Bronchitis

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Introduction

What is bronchitis?

Bronchitis is inflammation of the airways leading to the lungs (bronchi), resulting in congestion, mucus production, and shortness of breath. There are two types of bronchitis: acute (short-term) and chronic (long-term). Chronic bronchitis is a type of chronic obstructive pulmonary disease (COPD).

Bronchitis is a common respiratory disorder in the United States. Infants, young children, and the elderly have an increased risk of developing acute bronchitis, while smokers and people over 45 years of age are most likely to develop chronic bronchitis. Women are twice as likely as men to develop chronic bronchitis (Source: CDC).

Smoking is the most common cause of chronic bronchitis and can also lead to acute bronchitis. The primary cause of acute bronchitis is upper respiratory viral infection. Preexisting lung disorders, such as asthma, can increase the risk of bronchitis, and exposure to air pollution, secondhand smoke, and allergies can increase its severity.

The characteristic symptom of bronchitis is a congested cough; for bronchitis to be considered chronic, it must last longer than three months. Treatment for chronic bronchitis includes bronchodilators, anti-inflammatory drugs, and chest physical therapy for loosening mucus in the lungs. Treatment for acute bronchitis includes avoiding cigarette smoke, drinking plenty of fluids, adequate rest, taking aspirin or acetaminophen, and using a humidifier. Healthy lifestyle practices, including good hand washing to prevent infection, getting plenty of rest, and refraining from smoking, can reduce your risk of bronchitis. Current recommendations discourage the use of antibiotics for uncomplicated acute bronchitis in otherwise healthy individuals.

Left untreated, bronchitis can be associated with serious or even life-threatening symptoms. Seek immediate medical care (call 911) if you have severe difficulty breathing, which may be accompanied by pale or blue lips, rapid heart rate, sweating, and anxiety.

Seek prompt medical care if you are being treated for bronchitis but mild symptoms recur or are persistent.

Symptoms

What are the symptoms of bronchitis?

Bronchitis causes inflammation of the bronchi, resulting in wheezing, a cough with mucus, and other symptoms. Depending on whether you have acute or chronic bronchitis, the symptoms can be short-lived or persist over time.

Common symptoms of bronchitis

You may experience bronchitis symptoms daily or just once in a while. At times any of these bronchitis symptoms can be severe:

  • Chest pain or pressure

  • Coughing up clear, yellow, light brown, or green mucus

  • Fatigue

  • Shortness of breath or rapid breathing (tachypnea)

  • Wheezing (whistling sound made with breathing)

Serious symptoms that might indicate a life-threatening condition

Left untreated, bronchitis can be life threatening in some cases. Seek immediate medical care (call 911) if you, or someone you are with, have any of these life-threatening symptoms including:

  • Bluish coloration of the lips or fingernails

  • Change in level of consciousness or alertness, such as passing out or unresponsiveness

  • Rapid heart rate (tachycardia)

  • Respiratory or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, wheezing, not breathing, or choking

Causes

What causes bronchitis?

Bronchitis is inflammation in the airways leading to the lungs (bronchi), resulting in congestion, excess mucus, and shortness of breath. There are two types of bronchitis: acute (short term) and chronic (long term). Chronic bronchitis, like emphysema, is a type of chronic obstructive pulmonary disease (COPD).

Smoking is the most common cause of chronic bronchitis and can also lead to acute bronchitis. The primary cause of acute bronchitis is an upper respiratory viral infection.

What are the risk factors for bronchitis?

A number of factors increase the risk of developing bronchitis. Not all people with risk factors will get bronchitis. Risk factors for bronchitis include:

  • Age: infants and elderly

  • Air pollution, including fumes from cars, cooking fuel, and fires

  • Allergies to animal dander, dust particles, or pollen

  • Chronic sinusitis

  • Enlarged tonsils

  • Female gender

  • Jobs working with livestock, grain, textiles or coal

  • Preexisting lung disease

  • Secondhand smoke

  • Smoking

Reducing your risk of bronchitis

You may be able to lower your risk of bronchitis by:

  • Getting pneumococcal and annual flu vaccines

  • Practicing good hygiene by always washing your hands

  • Refraining from smoking and avoiding secondhand smoke

  • Taking medicine as prescribed, even if you do not have symptoms

Treatments

How is bronchitis treated?

Treatment for bronchitis begins with seeking medical care from your health care provider. The goal of treatment is to reduce inflammation and congestion and improve breathing. Bronchitis is not typically treated with antibiotics, because it is rarely caused by a bacterial infection. The most common causes are smoking, in the case of chronic bronchitis, and viral infection, in the case of acute bronchitis.

Treatment for chronic bronchitis includes bronchodilators, anti-inflammatory drugs, and chest physical therapy for removing mucus from the lungs. Treatment for acute bronchitis includes avoiding cigarette smoke, drinking plenty of fluids, getting adequate rest, taking aspirin or acetaminophen, and using a humidifier. In all cases, it is important to quit smoking to prevent further lung damage.

Treatment options for acute bronchitis

Acute bronchitis typically will go away without treatment within one week. The focus of treatment for acute bronchitis is relieving symptoms. Treatments include:

  • Antibiotics, if you have a treatable bacterial infection (pertussis)

  • Medications to help with smoking cessation, such as varenicline (Chantix) or bupropion hydrochloride (Zyban)

  • Pain medications such as aspirin or acetaminophen (Tylenol) to reduce discomfort

  • Room humidifier to increase movement of congestion

  • Short-acting bronchodilators to improve breathing, such as albuterol (ProAir, Proventil, Ventolin), and levalbuterol (Xopenex)

Treatment options for chronic bronchitis

  • Antibiotics during flare-ups to reduce the risk of complications

  • Bronchodilators to improve breathing, such as ipratropium (Atrovent), tiotropium (Spiriva), salmeterol (Serevent), and formoterol (Foradil)

  • Chest physical therapy (CPT) to help you cough up mucus

  • Inhaled corticosteroids to reduce inflammation, such as fluticasone (Flovent) and budesonide (Pulmicort)

  • Inhalers that include both a bronchodilator and a corticosteroid, such as budesonide-formoterol (Symbicort) and fluticasone-salmeterol (Advair)

  • Medications to help with smoking cessation, such as varenicline (Chantix) or bupropion hydrochloride (Zyban)

  • Oxygen therapy, if blood oxygen levels are low

What you can do to improve your bronchitis

In addition to reducing your exposure to bronchitis triggers, you can prevent or limit bronchitis by:

  • Drinking plenty of fluids
  • Getting plenty of rest
  • Taking all medications as prescribed

What are the potential complications of bronchitis?

Complications of untreated or poorly controlled bronchitis can be serious, even life threatening in some cases. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of bronchitis include:

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Jan 5
  1. What is bronchitis? National Heart, Lung, and Blood Institute Diseases and Conditions Index. http://www.nhlbi.nih.gov/health/dci/Diseases/brnchi/brnchi_whatis.html
  2. Chronic Bronchitis. U.S. National Library of Medicine. MedlinePlus. https://medlineplus.gov/chronicbronchitis.html
  3. Bronchitis. Centers for Disease Control and Prevention. https://www.cdc.gov/antibiotic-use/community/for-patients/common-illnesses/bronchitis.html

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