What Is Bronchitis? Symptoms, Causes, Diagnosis, Treatment, and Prevention
Bronchitis is the name for the condition that results when the bronchial tubes (the passageways that carry air to your lungs) become inflamed. (1) Those tubes swell, making it more difficult for air to move through them and making it more challenging to breathe. (2)
Bronchitis can be either acute or chronic, and both types have different causes, treatments, and outcomes.
Acute Bronchitis The defining symptom of acute bronchitis is a cough that typically develops after a cold or the flu and lasts for about 10 to 14 days (though it may linger for as long as three or more weeks). (3,4)
Chronic Bronchitis The other type, chronic bronchitis, is a far more serious, incurable lung disease involving periods of persistent coughing and inflammation. The condition causes structural changes to the bronchial tubes; symptoms may flare up and get better and worse over time, but they’ll never completely go away. (5) (The rest of this article and the related articles focus on acute bronchitis, often just referred to as bronchitis.)
Because bronchitis is typically caused by colds and flu viruses, it often begins with symptoms such as a sore throat and runny nose. (2,6)
Bronchitis results from the infection moving from your nose and throat into the lungs, resulting in the swelling and inflammation in your bronchial tubes that causes coughing, which can be dry, but often produces mucus (sputum) that’s yellowish-gray or green in color.
Other common symptoms of bronchitis include (6,7,8):
See your doctor if you experience any of these symptoms: (8,9,10)
If you have a chronic illness, such as heart or lung disease, and suspect you may have bronchitis, it’s also a good idea to see your doctor, as you may be at higher risk for complications from bronchitis. (See more about complications linked to bronchitis below.) (9)
Bronchitis is usually caused by a virus like the ones that cause the common cold or the flu. But occasionally — in fewer than 10 percent of cases — it can be caused by a bacterial infection. (2,11) You may also be at a higher risk of developing bronchitis if you are exposed to lung irritants such as smoke, dust, fumes, or air pollution. (7)
If the viral infections that cause colds and the flu can sometimes cause bronchitis, you may be asking: “Can I stop the flu or a cold from turning into bronchitis?” Not necessarily, according to Carlos Picone, MD, a pulmonologist in private practice at Chevy Chase Pulmonary Associates in Chevy Chase, Maryland, and former chair of pulmonary medicine at Johns Hopkins Medicine’s Sibley Memorial Hospital in Washington, DC.
It’s common for a cold or the flu to be caused by an infection in the upper nasal respiratory epithelium, and there’s nothing you can do to prevent that infection from spreading into the lower airways (resulting in bronchitis) because those airways are so close to one each other, Dr. Picone explains. “The two areas are very connected,” he says.
Learn More About What Causes Bronchitis and That Annoying Cough That Comes With It
Since acute bronchitis is usually caused by a viral or bacterial respiratory infection, it is typically contagious, though it’s the infection rather than the bronchitis itself that actually spreads. So if you have a bout of acute bronchitis you can give someone the infection that caused it, but it doesn’t necessarily mean that person’s infection will turn into acute bronchitis, too. (Chronic bronchitis, on the other hand, is not contagious.) (3,4,13)
The virus that causes bronchitis may be transmitted from person to person in the typical way — through droplets that are released when someone who has acute bronchitis coughs, sneezes, or talks. Viruses can also spread through touch when someone who is not sick comes into contact with a surface or object such as a doorknob or light switch that has the virus on it (say, because it’s been coughed on, sneezed on, or handled by the person who has the infection), and they then touch their own eyes, mouth, or nose, allowing the virus to enter their body. (3,4,13)
How long you are contagious after developing bronchitis depends on the type of infection that causes it, how active your symptoms are, and your overall health status prior to getting sick. Generally, you’re contagious for the first few days after cold or flu symptoms develop, possibly continuing up to a week for the flu. (14)
If the infection is bacterial (which is uncommon) and your doctor prescribes an antibiotic, you should no longer be contagious after 24 hours of starting the medication. (15)
Doctors typically diagnose bronchitis by doing a physical exam (which will likely include listening to your breathing), taking your medical history, and reviewing your symptoms. You may be asked questions such as whether you’ve had a cold recently and how long you’ve been coughing. (1,3,16)
Your doctor may also order the following tests if she or he suspects you may have another condition, such as pneumonia or asthma: (1,3,16)
For most cases of acute bronchitis, the illness usually gets better after about 7 to 10 days — and initial associated symptoms of acute bronchitis, such as nasal congestion, headache, and low-grade fever, usually improve in that time. But coughing may persist for an additional two or more weeks. (3,4,8,19) If those initial symptoms last beyond a few days, you should see your doctor to rule out complications such as pneumonia.
Chronic bronchitis — the type that is not caused by infection and is not contagious — is a lifelong condition.
The majority of cases of bronchitis are caused by a viral infection and will typically clear up on their own without treatment. (1,3,21)
Because the illness usually resolves on its own, Picone advocates taking a minimalist approach when you first notice symptoms. Keep hydrated (particularly when you have a fever) and avoid medication unless you have an underlying complication, such as asthma.
That said, you should monitor your symptoms for changes in cough frequency or mucous consistency or color. “Change from clear to yellow or green is often suggestive of infection,” says Albert Rizzo, MD, chief medical officer at the American Lung Association. If your cough has worsened or your sputum has thickened and turned yellow or green, you should call your doctor.
Here’s what you should know about when over-the-counter medications, antibiotics, home remedies, and alternative and complementary therapies might be helpful:
Acute bronchitis typically doesn’t need to be treated with medication but your doctor may recommend pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil) for fever or pain relief.
Picone notes that over-the-counter medications such as cough expectorants and decongestants have not been proven to be effective for acute bronchitis. (4) He particularly recommends avoiding medications with codeine. While codeine may help suppress a cough, it is also a powerful narcotic, and it won’t necessarily treat the cause of the symptoms or quicken your recovery. (22)
As for cough suppressants, there’s also not enough scientific evidence showing that they are effective. More importantly, coughing up mucus is the body’s way of carrying out the virus-causing infections and other undesirable materials from your body. If your doctor recommends you try this medication, it should only be used for a short period of time for dry coughs that interfere with you getting a good night’s sleep. (21)
“The science behind using expectorants and cough suppressants is weak, but I see many patients who feel that they benefit from using them,” says Dr. Rizzo. “I often tell them: ‘Give it a try — if you think it’s making a difference, no harm in using it until your symptoms are better. If you don’t notice any benefits, then stop.’”
The point, says Rizzo, is that each individual is different and they respond to these medications differently, and what works for someone may not work for someone else.
When bronchitis is caused by a virus, which is the case for most bouts of acute bronchitis, antibiotics won’t clear up the infection since these medications only help fight bacterial infections.
If your doctor determines through your personal history, physical exam, laboratory tests, and other diagnostic tools that you have a bacterial infection, such as pneumonia, they may prescribe antibiotics.
But generally antibiotics are not prescribed for acute bronchitis unless a patient has a chronic lung condition, because they have been shown to have very little benefit for acute bronchitis and to likely lead to negative effects such as nausea, vomiting, and allergic reactions. (19)
It’s also worth noting that a 2015 study showed that many doctors continue to prescribe antibiotics for acute bronchitis despite public health campaigns to stop the practice. (The overprescription of antibiotics can contribute to making certain forms of pneumonia, tuberculosis, and other diseases harder to treat globally.) (23)
According to Picone: “Doctors face a lot of pressure from patients to prescribe antibiotics, but usually [for bronchitis] the drugs are unnecessary because they won’t combat viruses.”
Yes, there are things you can do at home to help make bronchitis symptoms more manageable as you recover. They include:
Additionally, some supplements and herbs have been shown to be helpful in easing the symptoms of bronchitis and building immunity. But it’s worth noting that the evidence for these remedies is not yet robust enough to be conclusive. And it’s always important to first check with your doctor before trying herbs and natural remedies, as some can interfere with other medications you may be taking.
Here are a few that may help:
Learn More About How to Treat Acute Bronchitis
Children get bronchitis for the same reason adults do: infection. And most of the time the infection is viral, as it is in adults, though bacterial infections can cause acute bronchitis in children, too. (35)
Though anyone can get acute bronchitis, it’s worth noting that children who have chronic sinusitis, allergies, asthma, enlarged tonsils, or frequent exposure to secondhand smoke are at an increased risk.
Symptoms of acute bronchitis in children are nearly identical to those in adults: (36)
Most cases of acute bronchitis in children go away on their own and do not require medications. But if you see the following, call your child’s doctor right away: (10,35)
Babies and toddlers can become infected with the same germs that cause colds and the flu in adults and older children, though they usually develop bronchiolitis (an infection of the smaller breathing tubes in the lungs) rather than bronchitis. Babies are often more vulnerable to germs because they are more likely to touch toys and other objects they can get their hands on, and then touch their mouth, nose, or eyes. (37)
Learn More About What to Do When Your Child Has Bronchitis
The best way to avoid getting bronchitis is to reduce your risk of catching a cold or a flu in the first place. Here are some good habits you can follow to stay healthy and prevent getting an infection: (2,3,8)
While acute bronchitis usually doesn’t lead to long-term breathing problems in healthy individuals after they recover from the illness, people who have underlying lung or heart conditions may be at increased risk for health complications like pneumonia or asthma flares. (29,39) Repeated bouts of acute bronchitis can damage the lungs in ways that could result in chronic bronchitis. (8)
Children and the elderly are often more vulnerable to bronchitis-related complications. Others who may be at increased risk of complications include people with lung cancer, chronic obstructive pulmonary disorder (COPD), diabetes, asthma, or cardiovascular disease, as well as those who didn’t receive immunization for the flu, pneumonia, or whooping cough (pertussis). (39)
Here are some complications to be aware of:
Pneumonia If your bronchitis symptoms (such as coughing and fatigue) aren’t getting better after a few weeks and you’re experiencing shortness of breath, fever, or chest or shoulder pain, your doctor may evaluate you for pneumonia. Pneumonia occurs when the infection spreads beyond the bronchi and into the lung tissue. This results in the tiny air sacs in the lungs filling up with fluid or pus. (40)
Bronchitis can progress to pneumonia in anyone, but those with underlying conditions and weakened immune systems are particularly at risk of more serious complications. “In people who have heart disease, if the illness stays confined as bronchitis, they tend not to have too many symptoms like worsening oxygen levels or shortness of breath,” says Rizzo. “But if the infection either causes some airway spasms or develops into a pneumonia, then the work of breathing increases and the oxygen levels could be affected as well, which can potentially make the heart condition worse.”
Learn More About Bronchitis, Pneumonia, and the Differences Between the Two
Asthma Flares If you have asthma or another chronic lung condition, acute bronchitis may set off a flare. “People who have asthma or a chronic lung disease like COPD already have some degree of bronchial inflammation,” explains Rizzo. Bronchitis results in more inflammation, which can lead to an asthma attack or flare-up.
Depending on the severity of the asthma attack, your doctor may recommend medication to quell the airway inflammation and provide relief, says Picone. “You may need medication, often both a bronchodilator for relief of acute symptoms and an inhaled steroid to control the inflammation that’s flared up as a result of the acute bronchitis,” says Rizzo.
Learn More About Complications That Can Arise When People With Asthma Get Bronchitis
Acute bronchitis is common — an estimated 5 percent of adults get bronchitis every year, and about 90 percent will seek medical treatment. (About 10 million visits to the doctor each year are due to bronchitis.) In the United States, acute bronchitis is identified as one of the top 10 most common illnesses among nonhospitalized patients. (4)
As with other viral respiratory illnesses, acute bronchitis most commonly occurs during cold and flu season. Any upper respiratory infection can lead to bronchitis, but some common viruses (and the illness they cause) associated with bronchitis are: (4,19)
While viruses account for the majority of acute bronchitis infections, some bacterial infections can also be a cause. Some bacterial illnesses related to bronchitis are: (4,19)
In some cases, your illness may not be bronchitis but something else. If your cough persists for longer than three weeks, your doctor may need to evaluate you to rule out these possible conditions: (4)
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