Bronchitis

Risk Factors A risk factor is something that increases your chance of getting a disease or condition. Risk factors 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 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-raysto rule out pneumonia , a complication of bronchitis Pulse oximetryto 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 spirometryto evaluate lung function Sputum culture Arterial blood gasto 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. *

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.* Bronchodilators Oral or intravenous corticosteroid medications Inhaled bronchodilators or corticosteroids Expectorants to loosen secretions Mucolytics Supplemental oxygen Cool mist humidification Lung reduction surgeryremoval 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. RESOURCES: American Lung Association http://www.lungusa.org Familydoctor.org http://familydoctor.org 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.