Bronchitis is the inflammation or swelling of the bronchi (bronchial tubes), the passageway that supplies air to lungs
Bronchi are the main airways to lungs which branch off to smaller tubes called as bronchioles. The walls of bronchi create mucus to trap dust and other irritants.
The lining of bronchial tubes becomes infected, swells and closes up the small air ways to the lung. This leads to coughing fits, accompanied with mucus and shortness of breath.
This disease decreases the ability of a person to breathe in air as there is heavy mucus or phlegm formation in the passages.
There are two types of bronchitis:
This type lasts for one to three weeks
It is responsible for a hacking cough and follows a cold or viral infection, such as flu
It consists of a cough with mucus, chest discomfort, fever and breathlessness
It lasts longer than three months and is characterized by a chronic cough along with mucus
People having this ailment, suffer from breathing difficulties
Symptoms may get better or worse, according to seasons of the year
Chronic Bronchitis is one type of chronic obstructive pulmonary disease (COPD). A lot of mucus is produced by the inflamed bronchial tubes. This leads to coughing and breathing problems.
It is a long standing condition and is never cured completely
What are the causes of Bronchitis?
Causes of acute bronchitis:
90% caused by viral infections, originating in the lungs. These viruses are typically associated with common cold and flu.
The virus comes out in tiny droplets from the nose and the mouth, when someone sneezes. This virus can live for up to 24 hours.
Infections caused by bacteria can also cause acute bronchitis
Tobacco smoke, vapors, dust, fumes and air pollution, irritates the lungs and leads to this form of bronchitis
Causes of chronic bronchitis:
Repeated irritation of the lung passages cause damage to the pulmonary tissue and the tubes
Smoking is the most common cause
Long-term exposure to air pollution and dust in the environment
Recurring episodes of acute bronchitis
What are the symptoms of Bronchitis?
For both acute and chronic bronchitis, the symptoms are:
Production of mucus which can be white, yellow or green phlegm, after a period of 24 to 48 hours, after the cough begins
Fever accompanied with chills
Discomfort in the chest
Difficulty in breathing
For acute bronchitis, a nagging cough persists; long after the inflammation itself resolves. For chronic bronchitis, the cough lasts for more than three months, with short bouts occurring repeatedly, for two years. There will be some spells that are worse than others. At such times, acute bronchitis occurs on top of the chronic bronchitis.
A doctor should be consulted when the cough:
Lasts for over three weeks
Interferes with sleep
Is accompanied by a fever of over 100.4°F
Leads to expelling grayish-green mucus
Leads to breathlessness
What are the tests suggested for diagnosing bronchitis?
Firstly, the doctor performs a thorough physical examination along with a review of medical history of the patient. He or she may ask various questions about the cough, like:
Length of time since it started
What is expelled
How long the fit lasts
For a definite diagnosis, the tests performed are:
Pulmonary Function testing: A Spirometer is used and the patient is asked to breathe into it. A spirometer is a device which measures the volume of the lungs and how quickly the air can be expelled from it. The test is used to check for emphysema or asthma and the functioning of the lungs.
Chest X-ray: Helps to confirm whether the cough is due to pneumonia or some other condition. This is normally done for smokers; current or had been in the past.
High Resolution Computed Tomography(HRCT): This is a type of CT scan which creates a high quality image of the lungs. It is like any other CT scan that takes only a few minutes to perform.
Sputum tests: Sputum is the mucus which is coughed up. Examination of cells in the sputum can help in diagnosis of some of the lung problems. It can be tested for whooping cough (pertussis) or such diseases that can be cured with antibiotics. The sputum can also be tested for allergies.
What are the lab values of tests required for bronchitis?
The value of FEV1/FVC ratio is used to determine bronchitis. FEV1(Forced expiratory volume) is the volume of air forcefully exhaled in 1 sec. FVC(Forced vital capacity) is the maximum volume of air that can be forcefully exhaled (contains FEV1 inside it). When the ratio is:
Greater than 80%= minimal obstructive defect
65-80%= mild obstructive defect
50-65%=moderate obstructive defect
Less than 50%= severe obstructive defect
What are the costs of bronchitis tests in India?
The costs of bronchitis tests in India may vary depending on various factors such as, the severity of the condition, city of residence, hospital or diagnostic center where the test is being performed. To get an extensive list of the cost of tests in hospitals or diagnostic testing centers in a specific city, click here.
What are the treatment methods for bronchitis?
Acute Bronchitis treatment does not usually require a General Practitioner (GP) and can be overcome by home remedies. Chronic bronchitis cannot be cured, but a healthy style of living can help. Smoking should be stopped as it worsens the condition.
Plenty of rest should be taken
Intake of fluids should be increased as it helps in thinning of the mucus. This can help in coughing up the sputum and also prevents dehydration.
Aches and pains, headaches and fever can be relieved by over-the-counter medicines such as ibuprofen and paracetamol. However, ibuprofen should be avoided by people with asthma.
Smoke and fumes should be avoided
Vaporizers should be used
Inhaling steam to clear blocked passages
Bronchodilators: They can be used for immediate relief. It helps in opening up passageways of the lungs and are generally used by asthma patients.
Cough syrups can be taken to soothe the throat, but it should not be given to children below six. If the cough is disruptive, that is, it wakes a person up at night due to incessant coughing, then a cough suppressant can be taken.
As an alternative to taking cough medicines, a mixture of honey and lemon can be used to give relief to sore throat and help the cough to subside
Smoking: It inflames lungs and worsens the condition. It can lead to the chronic form of bronchitis. So it gives an ideal opportunity to give up smoking altogether.
Antibiotics: These are not required for people with normal lungs and no health conditions. In most cases it is a virus and antibiotics are ineffective. Normally for acute bronchitis, it is not necessary to consult a G.P, but in some cases a doctor should be visited.
In these cases, the G.P may prescribe antibiotics. Mainly, when there is risk of developing pneumonia. Antibiotics are advised for:
People who have crossed the age of eighty
Prematurely born babies
People with a history of lung, kidney, liver or heart condition
People having weak immune systems, caused by an undiagnosed disease or side effects of medication like steroids
People with an inherited condition called as cystic fibrosis, where the lungs and stomach become choked with a thick, sticky mucus
Antibiotics are not routinely prescribed as bronchitis is normally caused by virus and has no impact on it. If antibiotics are prescribed without being necessary, then the bacteria might grow stronger and grow resistant to that antibiotic.
If antibiotic is prescribed, then it will usually be a course for five days of:
Side Effects of this medicine are:
For Chronic Bronchitis:
The lungs are prone to infections. After consultation with a doctor, the following steps should be taken:
An annual flu shot
Pneumonia vaccination: A pneumonia vaccine called as PPSV23 is effective against the common bacterial pneumonia till the age of 65. After that, a booster shot may be required as well as a shot for a different form of bacteria. If there is any other medical condition, the booster may be required sooner.
For chronic bronchitis, over-the-counter cough syrups should be avoided. Productive coughing (that is coughing leading to expelling mucus), is helpful for the body to get rid of excess phlegm from the lungs. An expectorant may be prescribed if the phlegm is not easy to get rid of.
If the mucus is increasing or there is an increase in its thickness, there may be a bacterial infection. Then the G.P prescribes a broad-spectrum antibiotic for a wide range of bacteria, for a 5 to 10 day course. Overweight people may be put on a diet to avoid overstraining the heart.
If a person has Chronic Obstructive Pulmonary Disease (COPD), following treatment is given:
An Anticholinergic bronchodilator, to dilate the constricted passage ways of the lungs
Steroids to reduce the inflammation of the passages
Giving up smoking is the best and most effective way to cure chronic bronchitis, as well as COPD
For chronic bronchitis and COPD, ability of the body to transfer oxygen from the lungs to bloodstream is reduced. For this, oxygen therapy may be prescribed on a continuous basis or, as and when required.
What are the preventive measures to adopt for avoiding bronchitis?
Smoking should be stopped as it damages the lungs. By stopping, the lungs will begin to heal and coughing will stop. This will enable the person to breathe better. Even second hand smoke should be kept away from.
Aerosol products like hairspray, deodorant spray and spray paint should be avoided
Chemical fumes and dust should be avoided
While using anything with strong fumes, like varnish, paint and paint remover, a mask should be worn over the nose and mouth
Washing hands often can kill a lot of viruses and bacteria
Yearly flu shots should be taken
If a person is above 60 years of age, additional pneumonia shots are required (See Question 7 )