What is bronchospasm?

Causes, diagnosis, and treatment of this respiratory condition.


Bronchospasm happens when the bronchial muscles that line the airways in the lungs contract. This results in restriction of the airway, and shortness of breath, as less air reaches the lungs. The feeling has been likened to breething through a bent straw. Bronchospasms are reversible, however.

Many asthmatics suffer from bronchospasms, but it can affect patients with other respiratory conditions. It is most often reported in patients over the age of 65, and in children. Exercise-induced bronchospasms are observed in athletes because strenuous physical activity can lead to a temporary contraction of the bronchial muscle.

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What causes bronchospasm?

Certain underlying medical conditions, medications, allergies and exercise can cause bronchospasms. The most common causes include:


Medical conditions

  • Asthma
  • Chronic obstructive pulmonary disorder
  • Chronic bronchitis
  • Emphysema
  • Viral infections


Environmental causes

  • Smoking
  • Dust and air pollution
  • Chemical fumes (e.g. cleaning products, paints)
  • Cold air/weather



  • Mold
  • Dust mites
  • Pet dander
  • Pollen
  • Foods



  • Anaesthetics
  • Antibiotics
  • Blood pressure medications


Other causes

  • Exercise


The prevalence of exercise-induced bronchospasm is quite high at 5% to 20% of the general population, with a much higher prevalence in asthmatics. Scientists have found that it is particularly common among children (45%) and could be a predictor for asthma development in some kids.


When air is inhaled during exercise, the nose tries to warm up the air, but with increasing exercise duration and exertion, heat is lost, the airway cools down, and this causes our parasympathetic nervous system to contract the muscles lining the airways. This is also why breathing in cold air can be painful.


What are the symptoms of bronchospasm?

The most commonly observed symptoms of bronchospasm include:


  • Difficulty breathing
  • Wheezing
  • Coughing
  • Tightness in the chest


Severe cases of bronchospasm require urgent medical attention. In severe bronchospasm, a patient may not make any wheezing or breath sounds, because their airways are so restricted that there is very little air movement.


How is bronchospasm diagnosed?

Your doctor will usually examine your medical history and ask about asthma and other medical conditions as well as any allergies you may have. There are a variety of breathing tests a healthcare provider can perform to establish if further medical tests are required.


  • Lung function and volume tests. Spirometry is a common test to determine lung function. It measures how much air a patient breathes out into a mouthpiece.  The test determines how well a patient’s lungs are working.
  • Pulse oximetry. People living with asthma or other lung conditions may have less oxygen in their blood. The pulse oximeter is a little device that can be clipped onto a finger to measure oxygen level in blood. 
  • Blood gas test. Another way to measure how much oxygen and carbon dioxide are present in a patient’s blood is to draw a small amount directly from an artery.  
  • Chest x-ray. A chest x-ray is usually ordered to check whether a patient has an infection or respiratory obstruction.
  • CT scan. Computerized tomography (CT or CAT) takes multiple images to create a detailed rendition of the entire lungs.


What are the treatments for bronchospasm?

Treatment of bronchospasm will depend on the severity and the cause.


Patients with exercise-induced bronchospasms without asthma are advised to prevent bronchospasms by reducing their exercise intensity, or restricting exercise to warmer locations. A good physical warm-up before exercise has also been shown to be beneficial in reducing the severity of bronchospasm.


Prevention of bronchospasms is recommended in all cases. Patients should avoid triggers and reduce lung irritation by breathing through their nose when walking in cold weather.


To manage bronchospasms, a healthcare provider can prescribe bronchodilators. The medication is used to relax smooth muscles and widen the airways. Inhaled bronchodilators are recommended as they act faster than tablets or shots.


There are three types of bronchodilators:

  • Beta-2 agonists (including albuterol, formoterol, salmeterol and vilanterol)
  • Anticholinergics (including tiotropium, aclidinium and glycopyrronium)
  • Theophylline


Short-acting bronchodilators are used for fast relief from bronchospasm. They are taken as soon as an attack occurs to provide immediate relief. Some athletes use short-acting bronchodilators before they exercise to prevent bronchospasm. Their action lasts from 2 to 4 hours.


However, if you are using your short-term bronchodilators more than twice a week, it may be a sign of asthma. Speak to a doctor.


Long-acting bronchodilators can be used every day to manage symptoms long term. They are usually prescribed if you suffer from severe or recurring bronchospasms alongside asthma. Typically, they are used once or twice a day.


Common side effects of all types of bronchodilators include:

  • Nausea
  • Rapid heart rate/palpitations
  • Insomnia
  • Shakiness or nervousness
  • Achy muscles


If you experience any uncommon side effects or your condition isn’t improving, seek urgent medical attention.



  1. Benca, J. (2007). Bronchospasm. Complications in Anesthesia, 189–192.
  2. Caggiano, S., Cutrera, R., Di Marco, A., & Turchetta, A. (2017). Exercise-Induced Bronchospasm and Allergy. Frontiers in Pediatrics, 5.
  3. Scott, S. (2008). Exercise-Induced Bronchospasm. ACSM’s Health & Fitness Journal, 12(2), 36–38.
  4. Rees, L. T. (1963). Bronchospasm during anaesthesia. Anaesthesia, 18(1), 103–104.
  5. Aggarwal, B., Mulgirigama, A., & Berend, N. (2018). Exercise-induced bronchoconstriction: prevalence, pathophysiology, patient impact, diagnosis and management. NPJ primary care respiratory medicine, 28(1), 31.
  6. Cazzola, M., Page, C. P., Calzetta, L., & Matera, M. G. (2012). Pharmacology and Therapeutics of Bronchodilators. Pharmacological Reviews, 64(3), 450–504.

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