What Is The Difference Between Bronchiolitis And Bronchitis?

Introduction

Have you ever wondered about the difference between bronchitis and bronchiolitis? Despite having very similar-sounding names, they are two different conditions that affect our lungs. Bronchitis mainly affects the bigger airways in our lungs (the bronchi),¹ while bronchiolitis affects the smaller airways in our lungs (the bronchioles).²

In this article, we are going to cover what is the difference between bronchitis and bronchiolitis, including the causes, the symptoms, how they are diagnosed, and what treatments are available. 

What is bronchitis?

Bronchitis is a respiratory condition characterised by inflammation of the bronchial tubes, which are the air passages that carry air to and from the lungs.¹ This inflammation can result in swelling and increased production of mucus, leading to symptoms such as coughing, wheezing, chest discomfort, and difficulty breathing.³ Bronchitis can be acute or chronic, depending on the duration and frequency of symptoms.

Acute bronchitis typically develops as a result of viral infections, such as the common cold or the influenza virus.⁴ It can also be caused by bacterial infections or exposure to irritants like tobacco smoke, air pollution, or chemical fumes. Acute bronchitis usually lasts for a few weeks and tends to resolve with rest, hydration, and over-the-counter medications such as dextromethorphan (cough suppressant) to alleviate symptoms.⁴ Natural remedies that can help with the cough associated with acute bronchitis include hot tea, honey, and ginger. 

Chronic bronchitis, on the other hand, is a long-term condition characterised by persistent inflammation of the bronchial tubes.⁵ It is often associated with smoking or long-term exposure to irritants and pollutants. Chronic bronchitis is a type of chronic obstructive pulmonary disease (COPD) and is typically diagnosed when a person experiences a persistent cough with mucus production for at least three months in two consecutive years.⁵

Treating chronic bronchitis involves a range of medications including bronchodilators, glucocorticoids, and phosphodiesterase-4 inhibitors to reduce inflammation and mucus production. While acute bronchitis usually resolves with time and supportive care, chronic bronchitis requires ongoing management to control symptoms and prevent complications.

What Is bronchiolitis?

Bronchiolitis is a common respiratory infection that primarily affects infants and young children. It is caused by a viral infection, most commonly the respiratory syncytial virus (RSV).⁶ The virus inflames the small airways in the lungs, called bronchioles, making it difficult for air to move in and out of the lungs efficiently.

The primary symptom of bronchiolitis is wheezing, along with coughing and difficulty breathing. Sometimes, fevers also may occur. These symptoms can range from mild to severe and can be particularly concerning in infants, because they may struggle to feed or breathe properly.⁶ In severe cases, bronchiolitis can lead to complications such as respiratory distress, dehydration, and even pneumonia.⁷

Diagnosing bronchiolitis usually involves a physical examination by a doctor, a review of symptoms and sometimes additional tests like chest X-rays or lab tests.⁷ Treatment for bronchiolitis typically focuses on relieving symptoms and providing supportive care. This may include using a cool-mist humidifier, suctioning mucus from the nose and mouth, ensuring adequate hydration, and in some cases, providing supplemental oxygen or hospitalisation for more severe cases.⁸

Preventing the spread of bronchiolitis involves practising good hygiene, such as frequent handwashing and avoiding close contact with individuals who are sick, especially infants. a vaccine is available to help prevent RSV infection in high-risk infants, which may reduce the risk of developing bronchiolitis. If your child develops symptoms of bronchiolitis, it's essential to seek medical attention promptly to ensure proper evaluation and management.

What are the key differences between bronchitis and bronchiolitis?

Affected Airways

Bronchitis: In bronchitis, the larger airways in the lungs (called bronchi) become inflamed and irritated. This inflammation leads to swelling and increased production of mucus. 

Bronchiolitis: Bronchiolitis affects the smaller airways in the lungs known as bronchioles, causing inflammation and obstruction, which makes it difficult for air to move in and out of the lungs properly. 

Common age groups

Bronchitis: can affect people of all ages, but it's more common in adults. People with weakened immune systems or underlying respiratory conditions are more likely to develop bronchitis. 

Bronchiolitis: primarily affects infants and young children, especially those under the age of two. This is because this age group still has a developing immune system and smaller airways. 

Causes

Bronchitis: It is caused by viruses or bacteria, such as the common cold or flu viruses. Chronic bronchitis is typically associated with long-term exposure to irritants like cigarette smoke or air pollution.

Bronchiolitis: The most common cause of bronchiolitis is RSV, although other viruses such as the adenovirus or influenza virus can also be responsible.

Symptoms

Bronchitis: Symptoms typically include coughing, chest discomfort, and sometimes fever. It may also involve the production of mucus or phlegm.

Bronchiolitis: Symptoms typically include wheezing, rapid breathing, coughing, and difficulty breathing. There may also be a fever present.

Severity and complications

Bronchitis: While bronchitis can cause discomfort and inconvenience, it is usually not life-threatening and tends to resolve with proper care.

Bronchiolitis: Bronchiolitis can be more severe, especially in young infants, and may lead to dehydration, respiratory distress, and pneumonia.⁸

Treatment approach

Bronchitis: Treatment often involves rest, hydration, and over-the-counter medications to relieve symptoms such as cough and fever. Antibiotics are not usually recommended unless there is a bacterial infection present.

Bronchiolitis: Treatment focuses on supportive care, including ensuring proper hydration, using a cool-mist humidifier, and sometimes hospitalisation for severe cases requiring oxygen support.

FAQs

What are the risk factors for developing bronchitis and bronchiolitis? 

Risk factors for bronchitis include smoking, exposure to air pollutants, weakened immune systems, and frequent respiratory infections. For bronchiolitis, risk factors include age (infants and young children), premature birth, exposure to tobacco smoke, and crowded living conditions.

Can bronchitis and bronchiolitis be prevented?

While it may not always be possible to prevent bronchitis and bronchiolitis entirely, some measures can be taken to reduce their risk. These include practising good hand hygiene, avoiding close contact with sick individuals, quitting smoking, minimising exposure to air pollutants, and ensuring infants receive recommended vaccinations, particularly for RSV and especially in high-risk infants.

Can bronchitis or bronchiolitis lead to more severe respiratory conditions?

In some cases, untreated bronchitis or bronchiolitis can lead to more severe respiratory conditions. These may include pneumonia, the worsening of underlying lung conditions such as asthma or COPD, or even respiratory failure.

Is bronchitis or bronchiolitis more common in certain seasons?

Bronchitis and bronchiolitis can occur throughout the year, however they tend to be more common during certain seasons. Bronchitis is more common during the colder months, particularly in the fall and winter, when respiratory viruses, are more active. This is because people spend more time indoors close to others, increasing the likelihood of virus transmission. 

Bronchiolitis, is more common in the winter and early spring, typically peaking between November and April. This coincides with the peak season for respiratory syncytial virus (RSV) infections, which is the most common cause of bronchiolitis in infants and young children. RSV spreads easily in crowded settings, such as daycare centres and schools.

Are there any complications associated with bronchitis or bronchiolitis?

Yes, complications of bronchitis and bronchiolitis may include recurrent infections, chronic respiratory conditions such as asthma or COPD, pneumonia, and respiratory failure. in severe cases, death, particularly in vulnerable populations such as infants and older adults may occur.

Can bronchitis or bronchiolitis be contagious?

Yes, both bronchitis and bronchiolitis can be contagious, meaning they can spread from person to person. They are often caused by viruses that can be transmitted through respiratory droplets i.e. when an infected person coughs or sneezes. 

Additionally, these viruses can survive on surfaces and objects, making it possible to contract the illness by touching contaminated surfaces and then touching the face. It is important to practice good hygiene, such as frequent handwashing, covering the mouth and nose when coughing or sneezing, and avoiding close contact with individuals who are sick, to help prevent the spread of bronchitis and bronchiolitis.

Summary

In conclusion, while both bronchitis and bronchiolitis affect the respiratory system and share some similar symptoms, they are separate conditions with differences in the type of airways affected, common age groups, causes, symptoms, severity, and treatment approaches. 

Bronchitis primarily affects the larger airways of the lungs and is more common in adults, often caused by viruses or bacteria. On the other hand, bronchiolitis affects the smaller airways and is predominantly seen in infants and young children, with respiratory syncytial virus (RSV) being the primary cause. 

Treatment varies between the two conditions, hence be sure of which condition you have before using any medication. Seek help from a medical professional if you are concerned that you or your loved ones might have bronchitis or bronchiolitis.