What is Acute Bronchitis?
Acute bronchitis, a common lung infection, is a major health concern, especially in adults. This illness affects the lower part of the respiratory system, specifically the bronchi, which are the main air passages that move air in and out of the lungs. Acute bronchitis causes these bronchi to become inflamed, but there is no pneumonia present in this condition. It typically occurs in individuals who don’t suffer from a long-term lung disease known as chronic obstructive pulmonary disease (COPD).
Acute bronchitis initially presents as a continuous cough, which may or may not bring up mucus. It generally gets better on its own and disappears within 1 to 3 weeks. The cause of these symptoms originates from the inflammation in the lower part of the respiratory system, often started by viral infections.
What Causes Acute Bronchitis?
Acute bronchitis is a temporary condition that causes inflammation in the larger airways of the lungs. It is not pneumonia and primarily affects the bronchial tree, leading to irritation, inflammation, and excess mucus production. It is often caused by viral infections like the flu or colds, but bacteria can also be a rare cause. Influenza viruses are more common in winter, while other viruses like adenovirus and rhinovirus can cause bronchitis at any time of the year. Vaccination against the flu does not protect against other viruses like rhinovirus. Exposure to irritants and allergies can also trigger or worsen acute bronchitis.
Risk Factors and Frequency for Acute Bronchitis
Acute bronchitis is a common health issue that affects many people. In the United States, around 5% of people are diagnosed with this condition by their doctors every year. More people tend to get it during the winter, possibly because of increased exposure to respiratory viruses such as the flu.
In the UK, a study found a similar rate of acute bronchitis, estimating that 54 out of every 1000 people get it. Interestingly, these numbers can change depending on age. Younger men tend to experience lower rates (36 out of every 1000), while it’s far more common in people older than 85 (225 out of 1000). This could be due to different life habits, how our bodies respond to illness as we age, and exposure levels to sickness-causing viruses.
There are certain risk factors that may increase the chances of getting acute bronchitis. These include a history of smoking, living in areas with poor air quality, living in crowded conditions, and having asthma in your medical history. It’s also possible that allergies to things like pollen, perfume, and chemical vapors could trigger an episode in some people.
Some cases of acute bronchitis are caused by bacteria. In these cases, the bacteria are often the same types that cause community-acquired pneumonia, like Streptococcus pneumonia and Staphylococcus aureus.
- Acute bronchitis is a common health issue experienced by about 5% of people in the US each year.
- More cases occur during winter, perhaps due to common winter illnesses, such as the flu.
- A UK study found that around 54 out of every 1000 people get acute bronchitis.
- The rates vary with age, with younger men less likely to get it (36 out of 1000) compared to older individuals (225 out of every 1000 over the age of 85).
- Risk factors that might increase the likelihood of getting acute bronchitis include a history of smoking, living in an area with air pollution, crowded living conditions, and a past diagnosis of asthma.
- Certain allergies might also heighten the risk of developing this condition.
- Some cases are caused by the same types of bacteria that trigger pneumonia.
Signs and Symptoms of Acute Bronchitis
- Acute bronchitis symptoms:
- Persistent cough
- Discomfort throughout the body
- Difficulty breathing
- Wheezing sounds
- Cough producing clear or yellowish mucus
- Purulent mucus (not always indicating bacterial infection)
- Cough lasting 10 to 20 days (median duration of 18 days)
- Cough lasting more than 4 weeks may indicate whooping cough infection
- Common symptoms of acute bronchitis and mild upper respiratory infection:
- Cough (initially dry and irritating, later producing mucus)
- Low fever
- Fatigue and body aches
- Differentiating between acute bronchitis and mild upper respiratory infection:
- Upper respiratory symptoms that go away within a few days likely indicate a mild upper respiratory infection
- Symptoms persisting for a week or longer and involving the lower respiratory tract suggest acute bronchitis
- Physical examination findings:
- Presence of wheezing on lung breathing tests
- Chest sounds improving or clearing with coughing
- Rattling sounds in lungs or resonance in voice indicating possibility of pneumonia
- Mild rapid heart rate indicating fever and dehydration
- Other body systems appearing normal
Testing for Acute Bronchitis
Acute bronchitis is diagnosed through a health examination, medical history review, and physical checks. Additional tests may be done depending on symptoms and patient factors. These tests may include a chest x-ray, blood tests, rapid microbiological testing, multiplex PCR, procalcitonin levels, and spirometry. The diagnosis involves ruling out other conditions and determining symptom severity.
Treatment Options for Acute Bronchitis
Treatment for acute bronchitis focuses on relieving symptoms and providing support to the patient. Non-medical methods such as hot tea, honey, ginger, and throat lozenges can be used to relieve a cough, but these have not been tested in clinical trials. Medical approaches include cough suppressants like dextromethorphan, but there are no studies specifically evaluating their effectiveness in acute bronchitis. Medications that break down mucus have conflicting results and no clear consensus on their effectiveness. Beta-agonists, which relax muscles in the airways, may be given to patients with wheezing, but studies on their use for coughs in acute bronchitis have mixed results. Painkillers and fever-reducing medications can be taken to manage symptoms, and steroids may be given to treat inflammation, especially in patients with pre-existing conditions like asthma or COPD. Antibiotics are generally not recommended for uncomplicated cases of acute bronchitis, as they have minimal impact on cough duration and can contribute to antibiotic resistance. Treatment decisions should be based on individual response and weighing potential risks and benefits.
What else can Acute Bronchitis be?
If a cough persists for over three weeks, there could be other reasons behind it. Doctors might check for various conditions, including:
- Asthma: Acute asthma attacks are often mistaken for acute bronchitis. Around a third of patients who come in with a sudden cough might be facing this.
- Sinusitis: Both acute and chronic versions could be behind the cough.
- Bronchiolitis: This is an inflammation of the bronchioles, small air passages in the lungs.
- COPD: Chronic obstructive pulmonary disease is a chronic lung condition that can cause coughing.
- GERD: Gastroesophageal reflux disease is a condition where stomach acid flows back into the esophagus, which may cause a chronic cough.
- Viral pharyngitis: This is an inflammation of the throat due to a viral infection.
- Heart failure: Although it may seem surprising, heart failure can actually cause a persistent cough.
- Pulmonary embolism: This is a blockage in the lungs that could potentially cause a cough.
- Pneumonia: A lung infection like pneumonia can also cause ongoing coughing.
It’s essential to get the correct diagnosis to treat the cough effectively, so doctors will keep all these possibilities in mind.
What to expect with Acute Bronchitis
Acute bronchitis is usually self-resolving and often gets better with symptom-focused treatments. However, doctors need to be mindful of possible complications like pneumonia. There have been cases where acute bronchitis has led to severe respiratory conditions such as acute respiratory distress syndrome and respiratory failure. So, while acute bronchitis can typically be managed with care aimed at relieving symptoms, healthcare professionals should stay alert for any complications and be ready to provide suitable treatments if needed.
Possible Complications When Diagnosed with Acute Bronchitis
Acute bronchitis can sometimes lead to further health issues, such as:
- Secondary pneumonia, which is pneumonia that develops after another illness like bronchitis
- Acute respiratory distress syndrome, a serious condition where the lungs can’t provide the organs with enough oxygen
- Prolonged symptoms of bronchitis
- Spontaneous pneumothorax, which is a sudden lung collapse
- Spontaneous pneumomediastinum, a rare condition where air is present in the center of the chest
Preventing Acute Bronchitis
Changing lifestyle habits like quitting smoking and avoiding allergens and pollution can play a crucial role in preventing future bouts of severe bronchitis and lowering the risk of serious issues. Vaccinations for the flu and pneumonia are highly recommended for certain groups. These include adults aged 65 and older, kids under 2 years (above 6 months), pregnant women, and people living in nursing homes and long-term care places. People suffering from conditions like asthma, COPD, and those with weakened immune systems are also at higher risk of complications. Sadly, up to a third of severe bronchitis cases occur again.
Patients should also be informed about the risks of unnecessary antibiotics, which include developing resistance to antibiotics, cost issues, and potential negative side effects. They should be encouraged to have open, informed conversations with their healthcare providers to make sure that the chosen treatments match their medical requirements. This encourages better healthcare habits that are both effective and responsible.
