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Bronchitis

Dr. Gaurav Ghatawat
Chest Physician

verified

Bronchitis, which causes inflammation in lungs, is a viral infection or complication of chronic obstructive pulmonary disease. Productive cough, which is usually confused as a symptom of cold and is not given any special attention, is an important bronchitis symptom. If you are among those who overlook uneasiness caused by a persistent cough, it is time to understand whether your cough indicates a severe problem such as bronchitis.There are two types of bronchitis, acute and chronic, which differ from each other in terms of treatment, causes, and progression.

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Types

Bronchitis is broadly classified into two categories:


  • Acute Bronchitis: It is commonly found in people who suffer from respiratory infections or common cold. Along with cough, acute bronchitis is characterized with the involvement of upper respiratory symptoms body ache and tiredness. Improvement is observed over a period of appropriate treatment in certain days; however, symptom such as cough is persistent over an extended time period.

  • Chronic Bronchitis: It is a serious condition associated in chronic obstructive pulmonary disease (COPD). Chronic bronchitis can cause irreversible changes in bronchial tract, which can lead to airway obstruction. Its development is associated to persistent bronchial tube irritation. Smokers are commonly reported with this type of bronchitis. 

Symptoms

The most common symptom of bronchitis is persistent cough; however, there might be other signs that are observed in people suffering from bronchitis:


  • Cough with phlegm

  • Chest discomfort

  • Wheezing

  • Breathlessness

  • Fatigue

  • Fever


Acute bronchitis may be accompanied by fever, headache, fatigue, cold, and cough with sputum production. These symptoms improve over seven days; however, the cough, increased sputum production, and wheezing can last several weeks.

Causes And Risk Factors

Causes

Bronchitis is the bronchial tube inflammation that connects the airway or windpipe to the lungs. Acute Bronchitis, a mild form, is caused by viral infection; however, the primary cause of chronic bronchitis is smoking cigarettes. If the diagnosis is delayed, considerable damage may occur.

Acute bronchitis usually starts with a cause of cold or some other upper respiratory infection; therefore, if you have a runny nose, sinus infection, and mild cough, you probably suffer from a common cold.

If your cold worsens and you develop a persistent productive cough, you might have bronchitis.

Moreover, if you have fever along with other symptoms, you might have bronchitis.

Risk Factors

Various factors that increase the risk of contracting bronchitis include:


  • Low resistance, which is another factor that can influence by an acute or chronic condition or comorbidity, weakens your immune system. The compromised immune system is susceptible to infections, especially in young children for older adults.

  • People who smoke cigarettes irritate the bronchial tract, which leads to the risk of contracting acute or chronic bronchitis.

  • People exposed to lung irritants such as textiles or grains or the people who work in the chemical industry are often exposed to chemical fumes or gases. Working in such an environment increases your risk of developing bronchitis.

  • Gastric reflux is one of the contributing factors that can lead to severe heartburn and can cause irritation of the throat. Irritation to your throat can lead to inflammation and can place you at risk of developing bronchitis.

Prevention

The best approach to prevent bronchitis is the instant diagnosis and medication. Do not ignore persistent cough because it can lead to bronchitis. Chronic bronchitis can be prevented by quitting smoking and by avoiding passive smoking. Preventing inhalation of dust and air-borne chemicals can control the incidence of bronchitis. Maintaining hygiene is an essential factor in preventing acute bronchitis. Vaccination is one of the preventive measures that can be undertaken. The influenza virus is the cause of acute bronchitis. A yearly flu vaccine is available, which can prevent you from flu infection and bronchitis. Individuals exposed to chemical fumes, dust, or COPD must consider wearing a surgical mask for protection.

Diagnosis

Your doctor will first examine you based on your following symptoms:


  • Fever

  • Cough with mucus.

  • A patient is suffering from a cough for more than eight weeks.

  • Wheezing 

  • Difficulty to breathe


To eliminate the possibility of pneumonia, a chest X-ray and sample from the mucus may be taken. To exclude other serious causes, blood tests will be performed.

If bronchitis is suspected, you may have to undergo a lung function test; reduced lung function may indicate bronchitis.

Airflow limitation caused secondary to increased mucus and inflammation of the bronchial tract and mucous glands is a characteristic feature of chronic bronchitis.

The increased neutrophil count is observed in severe bronchitis patients.

Reduced anti-inflammatory cytokines such as IL-10 and increased levels of IL-8, TNF-alpha, IL-4, IL-13 molecules are observed in chronic bronchitis patients.

Treatment

The treatment of acute bronchitis can be managed with symptomatic treatment; however, if influenza virus causes a viral infection, it is necessary to initiate antiviral therapy. The use of antibiotics in treating bronchitis is only required for bacterial infection. Smoking cessation is a vital step in treating bronchitis. Nicotine gum and nicotine replacement therapy are agents used in treating smoking cessation. Combining nicotine therapy with bupropion antidepressant agent increases the possibility of treatment success. Symptoms such as wheezing and bronchoconstriction, which are characteristic features in acute bronchitis, can be treated with a beta-2 adrenoceptor agonist. 

Experimental therapies available but under investigation for treating acute infectious bronchitis, and excessive production of mucus is a symptom of chronic bronchitis. Mucolytic agents have been investigated to treat mucus hypersecretion.

Phosphodiesterase inhibitor and novel anticholinergic agents have been reported to be effective in treating acute or chronic bronchitis. The neutrophil count is reported to be higher in the patient with chronic bronchitis. 

Chronic bronchitis condition cannot be reversed if it has caused severe lung damage. Bronchodilators and steroids are two classes of drugs that are used to treat the condition. Bronchodilators relax the smooth muscles around bronchi, allowing expansion of airways. Steroids are given to reduce inflammation and bronchial swelling. Sometimes, to improve lung function, pulmonary rehabilitation involving exercising and breathing techniques is required.

Lifestyle/management

It can be managed with home remedies. People with bronchitis are advised to get sufficient rest and drink lots of water for faster recovery. Smoking cessation is the most crucial lifestyle modification required to treat bronchitis. A surgical mask is protective of polluted air or exposed chemicals or irritants. The shortness of breath and cough can be certain complications caused because of cold air. A face mask will help you prevent your symptoms to an extent. 

Prognosis And Complications

Prognosis

Airflow obstruction, hypersecretion of mucus and reduction and lung function is noted in chronic bronchitis. There is an increased risk of developing new COPD in patients with chronic bronchitis, which is associated with a high rate of fatality. C reactive protein and serum IL-8 levels are higher, which symbolizes the inflammatory response in the body. This can further aggravate the risk of heart illnesses and other complications.

Complications

Chronic bronchitis drastically reduces lung capacity and may cause respiratory failure. This has a significant impact on the person’s quality of life. People who continue to smoke may severely damage their lungs. There is a possibility for a person suffering from bronchitis to acquire a secondary infection such as pneumonia.

References


  1. Elseiver public health emergency collection. Bronchitis [Internet] Available at 


https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7151913/. 

  1. Information Health.org. Acute Bronchitis: Overview [Internet] [Updated on Dec 2, 2020] Available at ncbi.nlm.nih.gov/books/NBK458291/.

  2. Chest Foundation. Cough [Internet] [Updated on Feb 4,2021] Available at https://foundation.chestnet.org/lung-health-a-z/cough/.

  3. Beth Israel Lahey Health Winchester Hospital. Acute Bronchitis  [Internet] Available at https://www.winchesterhospital.org/health-library/article?id=11997 

  4. NHS. Bronchitis [Internet] [Updated on Aug 7, 2019] Available at https://www.nhs.uk/conditions/bronchitis/.

  5. Stat Pearls. Chronic Bronchitis [Internet] [Updated on Aug 23,2020] Available at https://www.ncbi.nlm.nih.gov/books/NBK482437/.

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