What is bronchitis?

Bronchitis is a respiratory disease in which the mucous membranes of the bronchial passages in the lungs become inflamed. As the irritated membrane swells and grows thicker, it narrows or shuts off the airways in the lungs, resulting in coughing spells accompanied by thick phlegm and breathlessness. The disease occurs in two forms: acute (lasting less than 6 weeks) and chronic (reoccurring frequently for more than two years).

Acute bronchitis

Acute bronchitis usually comes on quickly and gets better after several weeks. This form of bronchitis is responsible for the hacking cough and phlegm/mucus production that sometimes accompany an upper respiratory infection. In most cases the infection is viral in origin, but sometimes it's caused by bacteria. If you are otherwise in good health, the mucous membrane will return to normal after you've recovered from the initial lung infection, which usually lasts for several days.

Chronic bronchitis

Defined clinically as a daily cough with production of sputum (mucus) for at least a 3-month period, two years in a row; chronic bronchitis is a serious long-term disorder that often requires regular medical treatment. In chronic bronchitis, there is inflammation and swelling of the lining of the airways that lead to narrowing and obstruction of the airways. The inflammation stimulates production of mucus, which can cause further obstruction of the airways and increase the likelihood of bacterial lung infections.

Smokers and bronchitis

If you are a smoker and come down with acute bronchitis, it will be much harder for you to recover. Even one puff on a cigarette is enough to cause temporary paralysis of the tiny hair-like structures in your lungs, called cilia that are responsible for brushing out debris, irritants, and excess mucus. If you continue smoking, you may do sufficient damage to these cilia to prevent them from functioning properly, thus increasing your chances of developing chronic bronchitis. In some heavy smokers, the membrane stays inflamed, and the cilia eventually stop functioning altogether. Clogged with mucus, the lungs are then vulnerable to viral and bacterial infections, which over time distort and permanently damage the airways. This permanent condition is called COPD (chronic obstructive pulmonary disease).

What causes acute bronchitis?

Acute bronchitis is very common among both children and adults and is generally caused by lung infections; approximately 90% of these infections are viral in origin, and 10% are bacterial. Repeated attacks of acute bronchitis, which weaken and irritate bronchial airways over time, can result in chronic bronchitis.

What causes chronic bronchitis?

Chronic bronchitis may be caused by one or several factors. As mentioned on the previous slide, repeated attacks of acute bronchitis may be a cause of chronic bronchitis. Industrial pollution is another culprit. Chronic bronchitis is found in higher-than-normal rates among coal miners, grain handlers, metal molders, and other people who are continually exposed to dust. But the primary cause is heavy, long-term cigarette smoking, which irritates the bronchial tubes and causes them to produce excess mucus. The symptoms of chronic bronchitis are also worsened by high concentrations of sulfur dioxide and other pollutants in the atmosphere.

What are the symptoms of bronchitis?

Symptoms of bronchitis include the following:

• A cough that is frequent and produces mucus
• A lack of energy
• A wheezing sound when breathing, which may or may not be present
• A fever, which may or may not be present

When should I call my doctor about bronchitis?

• A chest cold that lasts for more than two weeks
• A fever greater than 102 F (38.8 C)
• A cough that produces blood
• A shortness of breath or wheezing

Can bronchitis be treated at home?

If you have bronchitis, home treatment should include the following:

• Drink fluids every one to two hours unless your doctor has restricted your fluid intake
• Rest
• Don't smoke
• Relieve body aches by taking aspirin or acetaminophen. (If you are taking any other drugs, talk to your doctor to make sure aspirin or acetaminophen will not interfere with them. Children should NOT take aspirin.)
• Follow your doctor's instructions on ways to help clear your mucus.
• If you are coughing up mucus, note how often you cough as well as the color and amount of the mucus. Report this to your doctor.

How is bronchitis diagnosed?

Tests are usually unnecessary in the case of acute bronchitis, as the disease is easy to detect from your medical history and by physical examination. Your doctor will simply use a stethoscope to listen for the rattling sound in your upper airways that typically accompanies the problem.

In cases of chronic bronchitis, the doctor will almost certainly augment these procedures with an X-ray of your chest to check the extent of the lung damage, as well as with pulmonary function tests to measure how well your lungs are functioning.

How is acute bronchitis treated?

Conventional treatment for acute bronchitis may consist of simple measures such as getting plenty of rest, drinking lots of fluids, avoiding smoke and fumes, and possibly getting a prescription for an inhaled bronchodilator medication.

Do not take an over-the-counter cough suppressant to treat chronic bronchitis unless your doctor directs you to do so. Your doctor may prescribe an expectorant to help loosen mucus so it can be more easily coughed up. The productive (phlegm-producing) coughing that comes with acute bronchitis is to be expected and, in most cases, encouraged; coughing is your body's way of getting rid of excess mucus.

How is chronic bronchitis treated?

If you have chronic bronchitis, your lungs are vulnerable to infections. Unless your doctor counsels against it get a yearly flu shot as well as a vaccination against pneumococcal pneumonia. The pneumococcal vaccine is typically a one-shot procedure and will protect many for life against the common strains of the disease.

In severe cases of chronic bronchitis, inhaled or oral steroids to reduce inflammation and/or supplemental oxygen may be necessary. Alternative choices, by and large, help relieve the accompanying discomfort but do not treat infections. If you notice any changes in the color, volume, or thickness of the phlegm, you may be coming down with an infection. In that case, your physician may prescribe a 5 to 10-day course of broad-spectrum antibiotics, which fight a range of bacteria.

Treatment for chronic bronchitis and COPD

If you have COPD (as demonstrated by an abnormal spirometry breathing test), many doctors also prescribe one of the anticholinergic bronchodilators, drugs that temporarily help dilate the lungs' constricted airways. However, the most important and most successful treatment for chronic bronchitis and COPD is smoking cessation.

In severe cases of chronic bronchitis with COPD, if your body's ability to transfer oxygen from your lungs into the bloodstream is significantly handicapped, your doctor may prescribe oxygen therapy, either on a continuous or on an as-needed basis.

If you smoke, your doctor will urge you to quit. Studies show that people who kick the habit even in the advanced stages of chronic bronchitis and COPD not only can reduce the severity of their symptoms, but also can increase their life expectancy.

How can I reduce the risk of getting bronchitis?

• Don't smoke.
• Don't allow others to smoke in your home.
• Stay away from or reduce your time around things that irritate your nose, throat, and lungs, such as dust or pets.
• If you catch a cold, get plenty of rest.
• Take your medicine exactly the way your doctor instructs you.
• Eat a healthy diet.
• Wash your hands often.
• Do not share food, cups, glasses, or eating utensils.

More Reading on Bronchitis

• Acute Bronchitis
• Chronic Bronchitis
• Emphysema, Chronic Bronchitis, and Colds
• Chronic Obstructive Pulmonary Disease (COPD)
• Asthma Complexities
• Chronic Cough