Bronchitis: Symptoms, Causes, Diagnosis, Treatment & Prevention

 Bronchitis occurs when the airways leading to your lungs (trachea and bronchi) become inflamed and full of mucus. You have a persistent cough as your body attempts to get rid of the mucus. Your cough could linger for two weeks or more.  A virus typically causes acute bronchitis and resolves on its own.  Chronic bronchitis never goes away, but it can be managed.

Bronchitis is an inflammatory condition that affects the lining of your bronchial tubes. These tubes transport air to and from the lungs. People with bronchitis frequently cough up thicker, darker mucus. Bronchitis can begin quickly and last only a short time (acute), or it might begin gradually and last a long time (chronic).

Also Read: Whooping Cough: Symptoms, Causes, Complications, Diagnosis, Treatment & Prevention

What is bronchitis?

Bronchitis is an inflammation of the airways that enter your lungs.

When your airways (trachea and bronchi) get irritated, they swell and fill with mucus, causing you to cough. Your cough can continue anywhere from a few days to a couple of weeks. It is the primary symptom of bronchitis.

Viruses are the leading cause of acute bronchitis. Smoke and other irritants can induce both acute and chronic bronchitis.

What are the types of bronchitis?

When people talk about bronchitis, they usually mean acute bronchitis, a temporary condition that causes coughing. Bronchitis can become chronic for certain people.

Acute bronchitis.

A viral infection typically causes acute bronchitis and resolves on its own in a few weeks. Most people do not require therapy for acute bronchitis.

Chronic bronchitis.

Chronic bronchitis is defined as having a cough with mucus on most days of the month for three months of the year or more. This continues for at least two years.

If you have persistent bronchitis, you could have chronic obstructive pulmonary disease (COPD). Consult your provider about whether you should be tested for COPD.

What are the symptoms of bronchitis?

Bronchitis is characterized by a persistent cough lasting one to three weeks. You normally bring up mucus when you cough with bronchitis, but you can get a dry cough instead. You might also hear a whistling or rattling sound as you breathe (wheezing).

You might have other symptoms, including:

• Shortness of breath (dyspnea)

• Fever

• Runny nose

• Tiredness or fatigue

What causes bronchitis?

Bronchitis is usually caused by a virus. However, almost anything that irritates your airways can trigger it. Bronchitis can be caused by both infectious and noninfectious causes, including:

• Viruses. Bronchitis is caused by several viruses, including influenza (the flu), respiratory syncytial virus (RSV), adenovirus, rhinovirus (the common cold), and coronavirus.

• Bacteria. Bacteria that cause bronchitis include Bordetella pertussis, Mycoplasma pneumonia, and Chlamydia pneumonia.

• Toxins are in the air.

• Smoking cigarettes or marijuana (cannabis).

Risk Factors:

Factors that enhance the risk of bronchitis are:

• Cigarette smoke. People who smoke or live with a smoker have an increased chance of developing acute and chronic bronchitis.

• Low resistance. This could be the result of another acute disease, such as a cold, or a persistent ailment that weakens your immune system. Older adults, newborns, and young children are more susceptible to infections.

• Job-related irritant exposure. Working near some lung irritants, such as grains or textiles, or being exposed to chemical fumes increases your risk of having bronchitis.

• Gastric reflux. Repeated bouts of severe heartburn can irritate your throat, increasing your risk of developing bronchitis.

Diagnoses and Tests:

How is bronchitis diagnosed?

Your healthcare professional can determine whether you have bronchitis based on your medical history and symptoms. They will listen to your lungs for symptoms of congestion and make sure you are breathing properly. They may test you for viral illnesses such as the flu or COVID-19.


What tests will be performed to diagnose this condition?

There are no specific tests for bronchitis; however, you may be examined for other illnesses. Possible tests include:

• A nasal swab. To test for viruses such as COVID-19 or the flu, your healthcare provider may insert a soft-tipped swab into your nose.

• Chest x-ray. If your cough persists for an extended period of time, you may need a chest X-ray to rule out any serious conditions. Your healthcare professional will use a machine to take images of your heart and lungs. They will check for indicators of other conditions that may be causing your symptoms.

• Blood testing. Your provider may perform blood tests using a needle in your arm to look for infections or to assess your overall health.

• A sputum test. Your provider may ask you to cough and then spit into a tube. Your sample will be examined for evidence of a virus or bacteria.

• Pulmonary function testing. If your doctor believes you have chronic bronchitis, they may use a machine to assess how well your lungs work.

Treatment:

How is bronchitis treated?

Acute bronchitis is typically not treated with medications. If you have the flu and your symptoms appeared within the last two days, your doctor may prescribe antivirals to help it go away faster.

Because bronchitis is nearly never caused by bacteria, antibiotics will not help you recover and may even make you feel worse.

What medications are used to treat bronchitis?

Most likely, your doctor will not recommend drugs to treat your bronchitis. In some circumstances, medication can help you with symptoms or treat the underlying cause, including:

• Antiviral medications. If your bronchitis is caused by the flu, your doctor may prescribe an antiviral medicine, such as Tamiflu®, Relenza®, or Rapivab®. If you begin taking antivirals shortly after your symptoms appear, you may feel better sooner.

• Bronchodilators. If you are having difficulty breathing, your doctor may prescribe a bronchodilator (a medication that helps open your airways).

• Anti-inflammatory medications. Your doctor may prescribe corticosteroids and other anti-inflammatory medications.

• Cough suppressants.  Cough suppressants (antitussives), whether over-the-counter or prescribed, can aid with a persistent cough.  Examples include dextromethorphan (Robitussin®, DayQuil™, PediaCare®) and benzonatate (Tessalon Perles®, Zonatuss™).

•  Antibiotics.  Antibiotics are unlikely to be used to treat bronchitis unless your doctor suspects a bacterial infection.

•  COPD and asthma medication.  If you have COPD or asthma, your doctor may prescribe extra medicine or breathing treatments for chronic bronchitis.

How can I manage bronchitis symptoms effectively?

Bronchitis symptoms can be managed at home using over-the-counter medications and rest. Running a humidifier or taking warm showers might help release mucus and improve breathing.

To relieve the aches and pains associated with a viral infection, take ibuprofen (Advil®, Motrin®) or acetaminophen (Tylenol®).

Prevention:

The greatest strategy to lower your risk of bronchitis is to prevent getting sick from viruses and other sources of lung inflammation. Specific approaches to lower risk include:

• Avoid being near others if you or they are sick. This is especially true in the winter, when people congregate indoors.

• Avoid smoking and other irritants.

• If you have asthma or allergies, avoid any triggers (such as pets, dust, and pollen).
• Run a humidifier. Moist air is less likely to irritate your lungs.

• Get lots of rest.

• Eat a nutritious diet.

• Wash your hands. To lower your risk of contracting a viral infection, wash your hands regularly and use alcohol-based hand sanitizers. Also, don't contact your eyes, nose, or mouth.

• Check your flu, pneumonia, and COVID-19 vaccination status.

References:

• National Heart, Lung and Blood Institute. Bronchitis (https://www.nhlbi.nih.gov/health-topics/bronchitis%29). Accessed 9/8/2022.

• Stern SC. Acute Bronchitis. In: Stern SC, Cifu AS, Altkorn D. eds. Symptom to Diagnosis: An Evidence-Based Guide, 4th ed. McGraw Hill; 2020.

• Acute bronchitis. Merck Manual Professional Version. https://www.merckmanuals.com/professional/pulmonary-disorders/acute-bronchitis/acute-bronchitis. Accessed Jan. 5, 2021.

• Lefebvre CW. Acute Bronchitis and Upper Respiratory Tract Infections. In: Tintinalli JE, Stapczynski J, Ma O, et al. eds. Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8th ed. New York, NY: McGraw-Hill; 2016.

• Bennett NL. Chronic Obstructive Pulmonary Disease (COPD). In: Stern SC, Cifu AS, Altkorn D. eds. Symptom to Diagnosis: An Evidence-Based Guide, 4th ed. McGraw Hill; 2020.

• Chest cold (acute bronchitis). Centers for Disease Control and Prevention. https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/bronchitis.html. Accessed Jan. 4, 2021.