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Bronchitis is an inflammatory condition that affects the airways that connect to the lungs (trachea and bronchi). The bronchial tubes transport air to and from the lungs. When the airways become irritated, they undergo inflammation and become swollen. Additionally, excess mucus is produced, leading to a coughing reflex. Bronchitis is often classified as acute or chronic.
The cough associated with bronchitis can persist for several days to a couple of weeks, serving as its primary symptom. Acute bronchitis is predominantly caused by viruses, making them the most common culprits. However, both acute and chronic bronchitis can be triggered by exposure to smoke and other irritants.
Acute bronchitis, commonly referred to as a chest cold, is primarily caused by viral infections. This condition typically resolves on its own within a week to ten days, without any lasting effects. In contrast, chronic bronchitis poses a more serious health concern as it involves persistent irritation or inflammation of the lining of the bronchial tubes. Smoking is a frequent culprit behind this condition, which can lead to long-term complications.
Chronic bronchitis is a component of chronic obstructive pulmonary disease (COPD). An additional set of treatments are often necessary to treat the condition.
Symptoms
Signs and symptoms for either acute bronchitis or chronic bronchitis may include:
- Fatigue
- Breathing difficulties
- Fever and chills
- Runny nose
- The production of mucus, known as sputum, can vary in color, ranging from clear, white, yellowish gray, to green. In rare cases, there may be traces of blood in the mucus.
- Chest discomfort
Symptoms of acute bronchitis are often similar to that of cold symptoms. If you are experiencing acute bronchitis, you may exhibit cold-like symptoms, including mild headache and body aches. Typically, these symptoms improve within a week. However, a persistent and lingering cough may persist for several weeks even after other symptoms have subsided.
With chronic bronchitis, cough and other symptoms are likely to worsen at times. Productive cough may last at least three months with repeated attacks lasting at least two years. An acute infection on top of chronic bronchitis is also possible.
The initial symptom of bronchitis is a persistent cough. In most cases of bronchitis, coughing is accompanied by the expectoration of mucus, although a dry cough can also occur. Furthermore, individuals with bronchitis may experience whistling or a rattling sound while breathing.
If any signs and symptoms persist, it is important to seek medical attention from a healthcare provider for accurate diagnosis and appropriate treatment. Distinguishing between bronchitis and more serious conditions can sometimes be challenging.
Particularly, consultation with a healthcare professional is necessary under the following circumstances:
- The cough persists for over three weeks
- Cough is accompanied by a fever exceeding 102°F (38.9°C).
- The cough produces blood or discolored mucus, causes wheezing or shortness of breath, and interferes with sleep.
Causes
With bronchitis, the airways become irritated, and the immune system triggers a response that leads to swelling and mucus accumulation. Coughing is an attempt to expel the mucus. If there remains mucus or inflammation in the airways, coughing will persist.
This condition is caused by a virus. It can, however, be caused by almost anything that irritates the airways. Bronchitis can be caused by both infectious and noninfectious agents.
Acute bronchitis is primarily caused by viruses. Influenza (the flu), respiratory syncytial virus (RSV), adenovirus, rhinovirus (the common cold), and coronavirus are all viruses that cause bronchitis. Cigarette smoking is the most common cause of chronic bronchitis. Air pollution, dust, and harmful substances in the environment or workplace can also aggravate the illness.
Risk factors
There are several factors that can increase the risk of developing bronchitis:
- Tobacco smoke: Either type of bronchitis is more likely to develop in people who smoke or live around with someone who does.
- Low resistance: This can occur due to another acute illness, like a cold, or it may be linked to a chronic condition that weakens your immune system. Older people, infants, and children are more vulnerable to infection.
- Frequent exposure to irritants: Exposure to air contaminants or lung irritants, such as grains or textiles, or being exposed to chemical fumes, increases one risk of having bronchitis. This is often a job-related exposure.
- Acid reflux: Suffering from GERD or chronic acid reflux can result in severe heartburn which can irritate the throat and increase one’s risk of developing bronchitis.
Diagnosis
Diagnosing bronchitis typically involves a comprehensive evaluation that includes a thorough medical history inquiry, assessment of presenting signs and symptoms, and a physical examination. Differentiating between the symptoms of bronchitis and those of a common cold can be challenging, particularly in the early stages of illness.
To confirm the diagnosis of bronchitis, additional tests may be necessary. These tests can include:
- Physical examination: During the physical examination, the healthcare provider will examine the lungs for symptoms of congestion and to ensure that one is breathing properly. They will attentively listen to the breathing using a stethoscope to assess the lungs.
- Chest X-ray: In cases where the cough persists, a healthcare provider may recommend a chest X-ray to rule out more serious conditions. A chest X-ray can provide detailed images of the heart and lungs, aiding in the detection of pneumonia or other underlying ailments that may be causing the cough. This is particularly important for individuals with a history of smoking or who are currently smokers.
- Sputum tests: Patients may be asked to cough and expel mucus into a tube. Sputum is the mucus that comes up from the lungs during a cough. The sample will undergo testing to identify any indications of a viral or bacterial presence. Sputum can also be checked for allergy symptoms. It is evaluated to discover whether one has any illnesses that might benefit from antibiotics.
- Pulmonary function test (PFT): This is often recommended if the healthcare provider suspects chronic bronchitis. This test looks for symptoms of asthma or emphysema. PFT assesses how effectively the lungs’ function.
In a pulmonary function test, one exhales into a device known as a spirometer. This device measures how much air the lungs can hold, and how quickly the air is released from one’s lungs.
- Nasal swab: The healthcare provider may put a soft-tipped stick, known as swab, in the nose to test for viruses such as COVID-19 or the flu.
- Blood tests: This test may be necessary to check for the patient’s overall health or existing infections.
Treatment
In general, acute bronchitis often resolves on its own without requiring medical intervention. Since viral infections are the primary cause of this condition, and most viruses do not have specific medications, the body’s natural defenses work to combat the infection. During the recovery period, managing the symptoms of acute bronchitis can be done at home while waiting for the inflammation to subside.
If bronchitis is caused by factors other than viruses, it may require treatment to manage the condition. In the case of chronic bronchitis, complete recovery is less likely, but appropriate treatment can lead to improvement of the condition.
- Medications: Medication is rarely used to treat acute bronchitis. In some instances, one can take drugs to alleviate symptoms or address the underlying problem, such as:
- Cough medicine: A lingering cough may benefit from over the counter or prescription cough suppressants, such as dextromethorphan and benzonatate.
- Bronchodilators: If one is having problems breathing, a bronchodilator may be prescribed.
- Antiviral drugs: If the bronchitis is caused by the flu, the healthcare provider may prescribe an antiviral drug. The sooner it is taken, the sooner one may feel better.
- Other medications: To minimize inflammation, corticosteroids and other drugs may be prescribed.
Individuals with allergies, asthma, or chronic obstructive pulmonary disease (COPD) might receive a doctor’s recommendation for using an inhaler and other prescribed medications. These treatments aim to minimize inflammation and widen constricted air passages within the lungs.
In approximately 95% of cases, bronchitis is attributed to viral infections. However, if the diagnosis suggests that bacterial infection is responsible for bronchitis, antibiotics may be prescribed. Once an individual begins taking antibiotics, they generally cease to be contagious within 24 hours.
- Therapies: Individuals with chronic bronchitis may find pulmonary rehabilitation advantageous. This program involves a series of breathing exercises facilitated by a respiratory therapist, who guides in learning techniques to enhance ease of breathing and improve exercise tolerance.
