Inflammation of the bronchial tubes due to an acute infection or a chronic illness is called bronchitis. It is often associated with breathing difficulties due to the narrowing and irritation of the bronchi.
Types:
- Acute bronchitis or chest cold is characterized by a cough that lasts for around three weeks and usually gets better on its own or without treatment.
- Chronic bronchitis is frequently seen in adults over the age of 40 and is characterized by a productive cough that lasts for three months a year for at least two years in a row.
- Eosinophilic bronchitis – Chronic dry cough is defined by the presence of an increased number of eosinophils and shows no airflow irritation in the x-ray.
- Protracted bacterial bronchitis – Chronic productive cough that is often seen in children and gets resolved with antibiotics.
- Plastic bronchitis is a rare disease characterized by lymph buildup in the airways and rubbery plugs that make it difficult to breathe.
- Aspergillus bronchitis – Chronic superficial infection of the lower airways, especially in non – immunocompromised patients.
Causes:
- The main causative factors of Acute bronchitis are – Viral infections such as cold or flu.
- Bacterial infections due to Mycoplasma pneumonia and Bordetella pertussis (less common).
- The etiological factors of Chronic bronchitis are –
- Cigarette smoking
- Lung diseases – Asthma, sinusitis, pulmonary fibrosis, pulmonary emphysema, tuberculosis, and upper respiratory infections.
Risk factors:
The main risk factors for getting bronchitis are as follows:
- Smoking – Exposure to secondhand cigarette smoke or smoking increases the risk of getting bronchitis as it irritates the white blood cells that make up the lining of the airways.
- Occupational exposure – Long–term exposure to grain dust, textiles (fabric fibers), ammonia, strong acids, chlorine, and other chemicals raises the risk of getting bronchitis.
- Asthma and allergy – Asthma constricts the air vessels in the lungs and puts the individual at a higher risk of developing bronchitis.
- Family history – The risk of chronic bronchitis is elevated if there is a family history of chronic obstructive pulmonary disease (COPD), wheezing, lung cancer, asthma, and other chronic lung diseases.
- Early life factors – Malnutrition and repeated childhood respiratory illnesses are linked to increased risk in later life.
- Other factors – The other factors that make a person vulnerable to developing acute and chronic bronchitis are :
- Close contact with someone having cold or acute bronchitis
- Not getting immunized against flu.
- Repeated gastric reflux that irritates the throat
Signs and symptoms of Bronchitis
- The symptoms of acute bronchitis last for around three to six weeks. Signs include –
- Cough that may or may not produce sputum
- Coughing up clear yellow-grey or greenish mucus
- Wheezing
- Shortness of breath
- Fever
- Chest discomfort
- Runny nose
- Low–grade fever
- Patients with chronic bronchitis develop the following symptoms –
- Productive cough that lasts for years
- Increased mucus production
- Shortness of breath, especially after mild activity
- Frequent colds
- Wheezing when breathing
- Fatigue
- Bluish fingernails, lips, and skin
- Swollen feet
Complications:
Acute bronchitis is not associated with any major complications, although, in some cases, it can lead to pneumonia. With chronic bronchitis, however, there is a possibility of developing the following complications:
- Respiratory failure
- Pneumonia
- Pneumothorax
- Polycythemia
- COPD
- Emphysema
Diagnosis:
- It is often challenging to diagnose bronchitis in the initial stages as the symptoms manifested during this time overlap with those of the common cold.
- The doctor assesses the patient’s medical history and performs a physical examination to check for signs of airflow obstruction.
- Diagnostic tests –
- Chest x-ray – It is done to see if the lungs and bronchial tubes look normal and rule out pneumonia.
- CT scan of the chest
- Pulmonary function tests – These tests are performed to characterize the structure and functioning of the lungs. Spirometry and peak flow monitor are commonly done for this purpose.
- Arterial blood gas measurements – It measures the acidity of the blood by checking the amount of oxygen and carbon dioxide in it.
- A doctor may do blood tests – A complete blood count test to check for signs of infection.
Treatment: How to treat Bronchitis?
- Acute bronchitis generally goes away without any treatment. Drinking plenty of fluid and taking lots of rest usually resolves this. Cough suppressants, pain relievers, and NSAIDs such as paracetamol may be given to treat the symptoms.
- The ultimate goal of chronic bronchitis treatment is to help the patient breathe better and control the symptoms.
- Treatment options may include one or more of the following:
- Lifestyle changes –
- Quitting smoking
- Staying away from secondhand smoke
- Humidifying the air
- Pulmonary rehabilitation to learn how to live with breathing problems and stay healthy.
- Medications –
- Beta – 2 – agonists – Albuterol and salbutamol are administered as inhalations to relax the airways and make breathing easier.
- Inhaled corticosteroids – Beclomethasone, budesonide, etc., to reduce airway swelling, excess mucus, and tight mucus.
- Nebulizer treatments – Combination of ipratropium and albuterol to calm the inflammation in the mucus membrane.
- Mucolytics – Guaifenesin and fudosteine are given to thin the mucus in the lungs, making it easier to cough up.
- Lifestyle changes –
- Oxygen therapy – It increases oxygen in the lungs and eases breathing problems.
- Surgery – In rare cases, the damaged part of the lungs or airways is surgically removed.
Prevention: How is Bronchitis prevented?
- Living with it –
- Eating a healthy diet
- Avoiding smoking
- Regular moderate exercise
- Staying hydrated
- Preventing it –
- Avoid lung irritants or wear masks when using lung irritants like paint, varnish, etc.
- Frequent hand washing
- Receiving a flu shot every year
- Getting a pneumonia shot, especially if the patient is above 65 years
When to see a doctor? :
Seek medical advice from a pulmonologist if cough lasts for more than three weeks, disrupts sleep, and produced discolored mucus or blood. It costs around Rs. 500 to 2K to consult with a pulmonologist.
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