A healthy living blog from Marshfield Clinic Health System

Vocal cord dysfunction and asthma: What’s the difference?

Vocal cord dysfunction and asthma can make breathing difficult for people of all ages. While patients with asthma and vocal cord dysfunction can have shortness of breath and cough, they are separate diagnoses with different treatments.

What is vocal cord dysfunction?

The vocal cords are two bands of muscle and tissue inside the larynx (voice box). We use our vocal cords to breathe, speak, shout, sing and more.

When you breathe in and out, air flows through the vocal cords and in and out of the lungs. For people with vocal cord dysfunction, or VCD, the cords close when you breathe in and out, rather than open.

Young girl smiling and living with vocal cord dysfunction

VCD most commonly affects teenagers and adults, but can be seen in younger children, too.

This causes a narrowing of the voice box, which leaves only a small opening for air to flow through your vocal cords. This can make it harder to move air in and out of the lungs.

“Raising awareness for this condition is important, in part because symptoms are commonly mistaken for asthma and treatments look very different,” said Dr. Joshua Freedman, pulmonologist with Marshfield Children’s.

VCD most commonly affects teenagers and adults, but can be seen in younger children, too.

Symptoms of VCD

Kids diagnosed with VCD may notice exercise-induced shortness of breath, chest pain, lightheadedness, sore throat, hoarseness and frequent throat clearing or cough.

VCD is commonly triggered by anything that can irritate the vocal cords or cause laryngeal inflammation. Common factors include reflux, post-nasal drip, chronic cough, throat clearing and overuse of the vocal cords from things like singing or cheering. Hoarseness may be associated.

Symptoms frequently are worsened during exercise or from upper respiratory infections, much like asthma.

“Sometimes a clear cause is difficult to identify. Strong emotions and stress also are known triggers,” Dr. Freedman said.

How is VCD diagnosed?

“Parents or guardians should seek care any time that shortness of breath or difficulty breathing limits their child from doing activities,” Dr. Freedman said.

Tests can be performed to confirm diagnosis and rule out other causes.

“Part of testing is to confirm that the shortness of breath or difficulty breathing is not due to asthma, as this is still the more common cause of symptoms,” Dr. Freedman said. “We also will assess for common triggers of laryngeal irritation, such as post-nasal drip or reflux.”

Exercised-induced bronchoconstriction, commonly referred to as exercised-induced asthma, is still much more common in patients.

“Vocal cord dysfunction is under-recognized as causing similar symptoms. It’s also common for some people to have both asthma and vocal cord dysfunction,” he said.

Caring for VCD

While the condition can be treated, VCD is different than many other breathing problems. This is because the treatment is learning to manage and control symptoms as they occur, because the cause of VCD is often unknown.

Your providers will make a treatment plan and recommendations. This can include speech therapy to learn relaxed breathing, medications to help treat upper airway irritations, diet changes for irritated vocal cords or reflux and counseling to help adjust to the new diagnosis.

It’s also important to help identify and eliminate sources of throat irritation.

“Vocal cord dysfunction can be treated, so patients can live a normal life. The amount of treatment may vary from one patient to the next,” Dr. Freedman said.

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