Overview

What Is Bronchitis? 

The major airway (trachea) walls lead to bronchioles, which are extremely small passages within your lungs that produce mucus to catch dust and other highly irritating particles.¹ Bronchitis is caused by an infection that irritates and inflames the main airways, that cause tissue swelling and producing more mucus than usual.² It is an inflammatory condition that affects the lining of your bronchial tubes, which transport air to and from your lungs.^2,3 Bronchitis patients frequently cough up thicker, brownish mucus. Coughing is an exaggerated response to persistent inflammation happening to clean the airway from mucus particles.⁴ Bronchitis may cause airway blockage, inflammation, and retained secretions leading to an imbalance between blood flow and airflow in the lungs. This can affect both the oxygenation of the blood and the elimination of carbon dioxide, a waste product.⁵ Although it primarily affects children under the age of five, anyone can be affected. It is more prevalent in winter and usually follows a cold, sore throat, or influenza.

What Are The Types Of Bronchitis?

Acute bronchitis and chronic bronchitis are the two forms of this disease. Acute bronchitis is more frequent and typically results from a respiratory infection or a cold.⁶ The more problematic form of bronchitis, known as chronic bronchitis, is caused by continuous irritation or inflammation of the bronchi. 

Acute Bronchitis

Acute bronchitis is a common illness, also known as a chest cold.⁶ Around 6% of kids and 5% of adults suffer from at least one episode annually. Often acute bronchitis follows an upper respiratory viral infection like the common cold. Acute bronchitis typically resolves without causing any lung damage. Exposure to harmful substances in the air, such as tobacco smoke, dust, and other pollutants, might increase the likelihood of infection. People with chronic sinusitis, allergies, or swollen tonsils and adenoids are at an increased risk of acute bronchitis.

Chronic bronchitis

Chronic bronchitis lasts at least two years and is characterised by a productive cough that produces sputum for at least three months per year.^7,8 The cough is commonly called a smoker's cough since it is frequently caused by smoking. In response to chronic irritation, goblet cells and larger submucosal glands create extra mucus, which can narrow the airways and restrict airflow. This can cause the deterioration of lung function and lead to chronic obstructive pulmonary disease (COPD).⁵ The cough is usually worse upon awakening, and the sputum produced may be yellow or green in colour and may contain blood spots. In the early stages, a cough can keep mucus moving; however, mucus clearance is reduced, and coughing becomes inefficient when the airways get clogged. 

How Can You Get Bronchitis? 

Acute Bronchitis

Most cases of bronchitis are acute in nature. It is commonly characterised by a cough that lasts for three weeks.⁶ Viral infections such as influenza, respiratory syncytial virus (RSV), and rhinoviruses are the primary reason in more than 90% of cases. Bacterial infections, such as Mycoplasma pneumoniae or Bordetella pertussis, are responsible for a limited number of cases. These pathogens may be transmitted through coughing or direct touch. Medical experts and scientists suggest that chronic bronchitis can be developed from recurrent episodes of acute bronchitis.

These less common factors can also cause acute bronchitis:

• Infections caused by bacteria or fungi. 
• Acid reflux, medically known as gastroesophageal reflux disease (GERD).
• Bronchial tubes that are already damaged, where one is at a higher risk.

Chronic Bronchitis

The majority of cases of chronic bronchitis are due to tobacco smoking. The inhalation of pipe, cigars and other forms of tobacco smoke can also induce chronic bronchitis. This also includes secondhand smoke.^2,3,7 Smoking affects the airways and causes an excess of mucus formation in the lungs, which causes blockages in airflow. Prolonged exposure to air pollution, irritating gases, or dust in occupations such as grain handling, metal moulding, textile manufacturing, coal mining, and livestock farming may serve as a risk factor for developing chronic bronchitis, also known as industrial bronchitis. Additionally, a hereditary condition called alpha-1 antitrypsin deficiency may occasionally play a role. It can cause permanent lung damage and reduced lung function over time. 

Symptoms

Acute bronchitis⁹ is characterised by symptoms that persist for less than three weeks and can include the following:

• Sore throat
• Soreness in the chest
• Chills
• Mild fever
• Watery eyes
• Running nose
• Mild headache
• Coughing with or without mucus
• Fatigue
• Mild body aches

Acute bronchitis typically appears suddenly. In contrast, chronic bronchitis often develops gradually and worsens over time. Initially, you may experience no symptoms or minor symptoms. Typically, as the disease progresses, the severity of your symptoms will increase. A person with chronic bronchitis may have periods of increased coughing or other symptoms. The presence of acute infection on top of chronic bronchitis is possible at these times.

Symptoms of chronic bronchitis may include:³

• Frequent coughing that lasts more than three weeks.
• Coughing is prevalent when you sleep.
• Cough producing mucus.
• Bloody or discoloured mucus
• Wheezing
• A whistling or squeaking sound is heard when inhaling
• Breathlessness, especially with vigorous activity
• Tightness in the chest

Respiratory infections like the common cold and the flu can be common for those who suffer from chronic bronchitis. 

How Long Does Bronchitis Last? 

The duration of bronchitis varies depending on whether the disease is acute or chronic. Acute bronchitis typically lasts between three and ten days; however, some symptoms, including coughing, may persist for longer.² Chronic bronchitis persists for a longer time. In many cases, chronic bronchitis symptoms continue for at least 3 months, for two years, or much longer.⁷ 

Complications Of Bronchitis

While most people recover from an episode of acute bronchitis, between 5 and 10% may develop a complication such as a subsequent bacterial infection such as pneumonia.⁴ As the pneumonia infection progresses deeper into the lungs, fluid begins to collect in the alveoli (air sacs) inside the lungs.

Chronic bronchitis is prone to a number of complications, the most common of which is a chronic obstructive pulmonary disease (COPD). Muscular spasms and inflammation cause a permanent, irreversible constriction of the airway and eventually chronic obstructive pulmonary disease (COPD), which is common among those who suffer from chronic bronchitis. If left untreated, bronchospasm (a spasm of the muscles that line the airways) can cause the airways to close completely, leading to respiratory failure and increased mortality. Respiratory failure happens when the body's tissues don't get enough oxygen because the lungs can't take in enough air (hypoxia).¹⁰ A person may become unconscious or acquire severe cyanosis (a bluish hue to the fingers and lips) if they have a sudden onset of respiratory failure.

Other possible complications of chronic bronchitis^2,8 are: 

• Pneumothorax, or collapsed lung.
• Right-sided heart failure, also known as cor pulmonale.¹¹
• Reactive airway disease (RAD) - when the bronchial tubes constrict in response to an irritant (smoke, an infection, etc.)
• Polycythemia (high red blood cell count).
• Dyspnea (shortage of breath).
• Hemoptysis (coughing blood).

In many cases, chronic bronchitis can lead to malnutrition, muscle weakness, and oedema in the lower extremities if left untreated. 

How To Treat Bronchitis 

The symptoms of acute bronchitis are often treated with bed rest, acetaminophen (paracetamol), and nonsteroidal anti-inflammatory medications (NSAIDs) to reduce fever and cough.^6,12

• Drink fluids.
• Avoid caffeine and alcohol.
• Get a lot of sleep.
• Use painkillers (ibuprofen or acetaminophen) to decrease pain, inflammation, and fever. 
• Use a humidifier to raise the humidity level in your home.
• Use saline nasal spray or drops to relieve a stuffy nose.
• Never suppress a cough that produces mucus. This kind of cough aids in the removal of mucus from the bronchial passageways.

The progression of chronic bronchitis can be slowed or even stopped with the help of medication and adjustments to your way of living.¹³ 

• Bronchodilators: these medications relax the airways, making it easier to breathe and alleviating the symptoms of bronchitis.
• Steroids: anti-inflammatory medications.
• Oxygen therapy: for severe conditions in which oxygen levels in the blood severely drop due to extensive lung injury.
• Specialized rehab program: to learn and manage shortness of breath.
• Lung transplant.

What To Do To Avoid Getting Bronchitis

• The best defence against bronchitis is to quit smoking. 
• Protect children, with or without bronchitis, from secondhand smoke since bronchitis is more prevalent in younger individuals.
• When working with lung irritants, like paint, paint thinner, and varnish, always use a face mask. 
• Get a flu vaccine. If you're over 60 years old, you may want to ask your doctor about getting a pneumonia vaccine.
• Cover your mouth and nose when coughing or sneezing.
• Wash your hands often.

When To See A Doctor

• Persistent cough for longer than two weeks.
• If the fluid that comes up into your mouth has a foul taste.
• Experiencing wheezing and coughing for longer than two weeks, especially when lying down or at night.
• The temperature of at least 100.4 ℉.
• Cough that is accompanied by bloody mucus.
• Experiencing difficulty breathing or shortness of breath.
• Symptoms that have persisted for longer than three weeks.
• Bronchitis that reappears on a regular basis.⁴

Summary

Inflammation in the air passages, or bronchitis, is a serious health problem. Acute bronchitis and chronic bronchitis are the two most common forms of bronchitis. Smoking is the major cause of bronchitis. Some viruses that trigger the common cold and flu may also cause it. Bacterial infections and prolonged exposure to air pollution, irritating gases, or dust may also contribute to chronic bronchitis. Acute bronchitis typically causes cough, chest pain, runny nose, tiredness and aches, headache, chills, mild fever, and sore throat. However, symptoms of chronic bronchitis may be worse, causing a cough with mucus that lasts for more than three months, breathlessness, and may even lead to pneumonia. If left untreated, bronchitis may result in permanent damage to the lungs and respiratory functions.

The most effective way to treat bronchitis is to stop smoking and encourage other family members to quit smoking to avoid secondhand smoke. Avoid inhaling harmful substances, and always wear a mask while handling harmful substances like varnish, paint, or other pollutants. Consult a physician if the cough lasts longer than two weeks, you have difficulty breathing, the cough contains blood, and the symptoms reoccur frequently.