Acute Bronchitis in Adults
Basics
Acute bronchitis is a short-term respiratory illness that usually lasts less than 15 days. With bronchitis, air passages in the lungs become irritated, swell, and produce mucus.
Acute bronchitis is one of the top 10 reasons people in the United States seek medical care. Bronchitis is diagnosed based upon physical signs and symptoms, and by ruling out more serious illnesses (such as pneumonia). Cough is the main symptom of bronchitis. Bronchitis may also be called a lower respiratory infection, or “chest cold.” It occurs most often during the winter months, and may follow a head cold, the flu, or another illness.
Causes
Acute bronchitis is usually caused by a viral infection Figure 01[Table 4].
About 90% of infectious bronchitis cases (bronchitis caused by a germ) are viral. Viruses may be spread in the air when someone coughs or sneezes and another person inhales the germs. A person may also be exposed to viruses by shaking hands with an infected person, or touching something contaminated by an infected person.
Bacteria, yeast, and fungi may also cause bronchitis. However, since a virus usually causes bronchitis, antibiotics often will not be helpful in treating the illness. This is because antibiotics are only effective against bacteria [Table 4].
Figure 01. Normal Lungs
Bronchitis can occur due to exposure to chemicals or irritants that are inhaled. This is referred to as occupational or environmental bronchitis.
You can avoid some bronchitis-causing irritants by refraining from smoking tobacco or other substances. If you work around dust or fumes, read and know the safety precautions recommended in the Material Safety Data Sheet(s) of the products or substances.
Symptoms
A persistent cough is the primary symptom of bronchitis.
With bronchitis, the cough may be dry or productive (mucus-producing). If your mucus is colored, it does not necessarily mean that you need antibiotics, as is often falsely believed. Your mucus may be clear, green, yellow, or white, or have streaks of blood in it. The cough from bronchitis can last for a month or longer.
With bronchitis, you may or may not have a mild fever, chest pain, or a sore throat. You may wheeze when you breathe, and have mild shortness of breath Table 01.
As with a cold, you may feel achy and tired in addition to having your other symptoms. A high or persistent fever may mean you have pneumonia or the flu. Any severe trouble breathing requires immediate medical attention.
The chest pain of bronchitis, if present, may worsen when you cough or take a deep breath. It is felt directly under the breastbone, and may feel like a burning pain Table 01.
Table 1. Symptoms of Acute Bronchitis
|
Persistent cough White, yellow, or green mucus that may appear 1 to 2 days after cough begins Feeling tired and achy Possible fever and chills Mild shortness of breath Soreness and tightness in the upper chest, which gets worse when you cough |
Risk Factors
Acute bronchitis tends to strike more often during the winter months, when viral infections are more prevalent.
It is important to wash your hands frequently, especially after shaking hands or touching common objects such as doorknobs. Also, avoid touching your eyes and nose. Try to stay away from people who have a cold or the flu, and insist that those around you cover their mouths when they cough.
Repeated episodes of acute bronchitis can increase your risk of developing chronic bronchitis. Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD), which can be a serious illness.
People who have repeated episodes of acute bronchitis have an increased risk of developing the chronic form of the disease. In the United States, about 5% of the population, or about 14 million people, have chronic bronchitis, making it the seventh-ranking chronic condition in the country. The disease affects people of all ages, but is most common in women and in people over the age of 45.
Recurrent viral respiratory tract infections during infancy or early childhood can also lead to chronic bronchitis. There may be a higher risk of developing chronic bronchitis if a parent or sibling has had the disease.
Smoking cigarettes or other tobacco products increases your risk for bronchitis.
Inhaling smoke temporarily paralyzes the tiny, hair like cells called cilia that line the airways. These cilia are important because they help to keep germs and irritants out of the lungs. The more you smoke, the more damage you do to the cilia.
Eventually, the cells may stop functioning altogether, putting you at constant risk for infection and bronchitis. If a person gets bronchitis often, it may lead to chronic bronchitis, which can be a serious health condition. Your clinician can inform you of a number of medications and programs available to help you quit smoking.
Children of heavy smokers have an increased risk for developing bronchitis, as do people who are repeatedly exposed to the cigarette smoke of others.
Prolonged exposure to air pollution or certain dusts found in industrial settings increases your risk for bronchitis.
Bronchitis is more common in urban areas where air pollution is greater. In particular, exposure to emissions of sulfur dioxide (SO2), a chemical used in bleaching and as a refrigerant and preservative, has been shown to increase the risk of bronchitis. Workers exposed to either inorganic or organic dusts (such as coal miners, grain handlers, and metal molders) are also at an increased risk of developing chronic bronchitis, which can be a serious health condition.
People with certain diseases are at a greater risk of becoming ill with acute bronchitis.
People who have chronic lung or airway diseases (such as asthma), or whose lungs are congested due to heart failure, are more prone to developing acute bronchitis. Children with enlarged tonsils and adenoids are also more prone to bronchitis.
Diagnosis
Acute bronchitis is a short-term respiratory illness that usually lasts less than 15 days. With bronchitis, air passages in the lungs become irritated, swell, and produce mucus.
Acute bronchitis is one of the top 10 reasons people in the United States seek medical care. Bronchitis is diagnosed based upon physical signs and symptoms, and by ruling out more serious illnesses (such as pneumonia). Cough is the main symptom of bronchitis. Bronchitis may also be called a lower respiratory infection, or “chest cold.” It occurs most often during the winter months, and may follow a head cold, the flu, or another illness.
Acute bronchitis is usually caused by a viral infection Figure 01[Table 4].
About 90% of infectious bronchitis cases (bronchitis caused by a germ) are viral. Viruses may be spread in the air when someone coughs or sneezes and another person inhales the germs. A person may also be exposed to viruses by shaking hands with an infected person, or touching something contaminated by an infected person.
Bacteria, yeast, and fungi may also cause bronchitis. However, since a virus usually causes bronchitis, antibiotics often will not be helpful in treating the illness. This is because antibiotics are only effective against bacteria [Table 4].Figure 01. Normal Lungs
Bronchitis can occur due to exposure to chemicals or irritants that are inhaled. This is referred to as occupational or environmental bronchitis.
You can avoid some bronchitis-causing irritants by refraining from smoking tobacco or other substances. If you work around dust or fumes, read and know the safety precautions recommended in the Material Safety Data Sheet(s) of the products or substances.
A persistent cough is the primary symptom of bronchitis.
With bronchitis, the cough may be dry or productive (mucus-producing). If your mucus is colored, it does not necessarily mean that you need antibiotics, as is often falsely believed. Your mucus may be clear, green, yellow, or white, or have streaks of blood in it. The cough from bronchitis can last for a month or longer.
With bronchitis, you may or may not have a mild fever, chest pain, or a sore throat. You may wheeze when you breathe, and have mild shortness of breath Table 01.
As with a cold, you may feel achy and tired in addition to having your other symptoms. A high or persistent fever may mean you have pneumonia or the flu. Any severe trouble breathing requires immediate medical attention.
The chest pain of bronchitis, if present, may worsen when you cough or take a deep breath. It is felt directly under the breastbone, and may feel like a burning pain Table 01.
Table 1. Symptoms of Acute Bronchitis
|
Persistent cough White, yellow, or green mucus that may appear 1 to 2 days after cough begins Feeling tired and achy Possible fever and chills Mild shortness of breath Soreness and tightness in the upper chest, which gets worse when you cough |
Acute bronchitis tends to strike more often during the winter months, when viral infections are more prevalent.
It is important to wash your hands frequently, especially after shaking hands or touching common objects such as doorknobs. Also, avoid touching your eyes and nose. Try to stay away from people who have a cold or the flu, and insist that those around you cover their mouths when they cough.
Repeated episodes of acute bronchitis can increase your risk of developing chronic bronchitis. Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD), which can be a serious illness.
People who have repeated episodes of acute bronchitis have an increased risk of developing the chronic form of the disease. In the United States, about 5% of the population, or about 14 million people, have chronic bronchitis, making it the seventh-ranking chronic condition in the country. The disease affects people of all ages, but is most common in women and in people over the age of 45.
Recurrent viral respiratory tract infections during infancy or early childhood can also lead to chronic bronchitis. There may be a higher risk of developing chronic bronchitis if a parent or sibling has had the disease.
Smoking cigarettes or other tobacco products increases your risk for bronchitis.
Inhaling smoke temporarily paralyzes the tiny, hair like cells called cilia that line the airways. These cilia are important because they help to keep germs and irritants out of the lungs. The more you smoke, the more damage you do to the cilia.
Eventually, the cells may stop functioning altogether, putting you at constant risk for infection and bronchitis. If a person gets bronchitis often, it may lead to chronic bronchitis, which can be a serious health condition. Your clinician can inform you of a number of medications and programs available to help you quit smoking.
Children of heavy smokers have an increased risk for developing bronchitis, as do people who are repeatedly exposed to the cigarette smoke of others.
Prolonged exposure to air pollution or certain dusts found in industrial settings increases your risk for bronchitis.
Bronchitis is more common in urban areas where air pollution is greater. In particular, exposure to emissions of sulfur dioxide (SO2), a chemical used in bleaching and as a refrigerant and preservative, has been shown to increase the risk of bronchitis. Workers exposed to either inorganic or organic dusts (such as coal miners, grain handlers, and metal molders) are also at an increased risk of developing chronic bronchitis, which can be a serious health condition.
People with certain diseases are at a greater risk of becoming ill with acute bronchitis.
People who have chronic lung or airway diseases (such as asthma), or whose lungs are congested due to heart failure, are more prone to developing acute bronchitis. Children with enlarged tonsils and adenoids are also more prone to bronchitis.
There is no specific test that confirms a diagnosis of acute bronchitis. Your clinician will determine if you have bronchitis based on your symptoms.
If your symptoms are severe, or if you have other health problems, your clinician may perform blood tests or a chest x-ray. This can help determine how your body is handling the illness and make sure you don't have pneumonia or another illness.
Your clinician will need to examine you and listen to your lungs to make sure you have bronchitis and not something else. If your clinician hears wheezing in your lungs, you are more likely to have bronchitis.
Your clinician will evaluate your vital signs, and listen closely to your chest and back as you breathe. This helps your clinician make sure you do not have a more serious infection, such as pneumonia. Your clinician will also rule out other possible causes of your symptoms, such as asthma, heart disease, other lung diseases, tuberculosis, or an allergic reaction.
Tests such as blood tests and chest x-rays are not usually done unless your clinician is trying to rule out other illnesses, such as pneumonia or heart failure.
If you have other health problems, or if you are in a high risk group for serious lung infections, your clinician may run other tests. Conditions that may place you at higher risk for serious lung infections include recent pneumonia or tuberculosis, cancer, or problems with mobility or your immune system.
If you get bronchitis-like symptoms a lot, it may mean you are developing a long-term respiratory problem, such as chronic bronchitis or asthma.
A clinician should evaluate any cough that is difficult to shake or that comes back frequently.
Pneumococcal and influenza vaccines may reduce your risk of becoming ill with infections that can cause bronchitis.
You can help prevent episodes of bronchitis by reducing your risk of getting pneumonia, influenza, and other respiratory illnesses. Ask your doctor whether you should be vaccinated against pneumococcal and seasonal influenza viruses. Both vaccines are usually recommended for people who are over the age of 65, have a chronic illness, or have a weakened immune system.
The pneumococcal vaccine protects against many strains of pneumococcal bacteria, a bacteria that causes a serious form of pneumonia as well as other illnesses. People who receive the vaccine after age 65 only need it once. Those who receive it before age 65 may need a repeat vaccine after 5 years. The influenza vaccine must be taken yearly, as it offers protection against only the current year's strains of influenza viruses.
Smoking increases your chance of developing bronchitis. If you already smoke, quit.
The more you smoke, the more damage you do to your lungs. Smoking puts you at greater risk for respiratory illnesses. Smoking can also make recovery from illness take longer.
If you get bronchitis often, it may lead to chronic bronchitis, which can be a serious health condition. Your clinician can inform you of a number of medications and programs available to help you quit smoking.
Children of heavy smokers have an increased risk for developing bronchitis, as do people who are repeatedly exposed to the cigarette smoke of others.
Limit your exposure to pollutants and airborne irritants.
If you live in a polluted area, limit your exposure to irritants by staying indoors as much as possible on days when pollutant levels are high. Also, limit your exposure to indoor pollutants by using fewer aerosol deodorants, insecticides, and hair sprays.
If you have bronchitis, cover your mouth when coughing, and wash your hands frequently to prevent spreading your illness to others.
Caregivers and family members of people with bronchitis should also wash their hands often to prevent the infection from spreading.
Take care of yourself by getting plenty of rest and eating right. Drink at least six to eight glasses of water daily.
Fluids help to keep mucous membranes hydrated and able to expel infectious organisms, irritants, and other debris from the respiratory tract more efficiently.
Good nutrition boosts your immune system and helps your body fight off infection. Eat foods rich in the antioxidant vitamins C, E, and beta-carotene, such as dark green vegetables (broccoli, kale), and orange or yellow-colored fruits and vegetables (winter squash, oranges, apricots).
Prevention and Screening
Pneumococcal and influenza vaccines may reduce your risk of becoming ill with infections that can cause bronchitis.
You can help prevent episodes of bronchitis by reducing your risk of getting pneumonia, influenza, and other respiratory illnesses. Ask your doctor whether you should be vaccinated against pneumococcal and seasonal influenza viruses. Both vaccines are usually recommended for people who are over the age of 65, have a chronic illness, or have a weakened immune system.
The pneumococcal vaccine protects against many strains of pneumococcal bacteria, a bacteria that causes a serious form of pneumonia as well as other illnesses. People who receive the vaccine after age 65 only need it once. Those who receive it before age 65 may need a repeat vaccine after 5 years. The influenza vaccine must be taken yearly, as it offers protection against only the current year's strains of influenza viruses.
Smoking increases your chance of developing bronchitis. If you already smoke, quit.
The more you smoke, the more damage you do to your lungs. Smoking puts you at greater risk for respiratory illnesses. Smoking can also make recovery from illness take longer.
If you get bronchitis often, it may lead to chronic bronchitis, which can be a serious health condition. Your clinician can inform you of a number of medications and programs available to help you quit smoking.
Children of heavy smokers have an increased risk for developing bronchitis, as do people who are repeatedly exposed to the cigarette smoke of others.
Limit your exposure to pollutants and airborne irritants.
If you live in a polluted area, limit your exposure to irritants by staying indoors as much as possible on days when pollutant levels are high. Also, limit your exposure to indoor pollutants by using fewer aerosol deodorants, insecticides, and hair sprays.
If you have bronchitis, cover your mouth when coughing, and wash your hands frequently to prevent spreading your illness to others.
Caregivers and family members of people with bronchitis should also wash their hands often to prevent the infection from spreading.
Take care of yourself by getting plenty of rest and eating right. Drink at least six to eight glasses of water daily.
Fluids help to keep mucous membranes hydrated and able to expel infectious organisms, irritants, and other debris from the respiratory tract more efficiently.
Good nutrition boosts your immune system and helps your body fight off infection. Eat foods rich in the antioxidant vitamins C, E, and beta-carotene, such as dark green vegetables (broccoli, kale), and orange or yellow-colored fruits and vegetables (winter squash, oranges, apricots).
Treatment
Most healthy adults who become ill with acute bronchitis can recover at home. However, any worsening of symptoms or increasing trouble with breathing requires immediate medical attention Table 02.
Rarely, bronchitis may progress into a serious infection. It is important to contact a clinician immediately if signs of serious illness occur. These signs may include a temperature less than 95ºF (35ºC) or greater than 104ºF (40ºC), a resting pulse (heart rate) of 125 beats per minute or greater, or a resting breathing rate of 30 breaths per minute or more.
You should seek immediate medical attention if your lips or nail beds begin turning dusky, gray, or blue, or if you must work so hard to breathe that you become tired. Fainting or becoming confused or dizzy are also signs that hospitalization may be necessary. Oxygen, intravenous medications, and close monitoring may be required for those with severe illness.
Do not hesitate to seek immediate medical attention if you are concerned that your bronchitis is getting worse. Dial 911 or 0 for an ambulance for any significant trouble with breathing, or any dizziness or fainting. Do not try to drive yourself to the hospital.
Table 2. What to Do If You Suspect Your Bronchitis May Be Serious
| Call your doctor |
| If the person with bronchitis is an infant or is elderly |
| If you have lung or heart disease and develop an acute attack of bronchitis |
| If you have a mild cough that persists for months |
| If you develop a fever of 102F (39C) or higher during an episode of acute bronchitis |
| If your symptoms of acute bronchitis do not improve within 48 hours, especially if you experience shortness of breath, or if your mucus thickens, darkens, or becomes streaked with blood |
| Seek emergency care |
| If your body temperature rises above 104F (40C) or falls below 95F (35C) |
| If you have a heart rate of 125 beats per minute or above while at rest |
|
If your breathing rate is greater than 30 breaths per minute while at rest If you have to work so hard to breathe that you become extremely tired If your nail beds and lips turn gray or blue |
| If you experience dizziness, confusion, or fainting |
Smoking when ill with bronchitis can make your illness worse, and cause recovery to take longer.
Smoking reduces the ability of the cilia in the lungs to function effectively. Cilia are small, hairlike cells that move to propel secretions, germs, and foreign particles out of the lungs. Having trouble coughing up the extra secretions in your lungs may cause you to feel worse or to feel sick longer. Your clinician can inform you of a number of medications and programs available to help you quit smoking.
Drink plenty of liquids (preferably water), eat healthy foods, and get plenty of rest. Over-the-counter medications may help with fever and muscle aches. Your clinician may also recommend an expectorant to help loosen the mucus in the lungs Table 03.
Table 3. Ways to Take Care of Yourself While Recovering From Bronchitis
| Drink plenty of water (at least six to eight large glasses a day). Drinking plenty of liquids helps keep the mucus in your lungs thin and loose. This can help you cough up the extra secretions in your lungs that are making it hard for you to breathe. |
| Use mucus-loosening medications (expectorants) to loosen the extra secretions in your lungs. This makes it easier to cough up the extra secretions. |
| Take aspirin, ibuprofen (Motrin, Advil), or acetaminophen (Tylenol) for fever, aches, and pains. Ask your clinician or pharmacist which medicine is right for you. Always follow directions on the label unless otherwise instructed by your clinician. |
| Avoid alcohol, which can reduce the coughing and sneezing reflexes needed to clear the lungs. Alcohol also causes your body to lose fluid, which can make it harder to cough up mucus from your air passages. Drinking alcohol can interfere with the effectiveness of antibiotics and many other medicines, and can increase your risk of serious side effects when taking certain medicines. |
| Do not smoke. Avoid working around chemicals, fumes, or fine dust particles. |
| Wash your hands frequently, especially after being outside or in public places. Avoid touching your eyes and nose. |
| Antioxidants (vitamins A, C and E) are important for healthy immune function. Be sure to eat plenty of dark green leafy vegetables (broccoli, spinach) and orange or yellow-colored fruits and vegetables (carrots, oranges, mangos, apricots). |
| Do not take a cough suppressant unless your clinician recommends it. You may need to take a cough suppressant at night if your cough makes it difficult for you to get enough rest. Use cough suppressants sparingly, and only if directed by your clinician. |
| Be sure to get at least 8 hours of rest a night, preferably in a warm room. You may need extra rest, such as naps, while recovering from bronchitis. |
|
Use a vaporizer or humidifier to add moisture to the air in your home. You can also try inhaling steam over a pan or sink of hot water, or take frequent hot showers. The extra humidity may help you clear your nasal and airway passages. Wash the humidifier or vaporizer unit once daily with soap and warm water, or a diluted bleach solution. Follow the manufacturer's directions. Keeping the unit clean will help prevent mold and germ growth. |
| If you must go outside in cold temperatures, wear a scarf over your mouth and nose to avoid further irritation of the airways. |
| Keep your clinician informed should your symptoms worsen. Contact your clinician if your medication causes any unpleasant side effects. |
Your doctor is the best source of information on the drug treatment choices available to you.
A healthy diet is important for the immune system to work properly.
Eating a diet high in simple sugars has been shown to interfere with immune system functioning. Try to avoid foods that contain processed sugar. Antioxidants (vitamins A, C and E) are important for healthy immune function. Be sure to eat plenty of dark green leafy vegetables (broccoli, spinach) and orange or yellow-colored fruits and vegetables (carrots, oranges, mangos, apricots).
Zinc helps your immune system by fostering a higher resistance to some illnesses.
Ask your clinician if you should take zinc, and if so, how much to take and how often to take it. Large doses of zinc can induce nausea, vomiting, and diarrhea. Taking more than 40 milligrams of zinc daily on a long-term basis can hurt the immune system and interfere with copper absorption.
Some herbs may help boost the immune system, which may help your body fight infection. However, people with an autoimmune disease may need to avoid immune-stimulating herbs.
Alternative therapies should not be used as a substitute for medical care. You should always tell your clinician or pharmacist what medicines you are taking, such as prescription or non-prescription medicines, herbs, vitamins, or other supplements.
Alternative therapies may react poorly with some prescribed or nonprescription medicines. Taking herbs, vitamins, or other supplements may interfere with lab tests or healing after surgery or illness, or may worsen some illnesses and health conditions. Your clinician and pharmacist can help you choose the complementary therapies or supplements that are right for you.
Certain age groups, such as infants and the elderly, are more susceptible to developing bronchitis. People with chronic lung, heart, or kidney disease, or a weakened immune system also have an increased risk of developing bronchitis.
People in high-risk groups, such as those listed above, should take steps to prevent becoming ill with bronchitis. This includes not smoking, and frequent hand washing. Also, ask your clinician whether you should receive vaccines against pneumonia and seasonal influenza viruses.
Most people recover from an episode of acute bronchitis within a few days, often without any medical treatment.
In smokers or people with heart disease or another chronic medical conditions, bronchitis may linger. Smokers are also at greater risk of developing a secondary bacterial infection in the lungs and eventually developing chronic bronchitis.
The cough of bronchitis may persist for several weeks.
Most symptoms of bronchitis peak within 1 to 3 days of falling ill, and are gone within a week or so. However, the cough from bronchitis can persist for several weeks.
If symptoms worsen, call your clinician.
Evidence that you are not getting better from an acute bout of bronchitis include a fever of 102°F (39ºC) or higher, increased shortness of breath, and mucus that thickens, darkens, or becomes streaked with blood.
If you seem to get frequent respiratory tract infections, or if you have a cough that persists, call your clinician.
Other illnesses and diseases can have the same symptoms as bronchitis. If you get bronchitis more than twice during a year, or if your symptoms persist, your clinician may need to examine you to rule out other illnesses.