Understanding Bronchitis

Last Editorial Review: 12/16/2009

What Is Bronchitis?

Bronchitis is a respiratory disease in which the mucous membrane in the lungs' bronchial passages becomes inflamed. As the irritated membrane swells and grows thicker, it narrows or shuts off the tiny airways in the lungs, resulting in coughing spells accompanied by thick phlegm and breathlessness. The disease comes in two forms: acute (lasting less than 6 weeks) and chronic (reoccurring frequently for more than two years). In addition, people with asthma also experience an inflammation of the lining of the bronchial tubes called asthmatic bronchitis.

Acute bronchitis is responsible for the hacking cough and phlegm 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 is a serious long-term disorder that often requires regular medical treatment.

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 lungs' airways. This permanent condition is called COPD (chronic obstructive pulmonary disease). Your doctor can perform a breathing test, called spirometry, to see if you have developed COPD.

Acute bronchitis is very common among both children and adults. The disorder often can be treated effectively without professional medical assistance. However, if you have severe or persistent symptoms or if you cough up blood, you should see your doctor. If you suffer from chronic bronchitis, you are at risk for developing cardiovascular problems as well as more serious lung diseases and infections, you should be monitored by a doctor.

Picture of Bronchitis Infection

What Causes It?

Acute bronchitis is generally caused by lung infections; approximately 90% of these infections are viral in origin, 10% bacterial. Chronic bronchitis may be caused by one or several factors. Repeated attacks of acute bronchitis, which weaken and irritate bronchial airways over time, can result in 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 chief 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.

When a Cold Becomes Bronchitis

When you catch a cold, does it often turn into bronchitis, which is sometimes called a chest cold? It's important to recognize what's normal and to know when something more serious is going on. Here's what you must know when that nasty cold turns into bronchitis.

Should I Call My Doctor About a Cough?

A cough is a common cold symptom. It's the body's way of getting rid of phlegm or mucus. But if a cough persists after the cold is gone, contact your doctor.

It is helpful to tell your doctor how long you've had the cough. You also should tell the doctor whether any activities or exposures seem to make it worse, if you notice any other different or unusual feelings, and if you cough up mucus.

If you are coughing up thick green or yellow phlegm, or if you are wheezing, running a fever higher than 101° F, having night sweats, or coughing up blood, you need to see a doctor. These may be signs of a more serious illness that needs to be diagnosed and treated.

A persistent cough may be a sign of asthma. Sometimes this condition is called "cough-variant asthma." Cough-variant asthma is vastly under diagnosed and under treated. Triggers for cough-variant asthma are usually respiratory infections like a cold or flu. You may even have cough-variant asthma and think the cough is due to an allergy. Until an asthma attack occurs, you may not realize that your lungs are involved.

What is bronchitis (chest cold)?

Bronchitis occurs when the airways in your lungs are inflamed and make too much mucus. There are two basic types of bronchitis:

  • Acute bronchitis is more common and usually is caused by a viral infection. Acute bronchitis may also be called a chest cold. Episodes of acute bronchitis can be related to and made worse by smoking. This type of bronchitis is often described as being worse than a regular cold but not as bad as pneumonia.

  • Chronic bronchitis is a cough that persists for two to three months each year for at least two years. Smoking is the most common cause of chronic bronchitis.

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

Should I Call My Doctor About Bronchitis?

See your health care provider if you have any of these symptoms:

  • A chest cold that lasts for more than two weeks

  • A fever greater than 102°F

  • A cough that produced blood

  • A shortness of breath or wheezing

Can I Treat Bronchitis at Home?

If you have bronchitis you should do 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 doesn't 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.

If you have a dry cough and cough up little to no mucus, your doctor may prescribe a cough medicine to suppress your cough. He or she may also prescribe an expectorant to help loosen mucus so it can be more easily coughed up.

Because most episodes of bronchitis are caused by viruses, antibiotics will not be useful or necessary. Exceptions would be bronchitis caused by a bacterial infection or bronchitis in a person who has impaired lung function.

How Can I Reduce the Risk of Getting Bronchitis (chest cold)?

  • 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 tells you.

  • Eat a healthy diet.

  • Wash your hands often.

  • Do not share food, cups, glasses, or eating utensils.

How Do I Know if I Have It?

Tests are usually unnecessary in the case of acute bronchitis, as the disease is easy to detect from your medical history and on examination. Your doctor will simply use a stethoscope to listen for the rattling sound in your lungs' 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 working.

What Are the Treatments?

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 and/or cough syrup. 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.

Conventional Medicine

In healthy people who have normal lungs and no chronic health problems, antibiotics are not necessary, even when the infection is bacterial. 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. However, if your cough is truly disruptive -- that is, it keeps you from sleeping or is so violent it becomes painful -- or nonproductive (dry and raspy sounding), your doctor may prescribe a cough suppressant. In most cases, you should simply do all the things you usually would do for a cold: Take or acetaminophen for discomfort and drink lots of liquids.

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 pneumonia. The pneumonia vaccine is typically a one-shot procedure: One vaccination will protect many for life against the common strains of the disease. Occasionally a second or booster shot is required.

Do not take an over-the-counter cough suppressant to treat chronic bronchitis unless your doctor directs you to do so. As with acute bronchitis, the productive coughing associated with chronic bronchitis is helpful in ridding the lungs of excess mucus. In fact, your doctor may even prescribe an expectorant if your cough is relatively dry. However, 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. If you are overweight, your doctor may insist that you diet to avoid putting excessive strain on your heart. If you have COPD (as demonstrated by an abnormal spirometry breathing test), many doctors also prescribe an anticholinergic bronchodilator, 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. Your doctor may also prescribe steroids to reduce inflammation in the airways.


COPD (chronic obstructive pulmonary disease) is the same as adult-onset asthma. See Answer

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. Oxygen-delivering devices are widely available. If you use an oxygen tank at home, be sure to take special care not to expose the apparatus to flammable materials (alcohol and aerosol sprays, for example) or to sources of direct heat, such as hair dryers or radiators.

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.

At-Home Remedies

For acute bronchitis:

During the acute phase of your illness when you are experiencing fever, shortness of breath, or wheezing, stay at home, keep warm, and drink plenty of fluids. You don't necessarily need to stay in bed, but don't overextend yourself. Consider using a vaporizer, or try inhaling steam over a sink full of hot water.

For chronic bronchitis:

Avoid exposure to paint or exhaust fumes, dust, and people with colds. Consider using a vaporizer or inhaling steam over a sink full of hot water. Dress warmly in cold, dry weather. Get help to quit smoking

WebMD Medical Reference

Reviewed by Michael W. Smith, MD on November 14, 2007

Health Solutions From Our Sponsors

SOURCES: Brunton, S.; Carmichael, B.; Colgan, R.; Feeney, A.; Fendrick, A.; Quintiliani, R.; Scott, G.; "Acute exacerbation of chronic bronchitis: a primary care consensus guideline." American Journal of Managed Care, October 2004; vol.10(10); pp 689-696. Smucny, J.; Fahey, T.; Becker, L.; Glazier, R.; "Antibiotics for acute bronchitis," Cochrane Database System Reviews, October 2004. vol. 18;(4); pp CD000245. Martinez, F.; "Acute bronchitis: state of the art diagnosis and therapy," Spring 2004, vol. 30; pp 55-69. Steinman, M.; Sauaia, A.; Maselli, J.; Houck, P.: Gonzolas, R.; "Office evaluation and treatment of elderly patients with acute bronchitis," American Journal of Geriatric Society, June 2004, vol. 52; pp 875-879. ERS Task Force, "The diagnosis and management of chronic cough," European Respiratory Journal, September 2004; vol. 24(3); pp 481-492. Sources: American Academy of Family Physicians (AAFP): Chronic Cough: Causes and Cures. CDC: Get Smart: Know When Antibiotics Work. AAFP: Acute Bronchitis.
© 2005 WebMD, Inc. All rights reserved.