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Bronchitis

Definition
Bronchitis is a condition in which the tissues lining the bronchi
two main divisions of the airway that lead into the right and left
lungs
a temporary illness that clears up in three weeks or less; or chronic, a
recurrent condition in which the person suffers coughing attacks for
at least three months over two successive years. Chronic bronchitis is
grouped together with emphysema as a form of chronic obstructive
pulmonary disease (COPD).
—the—become inflamed. Doctors define bronchitis as either acute,
Description
Bronchitis can be caused by a wide range of disease organisms and other
irritants that inflame the tissues of the bronchi, including viruses, bacteria,
parasites, smoking, chemical pollutants, or dust particles. Acute
bronchitis is caused most often by viruses, while chronic bronchitis is
caused most often by smoking.
In acute bronchitis, the tissues lining the bronchi become swollen
and irritated by the disease organism or chemical. The air passages slowly
become clogged by dead cells and leaking tissue fluid, which further irritates
the bronchial tissues. The tissues begin to secrete mucus in response
to the inflammation. As the mucus accumulates
in the airways, the person starts to cough in
order to clear the breathing passages. The
coughing, the sputum (mucus and other matter)
that is brought up by coughing, and wheezing or
shortness of breath are classic symptoms of acute
bronchitis. Chest pain may develop after several
days of severe coughing.
Demographics
According to the National Center for Health Statistics,
about 14 million Americans have chronic
bronchitis. In an average year, there are 12
cases of acute bronchitis reported in the United
States, compared to 91 million cases of influenza,
66 million cases of the common cold, and 31 million
cases of other acute upper respiratory infections.
Acute bronchitis is more common in the
winter months in most parts of the United States.
Children are more likely to develop acute
bronchitis, while chronic bronchitis is largely a
disease of adults. The male/female ratio for
chronic bronchitis is about three to two. As far
as is known, both acute and chronic bronchitis are
equally common in all races and ethnic groups.
Some people are at increased risk of developing
bronchitis:
–13 million
•
Smokers and people who live with smokers.
•
(GERD). GERD is a condition in
which stomach acid backs up into the esophagus,
which can trigger the coughing reflex.
People with gastroesophageal reflux disease
•
that irritate the airway. These may include cotton and
other textiles, wheat and other grains, ammonia, sulfur dioxide,
chlorine, and a few other strong chemicals.
People whose jobs expose them to chemicals, dust, or other substances
•
People exposed to high levels of automobile exhaust.•
Causes and Symptoms
The basic cause of bronchitis, whether acute or chronic, is a disease
organism or substance that irritates the tissues lining the bronchi.
The symptoms of acute bronchitis are similar to those of a bad cold
or other upper respiratory infection:
•
Sore throat
•
A feeling of tightness or congestion in the chest
•
Overall feeling of tiredness
•
Low-grade fever and chills
•
Difficulty breathing
•
Wheezing
Diagnosis
Acute bronchitis is essentially a diagnosis of exclusion, which means that
the doctor must rule out such other illnesses as influenza, strep throat,
pneumonia, whooping cough, or tonsillitis. The diagnosis is based on a
combination of the patient
respiratory tract infections or exposure to others with such infections,
and a physical examination. During the physical examination, the doctor
will listen to the patient
may be ordered to rule out pneumonia.
The doctor will sometimes collect a sample of the patient
there is reason to suspect that the bronchitis is caused by bacteria. Most
cases of acute bronchitis are caused by the same types of virus that cause
the common cold and cannot be treated with antibiotics; however, bacterial
infections can be effectively treated by antibiotic medications. If the
patient has a severe sore throat in addition to wheezing and coughing, the
doctor may order a rapid strep test to rule out the possibility of strep
throat, another type of bacterial infection.
If the patient has had several episodes of acute bronchitis or the
doctor has other reasons for suspecting chronic bronchitis, the doctor
will order pulmonary function tests (PFTs). These are tests in which the
patient is asked to breathe into a device called a spirometer. The spirometer
measures how much air the patient
air moves in and out of the lungs. It can also be used to determine how
well the lungs are exchanging oxygen and carbon dioxide. Another way
the spirometer can be used is to test the effectiveness of inhaled medications
in treating chronic bronchitis.
Treatment
Acute bronchitis is usually treated at home with a combination of bed
rest; over-the counter pain-relievers like aspirin, Advil, Tylenol, or
Motrin to lower the fever; and over-the counter cough medications.
Some of these medications (Robitussin, Mucinex) are intended to loosen
the mucus in the bronchial passages while others (Benylin, Pertussin) are
intended to suppress (quiet) the coughing. Patients should drink plenty
of clear fluids to loosen the mucus and use a humidifier or cool-mist
vaporizer to reduce the irritation in the bronchi.
Because the overuse of antibiotics can create drug-resistant organisms,
the doctor may not prescribe an antibiotic for acute bronchitis
unless he or she has test results indicating that the patient
caused by a bacterium and not a virus.
People with chronic bronchitis may need stronger medications:
’s illness is
•
up the airways, which allows for more efficient exchange of carbon
dioxide and oxygen. Some are taken in tablet form while others are
dispensed in inhalers.
Bronchodilators. Bronchodilators are drugs that work by opening
•
in the tissues lining the airways. These drugs can also be
taken in pill form or through inhalers.
Steroids. This type of medication works by lowering the inflammation
•
to lower the risk of developing complications.
Antibiotics. People with chronic bronchitis may be given antibiotics
•
need to go to the hospital for oxygen therapy. There are also oxygen
tanks that can be used in the home; some of these are portable units.
Oxygen. Patients who have severe attacks of chronic bronchitis may
Prognosis
Most cases of acute bronchitis clear up completely in two to three weeks with
no long-term complications. Chronic bronchitis, however, increases a person
risk of permanently weakened lungs, heart disease, and a shortened life span.
’s
Prevention
The best way to prevent chronic bronchitis is to quit smoking; parents
can protect their children from bronchitis by quitting or by not smoking
in the first place. In some cases, people whose jobs expose them to
chemicals, dust, or other materials that irritate the breathing passage may
benefit from changing their occupation.
Acute bronchitis is more difficult to prevent because its most
common cause is upper respiratory viruses that are hard to avoid. Regular
hand washing and the use of hand sanitizers can reduce the spread of
these viruses within a family, school, or day care center. Some people can
lower the risk of bronchitis by getting annual flu shots. In addition,
people who are over sixty-five or who have diabetes or emphysema may
benefit from getting immunized against the most common cause of
bacterial pneumonia.
The Future
Acute bronchitis is likely to continue to be a commonplace health problem
because the viruses that are its most common cause are widespread,
particularly during cold and flu season. Chronic bronchitis is expected to
affect an even larger proportion of the adult population in the years
ahead because many long-term smokers are now reaching the age at
which the symptoms of chronic obstructive pulmonary disease are most
likely to appear.
SEE ALSO
disease; Pneumonia; Smoking; Tonsillitus; Whooping cough
Asthma; Common cold; Emphysema; Gastroesophageal reflux
For more information
BOOKS
Jacoby, David B., and Robert M. Youngson.
ed. Tarrytown, NY: Marshall Cavendish, 2004.
Matthews, Dawn D.
Detroit, MI: Omnigraphics, 2002.
WEB SITES
American Academy of Family Physicians (AAFP).
online at http://familydoctor.org/online/famdocen/home/common/infections/
common/mulitsource/677.html (updated January 2006; accessed June
19, 2008).
American Academy of Family Physicians (AAFP).
online at http://familydoctor.org/online/famdocen/home/articles/280.html
(updated April 2008; accessed June 20, 2008).
Children
childrenshospital.org/az/Site561/mainpageS561P0.html (accessed June 19, 2008).
eMedicine Health.
bronchitis/article_em.htm (updated February 22, 2008; accessed June 20, 2008).
Mayo Clinic.
bronchitis/DS00031 (updated April 20, 2007; accessed June 20, 2008).
TeensHealth.
common/bronchitis.html (updated October 2007; accessed June 19, 2008).Acute Bronchitis. AvailableChronic Bronchitis. Available’s Hospital Boston. Bronchitis, Acute. Available online at http://www.Bronchitis. Available online at http://www.emedicinehealth.com/Bronchitis. Available online at http://www.mayoclinic.com/health/Bronchitis. Available online at http://kidshealth.org/teen/infections/Encyclopedia of Family Health. 3rdLung Disorders Sourcebook: Basic Information for Consumers.’s history, including a history of recent upper’s breathing through a stethoscope. A chest x ray’s sputum if’s lungs can hold and how fast theInfants, elderly people, and others with low resistance to infections.
Bronchitis
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