Is it Asthma or Allergies?


Feeling like you can’t breathe? Have the telltale signs of wheezing? Is it asthma, allergies or a bout of bronchitis, and how can you tell the difference?

The symptoms of all three are similar, making a self-diagnosis difficult. What’s more, when it comes to treatment, whether you have asthma, allergies or bronchitis is pretty much irrelevant, said Dr. Anna B. Fishbein, a board certified allergist and immunologist and assistant professor of Pediatrics at Northwestern University Feinberg School of Medicine. Fishbein also leads the asthma program at Chicago’s La Rabida Children’s Hospital.


“The treatment of bronchitis flare, asthma flare or allergic flare in the lungs is similar,” she said.


The term “bronchitis” means inflammation of airways, Fishbein said, and it’s difficult to remove tissue from a person’s lungs to test it for inflammation.So, like asthma, it’s initially a clinical diagnosis and treated the same way.

Doctors use lung-function testing and allergy tests to help distinguish between the three conditions.


The National Heart, Lung and Blood Institute (NHLBI) defines asthma as a chronic lung disease that inflames and narrows the airways. Asthma causes recurring periods of wheezing, chest tightness, shortness of breath and coughing. The coughing often occurs at night or early in the morning.


When folks have multiple bronchitis flares, it’s really just the same thing as asthma, Fishbein said.

Wheezing is also a symptom of what’s known as allergic asthma. A person may be allergic to something that sets off wheezing and/or coughing, Fishbein said. “Every once in a while someone will not have asthma and have very isolated allergic reactions to things, mostly seen with pets like cats or dogs. They will only wheeze in that scenario but never other times.”


According to the American Academy of Allergy, Asthma and Immunology, half of the 20 million Americans who have asthma have the allergic type of asthma, in which something specific sets off their attack.


Bronchitis, meanwhile, mostly occurs as the result of an infection. However, adult smokers who cough a lot are said to have chronic bronchitis. “Again, this is semantics, and one physician might call something bronchitis that another calls asthma,” Fishbein said.


Patients likely would need a methacholine challenge to discern whether they have asthma, said Fishbein. Physicians can administer the methacholine challenge test (MCT), which is widely used to evaluate for airway hyperresponsiveness, a hallmark sign of asthma.


Regardless of the diagnosis or the cause of the symptoms, patients with any difficulty breathing, coughing, wheezing or chest tightness should see their primary care doctor for an evaluation. If their doctor suspects an allergic cause, patients may be referred to an allergist. If at any time breathing becomes extremely difficult, patients should head straight to the emergency room.

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