Bronchitis
Posted July 1, 2008 7:12 PM
Posted in
Definition
Bronchitis is inflammation of the air passages (bronchi) of the lungs. It can make breathing difficult and sometimes painful.
- Acute bronchitis—This is a sudden onset of symptoms. The condition lasts only a short time, and there is full recovery of lung function.
- Chronic bronchitis—This involves long-term inflammation, obstruction, and degeneration of the bronchi. It is often the result of many years of cigarette smoking . This is a serious medical condition, also called chronic obstructive pulmonary disease (COPD) .
- Asthmatic bronchitis—This condition involves intermittent inflammation of the airways in people with underlying asthma . It is most commonly associated with allergies or environmental irritants.
- Irritative bronchitis—Also called industrial or environmental bronchitis, this is due to chronic exposure to substances such as acids, ammonia, chlorine, minerals, or vegetable dusts.
Chronic Bronchitis
© 2008 Nucleus Medical Art, Inc.
Causes
The inflammation may be caused by:
- Bacterial and viral infections
- Smoking (cigarettes or marijuana)
- Inhalation of certain respiratory irritants (ie, chemical pollutants or dust), particularly in an occupational setting
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
Risk factors include:
Symptoms
Symptoms depend on the type of bronchitis.
Acute 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
Chronic Bronchitis
- 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)
Diagnosis
The doctor will ask about your symptoms and medical history, and perform a physical exam.
Acute Bronchitis
Tests for acute bronchitis are not usually needed. However, for severe or questionable cases, the following may be recommended:
- 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
Chronic Bronchitis
Tests for chronic bronchitis 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
Acute Bronchitis
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
In most cases, antibiotics are not necessary because the infection is viral, not bacterial.
Questions have been raised about the safety of over-the-counter cough and cold products in children, especially those under two years of age. Some instances of serious harm associated with these products appear to be the result of not following directions regarding dosage or combining preparations with the same active ingredients. Given these concerns, it is best to avoid these products, especially in young children, unless advised otherwise by a doctor. *¹
Chronic Bronchitis
Treatment is based on:
- Age
- Overall health
- Extent of the disease
- Past response to treatments
Treatment may include:
- Oral antibiotics and bronchodilators, particularly clarithromycin
- A review of 21 trials found that shorter antibiotic treatment (five days or less) is as effective as longer treatment (more than five days) in people with chronic bronchitis and mild-to-moderate COPD episodes.*²
- 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)
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.
CANADIAN RESOURCES:
BC Health Guide
http://www.bchealthguide.org/
The Canadian Lung Association
http://www.lung.ca
References:
Bishai WR. Macrolide immunomodulatory effects and symptom resolution in acute exacerbation of chronic bronchitis and acute maxillary sinusitis: a focus on clarithromycin. Expert Rev Anti Infect Ther. 2006;4:405-416.
Harrison's Principles of Internal Medicine. 14th ed. New York, NY: McGraw-Hill; 1998.
National Heart, Lung, and Blood Institute website. Available at: http://www.nhlbi.nih.gov/ .
Poole PJ, Black, PN. Mucolytic agents for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2006;3.
*16/4/2007 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : Nonprescription cough and cold medicine use in children. Medwatch: 2007 Safety Alerts for Drugs, Biologics, Medical Devices, and Dietary Supplements. US Food and Drug Administration website. Available at: http://www.fda.gov/medwatch/safety/2007/safety07.htm#Cough . Accessed: September 4, 2007.
*26/4/2008 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : El Moussaoui R, Roede BM, Speelman P, Bresser P, Prins JM, Bossuyt PM. AbstractShort-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies. Thorax. 2008;63:415-422. Epub 2008 Jan 30. Review.
Last reviewed December 2007 by Jill Landis, MD
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.
Copyright © 2007 EBSCO Publishing All rights reserved.
Source: EBSCO
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