A Complete Guide to Acute and Chronic Bronchitis

Medically Reviewed By Kevin Martinez, M.D.
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Bronchitis is inflammation of the bronchi — the airways leading to the lungs. This results in congestion, mucus production, and shortness of breath. Bronchitis can be acute or chronic. Chronic bronchitis is a type of chronic obstructive pulmonary disease. This article reviews acute and chronic bronchitis. It covers the differences and similarities in symptoms, causes, diagnosis, and treatment.

What is bronchitis?

Child using an inhaler
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Bronchitis is a common respiratory disorder in the United States. Viral infections are responsible for many cases of acute bronchitis. Smoking is the main cause of chronic bronchitis. However, it can also lead to acute bronchitis. 

Young children, older adults, and people with chronic health conditions tend to have the highest risk of acute bronchitis. Lung problems, such as asthma, can increase the risk. Exposure to air pollution, secondhand smoke, and allergies can increase its severity.

Healthy lifestyle habits can reduce your risk of bronchitis. This includes handwashing to prevent infection, getting recommended vaccines, and refraining from smoking.

What are the different types of bronchitis?

There are two types of bronchitis: acute and chronic.

Acute bronchitis

Acute bronchitis is basically a chest cold. It typically lasts less than 3 weeks. Current guidelines discourage the use of antibiotics for simple acute bronchitis in otherwise healthy people. They will not help because the most likely cause is a virus.

Chronic bronchitis

Bronchitis becomes chronic when it lasts longer than 3 months and recurs for 2 or more years. Long-term exposure to smoke, air pollution, dust, or toxic gases can contribute to chronic bronchitis.

Treatment for chronic bronchitis includes bronchodilators, anti-inflammatory drugs, and chest physical therapy for loosening mucus in the lungs. 

What are the symptoms of bronchitis?

The characteristic symptom of bronchitis is a congested cough. Depending on whether you have acute or chronic bronchitis, the symptoms can be short-lived or persist over time.

Common symptoms of both acute and chronic bronchitis can include:

  • chest congestion or tightness
  • chest pain or soreness
  • cough, which may produce clear, yellow, light brown, or green mucus
  • fatigue
  • fever
  • headache or body aches
  • shortness of breath 
  • wheezed breathing

In severe cases, chronic bronchitis can lead to weakness, weight loss, or swelling in the lower extremities.

What causes bronchitis?

About 95% of the time, acute bronchitis is due to a viral infection, such as a cold or flu. Other causes include allergens, bacteria, and irritants, such as air pollution or fumes.

Smoking is the most common cause of chronic bronchitis and can also lead to acute bronchitis. About 75% of chronic bronchitis cases occur in people who smoke or used to smoke.

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 acute bronchitis

Risk factors for acute bronchitis include:

  • ages, with young children and older adults being most at risk
  • air pollution, including fumes from cars, cooking fuel, and fires
  • allergies to animal dander, dust particles, or pollen
  • chronic medical conditions or preexisting lung disease, such as asthma
  • secondhand smoke or smoking

Risk factors for chronic bronchitis

Risk factors for chronic bronchitis include:

  • ages 40 years or older
  • gastroesophageal reflux disease
  • genetics, including alpha-1 antitrypsin deficiency
  • history of childhood lung disease or family history of lung disease
  • long-term exposure to fumes, dust, or secondhand smoke
  • smoking, which is the main risk factor

Reducing your risk of bronchitis

The main way to prevent both acute and chronic bronchitis is by not smoking. Other ways to reduce your risk include:

  • avoiding secondhand smoke and other lung irritants, such as household cleaners, paint fumes, or perfumes
  • getting recommended vaccines, which may include pneumococcal vaccine and annual flu shot
  • practicing hygiene with thorough handwashing

How do doctors diagnose bronchitis?

To diagnose your bronchitis, your doctor will ask you several questions about your symptoms and medical and family history, including:

  • What symptoms are you experiencing, and when did they start?
  • Have your symptoms persisted over time, or do they come and go?
  • Are you experiencing chest pain or pressure, shortness of breath, wheezing, or fatigue?
  • Does anything worsen or relieve your symptoms?
  • Do you smoke? If so, how much do you smoke, and for how long have you been smoking?

During a physical exam, your doctor will use a stethoscope to listen to your lungs as you breathe. Tests your doctor may order include:

  • chest X-ray to look at your lungs for pneumonia or other conditions 
  • complete blood count and blood chemistry tests
  • oxygen saturation to see how much oxygen is in your blood
  • pulmonary function tests to measure your lung capacity and how quickly you can exhale the air in your lungs

How is bronchitis treated?

The goal of bronchitis treatment is to reduce inflammation and congestion and improve breathing. In both acute and chronic, quitting smoking can prevent further lung damage.

Acute bronchitis

Doctors generally do not treat acute bronchitis with antibiotics. Bacteria are rarely the cause. Plus, the condition is usually self-limiting, meaning it will resolve on its own. 

Acute bronchitis treatment is supportive. This includes avoiding smoke, drinking plenty of fluids, getting plenty of rest, and using a humidifier. Your doctor may also recommend over-the-counter cough medicines, pain relievers, and fever reducers.

If wheezing is present, doctors may prescribe inhalers or short-course steroids. These medicines can reduce inflammation and open airways to ease breathing.

Chronic bronchitis

There is currently no cure for chronic bronchitis. So, chronic bronchitis treatment is also supportive. Treatment can help reduce symptoms and flares and slow the condition’s progression.

Treatment for chronic bronchitis includes:

  • antibiotics during flare-ups to reduce the risk of bacterial infection
  • bronchodilator inhalers to relax the airways and improve breathing, such as ipratropium (Atrovent), tiotropium (Spiriva), salmeterol (Serevent), and formoterol (Foradil)
  • chest physical therapy 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)
  • oxygen therapy, if blood oxygen levels are low

What are the potential complications of bronchitis?

Acute bronchitis resolves without problems in multiple cases. However, it can cause you to miss school or work while you are sick. Sometimes, it leads to a secondary bacterial infection or pneumonia.

Chronic bronchitis is a lifelong condition. It can lead to complications, including declining lung function. Some people with the condition report that they experience a reduced quality of life as well. Stopping smoking can help reduce complications. Chronic bronchitis may also shorten life expectancy. 

Frequently asked questions

Here are some questions people often ask about bronchitis.

How long does bronchitis last? 

Acute bronchitis is usually self-limiting. Symptoms typically last 7–10 days before the immune system completely clears the infection. However, the cough can linger for up to 4 weeks. Contact your doctor for persistent or worsening symptoms.

Chronic bronchitis is a condition you have for life, since there is currently no cure.

Do I need antibiotics for bronchitis?

Doctors do not initially treat acute bronchitis with antibiotics. In many cases, a virus causes the condition and antibiotics will not work. Your doctor may prescribe antibiotics if you have a bacterial infection.

Antibiotics may be part of chronic bronchitis treatment during flares. 

What does a bronchitis cough sound like?

A cough with acute bronchitis sounds productive, meaning you can hear the mucus. You often hear wheezing during breathing in acute bronchitis.

Chronic bronchitis sounds like a typical cough from long-term smoking. It produces ample amounts of mucus. 

Summary

Acute and chronic bronchitis are similar in many ways. They share a lot of the same symptoms, as well as triggers, such as smoking. Acute bronchitis is usually a viral infection that only lasts for 1 or 2 weeks.

Chronic bronchitis is a form of a chronic obstructive pulmonary disease. It lasts for more than 3 months and comes back several times in the span of a couple of years. There is currently no cure for it.

Acute bronchitis usually goes away on its own. When symptoms persist, doctors may treat acute bronchitis with antibiotics. Antibiotics may also be useful in chronic bronchitis to treat flares.

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Medical Reviewer: Kevin Martinez, M.D.
Last Review Date: 2022 Jun 28
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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