Asthma and Anaphylaxis – Connected But Different


Asthma attacks and anaphylaxis seem very similar, and they are similar. They are also connected, and it is a known fact that someone with asthma is also more likely to have allergies that can cause anaphylaxis. Why these two conditions may be related is not certain, but the similarities are important. The differences are important too, and treatment for one may not work for the other. If you or a child has a food allergy, asthma or both, know the difference between the two and what you need to do in the event of either.

What is Asthma? 

Asthma is a condition that is characterized by constriction in the airways. During an asthma attack the airways swell and narrow so breathing becomes more difficult. An attack may also include coughing, shortness of breath and wheezing. The degree of severity of attacks and frequency vary by individual. In some people, asthma may be triggered by certain conditions such as pollutants or exercise.

While triggers are known, and can include allergens, why some people experience asthma and others don’t isn’t well understood. There are known risk factors including family history of asthma, exposure to secondhand smoke, being overweight and having allergies. While asthma can’t be cured, it can be managed and attacks can be controlled with medication. Many asthma medications are inhaled and used over the long-term to prevent attacks. A quick-relief medication to stop an asthma attack may also be used and include inhaled bronchodilators, drugs that expand the airways.

Asthma Compared to Anaphylaxis

Anaphylaxis and asthma can look and feel very similar. Both cause difficulty breathing that can be both frightening and life-threatening. Anaphylaxis may be accompanied by some additional symptoms that are not often seen with asthma: hives and skin rashes, swelling in the face, stomach discomfort, bloating, diarrhea and vomiting.

Treating Anaphylaxis versus an Asthma Attack

Both conditions should be treated as medical emergencies, but for anaphylaxis the only medicine that will reverse the attack is injected epinephrine. For an asthma attack, a rescue inhaler is the best solution, but epinephrine may also help. Epinephrine is not used to treat asthma as much as it was in the past, and bronchodilators are considered better treatment.

The manufacturers of epinephrine injectors recommend that if a child has both asthma and a severe allergy and it is uncertain whether an attack is one or the other, the injector should always be used first. This is because anaphylaxis is quickly life-threatening and only the injector will treat it. An asthma medication will not, so start with epinephrine if you are unsure.

Research studies have also found that anaphylaxis is underreported in children,, and deaths have occurred because the severe allergic reaction was mistakenly identified by parents or other adults as an asthma attack. Experts recommend that children with asthma should also carry epinephrine injectors since they are more prone to having allergies than children without asthma and because it can be difficult to determine the difference between the two emergency events.

These two conditions are closely related, yet different. It is important to get a diagnosis, or two, if your child experiences any symptoms similar to allergic reactions or asthma attacks. Even if your child is diagnosed only with asthma, have an epinephrine injector on hand. When in doubt between the two, it is always best to use the injector first.