Bronchitis

Bronchitis is a condition where there is inflammation in a part of the airways, called the bronchial tubes. It is a commonly occurring condition in adults and children alike, affecting 4% of the population.

There are several causes of bronchitis, so sometimes it is difficult to determine where it came from. 

Bronchitis symptoms start with a cough. Although symptoms of bronchitis can be mistaken for the flu or the common cold, there are notable differences. The flu and colds usually do not involve the bronchial tubes.

On the other hand, bronchitis usually does not lead to colds or the flu. In common colds, only the throat and pharynx (voice box) are typically affected.

The bronchial tubes or bronchi connect the lungs to the windpipe (trachea). From the windpipe, the bronchus appears as a single tube, and it branches into two and each branch goes to each lung. In each lung, the bronchus branches into smaller tubes called bronchioles. At the end part of bronchiole is the alveoli, a small air-filled space where oxygen exchange takes place.

The bronchial tubes simply act as a passageway for air. Their structure is composed of smooth muscles, cartilage, and mucous membrane. This enables the bronchi to have some degree of rigidity to keep airways open, while the mucous membrane secretes minuscule amounts of mucus to clean the airways to ensure good airflow.

Bronchitis may occur if bacteria or a virus makes its way into the bronchi and cause infection. Infections cause the bronchi to swell and produce more mucus, which constricts the airways, therefore making it harder for you to breathe.

There are also other important causes of bronchitis, such as breathing toxic fumes, dust, or tobacco smoke for an extended period of time. Conditions like emphysema and asthma may cause bronchitis. Sometimes, severe heartburn causes irritation in the throat that can result in bronchitis.

The disease process of bronchitis is somewhat similar to asthma. Note that asthma happens when there is long-standing inflammation and swelling in the bronchi, making the space inside the airways smaller. A slight contraction of the smooth muscles causes exacerbations, or asthma attacks. Note that asthma attacks can also happen with bronchitis. When this happens, it is referred to as asthmatic bronchitis.

Having bouts of bronchitis lasting three months or longer is called chronic bronchitis. Any shorter than that is called acute bronchitis. Having a cough, common cold, or other flu can sometimes cause acute bronchitis. Meanwhile, chronic bronchitis is often a consequence of tobacco use or living in a place with high levels of air pollution.

Diagnosing bronchitis requires a visit to the doctor. Bronchitis treatment is focused on relieving symptoms. Bronchitis usually goes away on its own, but if treatment is necessary, it consists of rest, medicine, and having therapy or certain treatment procedures.

Most cases are easily treatable, especially if the cause is found. Prescribed medicines work to treat the infection and reduce swelling. Other treatments also work to alleviate painful or irritating symptoms. Most cases of bronchitis, even chronic bronchitis, do not lead to other complications.

Usually, uncomplicated bronchitis lasts for around two weeks.

Acute bronchitis usually goes away without treatment. More severe bronchitis usually does not go away unless treated professionally. 

Yes, bronchitis is contagious. The viruses and bacteria that cause bronchitis can be spread via droplets expelled when you sneeze or cough.

Expelled mucus may also contain viruses and bacteria that can infect others. 

In most cases, all you need is adequate rest and sleep to treat bronchitis. A sufficient amount of rest helps your body battle infection.

As stated, you must stay away from irritants that can cause your airways to become inflamed. Wear a mask when going outside, and stay indoors if there is smog outside.

To help expectorate mucus and ease coughing, use a humidifier. Warm moist air helps loosen mucus in the airways, so you will have an easier time getting rid of it. However, make sure to clean the humidifier often to avoid it from becoming a breeding ground for bacteria.

Discuss herbal remedies and teas with your doctor. Steam will help loosen up mucus, and certain herbs such as mint may help relax your chest and airways.

The main symptom of bronchitis is a cough. This cough can be easily confused with a common cold or flu-associated cough. Fever with a cough, or if there is nausea, diarrhea, or vomiting, usually suggests flu.

Bronchitis causes a lingering and persistent cough, and sometimes it continues long after the inflammation has subsided.

A cough lasting longer than 5 days is indicative of bronchitis. The cough often lasts for 10 to 20 days, and often longer in the case of chronic bronchitis.

Most often, bronchitis causes a productive cough in 50% of patients. The expectorated mucus can be clear, white, yellowish gray, or greenish in color. Sometimes, the mucus has streaks of blood.

The color of mucus is influenced by the action of white blood cells in the bronchi, and so not useful in indicating a bacterial infection.

Other bronchitis symptoms include:

• Sore throat
• Runny or stuffy nose
• Headache
• Muscle pains
• Extreme fatigue.

Severe bronchitis may cause general malaise and chest pain. Symptoms like burning chest pain while breathing and coughing may happen when the bronchi become very inflamed.

When to see a doctor

You may need to a see a doctor if you have a cough that lasts more than three weeks, or if it causes sleeplessness. Other symptoms you should watch out for is wheezing, shortness of breath, and fever. Bronchitis caused by chronic obstructive pulmonary disease (COPD) may cause difficulty breathing and bluish discoloration of the nail beds and fingertips, and this too must be seen in the doctor right away. 

Bronchitis is caused by viruses, bacteria, and foreign substances making their way into the bronchi. The most common cause is viruses, and such cases are referred to as viral bronchitis.

Interestingly, the viruses that cause the common cold and flu can also cause bronchitis. Other viruses that are culprits include rhinovirus, adenovirus, influenza A and B, and parainfluenza virus. In most cases, the identity of the virus itself is not known.

Viruses cause the majority of bronchitis cases. Fortunately, most cases do not get worse, and they heal on their own.

Bacteria can also cause bronchitis, and this is more common in individuals with an underlying health problem. Such bacteria include Mycoplasma pneumoniae, Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Bordetella pertussis. Many of these bacteria are contagious.

Another cause of bronchitis is particulates in the air that end up in the bronchi, such as dust, air pollution, and tobacco smoke. These substances often cause chronic bronchitis, as frequent exposure tends to cause the bronchi to become inflamed repeatedly.

Rarely, bronchitis can occur if acidic stomach contents find its way into the bronchi and causes inflammation. Medical conditions like heartburn and gastroesophageal reflux (GERD) cause the stomach acid to rise up the esophagus and spill down the airways.

You should see a doctor if you have a lingering cough. To properly confirm a bronchitis diagnosis, you must be physically examined by the doctor.

The doctor may first listen for abnormal breathing sounds in your chest using a stethoscope. When diagnosing bronchitis, it is important to rule out pneumonia (inflammation of the lungs), which is considered to be much more dangerous. 

The doctor may order X-rays to inspect your lungs and airways. If the cough produces mucus, a sputum test may be ordered to determine the cause of infection.

If you have a history of asthma or have COPD, your doctor may order a spirometry, which measures the capacity of your lungs to hold air.

If the findings are inconclusive, or if there are other suspected causes, the doctor may order additional tests. For example, the doctor may inspect inside of your airways by through a bronchoscopy, which involves inserting a camera into the airways while you are sedated.

Aside from doing tests and procedures, the doctor may ask about your medical history, like having COPD, bouts of asthma, flu, colds, or a sore throat. You may have to disclose if you smoke tobacco or marijuana, or use e-cigarettes, which can trigger bronchitis.

You may be asked where you live or work to determine if air pollution could be the cause.

Most cases of bronchitis are highly treatable.

Most cases go away within two weeks without treatment. Bronchitis caused by viruses is self-limiting. You may only have to do some simple home remedies to treat viral bronchitis. However, be sure to consult with your physician before starting any home treatments.

Unless there are other underlying problems, you do not usually need to be confined in the hospital for treatment of bronchitis. Usually, long-term monitoring or frequent clinic visits are not needed. You may only have to return to the doctor if symptoms worsen or recur.

Bronchitis treatment relies largely on relieving symptoms. For example, you may be prescribed to take analgesics in case you have fever and malaise.

If doctors found that bronchitis is caused by bacteria, you may be prescribed antibiotics.

If you are taking antibiotics, always take them as prescribed and finish the entire course of treatment. Some antibiotics for bronchitis include amoxicillin, doxycycline, erythromycin, and trimethoprim-sulfamethoxazole. Only take antibiotics as prescribed by your doctor.

For a cough, the doctor may prescribe cough medicines. You may also use over-the-counter cough suppressants, but it is still best to consult your doctor.

You may have to take cough suppressants if you can’t sleep due to a persistent cough.

Drugs are also prescribed to treat other conditions that cause bronchitis. For example, inhaler drugs to open airways are often prescribed to patients with asthma or COPD. These medicines are often used to treat chronic bronchitis.

If you have chronic bronchitis and experienced exacerbations (asthma-like attacks), the doctor may prescribe corticosteroids to address inflammation in the airways.

Other treatments can be prescribed. In the case of chronic bronchitis, the doctor may enroll you in a pulmonary rehabilitation therapy program, where you will be taught specific breathing exercises to make breathing easier and increase endurance.

Aside from prescribed medicines, the doctor may recommend a current flu vaccine to reduce the risk of upper airway infections.

The doctor may also instruct to avoid certain things that worsen bronchitis. You should quit smoking and stay away from smoke.

If you already have bronchitis, you can prevent others from having it too by covering your mouth and nose each time you sneeze or a cough. Always wash your hands each time you touch your mouth or nose. 

These preventive measures can help you reduce your risk of bronchitis:

Avoid cigarette smoking

Cigarette smoke can increase your risk of developing chronic bronchitis. Avoid using tobacco and breathing in cigarette smoke. Tobacco has plenty of substances that are highly irritating to the airways.

Note that exposure to tobacco increases your risk of having chronic bronchitis. 

Wash your hands properly

To reduce your risk of catching a viral infection, wash your hands frequently and thoroughly using hand sanitizers.

Wear a surgical mask

If you have COPD, you may wear a face mask at work and while going out in crowded places.

Staying in a place with high levels of air pollution also increases risk. Stay indoors when there are smog warnings. Install air filters inside the house and replace them frequently.

If you have to go outside, wear a mask. The air inside the car can become polluted when driving down the road, so always keep windows closed and use a high-quality cabin air filter.  

Get influenza vaccines

Most cases of acute bronchitis are a result of influenza virus. Getting a yearly flu vaccine can prevent the development of flu. You may also consider vaccination that protects against some types of pneumonia.

The following self-care measures may help you in coping with bronchitis and feel better:

Avoid lung irritants

Avoid smoking cigarettes. Wear a mask when you have to go outdoors where the air is polluted or if you are exposed to irritants such as paint or household cleaners with strong smelling fumes.

Use a humidifier

Warm, moist air helps in relieving cough and loosens out mucus collected in your airways. Ensure that you clean the humidifier according to the manufacturer's recommendations, and avoid the growth of bacteria and fungi in the water container.

Consider wearing a face mask while going outside

If exposure to cold air exacerbates your cough and causes shortness of breath, put on a cold-air face mask before going outdoors.

Exposure to tobacco smoke greatly increases your risk of having chronic and acute bronchitis. Although e-cigarettes do not produce smoke in the way that burning tobacco does, they are still seen as an irritant that can put you at risk for bronchitis.

You may also contract bronchitis if you have the flu or a cold. Young children, the sick, and the elderly are most vulnerable. Having untreated heartburn or GERD may also increase the likelihood of bronchitis.

Living in a place with high air pollution levels, like in urban areas or working in places like factories where things are being burned, can also increase risk.

Complications of bronchitis

Usually, bronchitis does not become worse, and most cases it responds very well to treatment. Having repeated bouts of bronchitis, or chronic bronchitis is indicative of the development of COPD.

Rarely, bronchitis can lead to pneumonia. It happens when inflammation spreads into the lungs. Pneumonia can be fatal since inflammation often causes the alveoli to be filled with blood, water, or pus, cutting off air exchange and making it harder to breathe. Pneumonia signs and symptoms include very fast breathing, difficulty breathing, and bluish color of the nails. Because it can lead to death, pneumonia needs to be treated right away.