Bronchitis is an inflammatory respiratory condition that affects the primary airways called bronchi. It is often caused by viral infections, similar to the ones that trigger the common flu or cold, but features more severe flu-like symptoms.
Generally, there are two major types of bronchitis - acute (short-term) and chronic (long-term), each having unique characteristics, treatment options, and recovery timelines. Depending on the type, bronchitis may induce worn-out fatigue, productive cough, and restlessness that lasts for several weeks or months. However, experiencing repetitive bouts of respiratory illness such as chronic bronchitis requires medical attention and may indicate the development of chronic obstructive pulmonary disease (COPD).
What is bronchitis?
Bronchitis is a condition in which the lining of the bronchial tubes becomes inflamed and irritable. Physiologically, these airways carry oxygen to and from the lungs and are subdivided on either side of the trachea (windpipe) into smaller airways. The bronchial lining has specialised units (goblet cells) and mucinous glands in the main bronchi, which produce sticky mucus to prevent damage and entrap micro-organisms.
When bronchitis develops, infections cause the bronchial lining to secrete more mucus than normal. This leads to obstructed airways and leaves air trapped inside the lungs. In response, the body battles against the infection, which results in swelling at the site and coughing up excessive mucus to ease breathing.
Types of bronchitis
There are two main kinds of bronchitis: acute (short-term) and chronic (long-term).
It is often called a chest cold and is one of the most common illnesses among people. It is mostly triggered by viral infections or some environmental irritants such as dust, allergens, polluted air, smoke inhalation, or strong chemical compounds that can provoke bronchial inflammation. Infections like fungal or bacterial are less common causes of acute bronchitis. Most cases of chest colds are temporary and resolve on their own with minimal or no medical help. Approximately 5% of the general population experience episodes of acute bronchitis each year, making it a predominant presentation in a healthcare setting.1
It is a recurring illness often associated with an ongoing cough that lasts more than 3 months each year. In chronic conditions, the lining of the bronchial tubes is constantly inflamed, causing mucosal thickening and airway blockage, making it difficult to breathe.
Chronic bronchitis is mostly considered a type of serious lung disease called chronic obstructive pulmonary disease.
In the general population, the incidence of chronic bronchitis varies from 3% to 7% among healthy adults, although it is thought that the prevalence of the condition is higher in COPD patients.2 The major causative factors seen in both COPD and chronic bronchitis are exposure to cigarette smoking or passive inhalation. Moreover, viral and bacterial infections are usually observed in acute bronchitis, but repeated exposure to infections can lead to chronic bronchitis as well. Chronic bronchitis has still no cure, but fortunately, it can be treated with a wide range of options.
Causes of bronchitis
The causes of bronchitis generally depend on the type of bronchitis a person has. The major causes of acute bronchitis are viral infections similar to the ones that cause colds or flu. At times, upper respiratory infections can progress to the lower respiratory regions, leading to acute bronchitis.
Chronic bronchitis is mostly caused by repeated exposure to irritants or smoking. Either way, bronchitis unfolds when the bronchial lining is exposed to such irritants, which triggers the oversecretion of mucus in response to an inflammatory reaction. This leads to clogged airways, which further increases irritation and contributes to air trapping.
Other causative factors which contribute to bronchitis include
- Environmental pollutants: dust or airborne chemicals such as ammonia and sulfur dioxide.
- Bacterial infections (Staphylococcus, Streptococcus)
- Allergens like pollen or strong perfume.
- Compromised immune system.
- Having a background of respiratory problems like asthma, cystic fibrosis, or bronchiectasis.
- Family history of bronchitis.
- GERD (gastroesophageal reflux disease).
Symptoms of bronchitis
The common symptoms of bronchitis include:
Figure: Symptoms associated with Bronchitis
Created by Aastha Malik
How long do symptoms of bronchitis last?
The duration of acute and chronic bronchitis varies from each other. Acute bronchitis usually resolves in a short period of time, but chronic bronchitis might become a life-long condition.
Duration of acute bronchitis
Acute bronchitis symptoms progress three to four days after exposure to a viral infection. It usually starts with a dry cough and is followed by sputum with coughing spells. Since acute bronchitis is similar to the common cold, most individuals find relief in less than 3 weeks. Although in some cases, the cough may linger on for a couple of more weeks (it typically persists for 18 days). Acute bronchitis is a mild condition, so it mostly gets better on its own with little to no medication. Under healthy conditions, your lungs will return to normal function after recovery.
Duration of chronic bronchitis
The duration of chronic bronchitis lasts more than three months, typically recurring within a span of two years in a row. In severe cases, it can have life-long effects. Chronic bronchitis flare-ups can cause acute symptoms, which may happen at any time of the year, but they are more common during the winter season.
Is bronchitis contagious?
Yes, since the viruses can be contagious and most cases of bronchitis (particularly acute bronchitis) are caused by viral infection (such as observed in the flu - Influenza virus). Like all viral or bacterial infections, bronchitis can also be easily transmitted through airborne droplets when an affected person sneezes, talks or coughs around other people.3
For bacterial infections, starting a course of antibiotics can stop you from being contagious after 24 hours. However, if the infection is caused by a virus, then it might take a few more days or a week to become noncontagious.
The majority of cases of mild bronchitis clear away on their own. Taking a few steps at home can help to relieve those symptoms. Patients may need a range of medical therapies for chronic bronchitis in order to lessen their severe symptoms.
The following remedies might not cure your bronchitis, but they will help to manage the symptoms while you wait for your recovery.
- Drinking plenty of water prevents dehydration and breaks down the mucus. This will help to get rid of the sputum by coughing it up.
- Proper rest will give your body's immune system time to fight infection and improve the time of recovery.
- Hot beverages such as warm water and tea can reduce congestion and relieve other flu-like symptoms.
- Using honey can work effectively to suppress throat irritation.
- Gargling with salt water.
- Taking lozenges will help to lubricate and cool down irritation in the throat.
- Using steam inhalation or a room humidifier can improve coughing symptoms.
- Adding Vitamin C to the diet to support immune function.
To treat bronchitis symptoms, doctors may recommend the following class of medications:
- Antibiotics, in bacterial infections, treat worsening symptoms.
- Over-the-counter pain relievers (ibuprofen) to reduce fever.
- Corticosteroids to prevent swelling and mucous output.
- Bronchodilators ease muscles around the pulmonary airways.
- Cough suppressants like Guaifenesin, an expectorant to clear mucus.
The time period of recovery usually depends on the type of viral infection and overall health condition. On a general basis, without any complications, the recovery from bronchitis may take at least 2 to 3 weeks.
Repeated bouts of bronchitis cause prolonged irritation, which may lead to further complications. In some cases, extended cough injures the lining tissues in the throat, allowing microorganisms to move and set up as a new secondary inflammation.
Another potential complication may turn bronchitis into pneumonia, causing fluid build-up in the alveoli (air sacs), making it more difficult to breathe. Mild pneumonia is mostly treatable with antibiotics.
Other complications may include
- Avid smokers.
- Respiratory distress.
- A weakened immune system.
- Having other respiratory problems - asthma, sinusitis, or COPD.
When to seek medical help
It is recommended to consult your healthcare provider if the symptoms persist without getting better:
- High-grade fever - over 100.4ºF for several days.
- Cough that lingers for more than a few weeks.
- Blood is seen in the mucus.
- Having difficulty in breathing.
- Severe headaches.
- Chest discomfort.
- Recurring bronchitis.
Bronchitis is an inflammatory condition of the main airways called bronchi, which help transport oxygen in the lungs. Bronchitis mainly consists of two main types: acute and chronic. These types have different treatment options and recovery time lengths. Acute bronchitis, mostly caused by viral infections, clears away on its own with a slight requirement of over-the-counter medications and following home remedies. Moreover, chronic bronchitis has no known cure, but several treatment options are available to ease symptoms and manage flare-ups. If the symptoms worsen over time, seek the doctor immediately to deter the chances of further complications. To better control and manage your health condition, it is recommended to follow your healthcare provider's advice, quit smoking, avoid environmental pollutants, and make positive changes.
- Singh A, Avula A, Zahn E. Acute Bronchitis [Internet]. Nih.gov. StatPearls Publishing; 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK448067/
- Widysanto A, Mathew G. Chronic Bronchitis [Internet]. Nih.gov. StatPearls Publishing; 2019. Available from: https://www.ncbi.nlm.nih.gov/books/NBK482437/
- Cleveland Clinic. Bronchitis Symptoms & Treatment [Internet]. Cleveland Clinic. 2019. Available from: https://my.clevelandclinic.org/health/diseases/3993-bronchitis