Bronchitis (Inflammation in the Bronchus): Symptoms, Causes, Diagnosis & Treatment

Bronchitis is characterized by the inflammation of the bronchial tubes (bronchi), i.e. the air passages that extend from the trachea into the small airways and alveoli. It usually happens because of a virus or inhaling substances that irritate the lungs (such as tobacco smoke, fumes, dust, and air pollution). Bacteria sometimes cause acute bronchitis. Acute bronchitis is very common. Symptoms usually begin 3 to 4 days after an upper respiratory infection and disappear after two or three weeks. In contrast, chronic bronchitis, one of the two most common forms of COPD, is irreversible and is characterized by frequent re-occurrences.

Inflammation in the Bronchus affects 44 of 1000 adults annually, and 82% of episodes occur in fall or winter. In terms of gender-specific incidence, bronchitis affects males more than females. Although found in all age groups, acute bronchitis is most frequently diagnosed in children younger than 5 years of age, whereas chronic bronchitis is more prevalent in people older than 50 years of age. Acute bronchitis usually goes away within 10 to 12 days. However, one must visit the doctor if the coughing does not improve after 10 days, or lasts longer than 20 days. The doctor should also be consulted if there is extreme discomfort, severe coughing that affects sleep, breathing difficulty, chest pain, unexplained weight loss, or a fever over 100.4°F.

Symptoms like coughing up thickened mucus and shortness of breath suggest bronchitis. The doctor should be consulted for further diagnosis.

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How Does Bronchitis Affect Your Body?

In bronchitis, cells that line the bronchi become infected. The infection usually starts in the nose or throat and travels to the bronchial tubes. When the body tries to fight the infection, it causes the bronchial tubes to swell. This causes one to cough. Sometimes it is a dry cough, but often the cough is accompanied by mucus (sputum). The inflammation also causes less air to be able to move through the bronchial tubes, which causes wheezing, chest tightness and shortness of breath. Eventually, the immune system fights off the infection. Acute bronchitis usually lasts for 3-10 days. However, the cough and mucus (sputum) production can last for several weeks after the infection has cleared.

During an episode of bronchitis, the cells of the bronchial-lining tissue are irritated and the mucous membrane becomes hyperemic and edematous, diminishing bronchial mucociliary function. Consequently, the air passages become clogged by debris, thus increasing the irritation. In response, copious secretion of mucus develops, which causes the characteristic cough of bronchitis.

What Are The Causes of Bronchitis?

Acute bronchitis is usually caused by viruses, typically the same viruses that cause cold and flu (influenza). The most common cause of chronic bronchitis is cigarette smoking. Air pollution, dust, or toxic gases in the environment or at the workplace, can also contribute to the condition.

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What Are The Risk Factors of Bronchitis?

Common risk factors of bronchitis are :

  • Close contact with someone who has a cold or acute bronchitis
  • Failure to get age-appropriate immunizations (shots)
  • Exposure to tobacco smoke, fumes, dust, and air pollution
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What Are The Symptoms of Bronchitis?

The symptoms of bronchitis include:

  • A cough (the most common symptom)
  • Sputum production (clear, yellow, green, or even blood-tinged)
  • A relatively unusual fever, accompanied with a cough (suggestive of influenza or pneumonia)
  • Nausea, vomiting, and diarrhea (rare)
  • General malaise and chest pain (in severe cases)
  • Dyspnea and cyanosis (only seen with underlying chronic obstructive pulmonary disease [COPD] or another condition that impairs lung function)
  • A sore throat
  • Runny or stuffy nose
  • A headache
  • Muscle aches
  • Extreme fatigue
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How is Bronchitis Diagnosed?

Bronchitis can be diagnosed via following lab tests:

  • Chest X-ray – In the case of a fever, one can rule out or confirm pneumonia by opting for a chest x-ray.
  • Sputum Culture – If the symptoms are severe, the doctor might get a sample of the mucus coughed up (sputum). A lab test can tell whether the mucus is caused by an allergy or a whooping cough (pertussis), which is a very contagious bacterial infection. Serious symptoms may also call for other tests.
  • Spirometry – This tests the lung function. It measures how much air the lungs can hold and how quickly it can be blown out. The test can help the doctor find out whether one has asthma or another breathing problem, along with bronchitis.
  • Complete Blood Count (CBC) – A CBC gives information about the cells in the blood, such as the cell count for each blood cell type and the concentrations of hemoglobin. It helps to distinguish bacterial from nonbacterial infections.
  • Sputum Cytology – It is requested by the doctor in case the cough is persistent.
  • Blood Culture – If bacterial superinfection is suspected, then a blood culture is conducted.
  • Chest Radiography – It is suggested by the doctor if the patient is elderly or physical findings suggest pneumonia.
  • Bronchoscopy – It helps to exclude foreign body aspiration, tuberculosis, tumors, and other chronic diseases.
  • Influenza Tests
  • Spirometry
  • Laryngoscopy – It excludes epiglottitis.
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How to Prevent And Control Bronchitis?

Bronchitis can be prevented by following these guidelines:

  • Avoid smoking and secondhand smoke
  • Live in a clean environment
  • Receive the influenza vaccine yearly between October and December
  • Receive the pneumonia vaccine every 5-10 years if aged 65 years or older or with chronic disease

Treatment of Bronchitis

Bronchitis is usually treated with the following drugs:

  • Central Cough Suppressants (eg, codeine and dextromethorphan) – They provide short-term, and symptomatic relief of coughing in acute and chronic bronchitis.
  • Bronchodilators (eg, ipratropium bromide and theophylline) – They control bronchospasm, dyspnea, and chronic cough in stable patients with chronic bronchitis. A long-acting beta-agonist, plus an inhaled corticosteroid can also be offered to control a chronic cough.
  • Nonsteroidal Anti Inflammatory Drugs (NSAIDs) – NSAIDs are used in the treatment of constitutional symptoms of acute bronchitis, including mild-to-moderate pain.
  • Antitussives/Expectorants (eg, guaifenesin) – These are used in treating cough, dyspnea, and wheezing.
  • Mucolytics – This is used to manage moderate-to-severe COPD, especially during winters.
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Bronchitis – Lifestyle Tips

To alleviate symptoms of bronchitis, the following lifestyle changes should be made:

  • Don’t smoke and avoid breathing anything that irritates the lungs.
  • Humidify the air at home.
  • Drink plenty of fluids, more than the normal consumption.
  • Stay out of the air that is either too hot or too cold.
  • Rest as much as possible.

What Are Recommended Exercises For A Person With Bronchitis?

Some bronchitis symptoms may be exacerbated by exercise. However, if done carefully, regular physical activity is recommended for those recovering from acute bronchitis. If shortness of breath, wheezing, uncontrolled coughing or dizziness occur, exercise should be stopped.

Bronchitis And Pregnancy – Things to Know

Serious complications revolving around bronchitis are unlikely to develop in most women. However, the major risks include:

  • Breathing difficulty – Bronchitis results in ineffective oxygen intake into the lungs due to the inflammation of the bronchial walls. This deprives the body of oxygen, making one breathe lesser than the optimal required levels. This reduces the supply of the necessary oxygen to the fetus.
  • Medications that harm growing fetus – Certain cases of bronchitis may require treatment with antibiotics and other potent drugs. But these are harmful to the growing fetus. Therefore, doctors recommend good rest and basic caution to treat bronchitis. If these self-care measures fail, the doctors may prescribe medications whose effects cannot be predicted.
  • Pneumonia – In some cases, bronchitis occurs along with a low-grade fever. When the temperature increases, the growing baby will be at high risk. The need for potent medicines for pneumonia can also pose a great risk to babies.
  • Dehydration that can lead to preterm labor – In case of a fever, one usually does not consume enough liquids. This causes dehydration and leads to contractions that can cause preterm labor. Bronchitis associated with fever can also put the baby at risk of serious complications like spina bifida (4), and in some cases, even death.

Common Complications Related to Bronchitis

Pneumonia is the most common complication of bronchitis. It occurs when the infection spreads further into the lungs, causing the tiny air sacs inside the lungs to fill up with fluid. About 1 in 20 cases of bronchitis lead to pneumonia.

Other FAQs about Bronchitis

Q. What does bronchitis feel like?

A. Bronchitis causes inflammation or swelling in the passageways of the lungs. Thus, the significant symptoms of this ailment include difficulty in breathing and shortness of breath. It also feels as if there are large amounts of mucus or phlegm in the airways. Coughing, chest discomfort, fatigue, and slight fever are other hallmark symptoms of bronchitis.

Q. Can you have bronchitis without a fever?

A. Fever and fatigue are actually two hallmark symptoms of this disease. However, the fever brought on by bronchitis is generally low-grade. If one experiences high fever (higher than 100.4 degrees Fahrenheit or 38 degrees Celsius), chills, shoulder and chest pain, and other worsened symptoms, a doctor must be consulted. There are chances that the condition may already have progressed to the second stage of pneumonia.

Q. Can you catch bronchitis from someone else?

A. Yes, bronchitis can be contagious but only if it’s caused by a virus or bacteria. These infectious organisms can spread from one person to another through droplets when a person sneezes, coughs or talks. The risk of getting bronchitis rises if these infectious organisms touch any of the mucous membranes such as the eyes, mouth, or nose.

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