All about bronchitis
What causes bronchitis?
Bronchitis is a sickness characterized by coughing due to the irritation and inflammation of the trachea, and large airways which is usually caused by viruses. Viruses which commonly cause bronchitis are rhinovirus, enterovirus, influenza A and B, parainfluenza, coronavirus, human metapneumovirus, and respiratory syncytial virus. In very rare cases (1-10%), especially in people with underlying health conditions, bacteria are detected as the cause of bronchitis. Bronchitis can also be caused by inhalation of smoke or chemical fume which irritates the airways. Tobacco/cigarette smoking is the primary cause of chronic bronchitis, and people exposed to secondhand smoking are also at risk. You can also be at risk of occupational bronchitis if your occupation exposes you to irritants such as ammonia, dust, chlorine, e.t.c. These cause bronchitis or chronic obstructive pulmonary disease(COPD) in the case of prolonged exposure. However, your symptoms ease when you are no longer exposed to these irritants.
Bronchitis can be acute (lasts only a short time) or chronic (lasts for at least two months). While acute bronchitis is usually contagious, and can be spread through millions of tiny droplets (containing the virus) expelled while coughing or sneezing, chronic bronchitis is not often contagious.
What are the signs and symptoms?
- Cough which typically lasts for two to three weeks. It can be productive (with sputum) or not, and the sputum can either be clear or purulent
- Shortness of breath
- Blocked or runny nose
- Mild fever
- Mild body ache
- Sore throat
What it feels when having a bronchitis
Bronchitis feels like cold kicked up a few notches, the primary symptom is the hacking cough that is usually bothersome, you may develop soreness in your chest, throat and stomach muscle from all that coughing, it starts off as a dry cough and over time you may also cough up yellow to gray mucus (phlegm) from your airways, cough and wheezing may be more severe if you are a smoker or have asthma due to underlying inflammation. You may also experience wheezing and breathlessness when exerting yourself. However, this is usually seen in the case of chronic (long term) bronchitis. In addition you may experience headache, bodyache, chills and fever.
Pneumonia; this happens when the infection extends into the lungs from the airways. It is the most common complication that can arise from bronchitis, the risk of developing pneumonia is increased in the presence of these factors;
- Old age; the immune system response is reduced
- Weakened immune system; due to illness, chemotherapy, steroid medication or HIV infection
- Long term health conditions such as chronic obstructive pulmonary disease (COPD), sickle cell diseases, kidney, heart or liver diseases
Chronic obstructive pulmonary diseases (COPD); this is a lung condition that is used to refer to chronic bronchitis and emphysema in different percentages, having repeated episodes of bronchitis could be an indication of COPD.
Can you get bronchitis twice?
Yes, it is possible to get bronchitis twice and while repeated acute episodes can be due to repeated exposure to the causes of bronchitis, recurrent bronchitis is usually an indication that you have chronic bronchitis.
Treatment and prevention of bronchitis
In most cases, bronchitis does not need treatment as the infection resolves on its own after a few days or weeks. Antibiotics do not cure viral infection, bronchitis is usually caused by viruses, hence you do not need antibiotics. Unnecessary use of antibiotics can put you at risk of side effects and resistance.In some cases, however, bacteria can cause bronchitis. But even in these cases, antibiotics aren’t recommended.
However, as bronchitis can in some cases lead to pneumonia, your doctor may prescribe antibiotics for factors that can increase your risk of developing pneumonia or other complications. Furthermore, antibiotics can be prescribed in the presence of;
- Old age
- History of lung, liver, heart or kidney disease
- Weak immune system
- cystic fibrosis
Chronic (long term) bronchitis is managed the same way as COPD, and smoking cessation in particular is very important if you smoke. Pulmonary rehabilitation which is a breathing exercise and education program can also be of great benefit.
Generally, if you experience some severe or unusual symptoms, you should see your doctor for treatment.
Home remedies are alternatives to over the counter cough medicines. They can help to loosen mucus, soothe sore throat, ease inflammation and give relief of cough symptoms. Options you can try are;
- Honey and lemon drink
- Menthol; add menthol to a bowl of hot water and breathe in the steam
- Ginger tea
- Thyme tea
Things you can do at home
You can practice home care to help relieve your symptoms while the infection lasts by;
- Getting lots of rest
- Drinking lots of fluids; this will loosen up the mucus in your lungs and make it easier for you to cough up. It is also necessary to keep you hydrated
- Taking ibuprofen or paracetamol; this will help you relieve headaches, body aches and fever
- Using natural remedies to relieve cough symptoms
- Using lozenges
- Using saline nasal spray or drops to relieve a stuffy nose
- Avoiding smoke
Paracetamol can be used for pain, headache and fever, while ibuprofen can also be used for children from 6 months onwards. Adults can also take aspirin as an alternative but it is not applicable for children due to the risk of developing Reye's syndrome.
Cough medicines; there is little evidence that these work, do not use over the counter cough medicines for children under the age of four. Alternatively, natural remedies such as honey and lime can be used. Antitussives in particular should be avoided in bronchitis because it suppresses the cough reflex that helps to expel the mucus in your airways. You can consult your doctor or pharmacist for over the counter medications that can help you, it is also important to use these medicines as directed.
Mucolytics; these are medications that loosen the mucus and make it easier to cough up.
To ensure that you stay healthy and also help others stay healthy you should;
- Practice good hygiene; wash your hands regularly, use tissue to cover your mouth and nose when you cough or sneeze
- Avoid smoking as well as second hand smoking; smoking can trigger or worsen your bronchitis and also put you at risk of COPD
- Get vaccinated; this helps to prevent infection in the future, recommended vaccines include the flu and pneumococcal vaccine
- Eat a healthy and balanced diet which includes fruits and vegetables that help to improve your general well-being and boost your immunity against infection
When to consult a doctor
Bronchitis can often be treated easily at home with rest, hydration and some over the counter medicines. However, if you experience severe or unusual symptoms, that is an indication that you need to see your doctor
These symptoms include:
- Severe cough that lasts more than three weeks
- Repeated episodes of bronchitis
- Very high fever or constant fever (38°C and above) that lasts more than three days
- Bloody phlegm (coughing up blood)
- Dizziness or confusion
- Difficulty breathing
- Severe chest pain
Your doctor may perform a differential diagnosis to rule out other diseases which have the same symptoms as bronchitis such as pneumonia or whooping cough, you may require a chest X-ray or blood/sputum test if your doctor suspects pneumonia. If your doctor suspects that your symptoms are caused by an undiagnosed underlying health condition, he may order a pulmonary function test to assess your lung performance.
Furthermore, to reduce the risk of developing pneumonia or other complications, you should see a doctor when you suspect you have bronchitis and
- Have a weak immune system due to illness, chemotherapy, steroid medication or HIV infection.
- Older than 65
- Have a long term health condition such as COPD, sickle cell diseases, asthma, kidney, heart or liver diseases
Bronchitis can be short or long termed, acute bronchitis is usually self limiting and clears up on its own, home care and natural remedies can be used to make the infection more bearable while it lasts. Chronic bronchitis is often caused by smoking and can be managed with healthy living. Serious symptoms during episodes of bronchitis is an indication that a visit to your doctor is needed.
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