Bronchitis

Cause

There are two types of bronchitis: acute and chronic bronchitis.
Acute bronchitis often occurs after colds or flu and is caused by a virus or bacterium. If the virus or the bacterium has invaded into the bronchi, the wall of the bronchi gets irritated. The lungs respond with an inflammation. Around the site of the inflammation, the body produces mucus, causing the patient to cough.
In chronic bronchitis, the patient has not initially been ill with flu or a cold. Chronic bronchitis has several causes, but is mainly caused by smoking. A person can also get the condition when he or she has had acute bronchitis multiple times in succession. Rarely, a lung disease is the cause.
Acute bronchitis is contagious and chronic bronchitis is not.

Symptoms

The symptoms are mainly coughing, excessive production of mucus, often shortness of breath, wheezing sound from the lungs, itch under the chin, blood taste in the mouth and (in case of infection with viruses and bacteria) also fever.
In case of acute bronchitis, the inflammation will pass after some time. In case of chronic bronchitis, it may get better for a while, but the cough comes back. The inflammation is permanent. People with chronic bronchitis also have varying degrees of breathing problems due to airway narrowing.

Diagnosis

The symptoms and physical examination are usually sufficient to make the diagnosis. Sometimes, an X-ray of the chest or a culture of mucus is also necessary. Chronic bronchitis may require further examination in the form of pulmonary function tests, blood tests and CT scan.

Treatment

In the treatment of acute bronchitis, only the symptoms are usually challenged:

• Fever can be countered with paracetamol.
• Patients who are able to cough up mucus, might steam to make mucus more fluid.
• The cough can be countered with antitussives.
• Medications that widen the airway (bronchodilators) can bring relief and prevent chest tightness.
• In case of acute bronchitis by a bacterial infection, antibiotics are sometimes needed. If the cause is a virus, antibiotics don’t help.

The treatment of chronic bronchitis may include:

• Oral medications.
• Bronchodilators for widening the airway.
• Administering oxygen from portable containers.
• Lung reduction surgery to remove the damaged part of the lung.
• Lung transplantation.

Prognosis

Acute bronchitis usually heals on its own. The inflammation is gone after about two weeks. Chronic bronchitis doesn’t heal. The prognosis is determined by several factors. The (continued) smoking habit is probably the most important factor. If the patient will cease his or her smoking habit, together with the use of medication, the deterioration of the pulmonary function will keep pace with peers after some time, although at a lower level.

Considerations

• Take extra rest; there’s no need to stay in bed.
• Drink enough, especially when having fever. Water and tea are good choices.
• Eat healthy.
• Try to avoid lung irritation, by not (passively) smoking and by using a facemask in polluted air, for example of paint and household items.
• Steaming also helps. Inhale warm, moist air. It loosens the mucus in the lungs and relieves symptoms. Steam over a bucket of hot water, with a towel over the head.
• Take an expectorant cough syrup.
• Always finish an antibiotic course, otherwise antibiotics will work no more in the long run.
• Wash hands frequently. Viruses often spread via hands.
• Stay away from anyone who has the flu or a cold. Don’t shake hands.
• Get the flu shot if qualified.

Facts

• The term ‘bronchitis’ is derived from the Latin word bronchia (bronchi) and the Greek word brónkhos (windpipe, throat). The suffix -itis indicates that it is an inflammation.
• The prevalence of acute bronchitis is 2.7%.
• Bronchitis, as well as pulmonary emphysema, falls under the heading of ‘Chronic Obstructive Pulmonary Disease (COPD)’.