Bronchial Spasms: Causes, Treatment, and More

Bronchial Spasms: Causes, Treatment, and More

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Guide to Bronchial Spasms

Medically reviewed by Justin Choi, MD on March 22, 2017 — Written by James Roland

What are bronchial spasms?

When you breathe, air travels through your throat and trachea, which is also known as your windpipe. Then it travels into and out of your bronchial tubes. These tubes extend into your lungs and branch into smaller air passages.

Normally, the muscles surrounding your bronchial tubes are thin and smooth, and they allow air to flow easily. If you have a respiratory problem, such as asthma, these muscles can contract and narrow your airway. When that happens, it’s called a bronchial spasm, or a bronchospasm. During a bronchial spasm, breathing becomes more difficult. You may find yourself wheezing as you try to catch your breath.

In many cases, bronchial spasms are treatable or preventable.

What are the symptoms of bronchial spasms?

Bronchial spasms usually come on quickly. They can cause a feeling of tightness in your chest that makes it difficult to catch your breath. Wheezing is one of the most common symptoms of a bronchial spasm. You may also cough a lot when your bronchial tubes are constricted. This wheezing and coughing can make it difficult to get through daily activities and get a good night’s sleep.

Depending on the cause of your bronchial spasms, your bronchial glands may also produce more mucus. This can contribute to your cough and make your airways even narrower.

What causes bronchial spasms?

Bronchial spasms occur when your bronchial tubes become inflamed. This inflammation may be caused by asthma, bronchitis, emphysema, or other serious respiratory problems.

Asthma

Asthma is an inflammatory disease that can affect your lungs. Asthma attacks occur when the lining of your bronchioles swell and the muscles around them get tight.

Allergic asthma is one of the most common forms of asthma. If you have allergy-induced asthma, your bronchial tubes will constrict when you inhale substances that trigger an allergic reaction. These substances are known as allergens. Common allergens include plant pollens, pet dander, and dust.

Nonallergic asthma can be triggered by irritants such as air pollution, cigarette or wood-fire smoke, fumes from household cleaning products, or very cold air. Exercise can also trigger an asthma attack in some people.

Bronchitis, COPD, and emphysema

Bronchitis is another common cause of bronchial spasms. Acute bronchitis can develop as a complication of a respiratory infection or cold. It’s a temporary condition that can typically be treated with medications.

Chronic bronchitis is a long-term problem. It’s one of the conditions that make up chronic obstructive pulmonary disease (COPD). COPD is a group of progressive lung diseases that make it harder for you to breathe.

Emphysema is another disease that falls under the umbrella of COPD. In this condition, the tiny air sacs in your lungs become damaged or destroyed. This impairs their ability to fill with air and deflate properly.

What are the risk factors for bronchial spasms?

You’re at higher risk of developing asthma, a common cause of bronchial spasms, if you have another allergic condition. For example, if you have food allergy or eczema , you’re more likely to develop asthma. You’re also more likely to experience it if you have a close relative with asthma or other allergic conditions.

Heavy smokers are at greater risk of developing asthma and most other lung problems, including acute bronchitis, chronic bronchitis, and emphysema. Inhaling secondhand smoke also increases your risk of these conditions. Frequent exposure to air pollution or chemicals in your home or workplace can also increase your chances of developing them.

Older adults, young children, and anyone whose immune system is impaired face greater chances of developing respiratory infections. These infections can lead to acute bronchitis and bronchial spasms.

How are bronchial spasms diagnosed?

If you’re experiencing bronchial spasms, your doctor will probably ask you about your current symptoms and medical history. They will listen to your chest with a stethoscope for signs of wheezing or other symptoms. They may also conduct other tests to learn what’s causing your bronchial spasms.

For example, your doctor may order a chest X-ray or other imaging tests. This can help them assess your lung health and check for signs of infection or structural abnormalities.

They may conduct a spirometry test. This measures how much air you can inhale and exhale. It also measures how fast you can empty your lungs. All of these actions can be severely limited if your bronchial tubes are inflamed and narrowed.

If they suspect you have allergic asthma, your doctor may refer you to an allergist for allergy testing. This can help them identify any allergens that might trigger your symptoms.

If they suspect you have acute bronchitis, your doctor may collect a sample of your mucus to send to a laboratory for testing. This can help them learn if your symptoms are caused by a bacterial, viral, or fungal infection.

How are bronchial spasms treated?

Your doctor’s recommended treatment plan may vary, depending on the cause of your bronchial spasms. They will likely prescribe an inhaler to help relieve your symptoms. They may also prescribe other treatments or lifestyle changes.

If you have asthma, your doctor will likely prescribe one or more bronchodilators to help open your constricted airways. There are two main types of bronchodilators, both of which are delivered using handheld inhalers. You can use a long-acting inhaler to help prevent symptoms from developing. You can also use a quick-acting version, which is sometimes called a “rescue inhaler.” The quick-acting version can help relieve symptoms that come on suddenly during an asthma attack.

If you have acute bronchitis, your doctor may prescribe inhaled steroids. They can provide quick relief for bronchial spasms. However, they should only be used on a short-term basis. Long-term use of inhaled steroids can cause side effects, such as weaker bones and high blood pressure.

Your doctor may also prescribe other medications to treat the infection that’s causing your acute bronchitis. For example, a bacterial infection will require antibiotics to treat.

If you have chronic bronchitis or emphysema, your doctor will likely prescribe inhalers and antibiotics. They may also recommend oxygen therapy if your symptoms are very serious. In severe cases of COPD, you may be eligible for a lung transplant.

Your doctor may also encourage you to adjust your lifestyle to avoid triggers that make your bronchial spasms worse. For example, they may advise you to stay indoors on days when the air quality outside is bad or when plant-pollen allergens are in season.

What are the potential complications of bronchial spasms?

Bronchial spasms limit your ability to exercise. Over time, this can have far-reaching effects on your fitness and overall health, which depends on your ability to be physically active.

Serious bronchial spasms can also limit the amount of oxygen that you inhale. Your vital organs depend on an adequate supply of oxygen to work properly. If you’re unable to take in enough oxygen, your organs and other tissues may suffer.

If you have bronchial spasms that are getting worse, it may be a sign that the underlying cause is getting worse too or is no longer responding to treatment. For example, it may be a sign that your asthma is poorly controlled.

What is the outlook?

If your bronchial spasms are well-controlled through medications or other treatments, the underlying condition that causes them may have little impact on your quality of life.

If a respiratory infection is causing your bronchospasms, treating the underlying infection should have you breathing easier soon.

If you have chronic bronchitis, emphysema, or another chronic respiratory condition, you will have to take ongoing steps to manage it. But if you work with your doctor to develop an effective treatment plan and follow their advice, you may be able to limit your bronchial spasms and maintain a good quality of life.

Medically reviewed by Justin Choi, MD on March 22, 2017 — Written by James Roland

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Laryngospasm

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Involuntary contraction of the vocal folds restricting inhalation
This article includes a list of references , related reading or external links , but its sources remain unclear because it lacks inline citations . Please help to improve this article by introducing more precise citations. (March 2014) ( Learn how and when to remove this template message )
“Laryngospasms” redirects here. For the parody group, see The Laryngospasms .
Laryngospasm
Classification and external resources
Specialty pulmonology
[ edit on Wikidata ]

Laryngospasm is an uncontrolled/involuntary muscular contraction ( spasm ) of the vocal folds . [1] The condition typically lasts less than 60 seconds, but in some cases can last 20–30 minutes and causes a partial blocking of breathing in, while breathing out remains easier. It may be triggered when the vocal chords or the area of the trachea below the vocal folds detects the entry of water, mucus, blood, or other substance. It is characterized by stridor and/or retractions. [1] [ clarification needed ] Some people suffer from frequent laryngospasms, whether awake or asleep. In an ear, nose, and throat practice, it is typically seen in people who have silent reflux disease . It is also a well known, infrequent, but serious perioperative complication. [2]

It is likely that more than 10% of drownings involve laryngospasm, but the evidence suggests that it is not usually effective at preventing water from entering the trachea. [3]

Contents

  • 1 Signs and symptoms
  • 2 Causes
  • 3 Prevention
  • 4 Treatment
  • 5 References
  • 6 External links

Signs and symptoms[ edit ]

The main symptom is choking and difficulty or inability to breathe or speak, a feeling of suffocation, which may be followed by hypoxia-induced loss of consciousness. [2] As the airway reopens, breathing may cause a high-pitched sound called stridor . The episode seldom lasts over a couple of minutes before breathing is back to normal. [2]

Causes[ edit ]

Various stimuli including asthma, allergies, exercise, stress, and irritants such as smoke, dust, fumes, liquids, and food can trigger laryngospasm. [2] It is common in drowning, both as a direct response to inhalation of water, and as a complication during rescue and resuscitation due to aspiration of vomit.

In some individuals laryngospasm can occur spontaneously or as a result of reflux or impaired swallowing. GERD is a common cause of spontaneous laryngospasm. [2] Treating GERD can lessen the frequency of spasms. The onset of spasms may be caused by a viral infection.[ citation needed ]

It is also a complication associated with anesthesia . The spasm can happen often without any provocation, but tends to occur after tracheal extubation . [1] In children, the condition can be particularly deadly, leading to cardiac arrest within 30–45 seconds, and is a possible cause of death associated with the induction of general anesthesia in the pediatric population. [2] It can sometimes occur during sleep, waking up the sufferer. This usually occurs when the person has gastric acidity and develops re-flux during sleep, where the gastric acid causes irritation which will cause the spasm attack. [2]

It is also a symptom of Hypoparathyroidism [ citation needed ]

Prevention[ edit ]

When laryngospasm is coincident with a cold or flu, it may be helpful for some sufferers to take acid reflux medication to limit the irritants in the area.[ citation needed ] If a cough is present, then treat a wet cough; but limit coughing whenever possible, as it is only likely to trigger a spasm.[ citation needed ] Drink water or tea to keep the area from drying up.[ citation needed ] Saline drops also help to keep the area moist.[ citation needed ] Pseudoephederine may also help to clear any mucus that may cause coughing and thereby triggering more spasms.[ citation needed ]

Treatment[ edit ]

Minor laryngospasm will generally resolve spontaneously in the majority of cases. [1]

Laryngospasm in the operating room is treated by hyperextending the patient’s neck and administering assisted ventilation with 100% oxygen . In more severe cases it may require the administration of an intravenous muscle relaxant , such as Succinylcholine , and reintubation .[ citation needed ]

When gastroesophageal reflux disease (GERD) is the trigger, treatment of GERD can help manage laryngospasm. Proton pump inhibitors such as Dexlansoprazole (Dexilant), Esomeprazole (Nexium), and Lansoprazole (Prevacid) reduce the production of stomach acids, making reflux fluids less irritant. Prokinetic agents reduce the amount of acid available by stimulating movement in the digestive tract. [2]

Spontaneous laryngospasm can be treated by staying calm and breathing slowly, instead of gasping for air. Drinking (tiny sips) of ice water to wash away any irritants that may be the cause of the spasm can also help greatly.[ citation needed ]

Patients who are prone to laryngospasm during illness can take measures to prevent irritation such as antacids to avoid acid reflux, and constantly drinking water or tea keep the area clear of irritants.[ citation needed ]

Additionally, laryngospasms can result from hypocalcemia , causing muscle spasms and/or tetany . Na+ channels remain open even if there is very little increase in the membrane potential . This affects the small muscles of the vocal folds .[ citation needed ]

References[ edit ]

  1. ^ a b c d Gavel, Gil; Walker, Robert W. M. (26 August 2013). “Laryngospasm in anaesthesia”. Continuing Education in Anaesthesia, Critical Care & Pain. 14 (2): 47–51. doi : 10.1093/bjaceaccp/mkt031 .

  2. ^ a b c d e f g h Staff. “Laryngospasm” . Heartburn/GERD Guide. WebMD. Retrieved 8 February 2017.
  3. ^ North, Robert (December 2002). “The pathophysiology of drowning” (PDF). South Pacific Underwater Medicine Society Journal. SPUMS. 32 (4). Retrieved 9 February 2017.

External links[ edit ]

Classification
D
  • ICD – 10 : J38.5
  • ICD – 9-CM : 478.75
  • MeSH : D007826
  • Larson, Philip C., “Laryngospam -The Best Treatment”, Anesthesiology, 11 1998, Vol.89, 1293–1294

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        Calif Med. 1949 Oct; 71(4): 271–273.
        PMCID: PMC1520163
        PMID: 18143482

        LARYNGOSPASM FROM THE ANESTHESIOLOGIST’S VIEWPOINT

        Earl T. Hull, Jr.
        Copyright and License information Disclaimer
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        Abstract

        Laryngeal spasm is a problem constantly confronting the anesthetist. It can be serious and may produce fatal cerebral or cardiac complications. Etiologic agents include primary vagal hypertonicity, anoxemia, and painful stimulation of whatever source.

        Laryngeal spasm must be differentiated from simple obstruction by the tongue or foreign bodies, epiglottic impaction, laryngeal edema, tracheal spasm and collapse, and bronchial spasm.

        Proper checking of the patient before anesthesia and adequate premedication with atropine or scopolamine are preventive measures of great value. Once spasm has developed the etiologic agent should be removed if possible. Other measures include intravenous administration of atropine or curare, tracheal intubation, and tracheotomy.

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