Bronchitis

Inside your lungs are many branching airways called bronchial tubes that allow for the movement of air. Bronchitis occurs when these bronchial tubes become inflamed, often because of an infection. When your bronchial tubes become inflamed, they swell and produce mucus (sputum). This narrows your airways and makes it harder for you to breathe. Treatments for bronchitis differ, depending on if it is acute or chronic.

Acute bronchitis

Acute bronchitis (sometimes called a chest cold) refers to bronchitis caused by a virus or other irritant. It lasts for up to two weeks. While some symptoms may linger on for longer, acute bronchitis eventually goes away.

Chronic bronchitis

Chronic bronchitis refers to long-term inflammation of the bronchial tubes. It is part of a group of diseases referred to as chronic obstructive pulmonary disease (COPD). Unlike acute bronchitis, chronic bronchitis is typically caused by a history of smoking.

What are the symptoms of bronchitis?

Common symptoms

Common symptoms of bronchitis include:

  • Body or muscle aches.
  • Chest tightness.
  • Chills.
  • Cough.
    • Your cough may start dry, but then produce yellow, green, or clear mucus (sputum).
  • Feeling tired.
  • Fever.
  • Headache.
  • Shortness of breath
  • Sore throat.
  • Wheezing, or a whistling sound when you breathe.

Symptoms in young children

Bronchitis symptoms in young children may also include:

  • Chest pain.
  • Overall body aches and complaints of not feeling well.
  • Runny nose, which may start before the cough.
  • Vomiting or gagging.



Bronchitis symptoms can mimic other conditions

Symptoms of bronchitis are similar to many other respiratory infections, including pneumonia.

If you have symptoms, you should contact your doctor to get a proper diagnosis.

When to seek immediate medical care

  • You have a fever over 104º F.
  • You cough up blood.
  • You have severe shortness of breath.

Causes of acute and chronic bronchitis

Causes of acute bronchitis

Acute bronchitis is often caused by a viral infection. This means that most cases of bronchitis are infectious.

Many viruses can cause acute bronchitis, including:

  • Rhinovirus, which causes the common cold.
  • The influenza virus.
  • Respiratory Syncytial Virus (RSV), a common cause of pneumonia and other respiratory tract infections in young children.

You can breathe these viruses in or accidentally pick them up on your skin. The infection travels from your nose and throat to your airways. Your bronchial tubes then become inflamed and produce thick mucus, which causes symptoms like trouble breathing and a productive cough.

Less common causes

  • Bacterial infections.
  • Fungal infections.
  • Exposure to lung irritants like dust, fumes, chemicals, and smoke.
  • Exposure to tobacco smoke.
  • Gastroesophageal Reflux Disorder (GERD), or chronic heartburn. Acute bronchitis can happen if acid reflux makes it into your airways.

Causes of chronic bronchitis

Chronic bronchitis, like emphysema and other chronic obstructive pulmonary diseases, is largely caused by cigarette smoking. The chemical in cigarette smoke irritates and damages the bronchial tubes, bronchioles, and alveoli. Over time, this damage builds up and becomes more permanent.

Other causes of chronic bronchitis can include:

  • Exposure to chemicals, fumes, and lung irritants at work.
  • Exposure to air pollution.
  • Heavy exposure to secondhand smoke, such as by living with someone who smokes.
  • Heavy marijuana smoking.
  • Smoking tobacco products using a pipe, cigar, or other means.

Chronic bronchitis is usually not contagious. It tends to be long-lasting, and it gets worse over time.

You have chronic bronchitis if:

  • You have a productive cough (cough that brings up mucus) most days for three months in a row over two years.
  • You do not have another lung condition, like tuberculosis.

Diagnosing bronchitis

Woman checking in for clinic visit

If you have symptoms of bronchitis, you should go see your doctor or book an appointment at an urgent care clinic. Your healthcare provider will start by asking you questions about your symptoms and your medical history.

From there, your doctor will perform a physical exam, and listen to your breathing. The way that your lung sounds can provide a clue about the underlying cause of your symptoms.

If your doctor suspects bronchitis, they may also recommend the following tests:

  • Sputum culture. If you are coughing up mucus, your doctor may take a sample and analyze it in a lab. This can be used to diagnose a lung infection and specify the cause.
  • Chest X-ray. An X-ray uses high-energy beams to create a picture of your body. Your doctor will not be able to see bronchitis on the x-ray. However, they will be able to rule out other lung problems like pneumonia and lung cancer.
  • Lung function test. This test measures how much air your lungs can hold and how well you can inhale and exhale. Generally, this involves breathing into and out of a machine while following a doctor’s instructions. Your doctor can use this information to help rule out other conditions, like asthma and emphysema.

Treatments for bronchitis

Acute bronchitis often resolves on its own, although medications might be prescribed in certain cases.

Chronic bronchitis has no cure, but treatments and lifestyle changes help to manage symptoms.

At-home remedies

Acute bronchitis usually gets better on its own, without medications. There are many things you can do at home to speed up the healing process.

  • Avoid secondhand smoke, wood smoke, or other throat irritants, like cleaning supplies. Give your lungs time to heal. If you smoke, consider quitting.
  • Cough it up. Coughing up mucus may be uncomfortable, but it is your body’s way of getting rid of the infection. Try to avoid cough medicines or suppressants. If your coughing is disrupting your sleep, talk to your doctor about when and how to take cough medicine.
  • Drink plenty of clear fluids. Water, tea, and other fluids can help you stay hydrated, which is especially important if you have a fever. They can also help loosen the mucus in your lungs, making it easier and less painful to cough up.
  • Gargle warm salt water. Add a half teaspoon of salt to a cup of warm water. Gargle it for a minute or more, and then spit it out. This helps with swelling and sore throat.
  • Get plenty of rest. Your body needs it to help fight off the infection. Try to get help with household chores and avoid physical activities.
  • Suck on lozenges, mints, or ice cubes to soothe your sore throat.
  • Treat pain and fever with over-the-counter medications. Use acetaminophen (Tylenol) to reduce pain and break low fevers.
  • Use a humidifier to make breathing easier.

Most bronchitis symptoms clear up in a week or two, although you may have a lingering cough or fatigue.

Once you start to feel better, be sure to take it slow. Don’t push yourself too hard to do physical activities, and build up your strength slowly.

Acute bronchitis medications

Most cases of bronchitis do not require medications, but your doctor may prescribe medications if:

  • You have severe bronchitis and have symptoms like wheezing.
  • You have another lung disease, like asthma or COPD.
  • Your doctor suspects that you have another lung infection, like pneumonia or whooping cough.

In these circumstances, your doctor may prescribe a bronchodilator. Bronchodilators are medications that relax the muscles in your airways and make it easier for you to breathe. This reduces coughing and shortness of breath. You will use an inhaler to get the medication directly to your lungs.

Viruses cause the majority of bronchitis cases, so antibiotics (which kill only bacteria) are not an effective treatment. Antibiotics may be recommended if you have bronchitis plus another lung infection, like bacterial pneumonia or whooping cough.

Woman in sitting pose

Lifestyle changes

  • Quit smoking. If you smoke and are diagnosed with chronic bronchitis, your first step to treatment is to quit smoking. This will prevent further lung damage and make it easier to breathe.
  • Avoid secondhand smoke. Like smoking, continuous exposure to secondhand smoke means continuous inflammation of your bronchial tubes. Avoid places where there may be lots of smoke or other lung irritants.
  • Wear the appropriate protective equipment, such as face masks or respirators, while at work to protect your delicate lung tissue.
  • Chronic bronchitis and COPD can make it harder for you to stay active. But regular exercise is one of the best things you can do to maintain your lung function. Talk to your doctor about developing a customized exercise plan to meet your needs.

Chronic bronchitis medications

As chronic bronchitis worsens over time, you may need to use medications to help manage your symptoms.

Medications prescribed for chronic bronchitis include:

  • Bronchodilators are medications that relax the muscles in your airways and make it easier for you to breathe. This reduces coughing and shortness of breath. You will use an inhaler to get the medication directly to your lungs. Depending on the severity of your disease, your doctor may recommend you use the inhaler only as needed or on a regular schedule.
  • Inhaled corticosteroids. For severe chronic bronchitis, your doctor may prescribe an inhaler containing corticosteroids. These strong drugs fight inflammation and make it easier for you to breathe. Your inhaler may contain both corticosteroids and bronchodilators.
  • Vaccines. Chronic bronchitis can make common lung infections, like the flu and pneumonia, more dangerous. This makes it all the more important to get the annual flu vaccine, the pneumonia vaccine, and the COVID-19 vaccine.

Therapy

  • Oxygen therapy. If you have severe chronic bronchitis, your body may not be getting enough oxygen, and you need additional oxygen. You may only need to use oxygen when performing physical activities, or you may need it all the time.
  • Pulmonary rehabilitation. This therapy involves learning different breathing techniques and exercises to improve your ability to exercise and carry out daily activities. You may also get nutrition and psychological advice so you can better take care of yourself and your condition.

Surgery

Surgery is reserved for patients who have not gotten better with therapy and medication. The two main types of surgery for chronic bronchitis include:

  • Lung volume reduction surgery. Your surgeon removes a wedge of damaged lung tissue. This gives the rest of your lungs more space to expand and work more efficiently.
  • Lung transplant. A lung transplant is considered a last resort for treatment. In this procedure, your damaged lung will be removed and replaced by a lung from a donor. A lung transplant, involves many risks, such as rejection. Additionally, the wait times for a lung transplant are usually long.

Preventing acute bronchitis

You cannot always prevent bronchitis. However, there are steps you can take to reduce your chance of developing acute bronchitis:

  • Quit smoking. Smoking makes you more susceptible to developing lung infections like bronchitis. Additionally, a history of smoking can lead to chronic bronchitis. If you don’t smoke, don’t start. If you do smoke, consider joining a smoking cessation program.
  • Get your flu shot every year.
  • If you are over 65, ask your doctor about getting a pneumonia vaccine.
  • Practice good health habits: eat well, exercise, and get plenty of rest. This helps boost your immune system. Also, keep your environment clean and smoke-free.
  • Wash your hands regularly, especially after taking public transit or being in public spaces.