Bronchitis

There are two types of bronchitis, depending on the severity of the condition, they are:

1. Acute bronchitis

   It is also known as a chest cold and typically goes away without leaving any residual symptoms, but the cough may remain for weeks. Most patients with acute bronchitis don't require treatment.

2. Chronic bronchitis

   If a person coughs up mucus regularly for three months out of the year, they likely have chronic bronchitis. For at least two years, this continues. It is a type of chronic obstructive pulmonary disease. Chronic bronchitis reappears and can last for two years.

Signs and symptoms of acute or chronic bronchitis include:

• Cough
• Sore throat
• Coughing blood-stained mucus (sputum) can be clear, white, yellowish-grey, or green on rare occasions.
• Fatigue and tiredness
• Runny or stuffy nose
• Breathing difficulty
• Mild fever, chills
• Mild headache
• Body pain and chest pain

The causes of acute and chronic bronchitis are as follows:

• Viruses: Acute bronchitis is primarily caused by viruses, typically the same type of viruses that cause colds and flu (influenza). As antibiotics do not cure viruses, they are ineffective in most bronchitis cases.
• Bacteria: Chlamydia pneumonia, Mycoplasma pneumonia, and Bordetella pertussis are some bacteria that cause bronchitis.
• Smoking: Smoking cigarettes is the most frequent cause of chronic bronchitis. Dust, poisonous gases, and air pollution at work or in the surroundings can also worsen the illness.

In the initial few days of infection, it can be difficult to tell the difference between bronchitis and a regular cold. The doctor will perform a physical exam and can recommend a few tests.

The doctor may recommend the following tests:

• Physical examination: During the physical examination, the doctor will carefully listen to the lungs while breathing using a stethoscope.
• Nasal swab: The doctor may insert a soft-tipped stick (swab) into the nose to test for viruses such as the flu,
• Blood tests: Blood tests may be done to check for infections or to assess overall health.
• Chest X-ray: A chest X-ray detects whether a patient has pneumonia or any other ailment causing a cough. This test is specifically performed on smokers.
• Sputum test: The mucus patients cough up from their lungs is sputum. A sputum test is performed to check if the patient has any conditions that can be treated with antibiotics. This test is also used to examine allergy symptoms.
• Pulmonary function examination: During a pulmonary function test, a patient blows into a spirometer, which evaluates how much air the lungs can contain and how rapidly the air comes out. This test checks for any signs of asthma or emphysema.

Antibiotics are ineffective for treating bronchitis as viral infections are the primary cause of the condition. However, the doctor could recommend an antibiotic if they think patients have bacterial illnesses.

In some cases, the doctor may suggest additional drugs and other forms of treatment, such as:

• Cough syrup: If a severe cough prevents patients from falling asleep, they can take cough suppressants before bed.
• Antiviral medicines: The doctor may prescribe an antiviral medicine if the flu causes bronchitis. Antiviral medications can help relieve the symptoms faster.
• Bronchodilators: If a patient is experiencing breathing problems, the doctor may recommend a bronchodilator (a medication that helps open the airways).
• Anti-inflammatory drugs: The doctor may advise anti-inflammatory drugs to treat inflammation,
• Antibiotics: It is suggested in rare cases, such as when the doctor suspects a bacterial infection.
• Pulmonary rehabilitation therapy: Pulmonary rehabilitation is a breathing exercise programme in which a respiratory therapist teaches patients how to breathe more comfortably and improve their ability to exercise. This therapy is helpful for patients with chronic bronchitis.
• Other medicines: If patients suffer from allergies, asthma, or chronic obstructive pulmonary disease (COPD), the doctor may prescribe an inhaler and other drugs to reduce inflammation and expand blocked pulmonary passageways.

Several factors increase the risk of bronchitis. They include:

• Smoke from cigarettes: People who smoke or live with a smoker have an increased risk of developing acute and chronic bronchitis.
• Weak immunity: This can be caused by some acute sickness, such as a cold, or a persistent condition that weakens the immune system. Infants, young children, and older people are more prone to bronchitis.
• Exposure to irritants: Working around some lung irritants, such as grains or textiles, or being exposed to chemical fumes, increases the chance of having bronchitis.
• Gastric reflux: Repeated episodes of severe heartburn can irritate the throat and increase the risk of bronchitis.

Bronchitis can be avoided and prevented by taking a few precautionary measures, such as:

• Avoid smoking: Smoking cigarettes raises the chances of developing chronic bronchitis.
• Get vaccinated: Flu, a virus, is the cause of many occurrences of acute bronchitis. An annual flu shot can help prevent patients from contracting the infection. Additionally, get a shot pneumonia vaccine.
• Sanitise hands: Use alcohol-based hand sanitisers regularly and wash hands regularly to lower the chance of contracting a viral illness.
• Use a humidifier: Warm air eases coughs and helps airways clear mucus.
• Use a surgical mask: One must wear a face mask at work if exposed to dust or fumes and when around many people, like travelling.

Acute bronchitis can be easily treated and doesn't cause complications. The symptoms are for a few weeks, which can be painful. If a patient has a heart problem or any respiratory condition, such as asthma, it may worsen or prolong the symptoms.

Chronic bronchitis is a dangerous illness that can lead to lung damage. Although the damage cannot be reversed, the doctor can help to control the symptoms.

Reviewed by Dr. Prashant Saxena, Director & HOD (Pulmonology & Sleep Medicine) & Associate Director (Critical Care), Pulmonology on 23-Jan-2023.