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Bronchitis
Overview
Just when you thought you were finally over a cold, your chest starts to feel sore and you develop an irritating cough. Later, you might get the chills or a slight fever. If these symptoms sound familiar, you might have acute bronchitis, a condition that occurs when the inner walls that line the main air passageways of your lungs (bronchial tubes) become inflamed. Bronchitis often follows a respiratory infection such as a cold. And just as most people get occasional colds, virtually everyone has bronchitis at least once. Most cases of acute bronchitis disappear within a few days without lasting effects, although coughs may linger three weeks or more. But if you have repeated bouts of bronchitis, see your doctor. You may have a more serious health problem, such as asthma, chronic bronchitis or emphysema — a disease that causes progressive lung damage. You're much more likely to develop these conditions if you smoke. Signs and symptomsA cough that brings up yellowish-gray or green mucus (sputum) is one of the main signs of bronchitis. Mucus itself isn't abnormal — your airways produce at least an ounce of normal secretions every day. But these secretions usually don't accumulate because they're continuously cleared into your throat and swallowed with your saliva. When your bronchial tubes are inflamed, however, they often produce large amounts of discolored mucus that comes up when you cough. Mucus that isn't white or clear usually means there's a secondary infection. Still, these signs can be deceptive. You don't always produce sputum when you have bronchitis, and children often swallow coughed-up material, so parents may not know it's infected. Other signs and symptoms of bronchitis may include:
Sometimes chronic sinusitis — an ongoing infection in the lining of one or more of the cavities in the bone around your nose — can mimic bronchitis. That's because the signs and symptoms of chronic sinusitis include a thick, yellow or green discharge and a chronic cough that's triggered when you try to clear your throat of mucus draining from your sinuses. CausesThe same viruses that cause colds often cause acute bronchitis. But you can also develop noninfectious bronchitis from exposure to your own or someone else's cigarette smoke and even from pollutants such as household cleaners and smog. Bronchitis can also occur when acids from your stomach consistently back up into your food pipe, a condition known as gastroesophageal reflux disease, or GERD. And workers exposed to certain dusts or fumes may develop occupational bronchitis, an acute disease that generally clears up when exposure to the irritant stops. Sometimes inflammation and thickening of the lining of your bronchial tubes become permanent — a condition known as chronic bronchitis. Signs and symptoms include shortness of breath and a continuous cough that produces large amounts of mucus. You're generally considered to have chronic bronchitis if you cough most days for at least three months a year in two consecutive years. Often, however, smokers with chronic bronchitis cough almost every day, even if it's just to "clear their throats" in the morning. Unlike acute bronchitis, chronic bronchitis is an ongoing, serious disease. Smoking is the major cause, but air pollution and dust or toxic gases in the environment or workplace also can contribute to the condition. Chronic bronchitis is a chronic inflammation and thickening of the walls of your bronchial tubes, which narrows them. It often induces coughing spells. Risk factorsThe greatest risk factor for both acute and chronic bronchitis is smoking, either if you smoke yourself or live with someone who does. Children whose parents or siblings smoke are especially susceptible to bronchitis, as well as to asthma, pneumonia, colds and ear infections (otitis media). Other factors that increase your risk of bronchitis include: Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Gastroesophageal reflux disease. Stomach acids that persistently back up into your esophagus are likely to cause a chronic cough, usually through a reflex mechanism. Exposure to certain irritants on the job. You run the risk of developing occupational bronchitis if you work around certain lung irritants, such as cotton, flax or hemp dust, or are exposed to chemical fumes from ammonia, strong acids, chlorine, hydrogen sulfide, sulfur dioxide or bromine. Occupational bronchitis usually clears up when you're no longer exposed to these substances. When to seek medical adviceMost cases of bronchitis clear on their own in a few days, especially if you rest, drink plenty of fluids, and keep the air in your home warm and moist. But if you have a fever higher than 101 F, you're breathless, or you cough up bloody or yellow or green mucus, see your doctor. You may have pneumonia. And if you have a cough that lasts six weeks or more, be sure to seek medical care. The inflammation from a chronic infection can lead to asthma in some people. Also see your doctor if you have chronic lung or heart problems, including asthma, emphysema or congestive heart failure, and think you may have developed a case of bronchitis. These conditions put you at greater risk of developing complications from bronchial infections. If you have repeated bouts of bronchitis, tell your doctor. You may have chronic bronchitis, or you may live or work in an environment that continually irritates your airways. In some cases, you may have GERD or chronic sinusitis. If so, your doctor may be able to pinpoint the cause of your problem and suggest further testing and lifestyle changes that can help. Screening and diagnosisTo diagnose bronchitis, your doctor will likely listen to your chest with a stethoscope. You may also be asked to have a chest X-ray and perhaps a sputum culture — a test that checks for the presence of bacteria in sputum produced when you cough. In some cases your doctor may recommend additional tests to rule out other causes for your symptoms, including a pulmonary function test (PFT) that checks for signs of asthma or emphysema. During a PFT, you blow into a device called a spirometer, which measures the volume of air in your lungs after taking a deep breath and blowing it out. The spirometer also shows how quickly you can get air into your lungs. The test is painless and takes just a few minutes. If you have repeated bouts of bronchitis and your doctor doesn't suggest a PFT, ask to have one done. ComplicationsAlthough a single episode of bronchitis isn't cause for concern, repeated bouts of bronchitis should be taken seriously. They may signal chronic bronchitis, asthma or other lung disorders. Having chronic bronchitis also increases your risk of lung cancer. In addition, researchers are investigating the link between asthma and mycoplasma and chlamydia, two of the infectious organisms responsible for bronchitis. Respiratory infections can trigger asthma attacks in people who already have asthma, but scientists now wonder whether chlamydia or mycoplasma organisms also may actually cause asthma. Some evidence also suggests that chlamydia infection might act as a trigger for coronary artery disease, stroke and severe high blood pressure. TreatmentBecause bronchitis usually results from a viral infection, your doctor won't give you antibiotics, which aren't effective against viruses. Instead, getting plenty of rest, drinking extra liquids and taking a nonprescription cough medicine are the cornerstones of treatment for acute bronchitis. Your doctor may prescribe an antibiotic if he or she suspects a bacterial, mycoplasma or chlamydia infection, or if you're a past or current smoker. And if you have asthma, your doctor may recommend an inhaler and other asthma medications to reduce inflammation and open narrowed passages in your lungs. PreventionIf you have frequent, repeated attacks of bronchitis, the culprit may be something in your environment. Cold, damp locations — especially in combination with air pollution or tobacco smoke — can make you more susceptible to acute bronchitis. When the problem is severe, you may need to consider changing where and how you live and work. These measures may also help prevent bronchitis and protect your lungs in general: Avoid tobacco smoke. This includes your own smoke and secondhand smoke from others. Get an annual flu shot. Many cases of acute bronchitis result from influenza. Getting a yearly flu shot can help protect you from both bronchitis and the flu. Ask your doctor about a pneumonia shot. If you're an older adult, or you have risk factors such as diabetes, heart disease and emphysema, consider having a pneumonia shot. In addition, a vaccine known as Prevnar can help protect young children against pneumonia. It's recommended for all children under age 2 and for children 2 years and older who are at particular risk of pneumococcal disease, such as those with an immune system deficiency, asthma, cardiovascular disease or sickle cell anemia. Side effects of the pneumococcal vaccine are generally minor and include mild soreness or swelling at the injection site. Self-careThese suggestions can help make you more comfortable, speed recovery and prevent complications of acute bronchitis:
Use a humidifier in your room. Warm, moist air helps relieve coughs and loosens mucus in your airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container.
Dry Skin (xerosis)
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Soreness and a feeling of constriction or burning in your chest 