Bronchitis

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Acute Bronchitis - Topic Overview

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This topic is about acute bronchitis in people who don't have other health problems. Acute bronchitis may be treated differently if you have a long-term lung disease, such as chronic obstructive pulmonary disease (COPD). For more information, see the topics Chronic Obstructive Pulmonary Disease (COPD) andPneumonia. What is bronchitis? Bronchitis means that the tubes that carry air to the lungs (the bronchial tubes) are inflamed and irritated. When this happens, the tubes swell and produce mucus. This makes you cough. There are two types of bronchitis: Acute bronchitis usually comes on quickly and gets better after 2 to 3 weeks. Most healthy people who get acute bronchitis get better without any problems. See a picture of acute bronchitis . Chronic bronchitis keeps coming back and can last a long time, especially in people who smoke. Chronic bronchitis means you have a cough with mucus most days of the month for 3 months of the year for at least 2 years in a row.
This topic focuses on acute bronchitis. Both children and adults can get acute bronchitis. What causes acute bronchitis? Acute bronchitis is usually caused by a virus. Often a person gets acute bronchitis after having an upper respiratory tract infection such as a cold or the flu. In rare cases, acute bronchitis is caused by bacteria. Acute bronchitis also can be caused by breathing in things that irritate the bronchial tubes, such as smoke. It also can happen if a person inhales food or vomit into the lungs. What are the symptoms? The most common symptom of acute bronchitis is a cough that is dry and hacking at first. After a few days, the cough may bring up mucus. You may have a low feverand feel tired. Acute bronchitis symptoms usually start 3 or 4 days after an upper respiratory tract infection. Most people get better in 2 to 3 weeks. But some people continue to have a cough for more than 4 weeks. Pneumonia can have symptoms like acute bronchitis. Because pneumonia can be serious, it is important to know the differences between the two illnesses.Symptoms of pneumonia can include a high fever, shaking chills, and shortness of breath. How is acute bronchitis diagnosed? Your doctor will ask you about your symptoms and examine you. This usually gives the doctor enough information to find out if you have acute bronchitis. In some cases, the doctor may take a chest X-ray to make sure that you don't have pneumonia or another lung problem. How is it treated? Most people can treat symptoms of acute bronchitis at home. Drink plenty of fluids. Use an over-thecounter cough medicine with an expectorant if your doctor recommends it. This can help you bring up mucus when you cough. Suck on cough drops or hard candies to soothe a dry or sore throat. Cough drops won't stop your cough, but they may make your throat feel better. 1|2
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Last Updated: August 04, 2010 This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information. 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Next Article:
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Most people don't need antibiotics for acute bronchitis. Check with your doctor if you have heart or lung disease, such asheart failure, COPD, or asthma. You may need more treatment. Frequently Asked Questions Learning about acute bronchitis: What is acute bronchitis? What causes acute bronchitis? Can I prevent acute bronchitis? What are the symptoms? What happens in acute bronchitis? What increases my risk for acute bronchitis? Being diagnosed: Taking care of yourself:
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Who can diagnose acute bronchitis? How is acute bronchitis diagnosed? How is acute bronchitis treated? What medicines will I need to take? Should I take antibiotics for acute bronchitis? When should I call my doctor? What can I do to treat acute bronchitis at home?
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Last Updated: August 04, 2010
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information. 1995-2011 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. Next Article:
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What are the symptoms of acute bronchitis? What is chronic bronchitis? What are the causes of chronic bronchitis? What are the risk factors for chronic bronchitis? What are the symptoms of chronic bronchitis? When should an individual seek medical care for chronic bronchitis? How is chronic bronchitis diagnosed? What is the treatment for chronic bronchitis? What are the complications of chronic bronchitis? Can chronic bronchitis be prevented?
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Bronchitis Symptoms
What Are the Symptoms of Bronchitis? The symptoms for acute bronchitis are: Hacking cough.
Yellow, white, or green phlegm, usually appearing 24 to 48 hours after a cough. Fever, chills. Soreness and tightness in chest. Some pain below breastbone during deep breathing Some shortness of breath
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SOURCE: WebMD Medical Reference. Understanding Bronchitis Symptoms. The symptoms for chronic bronchitisare:... More bronchitis symptoms
Top Searched Chronic Bronchitis Terms: contagious, symptoms, treatment, children,chronic cough, asthma in children,emphysema, copd, lung cancer, pneumonia
Chronic Bronchitis Facts
Bronchitis is a term that describes inflammation of the bronchial tubes (bronchi and the smaller branches termed bronchioles) that results in excessive secretions of mucus into the tubes with tissue swelling that may narrow or close off bronchial tubes. Chronic bronchitis is defined as a cough that occurs every day with sputum production that lasts for at least 3 months, 2 years in a row. The major cause of chronic bronchitis is cigarette smoking; other causes are bronchial irritants, usually inhaled repeatedly by the affected person. Ideally, people should seek medical care before chronic bronchitis develops. People should seek care for tobacco addiction and the occasional chronic cough (less than daily for 3 months) to potentially avoid developing chronic bronchitis. Those with chronic bronchitis should seek care for severe dyspnea, cyanosis, and fever immediately. Diagnosis for chronic bronchitis is done by clinical history and physical exam, while other tests such as chest X-rays, pulmonary function tests, and CT imaging studies may also be used.
Treatment of most people with chronic bronchitis is to quit cigarette smoking and avoid air-borne bronchial irritants; medical treatments include bronchodilators, steroids, and oxygen therapy. The major complications of chronic bronchitis are severe shortness of breath, COPD, respiratory failure, and a high mortality rate. Risk factors for chronic bronchitis include smoking, exposure to airborne chemicals and secondhand smoke, dust, and other bronchial irritants. A majority of cases of chronic bronchitis can be prevented by not smoking and avoiding secondhand smoke. Avoidance of air-borne bronchial irritants, vaccinations, and asthma prevention may help prevent bouts of chronic bronchitis. Although the disease is chronic and progressive, patients that are diagnosed early before much bronchial damage occurs and who stop smoking (or avoid airborne dust, chemicals or other situations that lead to bronchial irritation) often have a good prognosis for many years.
What is bronchitis?
Bronchitis is a term that describes inflammation of the bronchial tubes (bronchi and the smaller branches termed bronchioles) that results in excessive secretions of mucus into the tubes, leading to tissue swelling that can narrow or close off bronchial tubes. Bronchial tubes extend from the trachea and terminate at the alveoli in the lungs; the bronchial system resembles an inverted tree and is sometimes termed the "bronchial tree." A few authors include the trachea and upper airway in the definition. There are two major types of bronchitis, acute and chronic. Many investigators conclude that recurrent incidences of acute bronchitis are the first steps that can lead to developing chronic bronchitis.
What is acute bronchitis?

Acute bronchitis is bronchitis that is short-lived; the bronchitis lasts about two weeks and usually people recover with no permanent damage to the bronchial tree. Viruses such as influenza, respiratory syncytial virus (RSV), and rhinoviruses cause the majority (about 90%) of cases of acute bronchitis, while the remainder are caused by bacteria (for example,Mycoplasma, Pneumococcus) or short-term exposure to chemical irritants (for example, tobacco smoke, gastric reflux contents, inhaled solvents).
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Medical Author: Charles Patrick Davis, MD, PhD Medical Editor: George Schiffman, MD, FCCP Medical Editor: Melissa Conrad Stppler, MD IN THIS ARTICLE Chronic Bronchitis Facts What is bronchitis? What is acute bronchitis? What are the symptoms of acute bronchitis? What is chronic bronchitis? What are the causes of chronic bronchitis? What are the risk factors for chronic bronchitis? What are the symptoms of chronic bronchitis? When should an individual seek medical care for chronic bronchitis? How is chronic bronchitis diagnosed? What is the treatment for chronic bronchitis? What are the complications of chronic bronchitis? Can chronic bronchitis be prevented? What is the outlook (prognosis) for chronic bronchitis? Patient Discussions: Chronic Bronchitis - Treatments Chronic Bronchitis Glossary Chronic Bronchitis Index Find a local Pulmonologist in your town
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What are the symptoms of acute bronchitis?

Symptoms of acute bronchitis may include:

a cough, mild wheezing, fever, chills and malaise, and shortness of breath especially with exertion.
Some people may cough up phlegm. Chronic bronchitis differs from acute bronchitis in several ways described below (for example, pathology, progression of disease, major causes, treatments, and outcomes).
What is chronic bronchitis?

Chronic bronchitis is defined as a cough that occurs every day with sputum production that lasts for at least 3 months, two years in a row. This definition was developed to help select uniform patient populations for research purposes, for example, to study
medication therapies for treatment of chronic bronchitis. Many of the bronchi develop chronic inflammation with swelling and excess mucus production. The inflammation causes a change in the lining cells of the airways to varying degrees. Many cells that line the airway lose the function of their cilia (hairlike appendages that are capable of beating rapidly), and eventually the ciliated cells are lost. Cilia perform the function of moving particles and fluid (usually mucus) over the lining surface in such structures as the trachea, bronchial tubes, and nasal cavities to keep these hollow structures clear of particles and fluids. These ciliated cells that help in clearance of secretions are often replaced by so-called goblet cells. This group of cells secretes mucus into the airway. The warm moist environment of the airway along with the nutrients in the mucus is an excellent medium for growing bacteria. The mucus often becomes infected and discolored from the bacterial overgrowth and the body's inflammatory response to it. The inflammation, swelling, and mucus frequently and significantly inhibit the airflow to and from the lung alveoli by narrowing and partially obstructing the bronchi and bronchioles. The muscles that surround the some of the airways can be stimulated by this airway irritation. This muscular spasm also known as bronchospasm can result in further airway narrowing. With long standing inflammation, as can be seen in chronic bronchitis, this muscular spasm and inflammation results in a fixed, nonreversible narrowing of the airway and the condition is termedchronic obstructive pulmonary disease (COPD). Chronic coughing develops as the body attempts to open and clear the bronchial airways of particles and mucus or as an overreaction to ongoing inflammation. Chronic bronchitis can be a progressive disease; symptoms (listed below) increase over time. Some NIH investigators consider chronic bronchitis a type of COPD. COPD also includes the entities of emphysema, chronic bronchitis, andchronic asthma. These conditions are not always separable and patients often have components of each. In the case of chronic bronchitis, the fixed airway obstruction, airway inflammation and retained secretions can result in a mismatch of blood flow and airflow in the lungs. This can impair oxygenation of the blood as well as removal of the waste product, carbon dioxide. Although people of any age can develop chronic bronchitis, the majority of people diagnosed with the disease are 45 years of age or older.
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What are the causes of chronic bronchitis?

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There can be many causes of chronic bronchitis, but the main cause is cigarette smoke.
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Statistics from the US Centers for Disease Control and Prevention (CDC) suggest that about 49% of smokers develop chronic bronchitis and 24% develop emphysema/COPD. Some researchers suggest that about 90% of cases of chronic bronchitis are directly or indirectly caused by exposure to tobacco smoke. Many other inhaled irritants (for example, smog, industrial pollutants, and solvents) can also result in chronic bronchitis. Viral and bacterial infections that result in acute bronchitis may lead to chronic bronchitis if people have repeated bouts with infectious agents. Also, underlying disease processes (for example, asthma, cystic fibrosis, immunodeficiency, congestive heart failure, familial genetic predisposition to bronchitis, and congenital or acquired dilation of the bronchioles, known as bronchiectasis) may cause chronic bronchitis to develop, but these are infrequent causes compared tocigarette smoking.
What are the risk factors for chronic bronchitis?

The major risk factor for individuals to develop chronic bronchitis is tobacco smoking and second-hand tobacco smoke exposure. However, there are others, such as repeated exposure to pollutants (especially airborne materials such as ammonia, sulfur dioxide, chlorine, bromine, hydrogen sulfide), dust, repeated bouts of acute bronchitis or pneumonia, and gastric reflux (by inhalation of gastric contents).
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Medical Author: Charles Patrick Davis, MD, PhD Medical Editor: George Schiffman, MD, FCCP Medical Editor: Melissa Conrad Stppler, MD IN THIS ARTICLE Chronic Bronchitis Facts What is bronchitis? What is acute bronchitis? What are the symptoms of acute bronchitis? What is chronic bronchitis? What are the causes of chronic bronchitis? What are the risk factors for chronic bronchitis? What are the symptoms of chronic bronchitis? When should an individual seek medical care for chronic bronchitis? How is chronic bronchitis diagnosed? What is the treatment for chronic bronchitis? What are the complications of chronic bronchitis? Can chronic bronchitis be prevented? What is the outlook (prognosis) for chronic bronchitis?
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What are the symptoms of chronic bronchitis?

The major symptoms of chronic bronchitis are as follows:
Cough and sputum production are the most common symptoms; they usually last for at least 3 months and occur daily. The intensity of coughing and the amount and frequency of sputum production vary from patient to patient. Sputum may be clear, yellowish, greenish, or occasionally, blood-tinged. Since cigarette smoke is the most common cause for chronic bronchitis, it should not be surprising that the most common presentation is so called smoker's cough. This is characterized by a cough that tends to be worse upon arising and is often productive of discolored mucus in the early part of the day. As the day progresses, less mucus is produced. Dyspnea (shortness of breath) gradually increases with the severity of the disease. Usually, people with chronic bronchitis get short of breath with activity and begin coughing; dyspnea at rest usually signals that COPD or emphysema has developed. Wheezing (a coarse whistling sound produced when airways are partially obstructed) often occurs.
In addition, symptoms of fatigue, sore throat, muscle aches, nasal congestion, and headaches can accompany the major symptoms. Severe coughing may cause chest pain; cyanosis (bluish/grayish skin coloration) may develop in people with advanced COPD. Fever may indicate a secondary viral or bacterial lung infection. When symptoms worsen or become more frequent, this is often referred to as an exacerbation of chronic bronchitis. These exacerbations often require antibiotics, and may need steroid medication and an increase in respiratory inhaled medications.
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Medical Author: Charles Patrick Davis, MD, PhD Medical Editor: George Schiffman, MD, FCCP Medical Editor: Melissa Conrad Stppler, MD IN THIS ARTICLE Chronic Bronchitis Facts What is bronchitis? What is acute bronchitis? What are the symptoms of acute bronchitis? What is chronic bronchitis? What are the causes of chronic bronchitis?
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What are the risk factors for chronic bronchitis? What are the symptoms of chronic bronchitis? When should an individual seek medical care for chronic bronchitis? How is chronic bronchitis diagnosed? What is the treatment for chronic bronchitis? What are the complications of chronic bronchitis? Can chronic bronchitis be prevented? What is the outlook (prognosis) for chronic bronchitis? Patient Discussions: Chronic Bronchitis - Treatments Chronic Bronchitis Glossary Chronic Bronchitis Index Find a local Pulmonologist in your town
When should an individual seek medical care for chronic bronchitis?

Ideally, a person should seek medical care before chronic bronchitis develops. It is reasonable for people to seek care for tobacco addiction and the occasional chronic cough (occurring less than daily for 3 months) and to get medical help to potentially avoid developing chronic bronchitis. However, any daily cough that lasts for at least 3 months in a person should be investigated by a physician. If a person develops chronic (3 months or longer) cough, difficulty breathing, sputum production, and other symptoms, it may represent the first bout of chronic bronchitis, so seeking medical care may help slow or prevent the usual progression of the disease. If a person with diagnosed chronic bronchitis (or COPD or emphysema) develops severe problems with breathing, cyanosis or fever, they should seek medical care immediately.
How is chronic bronchitis diagnosed?

Health care practitioner's diagnose chronic bronchitis by using a combination of a person's medical history, physical exam, and diagnostic tests. A history of a daily productive (sputum production) cough that lasts at least 3 months, especially if has occurred two years in a row, fits the criteria for a clinical diagnosis of chronic bronchitis. The physical examination often allows health care practitioners to hear wheezes and a prolongation of the exhalation of breathing, which are signs of airflow obstruction. A chest X-ray is often performed to help rule out other lung problems (for example, pneumonia, bronchial obstructions). Additional tests such as acomplete blood count (CBC), arterial blood gas measurements, CT scan of the chest, and pulmonary function tests are often done to characterize the structure and function of the lungs and to help exclude other conditions (for example, lung cancer, tuberculosis, lung infections). Often a pulmonologist (a physician with specialized training in the management of lung diseases) can help diagnose and treat chronic bronchitis.
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Medical Editor: George Schiffman, MD, FCCP Medical Editor: Melissa Conrad Stppler, MD IN THIS ARTICLE Chronic Bronchitis Facts What is bronchitis? What is acute bronchitis? What are the symptoms of acute bronchitis? What is chronic bronchitis? What are the causes of chronic bronchitis? What are the risk factors for chronic bronchitis? What are the symptoms of chronic bronchitis? When should an individual seek medical care for chronic bronchitis? How is chronic bronchitis diagnosed? What is the treatment for chronic bronchitis? What are the complications of chronic bronchitis? Can chronic bronchitis be prevented? What is the outlook (prognosis) for chronic bronchitis? Patient Discussions: Chronic Bronchitis - Treatments Chronic Bronchitis Glossary Chronic Bronchitis Index Find a local Pulmonologist in your town
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What is the treatment for chronic bronchitis?

For the majority of cases, the initial treatment is simple to prescribe but frequently ignored or rejected by the patient stop smoking cigarettes and avoid second-hand tobacco smoke. People should be encouraged in every way to cease smoking, as continuation will only cause further lung damage. Similarly, blocking or removing other underlying causes of repeated bronchial irritation (for example, exposure to chemical fumes) is a treatment goal. Fifty percent of patients with chronic bronchitis who smoke will no longer cough after 1 month of smoking cessation. The number increases to 80% after 2 months. Two major classes of medications are used to treat chronic bronchitis, bronchodilators and steroids.
Bronchodilators (for example,albuterol [Ventolin, Proventil, AccuNeb, Vospire, ProAir], metaproterenol[Alupent], formoterol [Foradil],salmeterol [Serevent]) work by relaxing the smooth muscles that encircle the bronchi, which allows the inner airways to expand. Anticholinergic drugs also can act as bronchodilators, including tiotropium (Spiriva) and ipratropium(Atrovent). Steroids (for example, prednisone, methylprednisolone [Medrol, Depo-Medrol]) reduce the inflammatory reaction and thus decrease the bronchial swelling and secretions that in turn allows better airflow because of reduced airway obstruction.
Often inhaled steroids are administered since they have fewer side effects than systemic (oral) steroids. Examples include budesonide (Pulmicort), fluticasone (Flovent), beclomethasone (Qvar), and mometasone (Asmanex). Combination therapy with both steroids and bronchodilators is often utilized. These include fluticasone/salmeterol (Advair), budesonide/formoterol (Symbicort), and mometasone/formoterol (Dulera).
PDE4 inhibitors are a new class of anti-inflammatory agents for exacerbations of COPD that has recently been approved by the FDA. It is primarily for exacerbations that involve excessive bronchitis and mucus production. There is currently only one agent available called roflumilast (Daliresp), a pill taken once per day.
Occasionally, antibiotics are used to treat chronic bronchitis exacerbations caused by bacterial infections. Broad spectrum antibiotics are often the choice. Examples include:

Fluoroquinolones (levofloxacin [Levaquin]) Macrolides (clarithromycin [Biaxin], azithromycin [Zithromax, Zmax]) Sulfonamides (sulfamethoxazole and trimethoprim [Bactrim]) Tetracyclines (doxycycline [Vibramycin])
Of course, if a culture is obtained, directed therapy at the specific offending organism is always best. Pulmonary rehabilitation is another treatment method that combines education and graded physical exercise. The education portion often includes smoking cessation techniques and the relationship of tobacco use to symptoms. Breathing techniques can be very helpful in overcoming theanxiety and discomfort of exacerbations. When chronic bronchitis is severe, airflow and blood flow may not move appropriately through the lungs. It is crucial for lung function that airflow and blood flow to the lung are precisely matched. When they are not, drops in oxygen and increases in carbon dioxide can result with profound negative consequences. Supplemental oxygen therapy may be an integral part of treatment. Often it is required with activity and sleep. Patients with severe disease can often benefit from purchasing a small finger oximeter (around $100) for monitoring blood oxygen levels at rest and with activity. Certain "home remedies" may ease the symptoms of chronic bronchitis. Cold air often aggravates coughing and dyspnea, so avoiding cold air or wearing a cold-air mask (such as a ski mask or face scarf) may help when in cold environments. Dry air also aggravates coughing so warm, humidified air may help by reducing coughing and
also may allow mucus to flow more freely, which may result in better clearing of the bronchial airways and less blockage by viscous mucus. One of the lessons of pulmonary rehabilitation is to instruct patients on the proper path for air to follow. This involves breathing in through the nose so that the air is moistened, cleansed, and warmed by the function of the upper airways (sinuses). Air is than expelled through the mouth and in some cases with pursed lips to help optimize the lung's function. Over-the-counter (OTC) cough suppressants such as dextromethorphan (for example, Pertussin, Vicks 44 or Benylin) may be helpful in reducing cough symptoms. OTC preparations with guaifenesin (for example, Robitussin or Mucinex) may make patients feel more comfortable but there is no scientific evidence that it helps mucus to become less viscous. Alternative treatments have been suggested by some individuals with little or no evidence of any benefit; and some may even be harmful (for example, herbal teas, high doses of vitamin C, South African geranium herb, eucalyptus oil inhalation therapy, and many others); it is advisable to check with the health care practitioner before using any of these remedies or products.
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What are the complications of chronic bronchitis?
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The major complications of chronic bronchitis are as follows:

dyspnea, sometimes severe, respiratory failure, pneumonia, cor pulmonale (enlargement and weakness of right heart ventricle due to lung disease), pneumothorax (collection of air or gas in lung causing lung collapse), polycythemia (abnormally high concentration of red blood cells needed to carry oxygen), COPD (some NIH investigators consider chronic bronchitis a type of COPD), emphysema, chronic advancement of the disease, and high mortality (death) rate (COPD is the 4th leading cause of death in the United States).
Can chronic bronchitis be prevented?

The majority of instances of chronic bronchitis can be prevented by not smoking and avoiding second-hand smoke. Flu and pneumococcal vaccinescan help prevent repeated infections that may lead to the disease. Certain industries (for example, chemical, textile, and farm workers) are often associated with air-borne chemicals and dust; avoiding air-borne chemicals and dust with appropriate masks may prevent or reduce the individual's chance of developing chronic bronchitis. Good control of asthma may prevent chronic bronchitis from developing. The genetic predisposition to chronic bronchitis is not currently preventable.
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IN THIS ARTICLE Chronic Bronchitis Facts What is bronchitis? What is acute bronchitis? What are the symptoms of acute bronchitis? What is chronic bronchitis? What are the causes of chronic bronchitis? What are the risk factors for chronic bronchitis? What are the symptoms of chronic bronchitis? When should an individual seek medical care for chronic bronchitis? How is chronic bronchitis diagnosed? What is the treatment for chronic bronchitis? What are the complications of chronic bronchitis? Can chronic bronchitis be prevented? What is the outlook (prognosis) for chronic bronchitis? Patient Discussions: Chronic Bronchitis - Treatments Chronic Bronchitis Glossary Chronic Bronchitis Index Find a local Pulmonologist in your town
What is the outlook (prognosis) for chronic bronchitis?

Although the disease is chronic and progressive, affected individuals that are diagnosed early before much bronchial damage occurs stop smoking (or avoid airborne dust, chemicals, or other situations that lead to bronchial irritation), they often have a good prognosis for many years. Approximately 50% of smokers with chronic bronchitis will stop coughing after 1 month of smoking cessation. This number increases to 80% after 2 months of abstinence. If airflow obstruction has occurred, this can improve but the improvement level depends on the duration of injury and the compliance with therapy. Obviously, the more impaired patients will have a lesser recovery of lung function. Conversely, those individuals that have continued bronchial irritation have only a fair to poor prognosis, since repeated bouts with the disease usually get worse, with affected individuals having more frequent incidents of coughing and dyspnea over time and further progression of lung function abnormalities. REFERENCES: Gotfried M, Grossman R. Short-course fluroquinolones in acute exacerbations of chronic bronchitis. Expert RevRespir Med, 4(5):661-672, 2010 Medscape Reference. Bronchitis. MedicineNet.com. Bronchitis. MedicineNet.com. Bronchitis Pictures Slideshow.
National Institutes of Health. Chronic Bronchitis.
Last Editorial Review: 5/19/2011
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I am 78 years old. I have had chronic bronchitis on and off for as long as I can remember. Often I would cough almost all night and gradually became almost immune to the coughing so that I did not actually wake up. Although there was some coughing during the day it was never as persistent as
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Chronic bronchitis is a cough that occurs daily with production of sputum that lasts for at least three months, two years in a row. Causes of chronic bronchitis include cigarette VIEW smoking, inhaled irritants, and underlying disease processes (such as asthma, or congestive heart failure). Symptoms include cough, shortness of breath, and wheezing. Treatments include bronchodilators and steroids. Complications of chronic bronchitis include COPD and emphysema.
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Bronchitis
What is bronchitis?
Bronchitis is an inflammation of the lining of the bronchial tubes, or bronchi, which connect the windpipe with the lungs. When the bronchi are inflamed and/or infected, less air is able to flow to and from the lungs and a heavy mucus or phlegm is formed in the airways. Acute bronchitis is usually a short illness that commonly develops from a severe cold or following other viral infections and is characterised by cough with green sputum and a soreness in the centre of the chest and perhaps fever and some (usually mild) shortness of breath. Chronic bronchitis is defined by the presence of a mucus-producing cough most days of the month, three months of a year for two successive years without other underlying disease to explain the cough. People with chronic bronchitis also have varying degrees of breathing difficulties. Periodically these people may get infections in their lungs which makes their breathing problems worse. Sometimes chronic bronchitis is called chronic obstructive lung disease or chronic obstructive airways disease. These terms reflect that the main problem is difficulty getting the air in and out of the chest and that is what causes the problems with breathing.
How do you get bronchitis?

Acute bronchitis is almost always caused by viruses that get into the bronchi and cause infection. As the bodys immune system fights against these viruses, more swelling occurs and more mucus is produced. In most cases, the viruses that cause colds cause acute bronchitis. Sometimes bacteria cause acute bronchitis, especially after viral infections like colds. Once the bronchial tubes have been irritated over a long period of time, excessive mucus is produced constantly, the lining of the bronchial tubes becomes thickened, an irritating cough develops, air flow may be hampered, and the lungs are endangered. The bronchial tubes then make an ideal breeding place for infections. Cigarette smoking is the most common cause of chronic bronchitis. Chronic bronchitis may also result
from a series of attacks of acute bronchitis. Other causes include air pollution and industrial dusts and fumes.
How serious is bronchitis?

Most cases of acute bronchitis go away after a few days to a week. Severe cases may also cause general malaise and chest pain. Chronic bronchitis starts with very minor symptoms. However in some people the symptoms get worse and worse over a number of years and may become so serious as to threaten the life of the patients. Chronic bronchitis is often associated with other pulmonary diseases, such as pulmonary emphysema (a chronic lung condition in which the alveoli may be irreversibly damaged).
How long does bronchitis last?

Most cases of acute bronchitis go away after a few days to a week without medical intervention. Sometimes, however, the cough associated with acute bronchitis lasts for several weeks or months. This is usually because the bronchi are taking a long time to heal. Chronic bronchitis is a progressive condition for which there is no cure. The symptoms of chronic bronchitis generally last for months at a time. The symptoms may get better but then occur again more than once each year, especially during the winter. The effects last longer as the condition worsens. Gradually, the coughing occurs all the time, getting worse in the morning and in damp, cold weather. As chronic bronchitis continues, chest infections become more frequent.
How is bronchitis treated?

Many cases of acute bronchitis will go away on their own without treatment. Chronic bronchitis can be more effectively treated if diagnosed in the early stages of the disease. While there is no cure for chronic bronchitis, there are different types of medicines that will help to keep it under control and relieve symptoms: Medicines called bronchodilators that are usually prescribed to treat asthma will help to open the bronchial tubes and clear out mucus. They are usually given with an inhaler. Medicines called mucolytics which thin or loosen mucus in the airways, making it easier to cough up can also be used to treat chronic bronchitis.
Persistent symptoms and more severe disease are treated with anti-inflammatory medicines called steroids (of the glucocorticoid type) which are given with an inhaler. Any medical information on this website is not intended as a substitute for informed medical advice and you should not take any action before consulting with a health care professional. Click here for more important information.
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Bronchitis
Introduction: Bronchitis occurs when the air passages in your lungs become inflamed. Bronchitis can be acute or chronic. Acute bronchitis is usually due to a viral infection -- such as a cold -- that starts in your nose or sinuses and spreads to the airways. Acute bronchitis usually lasts a few days, although you may have a cough for weeks afterward. Chronic bronchitis, on the other hand, occurs most often in people who smoke and, together with emphysema, is known as chronic obstructive pulmonary disease (COPD). Chronic bronchitis is characterized by a productive (wet) cough that is persistent. The mucus that' s produced by the inflamed airways eventually causes scar tissue to form in the lungs, making breathing difficult. See also: Chronic obstructive pulmonary disease Signs and Symptoms: Acute bronchitis:
Cough that produces yellow or green mucus Burning sensation in the chest Wheezing Sore throat Fever Fatigue
Chronic bronchitis:
Chronic cough that produces mucus Wheezing, shortness of breath Blue tinged lips Ankle, feet, and leg swelling
Causes: Acute bronchitis is usually caused by the same viruses that cause colds. But exposure to cigarette smoke or pollution, a condition called gastroesophageal reflux disease (GERD), and bacterial infections can also cause bronchitis. The main causes of chronic bronchitis are cigarette smoking and prolonged exposure to air pollution, dust, and environmental tobacco smoke. During their lifetimes, 40% of smokers develop chronic bronchitis. One study shows that snoring is also associated with chronic bronchitis. Diagnosis:
Your doctor will listen to your chest and back, look at your throat, and may draw blood and take a culture of the sputum from your lungs. If your health care provider is concerned about possible pneumonia or COPD, your health care provider may order a chest X-ray or a lung function test (which measures the amount of air in your lungs). Preventive Care: The best way to prevent chronic bronchitis is to avoid smoking and to stay away from air pollutants. For acute bronchitis, take steps to avoid colds and respiratory infections, such as washing your hands frequently, getting an annual flu shot, and (if you are over 65 or have a chronic illness) asking your health care provider about the pneumococcal vaccine (Prevnar). Treatment Approach: Acute bronchitis from a virus generally clears up on its own within 7 - 10 days. Using a humidifier, taking a cough medicine that contains an expectorant (something that helps you "bring up" mucus), and drinking plenty of fluids can help relieve symptoms. If a bacterial infection is the culprit, your doctor may prescribe antibiotics. Lifestyle
Do not smoke, and avoid secondhand smoke. Use a humidifier or inhale steam from a bowl. Drink plenty of fluids. Rest. If you have low oxygen levels from chronic bronchitis, you may need home oxygen therapy.
Medications For chronic bronchitis: Bronchodilators -- increase airflow by opening airways and help make it easier to breathe Corticosteroids -- reduce inflammation; either inhaled with an inhaler or taken by mouth, they are usually used to treat moderate to severe COPD For acute bronchitis: Cough medicines -- Two types of cough medicines, cough suppressants (for a dry cough) or expectorants (for a wet, productive cough that brings up mucus), are available over the counter and by prescription. Usually doctors recommend not suppressing a cough in cases of acute bronchitis, unless your cough is keeping you from sleeping at night.
Antibiotics -- Studies show that antibiotics are not an effective treatment for acute bronchitis and may contribute to antibiotic resistance. Nutrition and Dietary Supplements Because supplements may have side effects or interact with medications, you should take them only under the supervision of a knowledgeable health care provider. Be sure to talk to your physician about any supplements you are taking or considering taking. For chronic bronchitis: N-acetylecysteine (NAC, 400 - 1,200 mg per day) -- NAC is a modified form of a dietary amino acid that works as an antioxidant in the body. Several studies indicate that it may help relieve symptoms of COPD by acting as an antioxidant to reduce oxidative stress on the lungs (damage caused by free radicals, particles that harm cells and DNA). Although not all the studies agree, some suggest that taking NAC can reduce the number of attacks of severe bronchitis. For acute bronchitis: Because bronchitis often follows a cold, some of the same supplements used to prevent or treat a cold may be helpful.
Probiotics (Lactobacillus) -- So called good bacteria, probiotics help prevent infections in the intestines, and there is preliminary evidence that they might help prevent respiratory infections, too. One study found that children in daycare centers who drank milk fortified with Lactobacillus had fewer and less severe colds. Several studies that examined probiotics combined with vitamins and minerals also found a reduction in the number of colds caught by adults, although it' s not possible to say whether the vitamins, minerals, or probiotics were most responsible for the benefit.
Chicken soup -- It' s about as traditional a remedy for a cold as you can find (at least in modern history). In fact, chicken soup and warm liquids (such as broth and tea) can help soothe a sore throat and loosen mucus, which in turn helps ease congestion from a cold.
Herbs The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, you should take herbs with care, under the supervision of a health care provider. For acute bronchitis/Preventing respiratory infections:
Echinacea (Echinacea purpurea, 300 mg 3 times per day) -- Echinacea may help prevent colds, which can lead to bronchitis. An analysis of 14 scientific studies found that people who took echinacea reduced their risk of getting a cold by 58% and reduced the duration of a cold by an average of a day and a half. However, many of the studies used echinacea in combination with another herb or vitamin, so it' s impossible to say which one was responsible for the benefit. Echinacea should not be used by women who are pregnant or breastfeeding, or by anyone taking drugs that suppress the immune system (such as corticosteroids or methotrexate). Talk to your doctor before takign echinacea.
Andrographis (Andrographic paniculata) -- Andrographis may also help lessen cold symptoms and possibly reduce your risk of getting bronchitis. One study found that andrographis, an herb used in Ayurvedic medicine, combined with eleuthero (Eleutherococcus senticosus) in a formula called Kan Jang, helped reduce cold symptoms.
Garlic (Allium sativum) -- In one study, people who took garlic for 12 weeks between November and February had 63% fewer colds than people who took placebo. Those who did get a cold recovered about one day faster. Because garlic can increase the risk of bleeding, people who take anticoagulants (blood thinners, such as aspirin or warfarin) should not take garlic. Women who are pregnant or breastfeeding should talk to their doctor before taking garlic supplements.
Ginseng (Panax quinquefolius, 400 mg per day) -- At least two studies suggest that taking American ginseng may help prevent colds, as well as reduce the number of colds experienced and the severity of symptoms.
For acute and chronic bronchitis/Expectorants for cough:
Essential oil monoterpenes -- A combination of essential oils, including eucalyptus (Eucalyptus globulus), a citrus oil, and an extract from pine, has been suggested for several respiratory illnesses, including both acute and chronic bronchitis. One study found that people with acute bronchitis treated with essential oil monoterpenes did better than people who took placebo. Another study found that people who took the herbal treatment did as well as those who took antibiotics. More studies are needed. If someone is having an acute asthma attack, strong essential oils may be more irritating than helpful.
Lobelia (Lobelia inflata) -- Also called Indian tobacco, lobelia has a long history of use as an herbal remedy for respiratory problems including bronchitis. It is an effective expectorant, meaning that it helps clear mucus from your lungs. However, lobelia can be toxic and should only be used under a doctor' s supervision.
Mullein (Verbascum densiflorum, 3 g per day) -- Mullein is an expectorant, meaning it helps clear your lungs of mucus. Traditionally, it has been used to treat respiratory illnesses and coughs with lung congestion. However, it has not been studied for bronchitis.
Peppermint (Mentha x piperita) -- Peppermint is widely used to treat cold symptoms. Its main active agent, menthol, is a good decongestant. Menthol also thins mucus and works as an expectorant, helping loosen and break up phlegm.
For acute bronchitis: South African geranium (Pelargonium sidoides) -- Although scientific evidence is preliminary, a specific extract from South African geranium did show positive results in a few studies. In one study, people with acute bronchitis recovered faster when taking this extract than those who took placebo. In another study, people who took the extract did as well as those who took antibiotics, but without some side effects of the antibiotics. More studies are needed. Homeopathy Although very few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of bronchitis in addition to standard medical care. Before prescribing a remedy, homeopaths take into account a person's constitutional type. A constitutional type is defined as a person's physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual. Aconitum -- for early stages of bronchitis or other respiratory disorders; this remedy is most appropriate for people with a hoarse, dry cough who complain of dry mouth, thirst, restlessness, and being awakened by their own coughing; symptoms tend to worsen in cold air or when when lying on one's side Antimonium tartaricum -- for wet, rattling cough (that is usually too weak to bring up mucus material from the lungs) that is accompanied by extreme fatigue and difficulty breathing; symptoms usually worsen when lying on one's back; this remedy is particularly good for children and the elderly and is generally used during the later stages of bronchitis Bryonia -- for dry, painful cough that tends to worsen with movement and deep inhalation; this remedy is most appropriate for individuals who are generally thirsty, chilly, and irritable Hepar sulphuricum -- for later stages of bronchitis, accompanied by wheezing, scant mucus production, and coughing that occurs when any part of the body gets cold Ipecacuanha -- for the earliest stages of bronchitis accompanied by a deep, wet cough, nausea and vomiting; this remedy is commonly prescribed for infants Phosphorus -- for several different types of cough but usually a dry, harsh cough accompanied by a persistent tickle in the chest and significant chest pain; this remedy is most appropriate for individuals
who are often worn out and exhausted, tend to be anxious and fear death, and require a lot of reassurance Massage and Physical Therapy Aromatherapy Running a humidifier with an essential oil such as cedarwoord, bergamot, eucalyptus, myrrh, sweet fennel, jasmine, lavender, tea tree, or marjoram at night may help thin mucus and ease cough. Talk to an experienced aromatherapist to learn which oil, alone or in combination, is best for you. Prognosis and Complications For acute bronchitis, most symptoms usually resolve within 7 - 10 days, although a dry, hacking cough can linger for several weeks. The chance for recovery is poor for advanced chronic bronchitis. Early treatment, combined with stopping smoking, can stop lung damage from progressing and improve quality of life. Alternative Names: Respiratory infection - bronchitis
Reviewed last on: 12/2/2009 Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
Supporting Research Albert RH. Diagnosis and treatment of acute bronchitis. Am Fam Physician. 2010;82(11):1345-50. Baik I, Kim J, Abbott RD, Joo S, Jung K, Lee S, Shim J, In K, Kang K, Yoo S, Shin C. Association of snoring with chronic bronchitis. Arch Intern Med. 2008;168(2):167-73. Belongia EA, Berg R, Liu K. A randomized trial of zinc nasal spray for the treatment of upper respiratory illness in adults.Am J Med. 2001;111(2):103-108. Berggren A, Lazou Ahren I, Larsson N, Onning G. Randomised, double-blind and placebo-controlled study using new probiotic lactobacilli for strengthening the body immune defence against viral infections. Eur J Nutr. 2011;50(3):203-10. Blumenthal M, Goldberg A, Brinkman J, ed. Herbal Medicine. Expanded Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 2000:33-35, 297-303, 335-340.
de Vrese M, Winkler P, Rautenberg P, Harder T, Noah C, Laue C, et al. Probiotic bacteria reduced duration and severity but not the incidence of common cold episodes in a double blind, randomized, controlled trial. Vaccine. 2006 Nov 10;24(44-46):6670-4. Evans J, Chen Y. The association between home and vehicle environmental tobacco smoke (ETS) and chronic bronchitis in a Canadian population: the Canadian Community Health Survey, 2005. Inhal Toxicol. 2009;21(3):244-9. Ferri: Ferri's Clinical Advisor 2010, 1st ed. Philadelphia, PA: Mosby Elsevier Inc. 2009. Frank LG. The efficacy of Echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double blind, placebo-controlled study. J Comp Alt Med. 2000;6(4):327-334. Guo R, Pittler MH, Ernst E. Complementary medicine for treating or preventing influenza or influenzalike illness. Am J Med. 2007 Nov;120(11):923-929.e3. Review. Hasani A, Pavia D, Toms N, Dilworth P, Agnew JE. Effect of aromatics on lung mucociliary clearance in patients with chronic airways obstruction. J Altern Complement Med. 2003 Apr;9(2):243-9. Lindenmuth GF, Lindenmuth EB. The efficacy of echinacea compound herbal tea preparation on the severity and duration of upper respiratory and flu symptoms: a randomized, double-blind placebocontrolled study. J Altern Complement Med. 2000;6(4):327-334. Lindgren A, Stroh E, Montnemery P, Nihlen U, Jakobsson K, Axmon A. Traffic-related air polution associated with prevalence of asthma and COPD/chronic bronchitis. A cross-sectional study in Southern Sweden. Int J Health Geogr.2009;8:2. Lizogub VG, Riley DS, Heger M. Efficacy of a pelargonium sidoides preparation in patients with the common cold: a randomized, double blind, placebo-controlled clinical trial. Explore (NY). 2007 NovDec;3(6):573-84. Mahady GB. Echinacea: recommendations for its use in prophylaxis and treatment of upper respiratory tract infections.Nutr Clin Care. 2001;4(4):199-208. Mandell: Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, 7th ed. Philadelphia, PA: Churchill Livingstone. 2009; Ch. 61 Matthys H, Heger M. Treatment of acute bronchitis with a liquid herbal drug preparation from Pelargonium sidoides (EPs 7630): a randomised, double-blind, placebo-controlled, multicentre study. Curr Med Res Opin. 2007 Feb;23(2):323-31.
Nduba VN, Mwachari CW, Magaret AS, Park DR, Kigo A, Hooton TM, Cohen CR. Placebo found equivalent to amoxicillin for treatment of acute bronchitis in Nairobi, Kenya: a triple blind, randomised, equivalence trial. Thorax. 2008;63(11):999-1005. Pelkonen M. Smoking: relationship to chronic bronchitis, chronic obstructive pulmonary disease and mortality. Curr Opin Pulm Med. 2008;14(2):105-9. Pittler MH, Ernst E. Clinical effectiveness of garlic (Allium sativum). Mol Nutr Food Res. 2007 Nov;51(11):1382-5. Rantzsch U, Vacca G, Duck R, Gillissen A. Anti-inflammatory effects of Myrtol standardized and other essential oils on alvelor macrophages from patients with chronic obstructive pulmonary disease. Eur J Med Res. 2009;14 Suppl 4:205-9. Reichling J, Fitzi J, Furst-Jucker J, Bucher S, Saller R. Echinacea powder: treatment for canine chronic and seasonal upper respiratory tract infections. Schweiz Arch Tierheilkd. 2003;145(5):223-231. Rotblatt M, Ziment I. Evidence-Based Herbal Medicine. Philadelphia, PA: Hanley & Belfus, Inc; 2002:160-165, 252-256, 259-261, 337-338. Roxas M, Jurenka J. Colds and influenza: a review of diagnosis and conventional, botanical, and nutritional considerations. Altern Med Rev. 2007 Mar;12(1):25-48. Review. Schulz V. Liquid herbal drug preparation from the root of Pelargonium sidoides is effective against acute bronchitis: results of a double-blind study with 124 patients. Phytomedicine. 2007;14 Suppl 6:74-5. Shah SA, Sander S, White CM, Rinaldi M, Coleman CI. Evaluation of echinacea for the prevention and treatment of the common cold: a meta-analysis. Lancet Infect Dis. 2007 Jul;7(7):473-80. Review. Erratum in: Lancet Infect Dis. 2007 Sep;7(9):580. Stead LF, Hughes JR. Lobeline for smoking cessation (Cochrane Review). In: The Cochrane Library, 1, 2002. Oxford: Update Software. Stey C, Steurer J, Bachmann S, Medici TC, Tramer MR. The effect of oral N-acetylcysteine in chronic bronchitis: a quantitative systematic review. Eur Respir J. 2000 Aug;16(2):253-262. Wood LG, Wark PA, Garg ML. Antioxidant and anti-inflammatory effects of resveratrol in airway disease. Antioxid Redox Signal. 2010;13(10):1535-48. Yildirim A, Mavi A, Oktay M, Kara AA, Algur OF, Bilaloglu V. Comparison of antioxidant and antimicrobial activities of tilia (Tilia argentea Desf ex DC), sage (Salvia triloba l.), and black tea (Camellia sinensis) extracts. J Agric Food Chem. 2000;48(10):5030-5034.
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March 15, 1998 Table of Contents
Acute Bronchitis
WILLIAM J. HUESTON, M.D., Medical University of South Carolina, Charleston, South Carolina ARCH G. MAINOUS III, PH.D., University of Kentucky College of Medicine, Lexington, Kentucky
Am Fam Physician. 1998 Mar 15;57(6):1270-1276. See related patient information handout on acute bronchitis, written by the authors of this article.
Acute bronchitis is a lower respiratory tract infection that causes reversible bronchial inflammation. In up to 95 percent of cases, the cause is viral. While antibiotics are often prescribed for patients with acute bronchitis, little evidence shows that these agents provide significant symptomatic relief or shorten the course of the illness. In a few small studies, bronchodilators such as albuterol have been found to relieve some symptoms of acute bronchitis. Increased attention is being given to the role of Chlamydia species in acute bronchitis and adultonset asthma. Studies in progress may help to clarify the importance of these organisms in acute bronchitis and to determine whether early treatment can prevent or ameliorate asthma.
Acute bronchitis is one of the most common diagnoses made by primary care physicians.13 In the United States alone, the evaluation and treatment of this illness is estimated to cost $200 million to $300 million per year.4 Even though the diagnosis of acute bronchitis is frequently made, the definition of this illness lacks clarity and its pathophysiology is often misunderstood. Furthermore, acute bronchitis has traditionally been treated with antibiotics, although little evidence supports the effectiveness of antibiotic treatment in this illness. This article examines the causes of acute bronchitis, as well as the physiologic responses to this illness. The value of antibiotics and other agents in the treatment of bronchitic cough is also appraised.
Definition and Epidemiology

One reason that acute bronchitis is such a common diagnosis in primary care practice is that physicians often lump various conditions together under the diagnosis of bronchitis. In the absence of clear diagnostic signs or laboratory tests, the diagnosis of acute bronchitis is purely clinical.5 Consequently, cough from upper respiratory tract infections, sinusitis or allergic syndromes (e.g., mild asthma or viral pneumonia) may be diagnosed as acute bronchitis. True acute purulent bronchitis is characterized by infection of the bronchial tree with resultant bronchial edema and mucus formation.6 Because of these changes, patients develop a productive cough and signs of bronchial obstruction, such as wheezing or dyspnea on exertion. Unlike the chronic inflammatory changes of asthma, the inflammation in acute bronchitis is transient and usually resolves soon after the infection clears. In some patients, however, the inflammation can last several months.7 In rare cases, a postbronchitis cough can persist for up to six months. Bronchitis can have causes other than infection. Bronchial wall inflammation can occur in asthma or can be secondary to mucosal injury in an acute event, such as smoke or chemical fume inhalation. This inflammation can also result from chronic toxic exposure, such as cigarette smoking. It is important to realize that when underlying inflammation is present, such as in asthmatics or smokers, infective agents are likely to cause more severe cough and wheezing. Viruses are the most common cause of bronchial inflammation in otherwise healthy adults with acute bronchitis. Only a small portion of acute bronchitis infections are caused by nonviral agents, with the most common organism being Mycoplasma pneumoniae.810 Study findings suggest that Chlamydia pneumoniae may be another nonviral cause of acute bronchitis.11,12
The obstructive symptoms of acute bronchitis, as determined by spirometric studies, are very similar to those of mild asthma.13 In one study,13 forced expiratory volume in one second (FEV1), mean forced expiratory flow during the middle of forced vital capacity (FEF2575%) and peak flow values declined to less than 80 percent of the predicted values in almost 60 percent of patients during episodes of acute bronchitis. In the five weeks following the infection, these values returned to normal. Another study14found that patients with acute bronchitis were 6.5 times more likely to have been told they had asthma in the past and nine times more likely to be diagnosed with asthma in the future. The findings of these studies12,13 suggest that patients with acute bronchitis may have an underlying predisposition to bronchial reactivity during times of viral infection and that this reactivity may evolve into the more chronic bronchial inflammation which characterizes asthma. Recent epidemiologic findings of serologic evidence of C. pneumoniae infection in adults with new-onset asthma suggest that untreated chlamydial infections may have a role in the transition from the acute inflammation of bronchitis to the chronic inflammatory changes of asthma.11,12
Diagnosis
Patients with acute bronchitis usually have a viral respiratory infection with transient inflammatory changes that produce sputum and symptoms of airway obstruction. The cough in acute bronchitis may produce either clear or purulent sputum. While this cough generally lasts seven to 10 days, it can persist. Approximately 50 percent of patients with acute bronchitis have a cough that lasts up to three weeks, and 25 percent of patients have a cough that persists for over a month.12
PHYSICAL EXAMINATION
While a lung examination may be useful in patients with acute bronchitis, it is not diagnostic. Wheezing, rhonchi, a prolonged expiratory phase or other obstructive signs may be present. However, some patients may exhibit no signs of bronchospasm. Patients should be asked about night coughing, and they should undergo forced expiration in the prone position to detect wheezing. A night cough or wheezing may be the only signs that bronchial obstruction is present.
DIAGNOSTIC STUDIES
The appearance of sputum is not predictive of whether a bacterial infection is present. Purulent sputum is most often caused by viral infections.5,15 Microscopic examination or culture of sputum in the healthy adult with acute bronchitis generally is not helpful. Since most cases of acute bronchitis are caused by viruses, cultures are usually negative or exhibit normal respiratory flora. When M. pneumoniae infection is present, routine sputum cultures are still negative. Rapid tests for the identification of Mycoplasma organisms have been developed. However, these tests are not routinely available, and they are unlikely to be cost-effective studies in the acute care setting.16 No available test can provide a definitive diagnosis of acute bronchitis. While decreases in pulmonary function have been demonstrated in patients with acute bronchitis, diagnostic pulmonary function testing should not be performed in previously healthy patients. When underlying asthma is suspected, pulmonary function testing should be considered.
It must be kept in mind that acute bronchitis can cause transient pulmonary function abnormalities. Therefore, to diagnose asthma, the physician must find changes that persist after the acute phase of the illness. When pneumonia is suspected, chest radiographs and pulse oximetry may be helpful in making the diagnosis.
Differential Diagnosis
Many conditions other than acute bronchitis present with cough (Table 1). Acute bronchitis or pneumonia can present with fever, constitutional symptoms and a productive cough. While patients with pneumonia often have rales, this finding is neither sensitive nor specific for this illness. When pneumonia is suspected on the basis of the presence of a high fever, constitutional symptoms, severe dyspnea and certain physical findings or risk factors, a chest radiograph should be obtained to confirm the diagnosis.
TABLE 1
Differential Diagnosis of Acute Bronchitis

Disease process Reactive airway disease Asthma Allergic aspergillosis Occupational exposures Chronic bronchitis Signs and symptoms Evidence of reversible airway obstruction even when not infected Transient pulmonary infiltrates Eosinophilia in sputum and peripheral blood smear Symptoms worse during the work week but tend to improve during weekends, holidays and vacations Chronic cough with sputum production on a daily basis for a minimum of three months Typically occurs in smokers Tenderness over the sinuses Postnasal drainage Upper airway inflammation and no evidence of bronchial wheezing Evidence of infiltrate on the chest radiograph
Respiratory infection Sinusitis
Common cold Pneumonia Other causes Congestive heart failure Basilar rales Orthopnea Cardiomegaly Evidence of increased interstitial or alveolar fluid on the chest radiograph S gallop Tachycardia Reflux esophagitis Intermittent symptoms worse when lying down Heartburn Bronchogenic tumor Constitutional signs often present Cough chronic, sometimes with hemoptysis Other aspiration Usually related to a precipitating event, such as smoke inhalation syndromes Vomiting Decreased level of consciousness
3
Asthma and allergic bronchospastic disorders, such as allergic aspergillosis or bronchospasm due to other environmental and occupational exposures, can mimic the productive cough of acute bronchitis. When obstructive symptoms are not obvious, mild asthma may be diagnosed as acute bronchitis. Furthermore,
since respiratory infections can trigger bronchospasm in asthma, patients with asthma that occurs only in the presence of respiratory infections resemble patients with acute bronchitis. Asthma should be considered in patients with repetitive episodes of acute bronchitis. Patients who repeatedly present with cough and wheezing can be given full spirometric testing with bronchodilation or provocative testing with a methacholine challenge test to help differentiate asthma from recurrent bronchitis. Those with findings suggestive of the chronic inflammatory changes that occur in asthma may benefit from chronic anti-inflammatory therapy. Upper respiratory tract infection and sinusitis can also be confused with acute bronchitis. In all three of these illnesses, patients may have a productive cough. However, the material produced from the cough in an upper respiratory infection or sinusitis is from the deep pharynx and has accumulated from postnasal drainage. The differential diagnosis should also include nonpulmonary causes of cough and shortness of breath. In older patients, congestive heart failure may cause cough, shortness of breath and wheezing. Symptoms are often worse at night. Reflux esophagitis with chronic aspiration can cause bronchial inflammation with cough and wheezing.17 Finally, bronchogenic tumors may produce a cough and obstructive symptoms.4
Treatment
ANTIBIOTICS
Although many authorities have argued that antibiotics have no role in the treatment of acute bronchitis, these agents remain the predominant therapy offered to patients. Primary care physicians in the United States have treated acute bronchitis with a wide range of antibiotics,18,19 even though scant evidence exists that antibiotics offer any significant advantage over placebo (Table 2).20 Placebo-controlled studies using doxycycline,7,15 erythromycin21,22 and trimethoprim-sulfamethoxazole23 have failed to show consistent significant benefit for antibiotic therapy in acute bronchitis. Even when patients with M. pneumoniae infection can be identified using a rapid identification system, treatment with erythromycin has provided only limited benefit.24
TABLE 2
Trials of Antibiotics in the Treatment of Acute Bronchitis

Sample size 212 74 52 63
Study Stott and West (1976) Williamson (1984) Brickfield, et al. (1986) Dunlay, et al. (1987)
15 7 21 22
Antibiotic Doxycycline Doxycycline Erythromycin Erythromycin
Results No benefit on any outcome No benefit on any outcome No benefit on any outcome Reduced use of cough medicines and fewer abnormal lung examinations on follow-up in treated patients Fewer days of coughing, fewer days off work and reduced use of decongestants in treated patients
Franks and Gleiner (1984)
23
Trimethoprim with sulfamethoxazole
67
Study King, et al.* (1996)

24
Antibiotic Erythromycin
Sample size 91
Results Earlier return to work in treated patients
*The study population contained a disproportionate number of patients who were positive for Mycoplasma infection. Adapted with permission from Orr PH, Scherer K, Macdonald A, Moffatt ME. Randomized placebo-controlled trials of antibiotics for acute bronchitis: a critical review of the literature. J Fam Pract 1993;36(5):50712.
Frequently, antibiotics are prescribed primarily to meet patient expectations.25 While physicians may understand that antibiotics are not effective for acute bronchitis, they prescribe them anyway, fearing that failure to do so will leave patients less satisfied. However, one study26 found that patient satisfaction with care did not depend on the receipt of an antibiotic prescription. As long as physicians explained the rationale for treatment, patients who expected antibiotics and did not get them were just as satisfied as those who were given antibiotics. Another explanation for the frequent prescription of antibiotics is the lack of distinction between acute and chronic bronchitis. Chronic bronchitis is characterized by persistent and irreversible inflammatory changes in the bronchial tree, with these changes resulting in chronic cough, daily sputum production and shortness of breath. Patients with underlying chronic bronchitis may periodically become infected with a wide variety of organisms that produce changes in their usual respiratory symptoms. In such cases, the evidence regarding the effectiveness of antibiotic therapy is variable. Although some studies show that antibiotic therapy is beneficial in patients with exacerbations of chronic bronchitis,27,28 other studies are less convincing.29,30 Antibiotic effectiveness trials that do not differentiate between acute bronchitis and exacerbations of chronic bronchitis add to the confusion. Misconceptions about the role of bacteria in acute bronchitis and the widespread practice of treating this illness with antibiotics may stem from studies that included patients with chronic bronchitis who were mislabeled as having acute bronchitis.31
BRONCHODILATORS
The pulmonary function findings in mild asthma and acute bronchitis are similar. Thus, it has been hypothesized that bronchodilating agents may offer symptomatic relief to patients with bronchitis. Three studies3234 have evaluated the effectiveness of bronchodilators in the treatment of acute bronchitis (Table 3). These studies all demonstrated significant relief of symptoms in patients with bronchitis who received oral albuterol (4 mg four times daily),33 inhaled albuterol (two puffs four times daily)34 or fenoterol (not available in the United States).32 Compared with patients who received placebo, those who were treated with albuterol were more likely to have stopped coughing within a week of the initiation of therapy.33,34 The patients who were treated with inhaled albuterol also returned to work sooner.33 The effects of combining albuterol with an antibiotic have also been assessed. In one of these studies,32 no benefit was shown from adding erythromycin to the treatment regimen of patients who were already receiving albuterol.
TABLE 3
Studies of Bronchodilators for Acute Bronchitis or Cough
Study Study population Melbye, et al. Adults with (1991) bronchitis

32
Study size 73
Medication used Fenoterol aerosol vs. placebo
Hueston (1991)
33
Adults with bronchitis
34
Oral albuterol vs. erythromycin
Hueston (1994)
34
Adults with bronchitis
46
Albuterol aerosol vs. placebo (with and without an antibiotic)
Littenberg, et Acute al. (1996) nonspecific cough

35
104
Albuterol aerosol vs. placebo
Duration Main difference noted of therapy with drug therapy Seven days Improvement in general symptom score Faster resolution of abnormal lung findings Improvement in the forced expiratory volume in one second (FEV ) Seven days Reduction in the percentage of patients who were coughing after one week Trend toward improved well-being Seven days Reduction in the percentage of patients who were coughing after one week More patients returned to work by day 4 of treatment Seven days No benefits
1
Another study35 in patients with undifferentiated cough found no beneficial effect from albuterol therapy. The investigators who conducted this study did not attempt to select patients with productive cough and/or obstructive symptoms. Because of the multiple causes of cough, the study population most likely included patients with acute bronchitis as well as many other conditions, including sinusitis, upper respiratory infection and asthma. The results of this study demonstrate that bronchodilators are likely to be effective only when bronchial inflammatory changes are present. Until better clinical data are available, physicians must rely on an accurate history and the clinical picture of productive cough and wheezing to guide them in the use of bronchodilator therapy.
Possible Complication of Bronchitis: Adult-Onset Asthma

Serologic evidence of previous infection with C. pneumoniae has been found in some adults with newonset asthma.36 Consequently, considerable attention has been focused on whether adult-onset asthma is frequently preceded by a chlamydial respiratory infection.11,12 Both Chlamydia trachomatis37 and C. pneumoniae38 have been cultured from the sputum of children with asthma. However, no prevalence studies have assessed the frequency with which patients who have respiratory illnesses such as bronchitis are infected with Chlamydia species and the percentage of these patients who progress to asthma. The reversibility of bronchial inflammation when chlamydial infections are treated is uncertain. In one small open-label study of patients in a single practice,39 bronchial obstruction was reversed in about one half of the patients who received antibiotic therapy. The patients who responded to antibiotics tended to
have serologic evidence of acute infection or infection for a shorter period of time compared with the patients who did not respond to antibiotic therapy. While this evidence is still preliminary, it suggests that early treatment of persistent wheezing with agents effective against Chlamydia species may prevent the development of asthmatic symptoms in adults. Further studies that confirm the effectiveness of antichlamydial therapy would be useful in guiding treatment decisions.
The Authors
WILLIAM J. HUESTON, M.D., is chair of the Department of Family Practice at the Medical University of South Carolina, Charleston. Previously he was associate chair of the Department of Family Medicine at the University of Wisconsin, Madison, as well as director of the Eau Claire regional campus. Dr. Hueston received his medical degree from Case Western Reserve University School of Medicine, Cleveland, and completed a family practice residency at Riverside Methodist Hospital, Columbus, Ohio. ARCH G. MAINOUS III, PH.D., is associate professor and director of research for the Department of Family Practice at the University of Kentucky College of Medicine, Lexington. Dr. Mainous completed his doctoral training in social psychology at the University of Texas, Austin. Address correspondence to William J. Hueston, M.D., Department of Family Practice, Medical University of South Carolina, 171 Ashley Ave., Charleston, SC 29425-5820. Reprints are not available from the authors.
REFERENCES 1. Meza RA, Bridges-Webb C, Sayer GP, Miles DA, Traynor V, Neary S. The management of acute bronchitis in
general practice: results from the Australian Morbidity and Treatment Survey, 19901991. Aust Fam Physician. 1994;23:15503. 2. Kirkwood CR, Clure HR, Brodsky R, Gould GH, Knaak R, Metcalf M, et al. The diagnostic content of family practice: 50 most common diagnoses recorded in the WAMI community practices. J Fam Pract. 1982;15(3):485 92. 3. Marsland DW, Wood M, Mayo F. Content of family practice. Part 1. Rank order of diagnoses by frequency. J Fam Pract. 1976;3(1):3768. 4. Dunlay J, Reinhardt R. Clinical features and treatment of acute bronchitis. J Fam Pract. 1984;18(5):71922. 5. Gwaltney JM Jr. Acute bronchitis. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and practice of infectious diseases. 4th ed. New York: Churchill Livingstone, 1995:6068. 6. Perlman PE, Ginn DR. Respiratory infections in ambulatory adults. Choosing the best treatment. Postgrad Med. 1990;87(1):17584. 7. Williamson HA Jr. A randomized, controlled trial of doxycycline in the treatment of acute bronchitis. J Fam Pract. 1984;19(4):4816. 8. Evans AS, Brobst M. Bronchitis, pneumonitis, and pneumonia in University of Wisconsin students. N Engl J Med. 1961;265:4019. 9. Evans AS, Allen V, Sueltmann S. Mycoplasma pneumoniae infections in University of Wisconsin students. Am Rev Respir Dis. 1967;96:23744. 10. Mogabgab WJ. Mycoplasma pneumoniae and adenovirus respiratory illnesses in military and university personnel. Am Rev Respir Dis. 1968;97:34558. 11. Hahn DL, Dodge RW, Golubjatnikov R. Association of Chlamydia pneumoniae (strain TWAR) infection with wheezing, asthmatic bronchitis, and adult-onset asthma. JAMA. 1991;266:22530. 12. Falck G, Heyman L, Gnarpe J, Gnarpe H. Chlamydia pneumoniae (TWAR): a common agent in acute bronchitis. Scand J Infect Dis. 1994;26:17987. 13. Williamson HA Jr. Pulmonary function tests in acute bronchitis: evidence for reversible airway obstruction. J Fam Pract. 1987;25(3):2516. 14. Williamson HA Jr, Schultz P. An association between acute bronchitis and asthma. J Fam Pract. 1987;24(1):358.
15. Stott NC, West RR. Randomised controlled trial of antibiotics in patients with cough and purulent sputum. Br
Med J. 1976;2(6035):5569. 16. Hueston WJ. Antibiotics: neither cost effective nor cough effective. J Fam Pract. 1997;44(3):2615. 17. Mello CJ, Irwin RS, Curley FJ. Predictive values of the character, timing, and complications of chronic cough in diagnosing its cause. Arch Intern Med. 1996;156:9971003. 18. Nelson EC, Kirk JW, Bise BW, Chapman RJ, Hale FA, Stamps PL, et al. The cooperative information project: Part 2. Some initial clinical, quality assurance, and practice management studies. J Fam Pract. 1981;13(6):867 76. 19. Mainous AG 3d, Zoorob RJ, Hueston WJ. Current management of acute bronchitis in ambulatory care: the use of antibiotics and bronchodilators. Arch Fam Med. 1996;5:7983. 20. Orr PH, Scherer K, Macdonald A, Moffatt ME. Randomized placebo-controlled trials of antibiotics for acute bronchitis: a critical review of the literature. J Fam Pract. 1993;36(5):50712. 21. Brickfield FX, Carter WH, Johnson RE. Erythromycin in the treatment of acute bronchitis in a community practice. J Fam Pract. 1986;23(2):11922. 22. Dunlay J, Reinhardt R, Roi LD. A placebo-controlled, double-blind trial of erythromycin in adults with acute bronchitis. J Fam Pract. 1987;25(2):13741. 23. Franks P, Gleiner JA. The treatment of acute bronchitis with trimethoprim and sulfamethoxazole. J Fam Pract. 1984;19(2):18590. 24. King DE, Williams WC, Bishop L, Shechter A. Effectiveness of erythromycin in the treatment of acute bronchitis. J Fam Pract. 1996;42(6):6015. 25. Vinson DC, Lutz LJ. The effect of parental expectations on treatment of children with a cough: a report from ASPN. J Fam Pract. 1993;37(1):237. 26. Hamm RM, Hicks RJ, Bemben DA. Antibiotics and respiratory infections: are patients more satisfied when expectations are met? J Fam Pract. 1996;43(1):5662. 27. Anthonisen NR, Manfreda J, Warren CP, Hershfield ES, Harding GK, Nelson NA. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med. 1987;106:196204. 28. Saint S, Bent S, Vittinghoff E, Grady D. Antibiotics in chronic obstructive pulmonary disease exacerbations. A meta-analysis. JAMA. 1995;273:95760. 29. Nicotra MB, Kronenberg RS. Con: antibiotic use in exacerbations of chronic bronchitis. Semin Respir Infect. 1993;8:2548. 30. Staley H, McDade HB, Paes D. Is an objective assessment of antibiotic therapy in exacerbations of chronic bronchitis possible? J Antimicrob Chemother. 1993;31:1937. 31. Pozzi E. Clinical efficacy of dirithromycin versus miocamycin in the treatment of acute bronchitis or acute exacerbations of chronic bronchitis. J Antimicrob Chemother. 1993;31(Suppl C):1538. 32. Melbye H, Aasebo U, Straume B. Symptomatic effect of inhaled fenoterol in acute bronchitis: a placebocontrolled double-blind study. Fam Pract. 1991;8(3):21622. 33. Hueston WJ. A comparison of albuterol and erythromycin for the treatment of acute bronchitis. J Fam Pract. 1991;33(5):47680. 34. Hueston WJ. Albuterol delivered by metered-dose inhaler to treat acute bronchitis. J Fam Pract. 1994;39(5):43740. 35. Littenberg B, Wheeler M, Smith DS. A randomized controlled trial of oral albuterol in acute cough. J Fam Pract. 1996;42:4953. 36. Hahn DL, Anttila T, Saikku P. Association of Chlamydia pneumoniae IgA antibodies with recently symptomatic asthma. Epidemiol Infect. 1996;117:5137. 37. Bavastrelli M, Midulla M, Rossi D, Salzano M. Chlamydia trachomatis infection in children with wheezing simulating asthma [Letter]. Lancet. 1992;339:1174. 38. Emre U, Roblin PM, Gelling M, Dumornay W, Rao M, Hammerschlag MR, et al. The association ofChlamydia pneumoniae infection and reactive airway disease in children. Arch Pediatr Adolesc Med. 1994;148:72732. 39. Hahn DL. Treatment of Chlamydia pneumoniae infection in adult asthma: a before-after trial. J Fam Pract. 1995;41(4):34551.
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SymptomFind > Diseases & Conditions > Bronchitis
Bronchitis
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ABy Ashley Henshaw Published February 13, 2012
Though millions of people are diagnosed with bronchitis each year, there are still many individuals who dont understand this condition. In many cases, patients mistake their symptoms for a bad cold or the flu, which can lead to incorrect self-diagnosis and inadvertently prolonging the condition. Read this article to learn about bronchitis and tips for spotting its symptoms.
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Definition
Bronchitis is an inflammation of the lining of the bronchial tubes, which carry air between the trachea and the lungs. The lining in the bronchial tubes is important because it produces mucus, which covers and protects the respiratory system and its associated organs. Although bronchitis may develop from a cold or a respiratory infection, it can also be linked to other factors, including lifestyle habits like smoking.
Types
The two main types of bronchitis are acute and chronic bronchitis. Typically, acute bronchitis develops after a person has a respiratory infection or a bad cold. This condition is easy to treat and is only temporary. Chronic bronchitis, on the other hand, is a much more serious and long-term condition. It often occurs in response to environmental factors like exposure to allergens or from lifestyle habits like smoking. Over time, chronic bronchitis can cause serious damage to the lungs. Its important to note that chronic bronchitis is actually one type of chronic obstructive pulmonary disease (COPD). Like the other type of COPD emphysema chronic bronchitis can be fatal. According to the American Lung Association, COPD is the third leading cause of death in the U.S.
Symptoms
The first symptom of either type of bronchitis is typically a dry cough. However, other symptoms eventually accompany this cough to allow for a diagnosis of acute bronchitis: Shortness of breath Tight feeling in the chest Wheezing or whistling sound when breathing Coughing up thick yellow or greenish mucus Chills Mild fever Headache Most of the symptoms for acute bronchitis are the same for those with chronic bronchitis, with three exceptions. First, people with chronic bronchitis generally dont experience a fever or chills. Secondly, these symptoms persist for months or years rather than a matter of days, as is the case with acute
bronchitis. Finally, those with chronic bronchitis are more likely to experience episodes or periods where their symptoms worsen.
Causes And Risk Factors

Acute bronchitis and chronic bronchitis generally stem from different causes and risk factors. Acute bronchitis is typically triggered by a virus, often the same virus that causes the flu or a cold. Your risk for acute bronchitis is increased if yourimmune system has already been weakened by a cold, the flu, an infection or some other illness. Those who smoke or live with a smoker also have an increased risk of developing this condition. With chronic bronchitis, the causes are typically environmental, such as air pollution, allergens, toxic gases or dust. Smoking cigarettes continues to be the most common cause of chronic bronchitis. However, the risk of chronic bronchitis also increases for those non-smokers who are exposed to smoke regularly, such as those who live with a smoker. An additional risk factor is being exposed to airway irritants either at home or at work. Those irritants include grains, textiles and chemical fumes.
Prevention
The number one way to prevent bronchitis is to avoid cigarette smoke, whether that means quitting smoking or avoiding being around cigarette smoke often. You can also make lifestyle changes that limit your exposure to certain triggers of chronic bronchitis. This could include moving to a different location, changing jobs or wearing a mask during certain activities where you are exposed.
Since acute bronchitis is often caused by a virus, you can avoid developing this condition by following certain hygiene rules closely, such as washing your hands frequently and utilizing hand sanitizers. Additionally, you can get the flu vaccine each year to increase your protection against a virus. (For help on how to quit smoking, read Tips On How To Quit Smoking As Soon As Possible.)
Treatment
The treatment for acute bronchitis is extremely simple since it usually goes away on its own within a week. You wont need antibiotics since bronchitis usually stems from a virus, not bacteria. To increase the rate at which you recover from acute bronchitis, take the following steps: Get lots of rest Drink plenty of fluids Take over-the-counter pain medications if you have a fever Use a humidifier or steam in the bathroom Do not smoke and avoid exposure to cigarette smoke Unfortunately, there is no cure for chronic bronchitis, and any damage to your lungs as a result of the condition cannot be repaired. People with chronic bronchitis are strongly encouraged to stop smoking and limit their exposure to cigarette smoke in order to help reduce their symptoms. Additionally, some individuals with this condition can engage in pulmonary rehabilitation, which is a breathing exercise program designed to help those with chronic bronchitis breathe more easily. (To learn more about pulmonary rehabilitation, see Pulmonary Rehabilitation For COPD And Chronic Lung Conditions.)
Sources:

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Chronic Bronchitis
Complete Guide to Chronic Bronchitis
By Deborah Leader, RN, About.com Guide Updated October 29, 2011
About.com Health's Disease and Condition content is reviewed by the Medical Review Board
See More About: chronic bronchitis causes chronic bronchitis symptoms chronic bronchitis diagnosis chronic bronchitis treatments
Cough: A Common Symptom of Chronic Bronchitis Photo istockphoto.com user David Freund
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COPD Ads Chronic Bronchitis Chronic Bronchitis Symptoms Chronic Bronchitis Like Cough COPD Chronic Bronchitis Treatment Ads Stop Pulmonary Fibrosis95% Success, Dissolve Scar Tissue Breathe Better & Increase Oxygenwww.pivotalhealth.info China Stem Cell NewsSee Blogs and Videos of CP Patients Treated w/ Stem Cellswww.StemCellsChina.com Chronic Bronchitis Defined Chronic bronchitis, like emphysema, is among a group of lung diseases known as chronic obstructive pulmonary disease, orCOPD. Chronic bronchitis causes inflammation and irritation of the airways, the tubes in your lungs where air passes through. These airways are also called bronchial tubes, hence the name bronchitis. When the air tubes are inflamed and irritated, thick mucus begins to form in them. Over time, this mucus plugs up the airways of the lungs and makes breathing difficult. Unlike acute bronchitis, chronic bronchitis is irreversible and its path is one of frequent recurrences. Statistics According to the American Lung Association, in 2004, approximately 9 million people in the United States were diagnosed with chronic bronchitis. Chronic bronchitis can occur in all ages, but is more likely to affect those over 45 years. Unlike emphysema, chronic bronchitis affects women more than men. In 2004, 2.8 million males were diagnosed with chronic bronchitis compared to 6.3 million women. Causes Like other types of Chronic Obstructive Pulmonary Disease (COPD), chronic bronchitis is primarily caused by cigarette smoking, second hand smoke, and air pollution. Additionally, allergies, and infection are known factors that can cause exacerbation of chronic bronchitis. In fact, people who are diagnosed with chronic bronchitis are more likely to develop recurring infections in the lungs. Signs and Symptoms People with chronic bronchitis may experience the following symptoms:
Long-term cough Increased mucus production Dyspnea Frequent clearing of the throat Edema and weight gain (often occur as side effects of medication)
The cough that accompanies chronic bronchitis is sometimes brought on by cold weather, dampness and things that irritate the lungs, such as fumes or smoke. Usually, the patient will have a history of smoking and repeated infections of the lungs. To learn more about the signs and symptoms of chronic bronchitis, visit Symptom Checker, an interactive tool designed to help you understand your disease. Diagnosis The presence of a productive, long-term cough that lasts 3 months out of the year for 2 consecutive years points doctors in the diagnostic direction of chronic bronchitis. A diagnosis of chronic bronchitis is made by obtaining a complete history, including family, environmental and occupational exposure, and smoking history. Diagnostic tests may include:
Arterial Blood Gases Chest X-ray Pulmonary function tests Complete blood count Treatment The main goals in the treatment of chronic bronchitis is to keep the airways open and functioning properly, to help clear the airways of mucus to avoid lung infections and to prevent further disability. Treatment methods include:
Quitting smoking Antibiotics (if a bacterial infection is present) Bronchodilators Postural Drainage Chest physiotherapy Fluids (to liquify secretions) Corticosteroids
Prevention As with any type of COPD, quitting smoking remains the most important factor in the treatment and prevention of chronic bronchitis. Smoking causes the airways in the lungs to become constricted, or narrowed, and paralyzes the cilia in the lungs, which help the lungs remove irritating particles. Smoking also causes surfactant, the fluid that helps the lungs to expand, to become inactivated. Many options are available to those who wish to quit smoking and cannot do it on their own, including stop smoking aids, support groups and counseling. Learn more about the options available to you if you have a desire to quit. It is the best thing that you can do for your lungs and ultimately for your health. Still having trouble understanding chronic bronchitis? Watch this informative, About.com COPD video.
Sources:
COPD Fact Sheet. American Lung Association. http://www.lungusa.org/site/pp.asp?c=dvLUK9O0E&b=252866.
Smeltzer, Suzanne C. & Bare, Brenda, G. (1996). Brunnuer and Suddarth's Testbook of Medical-Surgical Nursing (8th Edition). Pennsylvania, PA: Lipponcott-Raven Publishers.
Suggested Reading What is Chronic Bronchitis? Symptoms of Chronic Bronchitis Treatment of Chronic Bronchitis Suggested Reading The Difference Between Emphysema and Bronchitis Overview of Types of COPD Chronic Cough: A Symptom of Chronic Bronchitis Suggested Reading What You Should Know About Chronic Obstructive Pulmonary Disease COPD Causes Increased Mucus Definition of COPD Exacerbation Related Articles Chronic Bronchitis - Definition of Chronic Bronchitis Chronic Bronchitis - What is Chronic Bronchitis Symptoms of Bronchitis - Acute and Chronic Bronchitis Symptoms Chronic Bronchitis - Definition of Chronic Bronchitis Bronchitis Natural Remedies for Bronchitis
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