Bronchitis

Bronchitis is an inflammatory reaction of the lining of the bronchial tubes (or airways). As it is a respiratory condition, it presents with symptoms such as frequent coughing with or without mucus, fatigue, fever and wheezing or whistling sound while breathing.

Other names #

Bronchitis is also known as

• Airways inflammation

• Chest cold

Causes #

Causes of acute bronchitis #

Infections #

Acute bronchitis can be caused by viral or bacterial infections of the respiratory tract. The same viruses that cause the common cold or the flu can also cause acute bronchitis. Viruses and bacteria can enter your body if you are in close proximity to a patient who has an ongoing respiratory illness. When a patient coughs or sneezes, millions of tiny droplets laden with microorganisms get released into the air. If you inhale such contaminated air, you may also get infected.

Inhalation of irritant substances #

Inhaling dust particles, smoke, and industrial pollutants such as tiny fibers, asbestos granules, acid fumes, etc. may also cause inflammation in the airways and lead to acute bronchitis.

Seasonal changes #

For some people, seasonal changes can also increase the risk of acute bronchitis due to allergic reactions. It is seen that during the winter season most people experience an episode of acute bronchitis every year.

Causes of chronic bronchitis #

Air pollution #

Living in polluted areas and constantly breathing in polluted air can lead to the development of chronic bronchitis.

Industrial exposure #

Working in industries that continually expose a person to tiny fibers, dust, smoke, acid fumes, etc., which irritate the lungs may cause chronic bronchitis.

Smoking #

Smoking for a longer duration, actively or passively (exposed to smoke when someone else is smoking), is one of the causes of chronic bronchitis.

Symptoms #

Symptoms of acute bronchitis #

Symptoms of acute bronchitis last for a week or two and usually do not cause any lingering effects. Following symptoms are seen with acute bronchitis:

• Persistent cough

• Coughing up sputum, which may be colorless or yellowish. Occasionally, it may be greenish or blood-tinged sputum.

• A runny or a stuffy nose

• Sore throat

• Chest pain or tightness

• Wheezing or whistling sounds may be heard during breathing

• Dyspnoea or breathlessness while performing activities or at rest

• Fever, chills, weakness, and body aches

• Dizziness and confusion

• Low levels of oxygen

Symptoms of chronic bronchitis #

• When the symptoms of acute bronchitis last for a longer time and recur frequently, it may be a case of a condition known as chronic bronchitis, an ongoing illness.

• Chronic bronchitis is characterised as a productive cough which may continue for a minimum of three months for two or more consecutive years.

• Chronic bronchitis, if left unattended, might lead to emphysema (a type of respiratory disease) which in turn can cause chronic obstructive pulmonary disease (COPD), a serious respiratory disorder that can also be life-threatening.

Risk Factors For Bronchitis #

• You have a higher chance of getting bronchitis if you:

• Are a smoker

• Have a family history of respiratory diseases

• Work in an industry that exposes you to lung irritants

• Have asthma or allergic diseases

• Have a weak immune system

• Suffer from repeated bouts of severe acidity (gastric reflux)

Diagnosis #

Laboratory investigations #

Blood tests #

Blood tests like Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), etc., may be required to evaluate if the patient is suspected of having a severe infection or inflammation.

Sputum analysis #

This has a limited role in diagnosing a case of acute bronchitis. Viruses are the most common cause of acute bronchitis, and they are not sufficiently detected in a sputum analysis. A sputum examination routine is required when a patient is suspected of having add-on infections or pneumonia (complications of acute bronchitis).

Pulmonary function testing #

Pulmonary Function Tests are tests that study the functioning of the airways and are used to determine their sensitivity to bronchodilator medications. They are an important diagnostic tool to evaluate chronic bronchitis and COPD.

Imaging studies #

X-Ray chest PA view and HRCT chest - plain are used to visualize the lungs and the airways to help establish a diagnosis for respiratory symptoms.

Prevention #

• Do not smoke or be around people when they are smoking

• Wear a mask when you are exposed to dust, smoke, or other lung irritants

• Wash your hands frequently, and do not touch your eyes, ears, and mouth repetitively

• Get yourself vaccinated yearly with the flu vaccine

Treatments #

Physiotherapy and pulmonary rehabilitation #

• Physiotherapy exercises for postural drainage effectively loosen the secretions in the chest and help with easy expulsion of mucus.

• Pulmonary rehabilitation exercises comprise breathing techniques and with time gradually progress to aerobic exercises to help improve a patient’s lung capacity and strengthen their respiratory system.

• Pulmonary rehabilitation is an important part of chronic bronchitis and COPD management.

Acute bronchitis treatment #

The treatment for acute bronchitis is mostly symptomatic and consists of:

• Antipyretics like paracetamol preparations are used to control the fever.

• Bronchodilators like salbutamol and ipratropium bromide help improve breathing.

• Antitussives and expectorant syrups help reduce cough and chest congestion. Antitussives help suppress cough whereas expectorants help to easily expel the mucus.

• Lozenges provide a soothing effect by reducing the coughing sensation.

• Antibiotics (rarely) may be given if your doctor suspects an additional bacterial infection.

Chronic bronchitis treatment #

Chronic bronchitis is an ongoing illness that requires additional treatment to the above-listed symptomatic treatment of coughing. The treatment may include:

• Antitussive medications which are used to treat the chronic cough associated with chronic bronchitis and COPD.

• Bronchodilators such as salmeterol and tiotropium and steroid medicines like fluticasone and beclomethasone are prescribed for inhalation to relieve airway inflammation seen in chronic bronchitis and COPD.

• Patients with a severe disease may require supplemental oxygen at home to combat the hypoxia (absence of sufficient oxygen to the tissues).

Personal Care #

• Drink plenty of fluids like warm water, herbal teas, and clear soups.

• Take sufficient rest. If you can’t sleep at night, use an extra pillow to prop up your head to prevent mucus from settling in the back of your throat.

• Perform steam inhalation as it humidifies the nasal passages and airways and helps loosen chest congestion.

• Using a cold or warm mist humidifier in the bedroom can help clear the mucus.

• Gargling with salt water can help break mucus that irritates the throat. Spit it out after gargling. You can repeat it many times a day to soothe your throat.

• You can use a saline nasal spray or drops to help with nasal stuffiness.

• You can suck on lozenges (small medicated tablet for cough) or a mixture of honey and lemon to help with a sore throat and cough. Do not give lozenges to children without consulting a doctor.

• Quitting smoking is one of the key lifestyle modifications advised to patients who smoke. Smoking cessation helps prevent disease from worsening.

Complications #

Bronchitis, whether it is acute or chronic, may cause severe activity limitations and lead to:

• Asthma

• COPD

• Emphysema

• Empyema

• Pneumothorax

• Pneumonia

• Lung collapse

• Chronic hypoxia

• Respiratory failure

• Death