Bronchitis by Jill Shuman, MS, RD, ELS

En Español (Spanish Version)

Definition | Causes | Risk Factors | Symptoms | Diagnosis | Treatment | Prevention

Definition

The bronchi are air passages of the lungs. Bronchitis is inflammation of the bronchi. It can make breathing difficult. It can also be painful.

Bronchi of Lungs

lungs and bronchioles

© 2009 Nucleus Medical Media, Inc.

There are different types of bronchitis, such as:

  • Acute bronchitis—This is a sudden onset of symptoms. It only lasts a short time. There is full recovery of lung function.
  • Chronic bronchitis —This is a long term condition. It causes obstruction and erosion of the lungs. It is often the result of many years of cigarette smoking . This is a serious condition. It is a type of chronic obstructive pulmonary disease (COPD) .
  • Asthmatic bronchitis—It occurs in people with asthma during an asthma attack. It is most common with allergies.
  • Irritative bronchitis—This is due to frequent contact with certain irritants. This often happens because of work setting (also known as industrial or environmental bronchitis).

Causes

The inflammation may be caused by:
  • Bacterial and viral infections
  • Smoking (cigarettes or marijuana)
  • Inhalation of certain respiratory irritants (usually in work setting) such as:
    • Ammonia
    • Chlorine
    • Minerals
    • Vegetable dusts

Risk Factors

Risk factors for bronchitis include:
  • Smoking
  • Exposure to second-hand smoke
  • Contact with a person infected with bronchitis
  • Cold or flu
  • Asthma
  • Chronic sinusitis
  • Occupational exposures to respiratory inhalants
  • Smog, in susceptible individuals
  • Enlarged tonsils and/or adenoids
  • Malnutrition

Symptoms

Symptoms will depend on the type of bronchitis.

Acute Bronchitis

  • Runny nose
  • Malaise
  • Slight fever
  • Back and muscle pain
  • Sore throat
  • Cough, initially dry, then produces mucus that may be thick, yellow, green, blood-streaked
  • Wheezing

Chronic Bronchitis

  • Cough that brings up yellow-green mucus, often worse in the morning
  • Difficulty breathing
  • Bluish tint to lips and skin (in severe cases)
  • Swelling of the feet (in end-stage cases)

Bronchi and Air Sacs of Lungs

© 2009 Nucleus Medical Media, Inc.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Acute Bronchitis

Tests are rare. The following may be recommended for severe or questionable cases:
  • Blood test
  • Chest x-rays —to rule out pneumonia , a complication of bronchitis
  • Pulse oximetry—to measure the amount of oxygen in the blood
  • Bronchoscopy with culture of the sputum

Chronic Bronchitis

Tests may include:
  • Blood test
  • Chest x-rays
  • Pulmonary function tests or spirometry—to evaluate lung function
  • Sputum culture
  • Arterial blood gas—to test for levels of oxygen, carbon dioxide, and acid in the blood
  • Pulse oximetry
  • Bronchoscopy with culture of obtained sputum

Treatment

Acute Bronchitis

Treatment is aimed at relieving the symptoms. It includes:

Antibiotics will not be helpful if the infection is viral.

There are some concerns about the safety of over-the-counter cough and cold products. The concern is highest for children under two years of age. It is best to avoid these, especially in young children. Talk to your doctor about medicine options.

Chronic Bronchitis

Treatment is based on:
  • Age
  • Overall health
  • Extent of the disease
  • Past response to treatments
Treatment may include:
  • Oral antibiotics and bronchodilators, particularly clarithromycin
    • If you have chronic bronchitis and mild-to-moderate COPD, you may not need antibiotics.
    • A study found that shorter antibiotic treatment (five days or less) is as effective as longer treatment (more than five days).
  • Bronchodilators
  • Oral or intravenous corticosteroid medicines
  • Inhaled bronchodilators or corticosteroids
  • Expectorants to loosen secretions
  • Mucolytics
  • Supplemental oxygen
  • Cool mist humidification
  • Lung reduction surgery —removal of the most damaged part of the lungs (in severe cases)
  • Lung transplant (in end-stage cases)

If you are diagnosed with bronchitis, follow your doctor's instructions .

Prevention

To reduce your chance of getting bronchitis:
  • Stop smoking or never start.
  • Avoid passive smoke.
  • Avoid exposure to respiratory irritants.
  • Avoid contact with people who have bronchitis.

RESOURCES:

CANADIAN RESOURCES:

References:

  • Bishai WR. Macrolide immunomodulatory effects and symptom resolution in acute exacerbation of chronic bronchitis and acute maxillary sinusitis: a focus on clarithromycin. Expert Rev Anti Infect Ther . 2006;4:405-416.
  • Harrison TR, Fauci AS. Harrison's Principles of Internal Medicine . 14th ed. New York, NY: McGraw-Hill;1998.
  • Poole PJ, Black, PN. Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev . 2006;3.
  • Smith S, Fahey T, Smucny J, Becker L. Antibiotics for acute bronchitis. Cochrane Database Syst Rev . 2009;CD000245.
  • What is COPD. National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/dci/Diseases/Copd/Copd_WhatIs.html . Accessed July 7, 2008.
  • 6/4/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Nonprescription cough and cold medicine use in children. Medwatch: 2007 Safety Alerts for Drugs, Biologics, Medical Devices, and Dietary Supplements. US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#Cough . Accessed: September 4, 2007.
  • 6/4/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : El Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM. Abstract Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax . 2008;63:415-422. Epub 2008 Jan 30. Review.
  • 10/14/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Timmer A, Gunther J, Rucker G, Motschall E, Antes G, Kern WV. Pelargonium sidoides extract for acute respiratory tract infections. Cochrane Database Syst Rev . 2008;(3):CD006323.

Last reviewed July 2010 by Marcin Chwistek, MD

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