What Are the Symptoms of Eosinophilic Asthma?

Medically Reviewed by Carol DerSarkissian, MD on March 17, 2024
3 min read

If you’re an adult with asthma that’s hard to manage, it’s possible you have eosinophilic asthma. It’s a subtype of asthma that’s usually severe and often much harder to keep in check.

The symptoms can be similar to other types of asthma, but sometimes they have their own twist to them. And people with eosinophilic asthma often have other health conditions as well. You can’t tell if you have eosinophilic asthma just from your symptoms and conditions -- you’ll need your doctor and some tests for that. But knowing what to look for can help you better prepare for your appointment.

Common symptoms of eosinophilic asthma include:

  • Blocked airways
  • Coughing
  • Tightness in the chest
  • Shortness of breath or hard time breathing
  • Wheezing

While these symptoms are the same as other kinds of asthma, they tend to be more constant and severe with eosinophilic asthma. You’re also likely to have more frequent asthma attacks, which tend to be more dangerous, too.

Generally, asthma causes swelling in the airways of your lungs. Eosinophilic asthma causes swelling in your entire respiratory system, from your nose all the way down to the tiniest airways. That’s why shortness of breath, rather than wheezing, is one of the main symptoms with this type of asthma. Even when you're doing physical activity, it’s often shortness of breath, not wheezing, that gets worse.

One of the other signs that your asthma could be caused by the eosinophilic subtype is if you find that the typical asthma treatment -- medicines called inhaled corticosteroids -- don’t have much of an effect on it. It often responds well to corticosteroids you take by mouth, but they usually have more side effects. Plus, if you do have eosinophilic asthma, you can become dependent on corticosteroids to prevent asthma attacks.

People with asthma often have different types of allergies that act as triggers. That’s not usually the case when you have eosinophilic asthma, but these other health conditions tend to be common with it.

Swollen sinuses. Your sinuses are little pockets of air located on either side of your nose, between your eyes, and in your lower forehead. When they’re constantly swollen, it’s known as chronic sinusitis, which can cause mucus that runs down the back of your throat, congestion, and pressure or pain in your face.

Swollen tissue in your nose. Swelling in the tissue that lines your nose, called the nasal mucosa, often comes along with swollen sinuses. Together with swollen sinuses, this condition is called rhinosinusitis.

Nasal polyps. These are small, painless growths in your nose or sinuses. They can block airflow and affect your sense of smell.

Aspirin sensitivity. Aspirin and other non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, can trigger asthma attacks in some people.

Middle ear infections. The swelling in your nose and sinuses may reach all the way to your ears and cause a middle ear infection, called otitis media. This leads to a thick fluid in your ears that can affect your hearing.

All of these symptoms limit your airflow. From polyps in your nose to tightened airways deep in your lungs, a simple breath gets a lot more complicated.

Because people with eosinophilic asthma may have less wheezing and more shortness of breath, along with other things that limit airflow, doctors sometimes think they have chronic obstructive pulmonary disease (COPD). That’s a different lung disease and is more common in people who smoke.

Keep a close watch on all your symptoms so you can give your doctor a complete picture of your condition. It helps to know you have eosinophilic asthma because you and your doctor need to keep a closer watch on it than other types of asthma. It’s also important to know because you might be able to get different treatments that can have a big impact on your quality of life.