Brief overview
- Symptoms: Difficulty breathing, shortness of breath, breathing noises, spasmodic cough, possibly shortness of breath, flu-like symptoms such as fever, sore throat, headache and aching limbs
- Treatment: Non-medication through rest, bed rest, sufficient fluids (drinking); medication with antispasmodics (sympathomimetics), in severe cases possibly cortisone or oxygen in case of shortness of breath, antibiotics in case of additional bacterial infection
- Causes and risk factors: Mostly viruses; existing respiratory diseases, allergies, hypersensitivity of the mucous membrane in the bronchi, obesity in childhood and early exposure to harmful substances such as tobacco smoke or viruses and premature birth increase the risk of the disease
- Examinations and diagnosis: medical history, physical examination with listening to the lungs and palpation of the chest, palpation of the lymph nodes in the neck, chest X-ray if necessary, blood test, allergy test, lung function test
- Prognosis: Usually completely curable; complications such as bronchial asthma are more common in patients with a history of other diseases or at increased risk
What is spastic bronchitis?
On the one hand, the constriction is caused by the inflamed mucous membrane becoming swollen. On the other hand, the muscles of the airways spasm. This is where the name “spastic” (= spasmodic) bronchitis comes from.
Baby bronchi are very delicate and not yet fully mature. They are therefore particularly susceptible to spastic bronchitis. The same applies to small children. Spastic bronchitis in adults, on the other hand, is rather rare. This is why it is often referred to as baby bronchitis or infant bronchitis. Babies and toddlers are most frequently affected – 30 to 50 percent of children up to the age of six have had spastic bronchitis at least once.
Toddlers and babies with spastic bronchitis often find it difficult to breathe – in severe cases, they suffer from shortness of breath. Because of these asthma-like symptoms, doctors sometimes also refer to spastic bronchitis as “asthmatic” bronchitis (also asthmatiform or asthmoid bronchitis). However, this term is not correct.
Typical symptoms of spastic bronchitis
The coughed up mucus is usually whitish, rarely bloody. If it turns yellowish-green, this often indicates that bacteria have also spread on the inflamed mucous membrane (secondary bacterial infection).
The problems with breathing and the frequent coughing are very exhausting. This is why those affected quickly become exhausted. The shortness of breath is sometimes frightening for both the patients themselves and their parents.
Spastic bronchitis (like normal acute bronchitis) is often accompanied by cold or flu-like symptoms. These include fever, sore throat, headache and aching limbs.
Spastic bronchitis or asthma?
The symptoms of spastic bronchitis are sometimes very similar to those of bronchial asthma. In principle, coughing tends to improve the condition in bronchitis. In contrast, coughing in asthma usually means an exacerbation. In asthma, the cough also tends to be dry. However, it is often difficult to differentiate between spastic bronchitis and asthma, especially in young children. As a rule, spastic bronchitis improves significantly after one to two weeks.
What to do in case of dangerous shortness of breath?
How to treat spastic bronchitis?
Doctors generally treat spastic bronchitis in the same way as acute bronchitis. Patients should take it easy or stay in bed if they have a fever. It is advisable to keep the upper body slightly elevated. This makes breathing easier than in a lying position.
It is also important to provide sufficient fluids (tea, broth, etc.).
Reassure your child if it is very anxious or restless due to the difficulty in breathing. Inner restlessness often exacerbates breathing difficulties.
Also make sure that the air is fresh and free of pollutants. Warm and humid ambient air (but not hot) has a positive effect. Regular ventilation or a damp cloth on the radiator are often helpful. Avoid tobacco smoke around the patient. Smoke often exacerbates spastic bronchitis and is therefore dangerous.
If you rub essential oils or ointments on the chest during spastic bronchitis, this may further irritate the mucous membrane of the bronchial tubes. The breathing problems and coughing fits then intensify. In addition, many essential oils (such as eucalyptus oil) are generally not recommended for small children.
Cough suppressants are rarely advisable
Antispasmodics
The spasmodically constricted airways in spastic bronchitis can be relaxed with the help of so-called sympathomimetics (β2 receptor agonists) such as salbutamol. The active ingredients ensure that the airways widen. They can be administered as an inhalation or spray. In this form, they reach their site of action (airways) directly. There are special inhalation devices for children that make it easier to inhale the vaporized active ingredients.
If the constriction of the bronchi is mainly due to swelling of the mucous membrane, treatment with sympathomimetics is usually of little benefit.
In some cases, spastic (obstructive) bronchitis can be treated with an anticholinergic (such as ipratropium). This group of active ingredients also has an antispasmodic effect on the muscles of the bronchi. The active ingredients are inhaled.
Antibiotics and cortisone
Spastic bronchitis is triggered by viruses. However, bacteria sometimes also spread on the affected bronchial mucosa. This carries the risk of the patient’s condition deteriorating as a result. The doctor then usually prescribes antibiotics. They fight the bacterial infection, but are not effective against viruses!
Further measures
Sometimes it is necessary to treat spastic bronchitis in hospital. This is particularly true for babies. The necessary medication and fluids can be administered to the little patient there by infusion. Doctors also constantly monitor the oxygen supply. If necessary, the child receives additional oxygen.
Physiotherapy is sometimes helpful, especially if the illness is prolonged. Suitable techniques can be used to additionally support coughing and breathing. For example, the therapist carefully taps the patient’s chest.
The administration of expectorants (cough suppressants) for spastic bronchitis is controversial.
What causes spastic bronchitis?
Spastic bronchitis (as with almost all forms of acute bronchitis) is caused by viruses. These are mainly RS (respiratory syncytial), parainfluenza, adenoviruses and rhinoviruses. The pathogens are easily transmitted, for example through coughing, sneezing or touching. However, they usually only cause a mild cold – without acute or spastic bronchitis.
Risk factors
Acute bronchitis often turns into spastic bronchitis, especially in the case of existing lung diseases or allergies. Babies and small children are particularly susceptible to this.
Premature birth and very early contact with viruses and harmful substances (possibly even during pregnancy) are also considered risk factors. This can be observed, for example, in mothers or their children who smoke near their children or during pregnancy. This increases the children’s risk of spastic bronchitis or other respiratory diseases.
Overweight and obesity also have a negative effect on the development of the lungs and airway mechanics. This increases the risk of developing spastic bronchitis.
Is spastic bronchitis contagious?
Yes, spastic bronchitis is contagious. The triggers – usually viruses – are easily transmitted from person to person.
Diagnosis: spastic bronchitis
The family doctor or pediatrician is the first point of contact if spastic bronchitis is suspected. Because bronchitis is generally very common, they have a lot of experience with it. They are usually able to assess whether spastic bronchitis is actually present, how severe it is and which therapeutic measures are suitable.
The doctor will first take a medical history to obtain all the important information that will help him to diagnose spastic bronchitis and assess its severity. He asks the following questions, for example:
- Do you or your child suffer from frequent infections (of the respiratory tract)?
- Are you aware of any previous respiratory illnesses?
- What are the exact symptoms and how long have they been present?
- Can you describe the cough in more detail (e.g. intermittent, barking, in the morning, with mucus sputum etc.)?
- Is there shortness of breath?
This is followed by a physical examination. The doctor will listen to the lungs. Breathing noises are typical of spastic bronchitis – a whistling noise that occurs mainly when breathing out is called “wheezing” by doctors. It indicates that the airways are obstructed. Humming breathing noises are an indication that there is more mucus in the airways.
The doctor also taps the lungs. The condition of the lungs is determined from the tapping sound. If the lungs are normally filled with air, the sound is similar to tapping on a drum. However, if there is a pronounced focus of inflammation, the knocking sound is muffled.
The doctor also palpates the (cervical) lymph nodes and takes a look at the mouth and throat.
A blood test is not absolutely necessary for first-time spastic bronchitis. If inflammatory parameters such as the white blood cell count or CRP are elevated, this is only a general indication of inflammation in the body.
Exclusion of other causes
In children with suspected spastic bronchitis, the doctor also always checks whether the symptoms may be caused by a foreign body that has been swallowed and is stuck in the bronchial tubes. In particular, if the abnormal sounds can only be heard on one side when listening to the lungs, the airways may have been blocked by a foreign body.
If someone often has spastic bronchitis, further examinations are advisable. These include, for example, an allergy test and an examination of the respiratory capacity (lung function test). Bronchial asthma should also be ruled out.
How does spastic bronchitis progress?
In most cases, spastic bronchitis heals without complications or consequences within a few weeks if treated early.
However, many parents are worried that their child will develop asthma after spastic bronchitis. This does not happen in the majority of children: around 30 percent of children who had spastic bronchitis as an infant later develop bronchial asthma.
