Bronchitis

Bronchitis is a very common infection of the major tubes (bronchi) that carry air within the lungs, but it occurs in two very different forms, acute and chronic.

BRONCHITIS, ACUTE

The acute form of bronchitis is commonly caused by viruses, occasionally by bacteria, and rarely by fungi.

It spreads easily from one person to another on the breath.

The symptoms include a fever, chest aches and pains, headache, tiredness, and a productive cough with dark yellow or green mucus.

The diagnosis is confirmed by listening to the chest through a stethoscope. In early stages, X-rays may be normal, but later show characteristic changes. Sputum may be cultured to identify any bacteria present, and the correct antibiotic to treat it.

Viral infections settle with time, rest, inhalations, bronchodilators (open up the bronchi) and physiotherapy. If bacteria are responsible, antibiotics can be prescribed. Bacterial infections settle rapidly with antibiotics, but viral bronchitis takes about ten days to fade in most patients, but may persist for several weeks in the elderly or debilitated.

BRONCHITIS, CHRONIC

The chronic form of bronchitis is a long-term inflammation of the larger airways (bronchi) in the lungs.

The cause may be repeated attacks of acute bronchitis, long-standing allergies, or constant irritation of the bronchi by noxious gases, particularly those found in tobacco smoke (most common cause).

Patients have a persistent moist cough, shortness of breath (particularly with exertion), constant tiredness, blue lips and swollen (“clubbed”) fingertips. The thickened and scarred bronchi, and poor air entry to the lungs, show up quite markedly on a chest X-ray.

Physiotherapy, bronchodilators (medications to improve air flow), anticholinergic inhalers (e.g. tiotropium) and antibiotics to for any infection are the main treatments.

It is a semi-permanent condition for which there is no effective cure, but treatment can keep the condition under control for many years. Sometimes it may progress to emphysema.

Illustration showing chronic bronchitis in the airways of lungs

(Last modified: 5th Nov 2014)

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