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Spastic bronchitis

Spastic bronchitis: description

In spastic bronchitis - as in normal acute bronchitis - the mucous membrane of the bronchial tubes is inflamed and produces more mucus. The bronchi are the heavily branched "channels" that connect the windpipe with the alveoli. In addition, in spastic bronchitis, the inflamed bronchi are narrowed. That is why she is also "obstructive bronchitis"(Obstruction = closure, narrowing) called.

On the one hand, the narrowing occurs because the inflamed mucous membrane is swollen. On the other hand, the muscles of the airways cramp. This is where the name "spastic" (= convulsive) bronchitis comes from.

Baby bronchi are very tender and not yet fully developed. They are therefore particularly prone to spastic bronchitis. The same goes for toddlers. Spastic bronchitis in adults, on the other hand, is rather rare. That is why one often speaks of Baby bronchitis or Infant bronchitis.

Toddlers and babies with spastic bronchitis whistle or wheeze when they exhale and often find it difficult to breathe - up to real difficulty breathing. Because of these asthma-like symptoms, it is sometimes called spastic bronchitis "asthmatic" bronchitis (also asthmatiform or asthamoid bronchitis). However, this designation is incorrect.

Spastic bronchitis: symptoms

Because of the narrowed, inflamed bronchi, that's Difficulty breathing, especially the exhalation. The patients are short of breath or have difficulty breathing. Also, when you exhale Breath sounds heard, such as a rattle, whistle or hum. There is also a convulsive cough. Intense coughing in the morning is particularly characteristic. This is because a lot of mucus has built up in the bronchi overnight. It triggers a violent urge to cough and has to be coughed up.

The coughed up mucus is mostly whitish, rarely bloody. If it turns yellowish-green, this often indicates that bacteria have also spread to the inflamed mucous membrane (secondary bacterial infection).

The problems with breathing and the many coughs are very exhausting. Therefore, those affected are quickly exhausted. Breathlessness can be frightening for both the patient and their parents.

Spastic bronchitis (like normal acute bronchitis) is often caused by Cold symptoms or flu-like symptoms accompanied. These are, for example, fever, sore throat, headache and body aches.

What to do in case of dangerous shortness of breath?

If the spastic bronchitis puts children in a state of dangerous shortness of breath, you should alert the emergency services (Tel. 112). Warning signs include bluish discoloration of the lips, nails, and skin. Movement of the nostrils (nostrils) and rapid breathing can also indicate shortness of breath.

Spastic bronchitis or asthma?

Symptoms of spastic bronchitis can be very similar to those of bronchial asthma. Basically, in the case of bronchitis, coughing tends to improve the condition. On the other hand, coughing can signal worsening asthma. In asthma, the cough is usually dry. However, it is often difficult to differentiate between spastic bronchitis and asthma, especially in small children. As a rule, the spastic bronchitis should have improved significantly after one to two weeks.

Spastic bronchitis: causes and risk factors

Spastic bronchitis (like almost all forms of acute bronchitis) is caused by viruses. These are mainly RS (respiratory syncytial), parainfluenza, adeno and rhinoviruses. The pathogens are easily transmitted, for example when you cough, sneeze or touch. Most of the time, however, they only cause a mild cold - without acute or spastic bronchitis.

Risk factors

Especially with existing ones Lung disease or allergies Acute bronchitis often results in spastic bronchitis. Babies and toddlers are particularly susceptible to this.

Another risk factor is the so-called "bronchial hyperresponsiveness". In affected people, the bronchial mucous membrane is particularly sensitive to infections and irritation. This hypersensitivity leads to the bronchial tubes constricting faster and their mucous membrane swelling.

Also Premature birth as well as a very early contact with viruses and pollutants (possibly already during pregnancy) are considered risk factors. This can be seen, for example, in mothers who smoke near their children or during pregnancy. This increases the children's rate for spastic bronchitis or other respiratory ailments.

Is Spastic Bronchitis Contagious?

Yes, spastic bronchitis is contagious. The triggers - viruses - can be easily transferred from patients to healthy people.

Spastic bronchitis: examinations and diagnosis

The family doctor or pediatrician is the first point of contact if you suspect spastic bronchitis. Because bronchitis diseases are generally very common, he has a lot of experience with them. This enables him to assess whether spastic bronchitis is actually present and how severe it is. He then decides on suitable therapeutic measures for spastic bronchitis.

Pediatricians and general practitioners have also usually known the little patients for a long time. You can therefore easily place an acute illness in the patient's individual medical history. Often they already know, for example, whether a child generally tends to have a high fever or a severe course of infections.

The doctor will first come to the Conversation (anamnesis) Obtain all important information that will help him diagnose and assess the severity of spastic bronchitis, such as asking:

  • Do you or your child suffer from infections (of the respiratory tract) more often?
  • Are there any known previous respiratory diseases?
  • What are the exact symptoms and how long have they been there?
  • Can you describe the cough in more detail (e.g. seizures, barking, in the morning, with expectoration of mucus, etc.)
  • Does it get breathless?

This is followed by one physical examination. The doctor will do this Listen to the lungs. Typical of a spastic bronchitis are Breath sounds. A whistling sound that occurs primarily when you exhale is called a wheezing. It indicates that the airway is blocked. Humming breathing sounds are an indication that there is increased mucus in the airways.

Also, the doctor will do the Tap your lungs. He can draw conclusions about the state of the lungs from the knocking sound. With a normal air-filled lung it sounds like knocking on a drum. In contrast, if there are pronounced sources of inflammation, the knocking sound is muffled.

In addition, the doctor palpates the (neck) lymph nodes and takes a look into the mouth and throat area.

In the case of longer and complicated disease courses, a Chest x-ray (X-ray chest) made. For example, the doctor can tell whether the inflammation is limited to the bronchial tubes or whether the spastic bronchitis threatens to develop into pneumonia. In addition, the X-ray image provides indirect information about obstructions in the airways (for example pulmonary emphysema).

A Blood test is not absolutely necessary in the case of spastic bronchitis for the first time. If inflammatory parameters such as the number of white blood cells or CRP are increased, this is only a general indication of inflammation in the body.

Exclusion of other causes

In children with suspected spastic bronchitis, the doctor must always check whether the symptoms are not caused by one swallowed foreign body that has got stuck in the bronchi. Especially if the conspicuous noises can only be heard from one side when listening to the lungs, the airways could be blocked by a foreign body.

If someone has spastic bronchitis frequently, further examinations are advisable. This includes, for example, allergy testing and an examination of respiratory performance. In addition, bronchial asthma must be ruled out.

Read more about the examinations

Find out here which examinations can be useful for this disease:

Spastic bronchitis: treatment

Spastic bronchitis is generally treated in the same way as other acute bronchitis. Patients should be save or if you have a fever bed rest adhere to. The Upper body slightly raised lie. This makes it easier to breathe than if you lie completely flat.

One is also important adequate hydration (Tea, broth etc.). If a child is very anxious or restless because of breathing difficulties, parents should try to calm them down. Inner restlessness can increase the shortness of breath.

In addition, a fresh and pollutant-free air be respected. The ambient air should be warm (but not hot) and humid. For example, you can ventilate the room regularly or place a damp cloth on the heater. The patient should also be kept away from tobacco smoke. It can dangerously exacerbate spastic bronchitis.

Caution: If you rub the chest with essential oils or ointments in spastic bronchitis, this can additionally irritate the mucous membrane of the bronchial tubes. The breathing problems and coughing fits can get worse. In addition, many essential oils (such as eucalyptus oil) are generally not recommended for young children.

Cough suppressants are rarely advisable

Medicines that dampen the urge to cough (cough suppressants or cough stoppers) should generally only be used when the cough is not productive (hardly any secretion in the bronchial tubes) and it interferes with night sleep. Coughing up is very important in bronchitis diseases: it clears the airways of mucus, pathogens and other pollutants.


The spasmodic narrowed airways in spastic bronchitis can be removed with the help of so-called Sympathomimetics (β2 receptor agonists) such as salbutamol relax. The active ingredients ensure that the airways expand. Mostly they are administered as inhalation or spray. In this form, they get directly to their place of action (airways). There are special inhalation devices for children that make it easier to inhale the vaporized active ingredients.

Note: If the constriction of the bronchi is mainly due to swelling of the mucous membrane, treatment with sympathomimetics is usually of little use.

Spastic (obstructive) bronchitis may also be treated with a so-called anticholinergic (such as ipratropium). This group of active ingredients also has an antispasmodic effect on the muscles of the bronchi. Here, too, it is used by inhalation.

Antibiotics and cortisone

Spastic bronchitis is caused by viruses. Bacteria can also spread on the damaged mucous membrane of the bronchi. The patient's condition may subsequently worsen. Then the doctor will Antibiotics prescribe. They fight the bacterial infection, but do not work against the viruses.

If the spastic bronchitis takes a severe, protracted course, a short-term treatment can sometimes also be used cortisone be useful. It makes the mucous membrane of the bronchi swell. In addition to cortisone tablets, there are also other dosage forms such as suppositories or juice, especially for spastic bronchitis in children.

Further measures

Sometimes spastic bronchitis needs hospital treatment. This is especially true with babies. The required medication and fluids can be given to the little patient by infusion. In addition, the oxygen supply is continuously monitored. If necessary, the child is given additional oxygen.

Physiotherapy can be particularly helpful in the case of a prolonged course of the disease. With suitable techniques, coughing up and breathing can be additionally supported. For example, the therapist may gently tap the patient's chest.

Attention: The administration of expectorants (cough removers) for spastic bronchitis is controversial.

Read more about the therapies

Read more about therapies that can help here:

Spastic bronchitis: course and prognosis

Many parents are worried that their child will develop asthma after spastic bronchitis. But that doesn't happen very often: only about 30 percent of children who had spastic bronchitis as babies later develop bronchial asthma. Children who are already known to have asthma, neurodermatitis or other allergic diseases in the family are particularly at risk. You should pay particular attention to them that they are not exposed to tobacco smoke (passive smoking). In addition, the air in the living area should be free of pollutants (e.g. no mold infestation) and not too dry.

In most cases it heals spastic bronchitis but without complications or consequences.

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