What is bronchitis?
Bronchitis is a medical condition that affects the respiratory system. It is attributed to inflammation of the inner lining of the bronchi which are the lung’s main airway. Inflammation leads to the production of thick mucus that is coughed up, causing the characteristic cough. Bronchitis can be sorted into acute and chronic.1
Types of bronchitis
Acute bronchitis
Acute bronchitis also called a chest cold, is commonly caused by viral infections. However, it can also be caused by inhalation of harmful chemical substances such as cigarette smoke and air pollution. Bacterial infection can also cause acute bronchitis. Acute bronchitis has a shorter duration than chronic bronchitis, as most acute bronchitis symptoms clear up within two weeks of the onset. It may occur as one has recovered from the common cold or the flu and in people with allergies, enlarged tonsils, and chronic sinusitis.2 Acute bronchitis differs from chronic bronchitis as it is shorter in duration and usually does not pose persistent problems following recovery.3
Chronic bronchitis
Chronic bronchitis occurs when the bronchi inflammation lasts for a long period of time. Individuals with chronic bronchitis are more prone to lung infections. One of the main causes of chronic bronchitis is smoking. Chronic bronchitis is recognized from acute bronchitis by the presence of a cough and thick mucus for most days for three months for two consecutive years and by ruling out other lung diseases. Chronic bronchitis is a chronic obstructive pulmonary disease (COPD). It can cause breathing problems by blocking the airflow in the lung.4
How do you get bronchitis?
Viral infections
Bronchitis is commonly caused by viral infections, specifically the ones that also cause the common cold and the flu.1-4 This is why it is common to suffer from bronchitis during or following recovery from the flu or common cold due to the presence of these viruses within the body, specifically the respiratory system.1 The bronchi become inflamed, swell, and produce more mucus as the body fights the virus.3
Bacterial infections
Bronchitis caused by bacterial infection is less common, it occurs in people having underlying health problems. Bacteria that are most detected in bacterial bronchitis are Haemophilus influenzae, Mycoplasma pneumoniae, Streptococcus pneumoniae, Moraxella catarrhalis, and Bordetella pertussis.5,6 Bronchitis caused by bacterial infections also has its unique risks, as it can become pneumonia if the bacterial infection spread from the bronchi to the alveoli of the lungs.7
Smoking and other air pollutants
Long-term smoking and exposure to other air pollutants are the leading cause of chronic bronchitis. Chest discomfort, wheezing, and coughing up mucus are symptoms that appeared due to exposure to these irritants. With time these irritants may lead to severe breathing problems.4
Risk factors
Asthma and allergies
Asthma is an inflammatory condition in which the respiratory muscles surrounding the airways swell and tighten, causing the narrowing of the airways.8 Allergies, physical exertion, or acid reflux can trigger asthma. Individuals with asthma are at increased risk of bronchitis as asthma constricts the airways and blood vessels of the respiratory system.9 This constriction aids in the development of bronchitis as the airways swell, narrow, and produce mucus. The body starts dealing with asthma the same way as infection producing more mucus that can block and damage airways.8,9
Gastroesophageal reflux disease
Gastroesophageal reflux disease (GERD) is a condition in which stomach acid flows back into the oesophagus (the oesophagus is the tube connecting the mouth and stomach), causing irritation of the esophageal lining. A circular band of muscle around the bottom of the oesophagus (lower esophageal sphincter) is responsible for allowing drink and food to reach the stomach after swallowing by relaxing and then closing. If this muscle is weak or does not work properly it will allow acid to follow back into the oesophagus.10 GERD patients are at risk of bronchitis as the stomach acid can reach the bronchial tree and irritate it, causing inflammation and swelling.11
Is bronchitis contagious?
Bronchitis is not contagious but causes like viruses and bacteria are. Other causes of bronchitis like smoking, air pollutants, and chemicals are not contagious. However, the body's response to contagious viruses or bacteria may differ from one to another. For example, if you get flu from someone who developed bronchitis due to flu, your airways do not get inflamed the same way as he did.12
How is bronchitis spread?
Bronchitis spreads through close contact with one who has the viruses and bacteria that cause bronchitis. The same virus that someone carries and does not have bronchitis may cause bronchitis in someone else. Bronchitis is spread also by smoking and air pollutants.12
Signs and symptoms of bronchitis
The signs and symptoms of bronchitis are very similar to those of the cold and flu. They include:
- Cough
- Increased Mucus production: the colour of the mucus can be clear, yellow, green or yellow-grey.
- Difficulty breathing
- Sore throat
- Wheezing
- Extreme Fatigue
- Body aches
- Headache
- Back pain
- Muscle Pain (especially of the chest).1-12
Despite these being the most common symptoms, symptoms do differ from person to person, so it is normal to experience a variety of the symptoms listed above.4
Symptoms that are unique to chronic bronchitis in its later stages include:
- Bluish skin, lips, and fingernails: This results from the lower oxygen levels in the body due to the bronchi being inflamed and swollen over a long period of time.4
- Heart Failure: Heart failure is a different symptom and complication of chronic bronchitis. Heart failure occurs because the inflamed bronchi cause the respiratory system to not work at its total capacity resulting in the heart needing to work harder to pump blood and deliver oxygen around the body.4
Treatment
Acute bronchitis
Acute bronchitis is usually mild and the symptoms resolve on their own.2 As acute bronchitis is commonly caused by a viral infection, antibiotics are not used in the treatment. This is because antibiotics target bacteria, not viruses, and unnecessary use of antibiotics increases the risk of bacteria resistance against them. Acute bronchitis treatment ultimately depends on one’s symptoms; if you are experiencing a bad cough due to acute bronchitis, you may be prescribed cough medicine. Other medicines to relieve the symptoms can be prescribed such as inhalers or tablets of bronchodilators and steroids to open up the inflamed airways. Mucolytic medicines are also helpful in thinning the mucus and making coughing up mucus easier.1 other things to do include using a humidifier to humidify, drinking lots of water, and taking painkillers to treat aches and pains but avoid ibuprofen in case of asthma.1,2
Chronic bronchitis
Chronic bronchitis treatment functions to prevent further complications while also treating symptoms. Individuals with chronic bronchitis who are also smokers are encouraged to stop smoking as it is the leading cause of chronic bronchitis.4 It is also important to avoid secondhand smoke and other irritants to prevent further complications.
Medications include:
- Oral medications open the airways and clear away mucus.
- Inhalers such as bronchodilators and steroids.
- Oxygen therapy.4
Lung reduction surgery is also used to remove damaged areas of the lung in chronic bronchitis patients. In rare cases, patients may require a lung transplant if the damage to the lung becomes too extensive to be treated.4
Home remedies
The most common home remedy for acute bronchitis is a humidifier. Humidifiers are used to humidify the air, causing cough relief and gradual thinning of mucus within the bronchi.3 Patients should also increase their intake of water as water also helps thin out the mucus and can ease cough. Also, acute bronchitis patients are advised to get adequate rest.1
When to see a doctor
You should see a doctor if you experience any of the following symptoms:
- Coughing blood or mucus.
- A cough that is causing you to have difficulty sleeping.
- A cough that lasts longer than three weeks.
- Cough and chest pain.
- Unexplained weight loss.
- Wheezing.
- Chest pain as you are recovering from a cold or flu.
- A fever with a temperature greater than 102° F (39°Cº).4
Summary
Bronchitis is a respiratory condition in which the airways (bronchi) become inflamed and swollen due to a viral infection or exposure to irritants or allergens.1 Bronchitis can be divided into two categories: acute bronchitis and chronic bronchitis. Acute bronchitis is mostly caused by a viral infection and is short, while chronic bronchitis is often caused by smoking cigarettes and is a long-term condition with several complications.3 Various risk factors are associated with bronchitis, most notably asthma and gastroesophageal reflux disease. Bronchitis symptoms overlap with many signs of a cold and flu. However, it does have different symptoms. Combining home remedies and over-the-counter medications can help in treating acute bronchitis, while chronic bronchitis requires further medical intervention.7 Therefore, you must contact a doctor immediately if you suspect bronchitis, as inaction can lead to other complications.
References
- Bronchitis [Internet]. NHS. UK. 2017 [cited 2022 Dec 23]. Available from: https://www.nhs.uk/conditions/bronchitis/
- John Hopkins Medicine. Acute Bronchitis [Internet]. 2021 [cited 2022 August 3]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/acute-bronchitis#:~:text=Bronchitis%20is%20inflammation%20of%20the,be%20called%20a%20chest%20cold.
- Contributors WE. Bronchitis [Internet]. WebMD. [cited 2022 Dec 28]. Available from: https://www.webmd.com/lung/understanding-bronchitis-basics
- Chronic bronchitis [Internet]. 2019 [cited 2022 Dec 28]. Available from: https://www.hopkinsmedicine.org/health/conditions-and-diseases/chronic-bronchitis
- Worrall G. Acute bronchitis. Can Fam Physician [Internet]. 2008 Feb [cited 2022 Dec 27];54(2):238–9. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2278319/
- How is viral bronchitis different from bacterial bronchitis? [Internet]. [cited 2022 Dec 27]. Available from: https://www.vinmec.com/en/news/health-news/how-is-viral-bronchitis-different-from-bacterial-bronchitis/
- Is bronchitis viral or bacterial? [Internet]. DispatchHealth. 2021 [cited 2022 Dec 28]. Available from: https://www.dispatchhealth.com/blog/is-bronchitis-viral-or-bacterial/
- Watson S. Asthmatic bronchitis: symptoms, treatment, and more [Internet]. WebMD. [cited 2022 Dec 28]. Available from: https://www.webmd.com/asthma/asthmatic-bronchitis-symptoms-treatment
- Asthma and bronchitis: understanding the link [Internet]. Healthline. 2016 [cited 2022 Dec 28]. Available from: https://www.healthline.com/health/asthma/asthma-bronchitis
- Gastroesophageal reflux disease (Gerd) - Symptoms and causes [Internet]. Mayo Clinic. [cited 2022 Dec 28]. Available from: https://www.mayoclinic.org/diseases-conditions/gerd/symptoms-causes/syc-20361940
- staff familydoctor org editorial. Acute bronchitis - persistent cough [Internet]. familydoctor.org. [cited 2022 Dec 28]. Available from: https://familydoctor.org/condition/acute-bronchitis/
- Bronchitis: causes, symptoms, diagnosis & treatment [Internet]. Cleveland Clinic. [cited 2022 Dec 28]. Available from: https://my.clevelandclinic.org/health/diseases/3993-bronchit