrifying, but it is manageable to ease the condition: 

• Stay hydrated it will help to loosen the mucus
• Warm up before exercising
• Avoid smoking or vaping
• Avoid exposure to triggers like pollen, dust, or chemicals 
• List down your allergies to limit the triggering reaction

Treating bronchospasm

Healthcare practitioners may advise treatment options depending on the cause and severity of the bronchospasms: 

• Bronchodilators: They help you to breathe easier by expanding your airways. Short-acting bronchodilators, also called rescue inhalers (albuterol and levalbuterol) offer quick relief from the symptoms. Long-acting bronchodilators offer a way to reduce bronchospasm risk in the future. Except for formoterol, most long-acting inhalers (vilanterol, salmeterol) take time to exert their effects
• Steroids - help to reduce airway inflammation
• Anticholinergics - They prevent the narrowing of airways, making it easier to breathe. They may also help to reduce mucus production
• In the case of exercise-induced bronchospasm, doctors may prescribe regular inhaler usage before exercising, mast cell stabilisers, or anti-inflammatory medications

Complications

Serious bronchospasm may reduce your physical abilities. Moreover, they may deprive you of your oxygen supply. Most of the complications happen due to underlying respiratory issues that are poorly controlled or that may not be responding to the treatment.

On rare occasions, some patients may suffer respiratory distress as an adverse effect of using reliever inhalers. This condition is known as paradoxical bronchospasm.

As paradoxical bronchospasm may become life-threatening, it is recommended to consult your doctor immediately to manage the outcomes.

When to consult a doctor

If you observe any of the symptoms interfering with your routine activities, contact and reach out to your nearest emergency unit. 

• Unable to catch your breath, along with chest pain
• Chronic cough or finding blood in your mucus
• Feeling dizzy
• Worsen wheezing
• Having a fever
• Irregular heartbeat

Summary

Bronchospasm is an abnormal contraction of smooth muscles present in the bronchial lining. Having an episode of bronchospasm can be a frightening experience. Fortunately, it can be managed with the appropriate treatment options. It is advised to speak with your healthcare professional if you are prone to bronchospasms or have a history of asthma, COPD, bronchitis, or other respiratory disorders. With your doctor's help, you can design an effective treatment plan that will aid in reducing bronchospasm symptoms and preserve a good quality of healthy life.