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How To Distinguish Bronchitis From Asthma?

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Posted on Wed, 12 Feb 2014
Question: Dear doctor, How can I distinguish bronchitis from asthma? Was diagnosed with pleurisy three months ago which I thought to have conquered...but 10 days ago I developed a painful dry irritating cough which prevents me from sleeping. No mucus though, only white phlegm. I'm 43, female, German, never smoked and I'm scared I develop asthma living in New Zealand. I'm currently on melatonin, 5 htp and lorazepam for sleeping problems. I panicked and took half a tablet of roxithromycin an hour ago which I did not use during the weeks of having pleuricy. Many greetings and thanks in advance from Dana
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Answered by Dr. Sudhir (40 minutes later)
Brief Answer: Investigations can help you distinguish. Detailed Answer: Hello, Investigations like chest xray, pulmonary function test and if needed CT scan help you distinguish between acute bronchitis and asthma. But other approach would be to get evaluated by your doctor and take a course of antibiotics.If your symptoms resolve without recurrence that means it was acute bronchitis. If symptoms persist then get investigations done. Roxithromycin may prove helpful but do consult doctor before starting medications.Also check expiry of the tablet you have taken. Hope this helps.Please ask if there are doubts.Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Sudhir (16 hours later)
Dear Dr XXXXXXX I was in hospital last night because breathing got so difficult. They did blood, X-ray and breathing test and could not decide if early stage asthma or viral cough. Everything was ok which frightens me even more. What can I do or take if such an attack happens again even though they say it is most likely no asthma? They did not give me an inhaler. Any alternative remedies like collodial silver? What else causes the evening cough and how long can a viral cough last? Weeks? Months? I feel pressure on the chest and wheezing but they could not hear or see anything. How long can I safely take lorazepam without getting addicted and when does 5htp start to work properly? I'm on 1 mg lorazepam and 120 mg 5 htp. Kind regards
doctor
Answered by Dr. Sudhir (5 hours later)
Brief Answer: Let me answer your queries. Detailed Answer: 1.To handle such attacks in future ask your doctor for bronchodilators.This can help till you get medical care. 2.Bronchospasm or bronchial blockage due to any reason can cause such cough particularly when you are lying down. 3.Viral cough generally doesn't last more than few weeks.In most patient it resolves in less than 10 days. 4.Since they were not able to hear wheezing,I would suggest to see dedicated chest physician. 4.Lorazepam - I would say use it only for two weeks or so.Beyond that decide as per your doctors guidance and use it if at all symptoms justify. Hope this answers your question.Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Sudhir (41 hours later)
Dear Dr, Have you used with success colloidal silver? I might have to change doctors as he tells me just to relax which is not easy if a cough brings on breathing difficulties and pain breathing.... What can you generally do to ease violent viral cough? There is something here they call 100 day cough, they might mean whooping cough which is epidemic here right now. I wait for the results but doubt it. Is here a safe alternative to Lorazepam like 5 htp?? Kind regards
doctor
Answered by Dr. Sudhir (5 hours later)
Brief Answer: Thanks for follow up. Detailed Answer: Hello, I personally have not been using silver colloid with my patients. Coughing is due to bronchial wall irritation leading to bronchospasm , so use of bronchodilator can help reduce coughing bouts. Antihistaminics can also help reduce cough bouts. Steam inhalation can help in removing secretions and provide soothing effect to reduce cough further. No side effect free alternatives to lorazepam are there.So one has to use them justifiably. Do antihistaminics make you feel sleepy, if that's the case then you can drop lorazepam. Hope this helps.Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Sudhir

Internal Medicine Specialist

Practicing since :2000

Answered : 1415 Questions

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How To Distinguish Bronchitis From Asthma?

Brief Answer: Investigations can help you distinguish. Detailed Answer: Hello, Investigations like chest xray, pulmonary function test and if needed CT scan help you distinguish between acute bronchitis and asthma. But other approach would be to get evaluated by your doctor and take a course of antibiotics.If your symptoms resolve without recurrence that means it was acute bronchitis. If symptoms persist then get investigations done. Roxithromycin may prove helpful but do consult doctor before starting medications.Also check expiry of the tablet you have taken. Hope this helps.Please ask if there are doubts.Regards.