| What Is Bronchitis? |
Just when you thought you were finally over a cold, your chest starts to feel sore and you develop an irritating cough. Later, you might get the chills or a slight fever.
Chances are you have acute bronchitis, a condition that occurs when the inner walls that line the main air passageways of your lungs (bronchial tubes) become inflamed. Bronchitis often follows a respiratory infection such as a cold. And just as most people get occasional colds, virtually everyone has bronchitis at least once.
Most cases of acute bronchitis disappear within a few days without lasting effects, although coughs may linger 3 weeks or more. But if you have repeated bouts of bronchitis, see your doctor — They may suggest a more serious health problem, such as asthma, chronic bronchitis or chronic obstructive pulmonary disease (COPD). Chronic obstructive pulmonary disease is a general term for a group of chronic conditions — including emphysema — that obstruct your lungs' airways. You're much more likely to develop these problems if you smoke.
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| Signs and Symptoms |
A cough that brings up yellowish-gray or green mucus (sputum) is one of the main symptoms of bronchitis. Mucus itself isn't abnormal — your airways produce at least an ounce of normal secretions every day. But these secretions don't accumulate because they're continuously cleared into your throat and swallowed with your saliva. When your bronchial tubes are inflamed, however, they often produce large amounts of discolored mucus that comes up when you cough. Mucus that isn't white or clear usually means there's a secondary infection.
Still, these symptoms can be deceptive. You don't always produce sputum when you have bronchitis, and children often swallow coughed-up material, so parents may not know it's infected.
Other signs and symptoms of bronchitis may include:
- Soreness and a feeling of constriction or burning in your chest
- Breathlessness
- Wheezing
- Chills
- Overall malaise and slight fever
| Causes |
The same viruses that cause colds often cause acute bronchitis. But you can also develop bronchitis from exposure to your own or someone else's cigarette smoke and to other pollutants such as household cleaners and smog.
Bronchitis can also occur when acids from your stomach consistently back up into your food pipe, a condition known as gastroesophageal reflux disease (GERD). In addition, workers exposed to certain dusts or fumes may develop occupational bronchitis. This is an acute disease that generally clears up when exposure to the irritant stops.
Sometimes, inflammation and thickening of the lining of your bronchial tubes become permanent — a condition known as chronic bronchitis. Signs and symptoms include shortness of breath and a continuous cough that produces large amounts of mucus. You're generally considered to have chronic bronchitis if you cough most days for at least 3 months in 2 consecutive years. Often, however, smokers with chronic bronchitis cough almost every day, even if it's just to "clear their throats" in the morning.
Unlike acute bronchitis, chronic bronchitis is an ongoing, serious disease. Smoking is the major cause, but air pollution and dusts or toxic gases in the environment or workplace also can lead to chronic bronchitis.
| Risk Factors |
You're more likely to develop acute bronchitis if you smoke or live with someone who does. And if your resistance is low, either because you've recently had another illness or because you have a chronic condition that compromises your immune system, you're at higher risk of bronchitis. Children whose parents or siblings smoke are extremely susceptible to bronchitis, as well as to asthma, pneumonia, colds and ear infections (otitis media).
Smokers are also at high risk of developing chronic bronchitis — a disease that has traditionally been more common in men than in women. But because more women are smoking now than in the past, rates of chronic bronchitis among women are increasing.
Having gastroesophageal reflux disease (GERD) increases your risk of developing a chronic cough. And you run the risk of developing occupational bronchitis if you work around certain lung irritants, such as cotton, flax or hemp dust, or are exposed to chemical fumes from ammonia, strong acids, chlorine, hydrogen sulfide, sulfur dioxide or bromine. Occupational bronchitis usually clears up when you're no longer exposed to these substances.
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| When to Seek Medical Advice |
Most cases of bronchitis clear on their own in a few days, especially if you rest, drink plenty of fluids, and keep the air in your home warm and moist. But if you have a fever higher than 101 F, you're breathless, or cough up bloody or yellow or green mucus, see your physician. You may have pneumonia. And if you have a cough that lasts 6 weeks or more, be sure to seek medical care.
Also see your doctor if you have chronic lung or heart problems, including asthma, emphysema, or congestive heart failure, and think you may have developed a case of bronchitis. These conditions put you at greater risk of developing complications from bronchial infections.
If you have repeated bouts of bronchitis, tell your doctor. You may have chronic bronchitis, or you may live or work in an environment that continually irritates your airways. In some cases, you may have GERD or chronic sinusitis. If so, your doctor may be able to pinpoint the cause of your problem and suggest further testing and lifestyle changes that can help.
| Screening and Diagnosis |
To diagnose bronchitis, your doctor will likely listen to your chest with a stethoscope. You may also be asked to have a chest X-ray and a sputum culture — a test that checks for the presence of bacteria in sputum produced when you cough.
In some cases your doctor may recommend additional tests to rule out other causes for your symptoms. One of these will likely be a pulmonary function test (PTF) to check for signs of asthma or emphysema. During a PTF, you blow into a device called a spirometer, which measures how quickly you can get air into and out of your lungs. The test is painless and takes just a few minutes. If you have repeated bouts of bronchitis and your doctor doesn't suggest a PTF, ask to have one done.
| Complications |
Although a single episode of bronchitis isn't cause for concern, repeated bouts of bronchitis should be taken seriously. They may signal chronic bronchitis, asthma or other lung disorders. Chronic bronchitis isn't only a serious problem in itself, but can lead to a lung condition known as bronchiectasis, which commonly causes recurrent lung infections such as pneumonia. Having chronic bronchitis also increases your risk of developing lung cancer.
In addition, researchers are investigating the link between mycoplasma and chlamydia, two of the infectious organisms responsible for bronchitis. Respiratory infections can trigger asthma attacks in people who already have asthma, but scientists now wonder whether chlamydia or mycoplasma organisms also may actually cause asthma. Some evidence indicates that chlamydia might act as a trigger for coronary artery disease , although it's too early to draw any definitive conclusions.
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| Treatment |
Because bronchitis usually results from a viral infection, your doctor won't give you antibiotics, which aren't effective against viruses. Instead, getting plenty of rest, drinking extra liquids and taking a nonprescription cough medicine are the cornerstones of treatment for acute bronchitis.
If you have asthma, your physician may prescribe a bronchodilator inhaler and other asthma medications to reduce inflammation and open narrowed passages in your lungs. And if your doctor suspects a bacterial infection, or if you're a past or current smoker, he or she may prescribe an antibiotic.
| Prevention |
If you have frequent, repeated attacks of bronchitis, the culprit may be something in your environment. Cold, damp locations — especially in combination with air pollution or tobacco smoke — can make you more susceptible to acute bronchitis. When the problem is severe, you may need to consider changing where and how you live and work. Your doctor may be able to help you identify ways to prevent recurrences of the condition. In most cases you'll need to avoid tobacco smoke of any kind.
| Self-Care |
These suggestions can help make you more comfortable, speed recovery and prevent complications of acute bronchitis:
- Get plenty of rest.
- Drink lots of fluids.
- Use a humidifier in your room. Warm, moist air helps relieve coughs and loosens mucus in
your airways. But be sure to clean the humidifier according to the manufacturer's
recommendations to avoid the growth of bacteria and fungi.
- Take a nonprescription cough medicine. It's best not to suppress a cough that brings up
mucus, however, because coughing helps remove irritants from your lungs and air passages. If
your cough is keeping you awake at night, use just enough cough medicine so that you can rest,
but not enough to suppress your cough completely.
- Avoid irritants to your airways, such as tobacco smoke.
- Wear a mask when the air is polluted, or if you're exposed to irritants at work.
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