Bronchitis is an inflammatory reaction of the lining of the bronchial tubes (or airways). As it is a respiratory condition, it presents with symptoms such as frequent coughing with or without mucus, fatigue, fever and wheezing or whistling sound while breathing.
Bronchitis is broadly classified into acute (if onset is recent) or chronic (if present for long) forms. Acute bronchitis is often caused by a mild infection such as seasonal viral flu or may be due to allergic reasons. Whereas smoking and exposure to air pollutants for a long time are the most common causes of chronic bronchitis. Chronic bronchitis is associated with a severe respiratory disease known as a chronic obstructive pulmonary disease (COPD).
Acute bronchitis, if mild, can be managed with home remedies, OTC products, and anti-allergic medications but consultation with a doctor or immediate intervention may be required in severe cases. Chronic bronchitis is an ongoing illness that requires lifelong treatment to keep the symptoms suppressed and is a cause of considerable morbidity and mortality in the long term.
The bronchioles and bronchi present in the respiratory system consist of airways or tubes that carry the air inhaled by the nose to the lungs. After inhalation, air enters the nose, crosses the larynx and enters the trachea. The trachea first divides into the two airways known as the right bronchus and the left bronchus. These bronchus further divide into many small bronchioles and ultimately supply air to the right and the left lung, respectively. Any inflammation occurring in the bronchi is known as bronchitis.
Bronchitis can be acute or chronic and the symptoms may vary slightly based on the type.
Symptoms of acute bronchitis last for a week or two and usually do not cause any lingering effects. Following symptoms are seen with acute bronchitis:
Persistent cough
Coughing up sputum, which may be colorless or yellowish. Occasionally, it may be greenish or blood-tinged sputum.
A runny or a stuffy nose
Sore throat
Chest pain or tightness
Wheezing or whistling sounds may be heard during breathing
Dyspnoea or breathlessness while performing activities or at rest
Fever, chills, weakness, and body aches
Dizziness and confusion
Low levels of oxygen
When the symptoms of acute bronchitis last for a longer time and recur frequently, it may be a case of a condition known as chronic bronchitis, an ongoing illness. Chronic bronchitis is characterised as a productive cough which may continue for a minimum of three months for two or more consecutive years.
Chronic bronchitis, if left unattended, might lead to emphysema (a type of respiratory disease) which in turn can cause chronic obstructive pulmonary disease (COPD), a serious respiratory disorder that can also be life-threatening.
Infections: Acute bronchitis can be caused by viral or bacterial infections of the respiratory tract. The same viruses that cause the common cold or the flu can also cause acute bronchitis. Viruses and bacteria can enter your body if you are in close proximity to a patient who has an ongoing respiratory illness. When a patient coughs or sneezes, millions of tiny droplets laden with microorganisms get released into the air. If you inhale such contaminated air, you may also get infected.
Inhalation of irritant substances: Inhaling dust particles, smoke, and industrial pollutants such as tiny fibers, asbestos granules, acid fumes, etc. may also cause inflammation in the airways and lead to acute bronchitis.
Seasonal changes: For some people, seasonal changes can also increase the risk of acute bronchitis due to allergic reactions. It is seen that during the winter season most people experience an episode of acute bronchitis every year.
Air pollution: Living in polluted areas and constantly breathing in polluted air can lead to the development of chronic bronchitis.
Industrial exposure: Working in industries that continually expose a person to tiny fibers, dust, smoke, acid fumes, etc., which irritate the lungs may cause chronic bronchitis.
Smoking: Smoking for a longer duration, actively or passively (exposed to smoke when someone else is smoking), is one of the causes of chronic bronchitis.
You have a higher chance of getting bronchitis if you:
Are a smoker
Have a family history of respiratory diseases
Work in an industry that exposes you to lung irritants
Have asthma or allergic diseases
Have a weak immune system
Suffer from repeated bouts of severe acidity (gastric reflux)
Acute bronchitis is commonly caused by respiratory viruses. In most cases, it is a self-limiting illness that resolves within 8 to 10 days. Doctors do not usually suggest any investigations for a single episode of acute bronchitis as the diagnosis is mostly based on the patient’s history and clinical symptoms. Laboratory investigations and imaging studies may be needed when symptoms are severe or recurrent and do not resolve within 8 to 10 days.
1. Blood tests: Blood tests like Complete Blood Count (CBC), Erythrocyte Sedimentation Rate (ESR), C-Reactive Protein (CRP), etc., may be required to evaluate if the patient is suspected of having a severe infection or inflammation.
2. Sputum analysis: This has a limited role in diagnosing a case of acute bronchitis. Viruses are the most common cause of acute bronchitis, and they are not sufficiently detected in a sputum analysis. A sputum examination routine is required when a patient is suspected of having add-on infections or pneumonia (complications of acute bronchitis).
3. Pulmonary function testing: Pulmonary Function Tests are tests that study the functioning of the airways and are used to determine their sensitivity to bronchodilator medications. They are an important diagnostic tool to evaluate chronic bronchitis and COPD.
X-Ray chest PA view and HRCT chest - plain are used to visualize the lungs and the airways to help establish a diagnosis for respiratory symptoms.
Although bronchitis can affect anyone and it is not possible to prevent it entirely, certain precautions and lifestyle modifications can help prevent frequent episodes of bronchitis.
Do not smoke or be around people when they are smoking
Wear a mask when you are exposed to dust, smoke, or other lung irritants
Wash your hands frequently, and do not touch your eyes, ears, and mouth repetitively
Get yourself vaccinated yearly with the flu vaccine
In most cases, you do not produce noticeable amounts of phlegm unless you are sick or suffer from any respiratory problem. But the presence of phlegm (known as sputum) could indicate the presence of an allergen, irritant or infection in your lungs or sinuses. Moreover, the color of the phlegm can give you an idea about your health problem.
Do you know how to differentiate the different colors of the mucus and know what each color means?
Acute bronchitis often resolves on its own, and the symptoms will clear off in a week or ten days. You may seek medical advice from a doctor if you have troublesome symptoms not relieved with home remedies or OTC preparations. If you have a cough for most days of the year, you must consult a
General physician
Respiratory specialist (Chest physician/pulmonologist)
If you experience severe symptoms during an episode of acute bronchitis, it may suggest an underlying secondary infection in the lungs which may require immediate medical attention. The symptoms include:
High fever
Chills
Breathlessness at rest
Low oxygen levels
Bad taste in the mouth
Cough with blood-tinged or greenish sputum
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The treatment for bronchitis is mostly based on the type and severity of the condition. Some of the most common treatments suggested include:
Physiotherapy exercises for postural drainage effectively loosen the secretions in the chest and help with easy expulsion of mucus. Pulmonary rehabilitation exercises comprise breathing techniques and with time gradually progress to aerobic exercises to help improve a patient’s lung capacity and strengthen their respiratory system. Pulmonary rehabilitation is an important part of chronic bronchitis and COPD management.
The treatment for acute bronchitis is mostly symptomatic and consists of:
Antipyretics like paracetamol preparations are used to control the fever.
Bronchodilators like salbutamol and ipratropium bromide help improve breathing.
Antitussives and expectorant syrups help reduce cough and chest congestion. Antitussives help suppress cough whereas expectorants help to easily expel the mucus.
Lozenges provide a soothing effect by reducing the coughing sensation.
Antibiotics (rarely) may be given if your doctor suspects an additional bacterial infection.
Chronic bronchitis is an ongoing illness that requires additional treatment to the above-listed symptomatic treatment of coughing. The treatment may include:
Antitussive medications which are used to treat the chronic cough associated with chronic bronchitis and COPD.
Bronchodilators such as salmeterol and tiotropium and steroid medicines like fluticasone and beclomethasone are prescribed for inhalation to relieve airway inflammation seen in chronic bronchitis and COPD.
Patients with a severe disease may require supplemental oxygen at home to combat the hypoxia (absence of sufficient oxygen to the tissues).
If you have a flare-up of acute bronchitis or are suffering from chronic bronchitis, you can do the following to get relief from symptoms:
Drink plenty of fluids like warm water, herbal teas, and clear soups.
Take sufficient rest. If you can't sleep at night, use an extra pillow to prop up your head to prevent mucus from settling in the back of your throat.
Perform steam inhalation as it humidifies the nasal passages and airways and helps loosen chest congestion.
Using a cold or warm mist humidifier in the bedroom can help clear the mucus.
Gargling with salt water can help break mucus that irritates the throat. Spit it out after gargling. You can repeat it many times a day to soothe your throat.
You can use a saline nasal spray or drops to help with nasal stuffiness.
You can suck on lozenges (small medicated tablet for cough) or a mixture of honey and lemon to help with a sore throat and cough. Do not give lozenges to children without consulting a doctor.
Quitting smoking is one of the key lifestyle modifications advised to patients who smoke. Smoking cessation helps prevent disease from worsening.
Bronchitis, whether it is acute or chronic, may cause severe activity limitations and lead to:
Asthma
COPD
Emphysema
Empyema
Pneumothorax
Pneumonia
Lung collapse
Chronic hypoxia
Respiratory failure
Death
1. Honey: It has antiviral as well as antibacterial properties and is useful in the treatment of bronchitis. Honey helps soothe the throat and moreover, it also builds a strong immune system.
Tip: Add half a teaspoon of honey with a pinch of black pepper, fresh ginger paste, and 1-2 clove powder. Consume this paste to ward off the burning sensation of the throat.
2. Ginger: It has immune-building and anti-inflammatory properties that not only help treat cold but also sore and inflamed bronchial tubes.
Tip: It’s safest to use ginger in a natural form, rather than in capsules or supplements. Prepare a mixture by adding one teaspoon each of pepper, dried ginger, and cloves. Add a little amount of this mixture in milk or honey and have it thrice a day to get relief.
3. Turmeric: To get relief from cough associated with bronchitis, turmeric is the best natural remedy. The anti-inflammatory properties of turmeric resolves excess mucus, which ultimately provides relief. Turmeric also increases antioxidant activity, meaning that it may help reduce irritation and boost your immunity.
Tip: Mix 1/2 teaspoon of powdered turmeric with 1 teaspoon of honey to make a paste. Consume the paste 1 to 3 times per day while symptoms last.
4. Garlic: Garlic is one of the most important home remedies to treat acute bronchitis. Results of a study published in 2016 show that garlic effectively inhibited the growth of infectious bronchitis virus.
Tip: Take three fresh garlic bulbs, peel, and chop them properly. Add the chopped pieces to a glass of milk. Boil the milk for some time and drink it warm before going to sleep.
5. Salt water: Gargling salt water may help break up mucus and reduce pain in your throat. This helps in soothing the irritated throat.
Tip: Add some salt in warm water and stir it well. Now, gargle with this warm salt water 3-4 times a day.
6. Pineapple: Pineapple contains bromelain, which is a natural and powerful anti-inflammatory that can help in expelling mucus and gives relief in bronchitis and other respiratory infections.
7. Orange juice: Oranges are rich in vitamin C and it is suggested to consume plenty of vitamin C to build a strong immune system. To treat bronchitis, fruit juices are the best home remedies to soothe the inflamed throat.
Tip: Orange juice can also be used with almonds to alleviate a sore throat. Finely crushed almonds can be added to orange juice and drink this at night.
There are various herbal remedies which are used to alleviate the symptoms of cough, such as sucking on a clove, taking powdered preparations from medicinal herbs, and condiments like long pepper, dried ginger, turmeric, etc. Formulations, such as Sitopaladi Churna, Karpuradi Churna, etc., are also used to alleviate dry cough. Vyaghriharitaki Avaleha, Bharangyadi Avaleha, and Vasavaleha are found to be useful in chronic bronchitis and childhood asthma.
Although there is little evidence, homeopathy preparations like Belladonna, Chamomilla, Antimonium Tartaricum, Nux Vomica, Kali Sulphuricum, etc. have been in use to treat cough, cold, and other symptoms of bronchitis.
Acute bronchitis does not majorly interfere with the patient’s lifestyle as the symptoms do not continue for long and resolve without any long-term effects. However, chronic bronchitis may impart a major impact on a patient’s quality of life.
A chronic bronchitis patient may not be able to perform strenuous physical activities as he or she may get breathless. As the disease progresses, the symptoms worsen and the chances of respiratory failure are high.
A COPD patient may often need oxygen supplementation at home, and their other physical activities may be severely limited. The quality of life of the patient with chronic bronchitis declines as the severity of the disease increases.
