How Does Bronchitis Start

When you start experiencing chest pain, tightness or difficulty in breathing, you might be having bronchitis. A persistent cough that may last up to two weeks and beyond is another symptom of bronchitis. Bronchitis is said to occur when there is an inflammation of the airways that leads to the lungs. This also results in excessive secretion of mucus. Hence, as the body tries to get rid of the mucus in the airways, a persistent cough would be experienced. This inflammation is what leads to the symptoms which are associated with bronchitis.

All about bronchitis

What are the types of bronchitis

Bronchitis is classified based on the severity of symptoms, causative agent or peculiar symptoms.

Based on how long the symptoms last; 

These are

• acute bronchitis 
• chronic bronchitis

Acute bronchitis: As the name implies, have severe acute symptoms and lasts for a fewer period. It should be suspected in persons with acute respiratory tract disease where cough dominates as the complaint.¹ These acute symptoms may be a result of viral infection or asthmatic attack. It could also be a result of exposure to irritants like dust, smoke and so on. Hypersensitive reactions to drugs could also result in acute symptoms. Travel history to a sick family member should also be evaluated for proper diagnosis

Chronic bronchitis: This lasts for a longer time with mild symptoms. Chronic Obstructive Pulmonary Disease, Asthma, and bacterial infection of the lower respiratory tract are some of the common causes of chronic bronchitis. Over exposure to irritants in workplace can also result in chronic bronchitis

Based on the causative agent or pathophysiology, bronchitis is categorized into the following;

• Viral Bronchitis
• Bacterial bronchitis
• Eosinophilic bronchitis - asthmatic and non-asthmatic

Viral Bronchitis is caused by several viruses like; Respiratory Syncytial Virus (RSV), adenovirus, coronavirus, influenza and parainfluenza virus and so on.

Bacterial bronchitis is caused by some bacterial like mycobacterium spp, pertussis spp and so on. Proper diagnosis is always required before treatment is initiated because antibiotic is not to be taken in viral infection or even in bacterial bronchitis without adequate culture and sensitivity test to determine the exact cause of bronchitis and hence target it with the appropriate antibiotic.

Eosinophile is a kind of white blood cell that is produced in large numbers in the presence of an antigen- foreign body. It is produced in response to triggers by either bacteria, viruses or even irritants. This results in the inflammation of the airways and hypersecretion of mucus to get rid of the external particles or organisms. Eosinophilic bronchitis could be of asthmatic or non-asthmatic origin. Triggers to asthmatic attack may result in the secretion of eosinophils which brings about eosinophilic bronchitis. Non-asthmatic triggers could be as a result of other stimulating agents that cause the secretion of eosinophils.

What are the causes of bronchitis

From the classifications of bronchitis, we could see that the causes include but are not limited to the following; bacterial infection, fungal infection, and viral infection. It could also be caused by irritants like smoke, and dust. Also,  cold weather, hot food, and smoke of any type can cause bronchitis.

Signs and symptoms of bronchitis

The common signs and symptoms of bronchitis include; wheezing or a rattling sound while breathing. This occurs as a result of resistance to airflow brought about by the narrowing of the airways by inflammation and hypersecretion of mucus. The resistance to airflow is inversely proportional to the radius of the airway to the 4th power.¹ Bronchiolitis is a term used to describe the inflammation of the smaller airways from the infection of the lower respiratory tracts. Other common symptoms include; mild headache and body aches, fever and chills, fatigue, mucus production, persistent cough, chest pain, laboured breathing.

Diagnosis

Diagnosis of bronchitis is based on the symptoms stated above. To determine the actual cause of bronchitis, other respiratory diseases must be ruled out like; Chronic Obstructive Pulmonary Disease- COPD, Pneumonia, asthma and other things that may give similar symptoms.

The following tests may be performed to ascertain bronchitis:

Nasal swab - this would tell the causative organism of the bronchitis when the swab is cultured.

Chest X-ray; This involves studying the pictures of your heart and lungs to pinpoint the actual cause of the disease.

Blood test; a Blood test is performed to check for the organism causing the infection.

Sputum test; a deep cough is advised which provides sputum that would be used to check for the presence of bacteria or viruses.

A pulmonary function test is another test performed to check how well the lungs are functioning. This may be used to check for chronic bronchitis.

Why do you get bronchitis? 

Bronchitis occurs in response to the presence of irritants, infections or other stimulating agents. When there is the presence of irritants like smoke, clouds of dust, ammonia, chloric acid, asbestos or even infections like bacteria or viruses. In the presence of these triggers, there is an autoimmune response which results in hypersecretion of mucus and inflammation of the airways that leads to the lungs. This happens in a bid to get rid of these irritants and infectious agents through deep coughs that would lead to expectorating of the mucus filled with them.

Who is at risk?

Bronchitis is common among COPD, asthmatic patients, smokers, those exposed to irritants through occupational hazards and so on.

What age does it usually start?

 People of 40 years and above are at high risk of bronchitis, though it can happen to anyone despite their age.

Treatment and prevention of bronchitis

Treatment of bronchitis are based on the causative agents. The use of antibiotics is prohibited in viral bronchitis. Antibiotic use for bronchitis caused by a bacterial infection should be strictly based on doctors' prescriptions. 

Medications

The medications for treating bronchitis are tailored to the actual cause.

Antiviral drugs are used for treating bronchitis caused by viral infections.

Antibiotics are used for the treatment of bacterial bronchitis.

Bronchodilators, that is drugs that help in opening up the airways are also used. Use of antitussives or cough suppressants is not advised since through the coughing, mucus containing the irritants and infectious agents are removed.

Antiinflammatory agents, both steroidal and non-steroidal can be used to reduce inflammation.

Home remedies

Home remedies include hot baths or even exercise can help loosen up the mucus. Use of over-the-counter drugs like ibuprofen and Tylenol to reduce the chills, inflammation and fever. 

Other ways

Other ways to reduce bronchitis is to avoid the triggers like dust, and occupational irritants by use of PPE(Personal Protective Equipment). Avoid smoking cigarettes, cannabis or any form of smoke.

Complications

Chronic bronchitis which is the type that lasts longer than three months could result in other respiratory diseases like COPD, and asthmatic symptoms. A persistent cough can cause lesions in the respiratory tract. Cancer of the airways could arise from this.

When to seek medical attention

When the fever, chills, coughs and other symptoms persist  3-5 days after the use of home remedies, you should see a general practitioner. Greenish or yellowish sputum is an indication of bacterial infection and hence, needs to be treated with antibiotics. Do not take any antibiotics without a doctor's prescription.

Summary

Bronchitis is the inflammation of the airways that leads to the lungs leading to the excessive secretion of mucus and tightening of the airways. It comes as a result of infection of the viral or bacterial origin or even as a result of exposure to irritants like clouds of dust, chemicals, and smokes that leads to an autoimmune response in a bid to get rid of the triggers. The common symptoms of bronchitis include headache and body aches, fevers and chills, wheezing, coughs lasting longer than normal, fatigue and so on. Treatment is based on the causative agents which are determined by appropriate diagnosis. The use of antibiotics is restricted to bronchitis caused by bacteria and must be taken with a doctor's prescription. Bronchitis of viral origin resolves on its own within 3-5 days, but if they persist, mild antivirals and supportive therapies like taking enough fluids to keep hydrated, use home remedies like bathing with hot water, drinking hot water and use of OTC to alleviate symptoms is advised. Acute and chronic bronchitis are the two major types of bronchitis based on the severity and duration of symptoms. Acute bronchitis symptoms like cough last fewer than 3-5 days while chronic bronchitis lasts longer than 3 months and is persistent within 2 years. Treatment of bronchitis is with bronchodilators, antibiotics, antivirals, antiinflammatory agents and OTCs.

To prevent bronchitis, it is advised that you avoid exposure to the causative agents. Avoid handshakes with people that have the infection as it could be transferred to you. Quit smoking and use PPE to avoid occupational irritants.

See your doctor when symptoms last longer than 3-5 days.