Getting a new bronchial asthma diagnosis can be worrisome. You can learn more about your bronchial asthma, acute exacerbation and how to find bronchial asthma relief with the right treatments and exercises. 

Understanding Your Bronchial Asthma Diagnosis

A bronchial asthma diagnosis often comes with a lot of questions. Learning more about your illness and what it means for your life can help you live as normally as possible while properly treating your condition. Start from the very beginning by understanding your diagnosis. 

If you have recently received a bronchial asthma diagnosis, you might first wonder, “Is bronchial asthma contagious?” The good news is that bronchial asthma is not contagious. However, this chronic inflammatory disease and obstructive respiratory disease does not yet have a cure. It does, however, have many possible treatments. Before looking at treatments, though, it is helpful to learn more about the disease. 

If you were recently diagnosed with bronchial asthma, you may have seen the diagnosis code “bronchial asthma ICD-10” on your medical records and wondered what that means. The bronchial asthma ICD-10 code is used by medical professionals to indicate unspecified asthma with acute exacerbation and is a medical classification listed by the World Health Organization (WHO) under diseases of the respiratory system.[1]  While that may explain the bronchial asthma definition in terms of medical codes, you may still be thinking, “What is the bronchial asthma definition in everyday terms?” Bronchial asthma is also known as asthma, but the bronchial asthma definition refers to bronchial hyperreactivity and variable airway obstruction within the chronic inflammatory disease of the airways.[2] Bronchial asthma is characterized by this bronchial hyperreactivity and obstruction, along with excess mucus secretion and airway thickening, or remodeling, over time, all of which lead to the progressive loss of lung function.[3]  Also characterized by episodes of acute shortness of breath, bronchial asthma in acute exacerbation often occurs at night or in the early morning hours.[2]
While that provides the most basic information, in order to best understand the definition, you have to understand bronchial asthma pathophysiology, or the disordered physiological processes, associated with bronchial asthma.

Bronchial Asthma Pathophysiology and Bronchial Asthma Symptoms

Studying bronchial asthma pathophysiology can help you better understand your diagnosis and your bronchial asthma signs. In bronchial asthma, airway obstruction is primarily caused by the following problems in the airways:[2]

• Contraction of airway smooth muscle
• Inflammation of the airway walls
• Mucus clogging the airway
• Remodeling of the airways

Bronchial asthma is usually associated with chest tightness, cough and wheezing like all forms of asthma, but bronchial asthma symptoms also include acute bronchoconstriction due to constrictor hyperresponsiveness in airway smooth muscle (ASM).[4] Airway smooth muscle contributes to a bronchial asthma attack in a number of ways, including causing airflow obstruction via contraction of the airway, which ultimately causes the shortness of breath and wheezing you associate with asthma. However, ASM also resists relaxation during a bronchial asthma attack, making it difficult to properly take deep breaths and achieve the stretching of the airways that those without asthma can.[4] Additionally, people with bronchial asthma typically have increased ASM mass, or inflammation and thickening of the airway walls known as remodeling, as well as excess mucus in the airways, which can be exacerbated by bronchoconstriction.[4] This creates an unfortunate cycle that makes bronchial asthma symptoms worse. 

Bronchial asthma symptoms may come and go, depending on exposure to symptom triggers. It may involve a sudden onset, often at night or in the early morning.[2] Symptoms are likely to vary and can include:

• Chest pressure and tightness
• Cough
• Shortness of breath
• Wheezing

All of these symptoms, but most notably shortness of breath, are most severe during acute exacerbations, the hallmark symptom of bronchial asthma.

Risk Factors for Developing Bronchial Asthma

When it comes to bronchial asthma causes, there are several determining factors that come into play. Studies have found that the major risk factor for developing bronchial asthma is allergies to animals or other allergens, followed by a family history of asthma and exposure to irritants like tobacco smoke.[5][6] Studies show other risk factors may include:[5][6][7]

• Hypersensitivity to NSAIDs 
• Premature birth or low birth weight
• Viral respiratory infections early in life
• Lung function abnormalities early in life
• Occupational exposure to irritants
• Low socioeconomic status
• Male gender

While it’s not possible to say that all these factors are certain to be bronchial asthma causes every time, they could contribute to the development of bronchial asthma, especially in children. As such, children and pregnant women should not be exposed to irritants or conditions which could increase the chance that bronchial asthma develops. 

Bronchial Asthma Types 

What is bronchial asthma vs. asthma? Bronchial asthma is often used interchangeably with the broad term asthma, though it refers to asthma that involves acute bronchoconstriction and hyperreactivity. You may hear about different bronchial asthma types. Some types with extrinsic causes and some with intrinsic causes include allergic asthma, exercise-induced asthma, aspirin-sensitive asthma or adult or late-onset asthma.[8][9] Each of these is a phenotype of bronchial asthma with acute exacerbation, though the causes of exacerbation with each phenotype may differ.[3] Whether bronchial asthma is associated with other comorbidities, triggered by environmental factors or due to a genetic predisposition, your doctor will help determine your bronchial asthma type.[3] 

When it comes to bronchial asthma vs. cardiac asthma, however, these are very different conditions. Cardiac asthma is not asthma at all, but rather a coughing and wheezing caused by left heart failure.[10] While bronchial asthma typically requires treatment and can be serious, cardiac asthma typically indicates a medical emergency due to fluid building up in your lungs.[10] Though there is no similarity between bronchial asthma vs. cardiac asthma when it comes to the cause of the symptoms, they may feel similar in the moment. As such, if you feel these symptoms, but have no history of bronchial asthma, seek medical help immediately as it may be a sign of heart failure.

Bronchial Asthma Grading

Your physician will use bronchial asthma grading to determine how severe your asthma is and what kind of treatment will be required. Bronchial asthma grading takes the frequency of your bronchial asthma symptoms and their severity into account. A physical exam and tests will be performed to measure lung function, after which your doctor can decide how to best control your symptoms. Bronchial asthma grading often follows the Global Initiative for Asthma (GINA) disease control classification and is typically measured in the following ways:[11][12][13][14] 

• Intermittent bronchial asthma: Symptoms no more than twice per week, with brief twice monthly acute exacerbations at most. Asymptomatic the rest of the time.
• Mild persistent bronchial asthma: Symptoms occur more than twice per week but less than once per day. Acute exacerbations may affect activity. Exacerbations at night may occur several times per month, but less than once per week. Lung function is 80% or greater. 
• Moderate persistent bronchial asthma: Daily symptoms with acute exacerbations that last for several days. Symptoms may interrupt activity and may interrupt sleep. Exacerbations at night may occur more than once per week. Lung function is between 60-80% without treatment.
• Severe persistent bronchial asthma: Symptoms occur daily and often, requiring limited activity and interrupting sleep. Lung function is less than 60% without treatment. 

While these measurements can be useful for making decisions about managing a patient’s symptoms, it is also important to look at the underlying causes for the bronchial asthma, as well as the efficacy of particular treatments for the patient as the severity of the disease is not static.[12] The American Academy of Pediatrics notes that the severity grades can be somewhat arbitrary, particularly with bronchial asthma in children, because asthma can change so much over time.[13] As such, doctors can use bronchial asthma grading as tool, but it should not be the only measurement by which a patient’s treatment is decided.[12] 

Bronchial Asthma Treatment Options 

When it comes to bronchial asthma treatment, your treatment will depend on your age and the severity of your disease, as determined by your doctor. Recently, the National Asthma Education and Prevention Program updated its treatment recommendations and has, therefore, released the 2020 Asthma Guideline Update with new evidence-based recommendations for bronchial asthma treatment.[15][16] Bronchial asthma treatment is separated into bronchial asthma medication treatments and other recommendations for the management of symptoms. Bronchial asthma treatment can include:[17]

• Long-term asthma control medications: These include inhaled corticosteroids, leukotriene modifiers, combination inhalers containing long-acting bronchodilators and corticosteroids or a bronchial asthma medicine called Theophylline that relaxes the muscles surrounding the airways.
• Quick relief medications: These rescue medications include beta agonist bronchodilators taken via bronchial asthma inhaler or nebulizer, anticholinergic agent bronchodilators or oral or intravenous corticosteroids to reduce airway inflammation.
• Allergy medications: These include a daily allergy medication or allergy shots to reduce your immune system’s reaction to specific allergens. 

The latest recommendations from the National Asthma Education and Prevention Program focused on the frequency of use of certain bronchial asthma medicine and the ages to which it is administered, as well integrating new strategies for diagnosis and symptom prevention. The new recommendations are as follows:[15][16]

• Intermittent inhaled corticosteroids: New recommendations are given for frequency of use determined based on the patient’s age, bronchial asthma severity and whether a bronchodilator inhaler for bronchial asthma is used in conjunction with the corticosteroid.
• Long-acting muscarinic antagonists (LAMA): While long-acting bronchodilators are still preferred for most patients, a LAMA can be used in conjunction with inhaled corticosteroids if long-acting bronchodilators cannot be used or if the long-acting bronchodilator and inhaled corticosteroid are not able to control the asthma.
• Indoor allergen reduction: Only for people who react to indoor allergens, the use of multiple allergen reduction strategies— including air purifiers, HEPA vacuum filters and pillow and mattress covers to reduce dust mites—are all recommended in tandem for efficacy. Pest management is also recommended for patients who are allergic to and exposed to pests.
• Immunotherapy: Allergy shots are recommended for people with allergic asthma who experience worsening symptoms after exposure to allergens. Sublingual therapy is not recommended for treating allergic asthma.
• Fractional exhaled nitric oxide (FeNO) testing: This test measures the amount of nitric oxide, produced as a result of inflammation, in your exhaled breath. It is recommended that people aged 5 and older receive FeNO testing when diagnosis or treatment is uncertain, but it should not be used alone to treat or assess severity of the disease.
• Bronchial thermoplasty: This medical procedure treats severe and persistent asthma by reducing the smooth muscle around the airways with heat, but it is only recommended for a small population willing to accept the moderate risks and uncertain outcomes associated with this therapy.

As always, the right course of bronchial asthma treatment for you will be determined by your doctor based on the cause of your disease, the severity of your disease, your age and your overall health. 

Living with Bronchial Asthma

Bronchial asthma affects your life. With successful treatment and mitigating strategies, you can continue to participate in most activities. Alternative strategies may also offer bronchial asthma relief. Talk to your doctor about what might help you, including practicing yoga for bronchial asthma, incorporating honey and celery seed into your diet or simply reducing the allergen exposure in your home.[18][19] 
Learn as much as you can about your disease. Then, work closely with your doctor to find the right bronchial asthma treatment for you to take control of your bronchial asthma.

Sources

[1] “ICD-10-CM Code for Unspecified Asthma with (Acute) Exacerbation J45.901.” Codify by AAPC, American Academy of Professional Coders , Accessed 21 Dec. 2020, www.aapc.com/codes/icd-10-codes/J45.901. 

[2] Ukena, Dieter, et al. “Bronchial Asthma: Diagnosis and Long-Term Treatment in Adults.” Deutsches Arzteblatt International, Deutscher Arzte Verlag, May 2008, www.ncbi.nlm.nih.gov/pmc/articles/PMC2696883/. 

[3] Heck, Sebastian, et al. “Pharmacological Therapy of Bronchial Asthma: The Role of Biologicals.” International Archives of Allergy and Immunology, Karger Publishers, 20 Feb. 2016, www.karger.com/Article/FullText/443930. 

[4] Doeing, Diana C., and Julian Solway. “Airway Smooth Muscle in the Pathophysiology and Treatment of Asthma.” Journal of Applied Physiology, American Physiological Society, 1 Apr. 2013, journals.physiology.org/doi/full/10.1152/japplphysiol.00950.2012. 

[5] Van Bever, Hugo PS. “Determinants in Early Life for Asthma Development.” Allergy, Asthma & Clinical Immunology, BioMed Central, 9 Nov. 2009, aacijournal.biomedcentral.com/articles/10.1186/1710-1492-5-6. 

[6] Pelta Fernández, Roberto, et al. “Risk Factors for Asthma Onset Between the Ages of 12 and 40: Results of the FENASMA Study.” Archivos De Bronconeumología (English Edition), Elsevier, 1 Sept. 2011, www.archbronconeumol.org/en-risk-factors-for-asthma-onset-articulo-S1579212911000875. 

[7] Hedlund, U., et al. “Socio-Economic Status Is Related to Incidence of Asthma and Respiratory Symptoms in Adults.” European Respiratory Society, European Respiratory Society, 1 Aug. 2006, erj.ersjournals.com/content/28/2/303. 

[8] “Asthma Is a Disease of Different Phenotypes.” The American Academy of Allergy, Asthma & Immunology, The American Academy of Allergy, Asthma & Immunology, 23 Aug. 2019, www.aaaai.org/conditions-and-treatments/library/asthma-library/asthma-phenotypes. 

[9] “Types of Asthma.” ACAAI , American College of Allergy, Asthma & Immunology, 8 Jan. 2019, acaai.org/asthma/types-asthma. 

[10] “What Causes Cardiac Asthma?” Mayo Clinic, Mayo Foundation for Medical Education and Research, 26 Jan. 2019, www.mayoclinic.org/diseases-conditions/heart-failure/expert-answers/cardiac-asthma/faq-20058447.

[11] Tosca, Maria Angela, et al. “The Measurement of Asthma and Allergic Rhinitis Control in Children and Adolescents.” Children (Basel, Switzerland), MDPI, 7 May 2020, www.ncbi.nlm.nih.gov/pmc/articles/PMC7278597/. 

[12] Bateman, E. D., et al. “Global Strategy for Asthma Management and Prevention: GINA Executive Summary.” European Respiratory Society, European Respiratory Society, 1 Jan. 2008, erj.ersjournals.com/content/31/1/143. 

[13] “Mild, Moderate, Severe Asthma: What Do Grades Mean?” HealthyChildren.org, American Academy of Pediatrics, 21 Nov. 2015, www.healthychildren.org/English/health-issues/conditions/allergies-asthma/Pages/Mild-Moderate-Severe-Asthma-What-Do-Grades-Mean.aspx?fbclid=IwAR2xQQFRMFg0qXk_habYXveXv8MMLv5J1jclot9SpHgYOlZPPxd7EFJ7xnY. 

[14] Colice, Gene L. “Categorizing Asthma Severity: an Overview of National Guidelines.” Clinical Medicine & Research, Marshfield Clinic Research Foundation, Aug. 2004, www.ncbi.nlm.nih.gov/pmc/articles/PMC1069088/. 

[15] Cloutier, Michelle M., et al. “2020 Asthma Guideline Update From the National Asthma Education and Prevention Program.” JAMA, JAMA Network, 8 Dec. 2020, jamanetwork.com/journals/jama/fullarticle/2773482. 

[16] “2020 Focused Updates to the Asthma Management Guidelines.” National Heart Lung and Blood Institute, U.S. Department of Health and Human Services, Updated 22 Dec. 2020, www.nhlbi.nih.gov/health-topics/asthma-management-guidelines-2020-updates. 

[17] “Asthma.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Aug. 2020, www.mayoclinic.org/diseases-conditions/asthma/diagnosis-treatment/drc-20369660. 

[18] Karmakar, Saurabh, and Shilpi Karmakar. “The Role of Yoga in Bronchial Asthma.” J Complement Med Alt Healthcare. , Research Gate, 22 Aug. 2018, www.researchgate.net/publication/330166094_The_Role_of_Yoga_in_Bronchial_Asthma. 
[19] Abbas, Alzhraa Salah, et al. “Honey in Bronchial Asthma: From Folk Tales to Scientific Facts.” Journal of Medicinal Food, Mary Ann Liebert, Inc., Publishers, 7 June 2019, www.liebertpub.com/doi/full/10.1089/jmf.2018.4303.