A.Vogel Talks Bronchitis

Acute Bronchitis - the causes, symptoms & treatments


Dr. Jen Tan
Immune System Expert
@AVogelUK
Ask Dr. Jen Tan

An introduction to bronchitis

Bronchitis is inflammation of the lower respiratory system stretching from the trachea (windpipe) to the bronchial tubes (or bronchi) and into the depths of the lung tissue. The condition can arise from a number of causes – from infection by viruses and bacteria, to irritation resulting from cigarette smoke, pollutants or occupational hazards.

Bronchitis can be acute (short-term) or chronic (long-term). Both share many symptoms but are quite different conditions. This page focusses on acute bronchitis.

What’s the difference between acute & chronic bronchitis?

Although both are lower respiratory tract conditions giving rise to inflammation of the bronchial tubes and share similar symptoms, the causes, severity and duration of symptoms and treatment are different

Acute bronchitis is usually the result of infection, lasting a short period of time (usually no more than 3 weeks). Chronic bronchitis on the other hand, is a longer-term condition developing over time as a result of exposure to irritants that have been inhaled.

What causes acute bronchitis?

Acute bronchitis is most commonly caused by viral or bacterial infection. It is sometimes referred to as a ‘chest cold’ and according to the NHS it is one of the top 5 reasons for GP visits1. It can come on quickly, but it only lasts for a short time (usually no more than 3 weeks).

Up to 95% of acute bronchitis are caused by viruses travelling from the upper respiratory tract (nose and throat) into the rest of the lungs. The most common viruses implicated are rhinovirus, adenovirus, influenza A and B, and parainfluenza virus – these are the same viruses giving rise to colds and flu.

What happens is that a ‘normal cold or flu’ infection lingers and spreads to lower parts of the respiratory tract causing more inflammation. This is known as a secondary infection or complication.

When the body tries to fight off the infection, the bronchial tubes swell and become inflamed, restricting airflow and making breathing more difficult.

In some cases this inflammation also causes the membranes that line the airways to produce more mucus than usual, which can cause congestion and restrict airflow to the lungs even further.

Coughing is triggered as your body naturally attempts to remove the irritant or infection that is causing the inflammation, as well as any excess mucus.

Other causes of acute bronchitis, although much less common, include bacterial infections and respiratory irritants such as inhaling or being exposed to air pollution, dust, smoke and chemical fumes. These irritants can also worsen symptoms of acute bronchitis caused by viruses.

Although anyone can develop acute bronchitis, some are more prone to the condition than others; including people with a weak immune system, such as children and the elderly, as well as smokers and those who suffer from severe allergies or asthma.

Over time, repeated attacks of acute bronchitis can weaken and damage bronchial airways, making you more susceptible to developing chronic bronchitis.

What are the symptoms of bronchitis?

The most common symptom of acute bronchitis is a short-term, persistent cough, which may initially be dry and hacking, but can develop into a productive (chesty) cough that brings up mucus from your airways.

Other symptoms of acute bronchitis include:
•    Mild fever
•    Chest discomfort
•    Fatigue
•    Shortness of breath
•    Wheezing

Since acute bronchitis often follows an upper respiratory tract infection such as a cold, it is also common to experience ‘cold-like’ symptoms at the beginning of the infection, such as headaches, a sore throat and body aches.

Like the common cold, symptoms come on quickly, but only last for several days or weeks (usually no more than 3 weeks). However, you may find that your cough can linger for longer until your bronchial tubes fully heal.

How long does acute bronchitis last?

Acute bronchitis is usually a short-term condition, which can start suddenly and clears up within a few days or weeks (usually no longer than 3 weeks). A cough can linger for several weeks more as the bronchial tubes heal.

Is acute bronchitis contagious?

Acute bronchitis caused by viruses is contagious but in general, less so than the common cold or flu. Infections caused by bacteria can also be contagious.

The viral infection you might pick up from someone with acute bronchitis will initially start off as a cold or flu. Typically, this is the result of touching an object or surface contaminated by the virus than touching your mouth, nose or eyes.

As symptoms ease so does the level of contagion. However, as with colds and flu, it is best to assume you are contagious until symptoms have gone altogether.

Acute bronchitis is not contagious if it is being caused by lung irritants such as pollution, tobacco smoke, dust or chemical fumes.

How is bronchitis diagnosed?

There are no specific tests for acute bronchitis and during the first few days it can often be difficult to distinguish it from a common cold or flu. For your doctor to diagnose acute bronchitis, your medical history, whether you have had a recent cold or flu, whether you smoke or are exposed to other lung irritants, as well as your symptoms and how long you have had them, will all be considered.

Your doctor is also likely to check your lungs with a stethoscope to listen for abnormal sounds, which might indicate if there is any lung inflammation.

Tests such as x-rays and blood tests are not usually needed for people with acute bronchitis. However, your doctor may recommend specific tests to rule out other conditions such as whooping cough, pneumonia or other lung conditions.

Are there any self-help measures for bronchitis?

There are several things you can do to help ease the symptoms of acute bronchitis. In most cases, like the common cold, acute bronchitis can be self-managed by a few simple measures. You should:

Get plenty of rest: Your body needs plenty of time to rest and recover, especially if it is fighting off a viral or bacterial infection. Stress, lack of sleep and over-exerting yourself can slow your body’s ability to fight infection.

Drink water: Water is a natural expectorant. It can help loosen and thin mucus, making it easier to cough up. Furthermore, if you are dehydrated mucus will become thicker, making it harder to bring up.

Drinking plenty of fluids can also help to keep mucous membranes moist and keeps mucus from collecting in the respiratory tract. Warm drinks such as herbal teas and broths can also help to soothe irritated airways.

Use a humidifier: This helps to keep your bronchial tubes moist and prevents them from drying out and causing further irritations. The added humidity can also help to thin out mucus, making it easier to cough up.

Use steam treatments: Taking a hot shower, bath or using a steam inhaler can help to loosen mucus and relieve chest congestion.

You can also make a steam tent by filling a bowl or sink with hot water, bending over it and covering your head with a towel, then breathing in deeply.

Adding some essential oils such as peppermint and eucalyptus oil can help to clear your respiratory passages and provide some extra soothing relief.

Avoid smoke: If you are a smoker, try to reduce the amount you smoke, as this can further irritate your already very irritated airways and make your cough worse. If you don’t smoke, try to avoid second-hand smoke or smoky environments.

Strengthen your immune system: If your acute bronchitis is being caused by a viral or bacterial infection, then boosting your immune system can not only help prevent it from recurring and speed up your recovery.

Increasing your vitamin C intake and taking Echinacea can both help to strengthen your immune system. There is good evidence to suggest that using Echinacea when you do have the cold or flu can reduce the risk of developing complications.2

Are there any herbal remedies that can help?

Coughing is one of the most prominent symptoms of acute bronchitis and these coughs may or may not be accompanied by the production of mucus.

Chesty coughs as a result of acute bronchitis often come about as a result of a viral or bacterial infection, but please note, if sputum is green or foul smelling, this is a sure sign that an infection is present and you may need to see a doctor.

In the meantime, to help ease a chesty or mucus cough, using the herbs Ivy and Thyme found in Bronchoforce can be useful.

Ivy is naturally anti-spasmodic and can work well to help loosen any stubborn mucus, whilst thyme is gently anti-septic, helping to thin the mucus to make it easier to expel.

Next, we know that infections are often thought to be at the root of the cause when it comes to acute bronchitis. Therefore, it can help to support your immune system with some Echinaforce.

The fresh echinacea in Echinaforce works hard to stop the infection in its tracks, but also helps to support your immune system longer-term.

Finally, if acute bronchitis has created a dry cough, the addition of Bronchosan Pine Cough Syrup may be helpful.

Made from fresh spruce shoots combined with honey, this fragrant mix can help to unstick any stubborn mucus, whilst also soothing the length of your respiratory tract.

What about conventional medicines?

Many mild cases of acute bronchitis do not require treatment from a doctor, and the symptoms can be easily managed with some self-care measures. It can often be treated in the same way as you would treat a common cold. The symptoms usually go away on their own within a few days or weeks, although the cough can sometimes linger.

Some over-the-counter medicine to help ease some of the symptoms. These include:

Cough suppressants: If your cough is dry and hacking, over-the-counter cough suppressants can be used to reduce the activity of the cough reflex.

If your cough is mucus-producing, it is advisable not to suppress this cough because it’s your body’s way of removing the infection or irritation.

However, if your cough is keeping you from getting to sleep for an extended period of time, then your doctor may recommend a cough suppressant that contains dextromethorphan, but this is usually only recommended if absolutely needed.

Expectorants: If your cough is mucus-producing, an expectorant can be used to help thin the mucus, making it easier to cough up. Unlike cough suppressants they do not stop the cough; they only make it easier to expel the mucus which is blocking the bronchial tubes.

Antibiotics: Unfortunately, because acute bronchitis is nearly always caused by a virus, antibiotics are rarely prescribed as a treatment, unless your doctor thinks it is being caused by a bacterial infection. This is because antibiotics have no effect on viruses.

However, your doctor may prescribe antibiotics if there is an increased risk that you may develop other conditions, such as pneumonia, a sinus infection or an ear infection.

Over-the-counter painkillers: You can treat other symptoms of acute bronchitis such as headaches, fever, and aches and pains with pain medication such as paracetamol or ibuprofen; however, ibuprofen should not be used if you have asthma.

When should I go to the doctor with bronchitis?

In most cases, acute bronchitis will clear up within a few days or weeks, without any complications.

However, you should consult your doctor if:
•    Your cough lasts longer than 3 weeks
•    You have a fever higher than 38ºC
•    You are wheezing heavily or feel like you can’t breathe
•    You experience chest pains
•    You cough up phlegm that has blood in it.

If your symptoms worsen or persist for more than 3 weeks if is important to consult your doctor. Pneumonia is the most common complication of bronchitis – this happens when the infection spreads further into lung tissue.

If you are experiencing a mucus-producing cough on most days, which persists for 3 months or more, then you must consult your doctor as this could be a sign of chronic bronchitis.

References

1. NHS Inform {www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/bronchitis}

2. Schapowal A, Klein P, Johnston SL. Adv Ther. 2015; 32 (2): 187-200
Echinacea reduces the risk of recurrent respiratory tract infections and complications: a meta-analysis of randomised controlled trials.

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