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Introduction

The term “airflow obstruction” refers to the obstruction or narrowing of the airways that compromise ventilation. An obstruction may partially or totally prevent air from getting into your lungs. It can range from acute to chronic, congenital to acquired, and in many cases, if left untreated, can be fatal.

In a patient with airway obstruction, it is frequently difficult to determine whether the obstruction is caused by asthma or COPD. Airflow obstruction in asthma is common. Some are minor and may go unnoticed, while others are life-threatening situations that necessitate immediate medical attention.

Continue reading this article to learn more about airflow obstruction in asthma or COPD, the distinction between COPD and asthma, what is the most common cause of airway obstruction, and its management.

Also Read: Is Asthma a Disability or Considered A Disability?

Airflow Obstruction in Asthma

Asthma is a chronic disease that impairs airflow. Symptoms include airway swelling, hyperreactivity, and increased mucus production. This can cause coughing, wheezing, shortness of breath, and chest tightness. Many different factors can cause airflow obstruction in asthma, including:

  • Weather changes
  • Allergens
  • Infections
  • Exercise

Airflow Obstruction in COPD

Chronic obstructive pulmonary disease (COPD) causes a persistent decrease in the rate of airflow from the lungs when the person breathes out (exhales), which is known as chronic airflow obstruction. COPD encompasses the diagnoses of chronic obstructive bronchitis and emphysema. Both disorders are common.

  • Chronic bronchitis is defined as a cough that produces sputum for at least three months in two consecutive years. Chronic bronchitis becomes chronic obstructive bronchitis when airflow obstruction occurs.
  • Emphysema is defined as the widespread and irreversible destruction of the alveolar walls (the cells that support the air sacs, or alveoli, that make up the lungs) and enlargement of many of the alveoli.

Learn more about what is the most common cause of airway obstruction, other than COPD or Asthma.

The Distinction between Airflow Obstructions in Asthma & COPD

Airflow obstruction is a feature of both COPD and asthma. Unlike COPD, however, airflow obstruction in asthma is completely reversible in the majority of people, either spontaneously or with treatment.

Chronic asthmatic bronchitis is synonymous with chronic bronchitis. People have wheezing and partially reversible airflow obstruction in addition to a cough that produces sputum. It is more common in smokers with asthma. When the line between chronic obstructive bronchitis and chronic asthmatic bronchitis becomes blurred, the condition is referred to as asthma COPD overlap.

What are the Signs of an Airflow Obstruction in Asthma?

Depending on the severity of the obstruction, symptoms of airway obstruction in asthma can include:

  • Severe coughing 
  • Breathlessness
  • Turning blue
  • Choking
  • Gagging
  • Vomiting
  • Wheezing
  • Losing consciousness

What is the Most Common Cause of Airway Obstruction?

The most common causes of airflow obstruction, other than asthma or COPD are listed below.

Airway Obstruction Caused by the Tongue

In patients who are unconscious or have suffered a spinal cord or other neurological injuries, the most common cause of upper airway obstruction is a relaxed tongue. The tongue may relax into the airway, obstructing it. Other injuries may complicate this phenomenon in some cases. A patient who is unconscious after a blow to the head, for example, may have also suffered upper airway trauma, causing both the tongue and the trauma to block the airway.

Choking/Foreign Body

A foreign body lodged in the airway is the most common cause of airway obstruction in children. Choking can completely or partially obstruct the airway. Common culprits include small toys, round foods like berries and grapes, rocks, pebbles, and other enticing objects. Children under the age of four account for 88% of all airway obstruction deaths.

Swelling

In a matter of seconds, swelling can obstruct the airway. Though infections can cause severe upper airway swelling, anaphylaxis is the most common cause. Anyone who has an allergy can have an anaphylactic reaction, even if they have previously been exposed to the allergen without experiencing such a severe reaction. Food allergies affect more than 32 million Americans, putting millions at risk of swelling-related airway obstructions. Furthermore, the prevalence of food allergies is rising.

Upper airway swelling can also be caused by asthma. Airflow obstruction in asthma is common. Itcan usually be controlled with a rescue inhaler, but severe asthmatic reactions can be fatal. Asthma affects approximately 25 million Americans. Asthma kills approximately 180,000 people worldwide each year, but prompt medical care and diligent airway management have greatly reduced mortality in the United States.

Infection

Infections such as pneumonia, RSV, and even common colds can clog the upper airway. Because of their smaller airways, children are more vulnerable. Upper airway obstructions, even partial ones, are especially dangerous in newborns because they breathe through their noses. Chronic respiratory diseases, such as COPD, increase the risk of infectious upper airway obstructions.

Trauma

Traumatic injuries can obstruct the airway directly, such as when a gunshot or knife wound collapses sections of the airway. Continuous bleeding or vomiting from trauma can also obstruct the airway, making airway management difficult and increasing the risk of aspiration pneumonia. In the latter case, continuous suction via the SALAD technique can clear the airway and reduce the risk of death.

Upper airway obstruction can also result from traumatic brain and spinal cord injuries. If a patient is unable to clear their own airway, suctioning may be required. Brain and spinal cord injuries can impair the brain’s ability to control breathing, coughing, and other important respiratory functions in some cases.

Treatment Options Available to Manage Airflow Obstruction in Asthma

To help you in managing airflow obstruction in asthma your doctor may prescribe medications to help you manage your symptoms. These are some examples:

  • Bronchodilators:  These medications relax the muscles surrounding your airways. The relaxed muscles allow the airways to move. They also facilitate mucus movement through the airways. These medications relieve your symptoms as they occur and are used to treat both intermittent and chronic asthma.
  • Anti-inflammatory medications: These reduce swelling and mucus production in the airways and also facilitate the passage of air into and out of your lungs. Your healthcare provider may prescribe them to you on a daily basis to control or prevent your chronic asthma symptoms.
  • Asthma biologic therapies: These are used for severe asthma when symptoms persist despite proper inhaler therapy.

Asthma medications can be prescribed in a number of different ways. To inhale the medications, you can use a metered-dose inhaler, a nebulizer, or another type of asthma inhaler. Oral medications may be prescribed by your doctor.

Summary

Airway obstruction occurs when you are unable to move air into or out of your lungs. It could be because you inhaled something that is blocking your airway. Or it could be caused by disease, infection, allergic reaction, or trauma. Airway obstructions can completely or partially block your airway. Since it is a chronic inflammatory condition airway obstruction in asthma is common. It can strike anyone at any age, with symptoms ranging from mild to severe.

In most cases, effective treatment can enable asthmatics to lead a full and active life. Your healthcare provider can assist you in determining the best way to manage your asthma. Consult your doctor about how to manage your asthma symptoms.

Dr. Anusia Thourani

Dr. Anusia is a Dentist and currently working as a Recruitment Associate at Revive Research Institute. Her cheerful personality and enthusiasm for her work in this organization make her a great part of our team.

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