Bronchitis

What is Bronchitis?

Bronchitis is an inflammation of the large, flexible passages that carry air to and from your lungs. It can vary in severity, with symptoms ranging from a chronic, productive cough and sore throat to more severe acute exacerbations. 

Bronchitis has many causes, including cigarette or tobacco smoke, air pollution, and infections such as the flu, strep throat, or pneumonia. As a bacterial infection is the usual cause, antibiotics can relieve symptoms and shorten the length of time you're sick. In many cases, cough medications can help alleviate the symptoms.

Pathophysiology and Risk Factors

The common denominator in all cases is inflammation of the bronchial tubes. This is usually caused by a viral or bacterial infection such as the common cold, influenza, or rhinovirus. 

Risk factors are the same whether the cause is bacterial or viral. The most significant is cigarette smoke because it contains harmful chemicals and lung irritants. These cause inflammation in bronchial tubes and air sacs and encourage infection. Other common causes are lung irritants such as air pollution, dust, pollen, animal dander, and environmental toxins from asbestos or chemical fumes.

Another risk factor is respiratory diseases. Smokers with pre-existing lung disease are much more likely to develop this illness than non-smokers in the same demographic. Individuals with heart problems and congestive heart failure also have an increased risk of developing acute or chronic bronchitis.

Signs and Symptoms

The two main types of bronchitis are chronic and acute. The signs and symptoms of both can vary depending on the severity.

Acute Bronchitis

Acute Bronchitis is a common infection that primarily affects young children and the elderly. Symptoms of acute bronchitis include coughing, which usually begins suddenly and worsens during the first week. Coughing will often produce mucus (sputum) which is generally clear but can be yellow or green.This usually lasts two to three weeks and then gradually gets better over one to two months. Chest pain or shortness of breath may occur at first and get better once coughing stops.

A less common form of acute bronchitis is acute bacterial bronchitis, caused by many different bacteria, such as streptococcus. Symptoms are similar to those seen with other forms of bronchitis but more intense. You may experience fever, body aches, fatigue, and difficulty breathing. You may also have an unproductive cough that becomes productive as the disease progresses and mucus begins to loosen.

Chronic Bronchitis

Chronic bronchitis presents with persistent symptoms, cough, excess mucus production (often with coloration), and a decreased ability to fight infection. Coughing is often worse at night and sometimes includes wheezing or shortness of breath. Other common symptoms are difficulty breathing and frequent respiratory infections, unproductive cough, and general fatigue.

Diagnosis

Your doctor will diagnose this condition by taking your health history and performing a physical exam. They will look for the signs and symptoms discussed above. 

Your doctor may perform heart, lung, and blood tests to differentiate an upper respiratory infection vs bronchitis. They may also identify the difference between bronchitis and pneumonia by taking a bronchitis chest x ray or computed tomography (CT) scan. Many will use spirometry and pulse oximetry to test for chronic bronchitis.

If your symptoms are longstanding, your doctor may diagnose you with chronic bronchitis. This means you have had a cough and mucus most days for at least three months a year, for two consecutive years. It also requires ruling out tuberculosis or other lung diseases.

Treatment

Treatment depends on the duration and severity of your symptoms. Many at-home remedies can ease your discomfort. These include using a cool mist humidifier for bronchitis or a saline nasal spray or sinus rinse to clear your mucus and congestion. Over the counter medicines can help with your symptoms.

In most cases, acute infection will resolve without any treatment within a week or two. Bronchitis treatment antibiotics are an option if the person is over 65 years old, has a weakened immune system, or symptoms persist long term. 

The best cough medicine for bronchitis depends on whether or not your cough is productive. Your doctor can recommend a syrup or pill to help suppress cough.

Most chronic cases are due to smoking or prolonged exposure to secondhand smoke. Therefore, your doctor will advise you to stop smoking with bronchitis or avoid secondary smoke sources to reduce symptoms.

Oxygen therapy or a nebulizer for bronchitis may help some patients with severe symptoms. Steroids for bronchitis can also help control long-term or serious symptoms. If you live an active lifestyle, seek medical care before exercising with bronchitis.

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Prognosis

The prognosis is different in each case but generally good. Many patients will get well quickly, and other times it takes a long time before any improvement happens. According to the American Lung Association, acute infection usually lasts for a week to 10 days. Chronic bronchitis is a persistent condition, but lifestyle modifications, home remedies, and medication can usually control symptoms. 

Complications can occur in some situations. One of the most common is pneumonia, which includes both viral and bacterial infections. Other risks are developing chronic obstructive pulmonary disease (COPD) and gastroesophageal reflux disease (GERD).

By living a healthy lifestyle, you can take steps to prevent acute infection and reduce your risk of developing a chronic condition. If you are experiencing any of the bronchitis symptoms, see one of our doctors available online now to feel better and avoid potential complications.

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