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Chronic bronchitis

by Jill Shuman, MS, RD, ELS

Definition

The bronchi are air passages of the lungs. Bronchitis is inflammation of the bronchi. It can make breathing difficult. It can also be painful.

lungs and bronchioles

© 2009 Nucleus Medical Media, Inc.

There are different types of bronchitis such as:

  • Acute bronchitis—is a sudden onset of symptoms. It only lasts a short time. There is full recovery of lung function.
  • Chronic bronchitis —is a long term condition. It causes obstruction and erosion of the lungs. It is often the result of many years of cigarette smoking . This is a serious condition. It is a type of chronic obstructive pulmonary disease (COPD) .
  • Asthmatic bronchitis—occurs in people with asthma . Occurs during an asthma attack. It is most common with allergies.
  • Irritative bronchitis—due to frequent contact with certain irritants. This often happens because of work setting. (also known as industrial or environmental bronchitis)

Causes

The inflammation may be caused by:

  • Bacterial and viral infections
  • Smoking (cigarettes or marijuana)
  • Inhalation of certain respiratory irritants (usualy in work setting) such as:
    • Ammonia
    • Chlorine
    • Minerals
    • Vegetable dusts

Risks

Risk factors for bronchitis include:

  • Smoking
  • Exposure to second-hand smoke
  • Contact with a person infected with bronchitis
  • Viral upper respiratory tract infection ( cold or flu )
  • Asthma
  • Chronic sinusitis
  • Occupational exposures to respiratory inhalants
  • Smog, in susceptible individuals
  • Enlarged tonsils and/or adenoids
  • Malnutrition

Symptoms

Symptoms will depend on the type of bronchitis.

  • Runny nose
  • Malaise
  • Slight fever
  • Back and muscle pain
  • Sore throat
  • Cough, initially dry, then produces mucus that may be thick, yellow, green, blood-streaked
  • Wheezing
  • Cough that brings up yellow-green mucus, often worse in the morning
  • Difficulty breathing
  • Bluish tint to lips and skin (in severe cases)
  • Swelling of the feet (in end-stage cases)

© 2009 Nucleus Medical Media, Inc.

Diagnosis

The doctor will ask about your symptoms and medical history. A physical exam will be done.

Tests are rare. The following may be recommended for severe or questionable cases:

  • Blood test
  • Chest x-rays —to rule out pneumonia , a complication of bronchitis
  • Pulse oximetry—to measure the amount of oxygen in the blood
  • Bronchoscopy with culture of the sputum

Tests may include:

  • Blood test
  • Chest x-rays
  • Pulmonary function tests or spirometry—to evaluate lung function
  • Sputum culture
  • Arterial blood gas—to test for levels of oxygen, carbon dioxide, and acid in the blood
  • Pulse oximetry
  • Bronchoscopy with culture of obtained sputum

Treatment

Treatment is aimed at relieving the symptoms. It includes:

  • Aspirin or acetaminophen to treat pain and fever
  • Expectorants or cough suppressants
  • Increased fluid intake
  • Cool mist humidification
  • Herbs and supplements — Pelargonium sidoides extract may help resolve symptoms in patients with acute bronchitis

Antibiotics will not be helpful if the infection is viral.

There are some concerns about the safety of over-the-counter cough and cold products. The concern is highest for children under two years of age. It is best to avoid these, especially in young children. Talk to your doctor about medication options.

Treatment is based on:

  • Age
  • Overall health
  • Extent of the disease
  • Past response to treatments

Treatment may include:

  • Oral antibiotics and bronchodilators, particularly clarithromycin
    • If you have chronic bronchitis and mild-to-moderate COPD, you may not need antibiotics
    • A study found that shorter antibiotic treatment (five days or less) is as effective as longer treatment (more than five days)
  • Bronchodilators
  • Oral or intravenous corticosteroid medications
  • Inhaled bronchodilators or corticosteroids
  • Expectorants to loosen secretions
  • Mucolytics
  • Supplemental oxygen
  • Cool mist humidification
  • Lung reduction surgery —removal of the most damaged part of the lungs (in severe cases)
  • Lung transplant (in end-stage cases)

If you are diagnosed with bronchitis, follow your doctor's instructions .

Prevention

To reduce your chance of getting bronchitis:

  • Stop smoking or never start.
  • Avoid passive smoke.
  • Avoid exposure to respiratory irritants.
  • Avoid contact with people who have bronchitis.

Last reviewed September 2009 by Christine Colpitts, CRT, MA

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Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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