Bronchitis is a condition of the respiratory system. It is characterized by inflammation of the bronchial tubes within the lungs. These tubes are one part of our respiratory system that is responsible for getting the air that we breathe to oxygenate our bodies.
What are the bronchial tubes?
When we breathe air in through our mouth or nose it enters our trachea. This is a long tube that runs parallel to our esophagus that brings the air from our mouth or nose into our lungs. When the trachea enters the lungs, it divides into smaller and smaller tubes (bronchi and bronchioles) to ensure that air gets evenly distributed. If even one of these small tubes gets inflamed, swollen or blocked it can cause difficulty breathing, shortness of breath, wheezing and a decreased perfusion of oxygen into our body. This condition can be characterized as acute bronchitis or chronic bronchitis. Other conditions that affect the respiratory system include obstructive diseases like chronic obstructive pulmonary disorder (COPD), emphysema, bronchiectasis, infections, cancer and asthma.
The most common symptoms are
- Cough - often a productive cough with increased mucus and sputum production
- Chest pain
- May have associated symptoms of a common cold if that preceded the infection
- Shortness of breath
- Wheezing - can be audible to the ear or just to a stethoscope on evaluation by a doctor
Acute exacerbations of symptoms can happen with exposure to cigarette smoking or air pollution.
The main cause is when something unwanted gets into the bronchial tubes. When the immune system senses this pathogen/trigger it sends an immune response to the bronchial mucous membranes. This results in increased circulation and immune activity in the area causing swelling, and heat within the tube. This makes it much harder for air to move in or out of the tube and can cause a wheezing sound to be heard whenever one breathes. One of the most common triggers for bronchitis is a bacteria or virus.
This bacteria or virus often starts as a cold or flu-like illness that moves further down into the lungs causing swelling in the tubes. In addition, it can also be from a new pathogen entirely that gets directly into the lungs and does not affect any other system of the body.
Bronchitis can either be chronic or acute bronchitis.
Chronic bronchitis consists of a cough that lasts longer than 3 months while acute bronchitis doesn’t tend to last longer than 3 weeks. Both chronic and acute bronchitis is characterized by a cough, increased mucus, possible wheezing and chest pain.
Depending on whether it is acute or chronic symptoms may last from as little as 3 weeks to potentially multiple years. If it lasts for years it is most often characterized by a chronic cough.
Chronic vs Acute Bronchitis?
Both chronic and acute bronchitis are swelling of the bronchial mucous membrane due to a pathogen. It is also called bronchial catarrh and is one of the most common respiratory tract illnesses. It often develops from a previous respiratory tract infection. Normally, acute bronchitis lasts for around 3 weeks. It usually starts a few days after the onset of a flu-like infection. The primary symptom of the cough usually lasts a few days longer than the other cold symptoms such as increased mucus.
Chronic bronchitis arises from acute bronchitis that the body is unable to fight off. Chronic bronchitis is diagnosed if the symptoms occur within two years for longer than three months per year in one stretch. If the swelling also affects the trachea, this is tracheobronchitis. If it spreads to the lungs, this results in pneumonia or bronchopneumonia and can cause further health problems especially with the air passages.
Other causes of a Cough
- The common cold
- Whooping cough (pertussis)
- Chronic obstructive pulmonary diseases (COPD) include chronic bronchitis and emphysema
- Viral infection
Viral syndromes, common colds and sinusitis tend to last only about 7-10 days whereas acute bronchitis lasts about 3 weeks. Chronic bronchitis can last for years. These will also have additional symptoms such as sinus pain, or a sore throat.
Other more serious causes will have extra symptoms. For example, pneumonia often has a fever, asthma has episodes of trouble breathing, whooping cough the cough is so intense that it can cause vomiting and COPD has other distinctive characteristics including specific results on a spirometry test to evaluate your lungs capacity.
Often a chest x-ray or a sputum culture is done to try and distinguish between common causes including bronchitis, pneumonia or other lung diseases.
Acute bronchitis can severely irritate the mucous membranes in the lungs. If it recurs frequently it can give rise to a hypersensitive bronchial system and chronic bronchitis.
Depending on the type of pathogen causing bronchitis it can lead to the development of other conditions. An infection with bacteria such as pneumococci can lead to inflammation of the lungs (pneumonia or bronchopneumonia)
Permanent irritation and inflammation of the bronchial mucous membranes can lead to constriction or obstruction in the lungs. This is referred to as obstructive bronchitis or Chronic Obstructive Pulmonary Disease.
Chronic Obstructive Pulmonary Disease
Chronic Obstructive Pulmonary Disease is characterized by coughing, increased phlegm and breathlessness upon exertion. The major risk factor for chronic bronchitis and COPD is smoking. It destroys the cilia in the bronchial mucous membrane which is part of the lung's defence system to remove pathogens and harmful substances from the lungs. Furthermore, cigarette smoke promotes inflammatory processes and weakens the immune system. COPD is often known colloquially as a "smoker's cough" for this reason. Pulmonary emphysema can even develop which causes enlargement of the air sacs in the lungs thus impairing function.
Treatment depends on the pathogen causing bronchitis.
1) Viral Bronchitis: treatment targets symptom relief.
Some over-the-counter medications or herbal remedies could aid in relieving or treating the symptoms. These can either be prescription or non-prescription.
- Cough expectorants can be very helpful to help the body expel pathogens or mucous that might be impeding breathing.
- Cough medicine (antitussives) might help to relieve the cough acutely however it might not be an effective treatment long term.
- Mucolytics either pharmaceutical or herbal can help to break up the mucus that is stuck in the lungs so that it is easier to expel via a cough.
- Bronchodilators should only be used if there is shortness of breath or trouble breathing, to open the airways acutely to make it easier to breathe. These are often known as beta2-agonists or beta-agonists. They can help with airflow limitation or airflow obstruction. Bronchodilators are classified as long-acting or short-acting and are chosen based on the desired effects.
2) Bacterial Bronchitis: treatment should be focused on killing off the bacterial infections
- Anti-inflammatory medications are another way of approaching this condition. This can be done through corticosteroids or non-steroidal anti-inflammatories or herbal anti-inflammatories.
3) Chronic Bronchitis: in addition to all of the treatments above
- Treating other health problems can also help to support the body decreasing the symptoms associated with the respiratory system
- General immune support through home treatment is integral to strengthening the body against subsequent illnesses
- Drinking plenty of fluids
- Getting plenty of rest
- Eating fruits and vegetables
- Cessation of smoking
- Avoiding second-hand smoke
- Increasing the humidity in the house to moisten mucus membranes and decrease coughing and pain
Overall there are many ways to approach bronchitis treatment. It is important to always check in with a healthcare provider to try and find out what is the best course of treatment for everyone. Some cases are self-limited and will not need any treatment or only pain relief with acetaminophen. Any medication or products should be taken with caution because of potential side effects.