- With Mayo Clinic asthma and allergy specialist
James T. Li, M.D.
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James T. Li, M.D.
James T. Li, M.D.
"People with allergy or asthma can lead full and healthy lives." — Dr. James Li
Dr. Li is chair of the Division of Allergic Diseases in the Department of Internal Medicine and a board-certified asthma and allergy specialist. He hopes his expertise and the information on the site educates health care consumers in an area of rapid change both in medications and diagnoses.
"There are a lot of misperceptions about allergy and asthma," says Dr. Li, a New York City native who has been with Mayo since 1985 and works with a group of subspecialists in allergy, asthma and immunology. "I believe it's important to provide truthful, accurate information about allergy and asthma to the public. The more people know, the better they can take care of these conditions."
Dr. Li is a professor of medicine at Mayo Clinic College of Medicine. He is a past director of the American Academy of Allergy, Asthma & Immunology and is a director of the American Board of Allergy and Immunology. He is a fellow in the American College of Allergy, Asthma & Immunology and is a director of the American Board of Internal Medicine.
The American College of Allergy, Asthma & Immunology honored him with the Distinguished Service Award and the American Academy of Allergy, Asthma & Immunology with its Special Recognition Award.
Symptoms (2)
- Vocal cord dysfunction: Is it a type of asthma?
- Asthma without wheezing: Is this possible?
Tests and diagnosis (1)
- Reactive airway disease: Is it asthma?
Lifestyle and home remedies (3)
- Asthma: Why are symptoms worse during my period?
- Asthma diet: What you eat can affect asthma symptoms
- Ozone air purifiers: Can they improve asthma symptoms?
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Question
Vocal cord dysfunction: Is it a type of asthma?
What's the difference between vocal cord dysfunction and asthma?
Answer
from James T. Li, M.D.
Although they can have similar triggers and symptoms, vocal cord dysfunction is not the same as asthma.
- With asthma, exposure to a lung irritant triggers the release of immune system chemicals that cause the airways (bronchial tubes) to tighten and produce excess mucus.
- With vocal cord dysfunction, also called paradoxical vocal cord movement and laryngeal dysfunction, vocal cord muscles tighten and make breathing difficult. Unlike asthma, vocal cord dysfunction isn't an allergic reaction and doesn't involve the lower airways.
Because they have similar triggers and symptoms, it's common for vocal cord dysfunction to be misdiagnosed as asthma. This can lead to long-term use of asthma medications that don't help and in some cases cause serious side effects.
As with asthma, breathing in lung irritants, having an upper respiratory infection or exercising may trigger symptoms of vocal cord dysfunction. Both asthma and vocal cord dysfunction make breathing difficult and can cause coughing, wheezing, throat tightness and hoarseness. Unlike asthma, however, vocal cord dysfunction causes more difficulty breathing in than breathing out.
Doctors aren't sure what causes vocal cord dysfunction. Symptoms may appear after you've had a breathing tube in your throat, had certain anesthetic medications or if you have gastroesophageal reflux disease (GERD).
You may have vocal cord dysfunction and not asthma if your lungs have a normal response to asthma tests. These can include:
- A lung-irritant test (methacholine challenge). Lower lung function test scores after breathing in methacholine are a sign that you may have asthma.
- A nitric oxide test. This test measures the amount of nitric oxide gas in the air you breathe out. High levels of nitric oxide may be an indication of asthma.
Many people have both vocal cord dysfunction and asthma. Each may require separate treatment.
Vocal cord dysfunction generally improves with treatment, which can include learning deep-breathing techniques, learning to relax your throat muscles, speech therapy and psychotherapy to reduce stress.
Next questionAsthma without wheezing: Is this possible?
- Balkissoon RC, et al. Disorders of the upper airways. In: Mason RJ. Murray & Nadel's Textbook of Respiratory Medicine. 4th ed. Philadelphia, Pa.: Saunders Elsevier; 2005. http://www.mdconsult.com/das/book/body/156419261-3/0/1288/367.html?tocnode=51472411&fromURL=367.html#4-u1.0-B0-7216-0327-0..50043-4_2475. Accessed Aug. 25, 2009.
- Kelkar P, et al. Approach to the patient with chronic cough. In: Adkinson FM, et al. Middleton's Allergy: Principles and Practice. 7th ed. Philadelphia, Pa.: Mosby Elsevier. 2008. http://www.mdconsult.com/das/book/body/156419261-4/0/1806/83.html?tocnode=56311186&fromURL=83.html#4-u1.0-B978-0-323-05659-5..00079-6_2749. Accessed Aug. 25, 2009.
