What is Bronchitis?

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Bronchitis is an inflammation of the inner mucus lining of the bronchial tubes in the lungs, which is often caused by a respiratory infection. These branch-like passageways, also known as bronchi, carry air from the windpipe, or trachea, to the lungs. But when the tubes become infected or irritated, they swell and thicken with mucus, constricting airflow. People with bronchitis typically experience a nagging cough. It usually starts as a dry cough but eventually produces phlegm. These symptoms can make it difficult to breathe.

There are two distinct types of bronchitis.

Acute bronchitis is the most common. This inflammation of the bronchial tubes is temporary. Most people with healthy immune systems and no underlying illnesses can shake it off after two to three weeks, and if they do need treatment, it can cause the inflammation to subside.

Not so with chronic bronchitis. It is persistent and can be debilitating at times when symptoms flare up and subside. These can occur because people with chronic bronchitis are more susceptible than others to lung infections, and more sensitive to air pollutants and allergens.

Acute Bronchitis

Acute bronchitis is another name for a chest cold. Anyone can acquire this type of bronchitis, but it is most common in infants, young children and older adults. It typically strikes in the wake of a cold, flu, or other viral infection. Before you know it, the virus that triggered mucus production in your sinuses or caused a sore throat invades your bronchial tubes. All of sudden, you've got a pretty nasty, phlegmy cough.

Much less frequently, acute bronchitis is caused by a bacterial infection.

Sometimes irritants in the air, such as tobacco smoke, smog, dust, fumes, vapors and air pollution, can trigger acute bronchitis without any sign of bacteria or viruses.

Older people may experience complications such as pneumonia.

Chronic Bronchitis

Chronic bronchitis is a serious illness with a persistent cough, often caused by long-term smoking, although not everyone with chronic bronchitis is a smoker or former smoker. People sometimes mistake chronic bronchitis for "a smoker's cough." Other environmental irritants, like dust and fumes, can also cause chronic bronchitis, and a rare genetic condition called alpha-1 antitrypsin deficiency can also increase the susceptibility to chronic bronchitis and other lung conditions.

Constant irritation of the bronchial tubes leads to inflammation and excess mucus production that clogs up the airway. People with this chronic form of bronchitis are vulnerable to infections that can lead to symptom flare-ups.

Over time, chronic bronchitis can make it difficult for enough oxygen to get to the lungs and blood. It is the most common type of chronic obstructive pulmonary disease (COPD), a term used to describe progressive lung conditions (another type of COPD is emphysema) that make it hard to breathe.

Chronic bronchitis is diagnosed when people experience a phlegm-producing cough that lasts three months of the year over at least two years in a row.

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Symptoms of Bronchitis

1. Coughing
2. Mucus
3. Wheezing or whistling sound in the lungs
4. Low fever
5. Chest discomfort
6. Shortness of breath
7. Cold symptoms, such as headache, fatigue, and watery eyes.

Acute bronchitis symptoms

The most common sign that you have acute bronchitis is a persistent cough. It can last from three days to three weeks. Coughing may produce clear, slimy phlegm, or the mucus may be white, yellow, or green.

Acute bronchitis often strikes when you're sick or recovering from a cold of flu. Days before your cough ensues, you may have a drippy nose or sore throat as well as other symptoms, like body aches, fatigue, or chills.

Bronchitis narrows your airway, so you may notice a wheezing or whistling sound when you breathe. Other symptoms include low fever and chest tightness or pain.

In severe cases, acute bronchitis may cause shortness of breath.

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Chronic bronchitis symptoms

Symptoms of chronic bronchitis include persistent coughing with thick mucus, wheezing, chest discomfort or tightness, and shortness of breath. People with this chronic form of bronchitis are more likely to have frequent respiratory infections. As the disease progresses, they may develop a blue skin discoloration due to lack of oxygen in the blood.

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How is Bronchitis Diagnosed?

Acute bronchitis can be diagnosed by its symptoms and if you do have a physical exam. Your doctor can use a stethoscope placed on the chest to listen for wheezing to help make a bronchitis diagnosis. Your doctor may also order other tests, depending on the severity of symptoms. A small sensor called a pulse oximeter may be clipped to a finger or toe to measure blood oxygen levels. A chest x-ray can be used to rule out pneumonia, a serious infection that can have symptoms that can be confused with bronchitis.

A diagnosis of chronic bronchitis begins with a thorough health history and exam. Your doctor may order a chest x-ray. You may be asked to take a spirometry test to assess your lung function. (For spirometry, you will be asked to blow into a tube to measure lung function.) An arterial blood gas test can check the amount of oxygen and carbon dioxide in the blood.

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Bronchitis Treatment

Medications for acute bronchitis

1. Acetaminophen (Tylenol) for pain relief and fever.

2. Non-steroidal anti-inflammatory drugs to reduce pain, and inflammation, and fever. These include ibuprofen (Advil, Motrin), naproxen (Aleve), or aspirin. Note: Never give aspirin to children or teens because it is linked to a rare, but serious condition called Reye's syndrome.

3. Expectorants containing guaifenesin to clear mucus from the airway.

4. Cough suppressants like dextromethorphan for a dry cough. Medicine containing dextromethorphan can be prescribed by your doctor and are available over the counter in products like Delsym, Robitussin, and Zicam. Only take these drugs if coughing is keeping you from falling asleep. These medicines are not recommended for a phlegm-producing cough because coughing is the body's way of expelling excess mucus. Don't give these products to children under age 4, and do not give adult versions to kids.

5. Inhaled bronchodilator medicines like albuterol or ipratropium bromide are sometimes used to relieve wheezing.

6. Antibiotics. These are only given when acute bronchitis is caused by a bacterial infection. (Viruses cause most cases of acute bronchitis, and antibiotics are not recommended for uncomplicated cases of acute bronchitis.)

Medications for chronic bronchitis

1. If you smoke, nicotine replacement therapy and other medicines can help you quit smoking.

2. Inhaled bronchodilator medicines like albuterol, can help open the airways making it easier to breathe.

3. Inhaled corticosteroids control symptom flare-ups by suppressing inflammation in the lungs.

4. Antibiotics may by used to treat symptom flare-ups if a bacterial infection is suspected.

5. Vaccines, like an annual flu shot and pneumonia vaccine, can help protect your lungs if you have chronic bronchitis.

Therapy

If you have chronic bronchitis, your doctor may order oxygen therapy. This bronchitis treatment may be delivered in a hospital, at a medical facility, or at home. Inhaled oxygen increases the availability of necessary oxygen to your lungs and blood and helps with breathing.

Pulmonary rehabilitation is a treatment for people whose chronic bronchitis leads to airway obstruction, or COPD. It combines exercise, education, and support services. With a doctor's referral, patients work with a team of health professionals to increase their strength and endurance, learn breathing techniques and acquire other skills to manage the disease and improve their quality of life.

Home remedies for bronchitis

Try these natural remedies for relieving bronchitis symptoms:

1. Rest.

2. Drink fluids. Staying hydrated will thin out your mucus so it is easier to expel. A concoction of warm water with honey and lemon may provide some relief. Do not give honey to children younger than 1 due to the risk of botulism.

3. Use a humidifier or inhaled steam from a bath or shower to loosen mucus and ease wheezing. These measures, under a parent's supervision, may help ease a child's congestion.

4. Gargle with warm salt water or pop a lozenge to soothe a sore throat.

5. Use aromatherapy to ease symptoms. Add a drop of eucalyptus or tee tree oil to a steamy bowl of water and inhale.

6. Spice it up. An ingredient in hot chili peppers, called capsaicin, has been shown to ease sinus congestion. It may also be useful in thinning out mucus in your chest.

7. Try pursed-lipped breathing, a technique to control shortness of breath. Breathe in through the nose for 2 seconds, pucker your lips, and blow out very slowly, then repeat.

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When to see a doctor

Acute bronchitis usually gets better on its own, but there are times when you should seek medical attention:

  • Any fever in children three months of age or younger should be reported to your health professional immediately.

Chronic bronchitis is a long-term health condition that requires ongoing management. If you have persistent bouts of coughing, your doctor can perform tests to confirm a diagnosis. People with chronic bronchitis should seek medical attention if symptoms worsen or complications develop.

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Is Bronchitis Contagious?

A virus usually causes acute bronchitis. If you have this type of bronchitis, you can spread the virus to other people through coughing, sneezing, hand holding, touching germy surfaces, kissing, or talking in close contact.

Bronchitis caused by inhaled irritants, however, is not contagious.

Chronic bronchitis is one of the most common reasons for a persistent cough. But it is usually not something that can be transmitted to someone else, unless the bronchitis patient also has a current infection.

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How Long Does Bronchitis Last?

Acute bronchitis typically lasts two to three weeks, but coughing may persist for up to eight weeks in some people.

Chronic bronchitis doesn't ever go away. With this type of bronchitis, coughing jags can last for three months before the next episode. What's more, chronic coughing can damage the mucus lining of the bronchial tubes, which leads to even more coughing.

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How Long Before I Know I Have It?

 

People who live with chronic bronchitis are diagnosed when coughing occurs three months at a time for at least two years.

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Prevention

To avoid bronchitis, do not smoke and avoid smoke-filled environments. Consider wearing a mask over your nose and mouth when you are exposed to smoke, dust, fumes, vapors, and air pollution. Stick to a healthy diet and remain as active as you can. Good hand hygiene can reduce your risk of catching and spreading viruses that cause acute bronchitis or trigger a chronic bronchitis flare-up. Getting an annual flu shot and recommended pneumonia vaccines also protect against infection.

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