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Bronchitis

Overview

Bronchitis is an inflammation of the lining of your bronchial tubes. These tubes carry air to and from your lungs. People who have bronchitis often cough up thickened mucus, which can be discolored. Bronchitis may start suddenly and be short term (acute) or start gradually and become long term (chronic).

Acute bronchitis, which often develops from a cold or other respiratory infection, is very common. Also called a chest cold, acute bronchitis usually improves within a week to 10 days without lasting effects, although the cough may linger for weeks.

Chronic bronchitis, a more serious condition, is a constant irritation or inflammation of the lining of the bronchial tubes, often due to smoking. If you have repeated bouts of bronchitis, you may have chronic bronchitis, which requires medical attention. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD).

What are the types of bronchitis?

When people talk about bronchitis, they usually mean acute bronchitis, a temporary condition that makes you cough. Some people get bronchitis so often that it’s considered chronic bronchitis.

Acute bronchitis

Also called a chest cold, this type is more common. Symptoms last a few weeks, but it doesn’t usually cause problems beyond that time. Most people don’t need treatment for acute bronchitis.

Chronic bronchitis

This one is more serious. It keeps coming back or doesn’t go away and causes ongoing irritation or inflammation of the bronchial tube lining. Chronic bronchitis is part of a condition called chronic obstructive pulmonary disease (COPD). With chronic bronchitis, your cough lasts at least 3 months and comes back at least 2 years in a row.

Who does bronchitis affect?

Anyone can get bronchitis, but you’re at higher risk if you:

Smoke or are around someone who does.

Have asthma, COPD or other breathing conditions.

Have GERD (chronic acid reflux).

Have an autoimmune disorder or other illness that causes inflammation.

Are around air pollutants (like smoke or chemicals).

Acute bronchitis is one of the most common diseases and the most common type of bronchitis. About 5% of adults are affected, and about 6% of children have at least one episode yearly. It occurs more often in the winter. More than 10 million people in the U.S. visit a healthcare provider each year for this condition, with about 70% receiving antibiotics that are mostly unnecessary. There are efforts to decrease the use of antibiotics in acute bronchitis.

Chronic bronchitis affects about 3.4–22% of the general population. Individuals over 45 years of age, smokers, those that live or work in areas with high air pollution, and anybody with asthma all have a higher risk of developing chronic bronchitis. This wide range is due to the different definitions of chronic bronchitis that can be diagnosed based on signs and symptoms or the clinical diagnosis of the disorder. Chronic bronchitis tends to affect men more often than women. While the primary risk factor for chronic bronchitis is smoking, there is still a 4–22% chance that non-smokers can get chronic bronchitis. This might suggest other risk factors such as the inhalation of fuels, dusts, fumes and genetic factor. In the United States, in 2016, 8.6 million people were diagnosed with chronic bronchitis, and there were 518 reported deaths. Per 100,000 of population the death rate of chronic bronchitis was 0.2.

Symptoms

If you have acute bronchitis, you may have cold symptoms, such as:

Cough

Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color — rarely, it may be streaked with blood

Sore throat

Mild headache and body aches

Slight fever and chills

Fatigue

Chest discomfort

Shortness of breath and wheezing

While these symptoms usually improve in about a week, you may have a nagging cough that lingers for several weeks.

For chronic bronchitis, signs and symptoms may include:

Cough

Production of mucus

Fatigue

Chest discomfort

Shortness of breath

Chronic bronchitis is typically defined as a productive cough that lasts at least three months, with bouts that recur for at least two consecutive years. If you have chronic bronchitis, you're likely to have periods when your cough or other symptoms worsen. It's also possible to have an acute infection on top of chronic bronchitis.

When to see a doctor

Contact your doctor or clinic for advice if your cough:

Is accompanied by a fever higher than 100.4 F (38 C).

Produces blood.

Is associated with serious or worsening shortness of breath or wheezing.

Includes other serious signs and symptoms, for example, you appear pale and lethargic, have a bluish tinge to your lips and nail beds, or have trouble thinking clearly or concentrating.

Lasts more than three weeks.

Before you go in, your doctor or clinic can give you guidance on how to prepare for your appointment.

Causes

Acute bronchitis is usually caused by viruses, typically the same viruses that cause colds and flu (influenza). Many different viruses — all of which are very contagious — can cause acute bronchitis. Antibiotics don't kill viruses, so this type of medication isn't useful in most cases of bronchitis.

Viruses spread mainly from person to person by droplets produced when an ill person coughs, sneezes or talks and you inhale the droplets. Viruses may also spread through contact with an infected object. This happens when you touch something with the virus on it and then touch your mouth, eyes or nose.

Factors that increase your risk of bronchitis include:

Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis. The use of e-cigarettes (vaping). Breathing in secondhand cigarette and marijuana smoke for a long time

Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises your immune system. Older adults, infants and young children have greater vulnerability to infection.

Exposure to irritants on the job. Your risk of developing bronchitis is greater if you work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes.

Gastric reflux. Repeated bouts of severe heartburn can irritate your throat and make you more prone to developing bronchitis.

Complications

Although a single episode of bronchitis usually isn't cause for concern, Bronchitis can lead to pneumonia, though this is rare. Usually, it doesn’t cause any other problems. Repeated bouts of bronchitis, however, may mean that you have chronic obstructive pulmonary disease (COPD). If you have an ongoing condition like asthma, diabetes, chronic obstructive pulmonary disease or heart failure, bronchitis might make it worse (exacerbation). Tell your healthcare provider if you have any ongoing conditions.

When Should I Call My Doctor?

Call your doctor if your cough:

Brings up blood or mucus that thickens or darkens

Keeps you awake at night

Lasts more than 3 weeks

Causes chest pain

Has a barking sound and makes it hard to speak

Comes along with unexplained weight loss

You’ll also want to call your doctor if you have a cough along with:

A foul-tasting fluid in your mouth

A fever over 100.4 F

Wheezing or shortness of breath

If you’re 75 or older and you have an ongoing cough, check with your doctor to see whether you should come in. Call your doctor if you have a lung condition such as COPD and a flare-up of chronic bronchitis.

Prevention

To reduce your risk of bronchitis, follow these tips:

Get an annual flu shot. Many cases of acute bronchitis result from influenza, a virus. Getting a yearly flu vaccine can help protect you from getting the flu. Also ask your doctor or clinic if you need a vaccination that protects against certain types of pneumonia.

Wash your hands. To reduce your risk of catching a viral infection, wash your hands frequently and get in the habit of using alcohol-based hand sanitizers. Also, avoid touching your eyes, nose and mouth.

Avoid close contact with people who have a viral infection. Stay away from people who have the flu or another respiratory illness.

Avoid cigarette smoke. Cigarette smoke increases your risk of chronic bronchitis.

Wear appropriate face covering. If you have COPD, consider wearing a face mask at work if you're exposed to dust or fumes. Talk to your employer about the appropriate protection. Wearing a face mask when you're going to be among crowds helps reduce exposure to infections.

Diagnosis

During the first few days of illness, it can be difficult to distinguish the signs and symptoms of acute bronchitis from those of a common cold. During the physical exam, your doctor will use a stethoscope to listen closely to your lungs as you breathe.

In some cases, your doctor may suggest the following tests:

Chest X-ray. If your cough lasts for a long time, you may get a chest X-ray to rule out more serious conditions. Your healthcare provider will use a machine to get pictures of your heart and lungs. They’ll look for signs of other diseases that could cause your symptoms.

Sputum culture. If your symptoms are serious, your doctor might get a sample of the mucus you cough up (sputum). A lab test can tell whether the mucus is caused by an allergy or whooping cough (pertussis), which is a very contagious bacterial infection. Serious symptoms may also mean another test.

Pulmonary function test (PFT). During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma, chronic bronchitis or emphysema.

Pulse oximetry. This uses a device on the end of your finger to measure oxygen levels in your blood.

Nasal swab. Your healthcare provider may use a soft-tipped stick (swab) in your nose to test for viruses, like COVID-19 or the flu.

Blood tests. Your doctor may test a sample of your blood for infections or other indicators of health problems.

Spirometry. This is a test of your lung function. You blow into a machine called a spirometer, which measures how much air your lungs can hold and how quickly you can blow it all out. This also helps your doctor see whether you have signs of asthma or emphysema.

Treatment

Most of the time, acute bronchitis goes away on its own within a couple of weeks.

If yours is caused by bacteria (which is rare), your doctor may give you antibiotics. If you have asthma or allergies, or if you’re wheezing, they might suggest an inhaler. This helps open your airways and makes it easier to breathe.

To ease your acute bronchitis symptoms, you can:

Drink a lot of water. About 8-12 glasses a day can help thin out your mucus, making it easier to cough it up.

Get plenty of rest.

Take OTC pain relievers. Aspirin, ibuprofen, or naproxen treat pain. But avoid giving aspirin to children. You can use acetaminophen to treat both pain and fever.

Use a humidifier or steam. A hot shower can be great for loosening mucus.

Take OTC cough medicines. You might take a medicine such as guaifenesin during the day to loosen your mucus so it's easier to cough up. Your doctor will call this an expectorant. Check with your pediatrician before giving any cough medicine to children.

Most cases of acute bronchitis get better without treatment, usually within a couple of weeks.

Medications

In some circumstances, your doctor may recommend other medications, including:

Cough medicine. Your doctor will only suggest these if you’re not bringing up mucus anymore. If you are, it means your body is still clearing your airways.

Antiviral medicine. Your doctor might prescribe this if the flu is causing your bronchitis. If you take it soon after getting sick, it can keep symptoms mild and speed recovery.

Bronchodilators. These medications relax the muscles surrounding your airways, which helps open them. They come in short-acting and long-acting forms. You can take them by tablet, nebulizer, or inhaler.

Inhalers for bronchitis. Most bronchodilators are taken in an inhaler. Some inhalers contain corticosteroids to reduce swelling in your lungs. Your doctor might prescribe an inhaler for bronchitis if your condition is chronic or if you also have allergies or asthma, both of which can narrow your airways.

Over-the-counter pain relievers. Medications such as aspirin, acetaminophen, and naproxen reduce fever and body aches.

Therapies

If you have chronic bronchitis, you may benefit from:

Pulmonary rehabilitation. This therapy is aimed at improving the health of people with breathing problems. You'll learn exercises to improve your breathing. Your treatment may also include psychological counseling and nutrition guidance.

Oxygen therapy. You might get extra oxygen all the time or only when needed.

A lung transplant. This may be an option if you have very serious chronic bronchitis that hasn't responded to other treatments.

Lifestyle and home remedies

If you have bronchitis, to help you feel better, you may want to try the following self-care measures:

Get enough rest. Rest and sleep help your body heal.

Drink plenty of fluids. Staying hydrated can help to thin mucus.

Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if you're exposed to irritants, such as paint or household cleaners with strong fumes.

Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in your airways. Be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container.

Consider a face covering in cold air. If cold air makes your cough worse and causes shortness of breath, put on a face mask or cover your mouth and nose with a scarf before you go outside.

Preparing for your appointment

You're likely to start by seeing your family doctor. If you have chronic bronchitis, you may be referred to a doctor who specializes in lung diseases (pulmonologist).

What you can do

Before your appointment, make a list of answers to the following questions:

Have you recently had a cold or the flu?

Have you ever had pneumonia?

Do you have any other medical conditions?

What medications, vitamins and supplements do you take regularly?

Are you exposed to lung irritants at your job?

Do you smoke or are you around tobacco smoke?

If possible, bring a family member or friend to your appointment. Sometimes it can be difficult to remember all the information provided. Someone who accompanies you may remember something that you missed or forgot.

If you've ever seen another physician for your cough, tell your present doctor what tests were done. If possible, bring the reports with you, including results of a chest X-ray, sputum culture and pulmonary function test.

What to expect from your doctor

Your healthcare professional is likely to ask you several questions, such as:

When did your symptoms begin?

Have your symptoms been continuous or occasional?

Do your symptoms affect your sleep or work?

Does anything improve or worsen your symptoms?

Does cold air bother you?

Do you notice that you wheeze sometimes?

Have you had bronchitis before? Has it ever lasted more than three weeks?

In between bouts of bronchitis, have you noticed that you're more short of breath than you were a year earlier?

Do you exercise? Can you climb one flight of stairs without difficulty? Can you walk as fast as you used to?

Do you smoke? If so, how much and for how long?

Have you inhaled recreational drugs?

Have you received the annual flu shot?

Have you ever been vaccinated against pneumonia? If so, when?

Bronchitis Prognosis

Even with treatment for acute bronchitis, your cough may last a few more weeks. It should become milder and drier as the days go by. You may also feel tired for a while longer. Plan to get rest. Don’t expect to have a lot of energy right away.

If your cough doesn’t improve and you continue to feel sick, see your doctor again. It could be a bacterial infection after all. Or you might have other breathing problems that could be delaying your recovery from acute bronchitis.

While there's no cure for chronic bronchitis, treatment can improve your symptoms and reduce how many flare-ups you have.

Additional Common Questions

What’s the difference between bronchitis and pneumonia?

Bronchitis is an inflammation of the airways leading to the lungs. Pneumonia is an inflammation of the lungs themselves.

Bronchitis causes inflammation and mucus in your trachea and bronchi that make you cough a lot. Pneumonia causes inflammation and fluid in the small sacs in your lungs (alveoli) that makes it hard to breathe. You also usually have a cough and a fever. Pneumonia is more serious than bronchitis.

While you could have an infection that causes both, bronchitis doesn’t usually turn into pneumonia.

What’s the difference between bronchitis and bronchiolitis?

Bronchitis is inflammation in the larger airways (trachea and bronchi) coming into the lungs. Bronchiolitis is an inflammation of the next smaller airways (bronchioles) that come off of the bronchi. Children usually get bronchiolitis while adults get bronchitis.

Is menthol vapor rub good for bronchitis?

You might use vapor rubs, like Vicks VapoRub® or Mentholatum® ointment, for anything that ails you and wonder if they work for bronchitis. Vapor rubs have ingredients in them intended to calm down coughs, so they may help your bronchitis symptoms. Don’t use vapor rubs on children under two without asking your pediatrician first.

One Final Note..

Bronchitis happens when the tubes that carry air to your lungs become swollen and irritated, causing symptoms such as cough and mucus. There are two types: acute, which lasts a few weeks and usually isn't severe, and chronic, which persists or keeps coming back and can be more serious. Causes include viruses, bacteria, smoking, and exposure to irritants. Treatment usually involves managing symptoms with rest, hydration, and sometimes medications. If symptoms continue or worsen, it's important to talk to your doctor.

Having bronchitis can be frustrating at best. Even once you’re free of a runny nose and body aches, the cough seems to last forever. Over-the-counter medicines and even home remedies, like honey, can help get you through until you feel better. If you’re having trouble managing your symptoms, talk to your healthcare provider.

If you frequently have bronchitis, you may have chronic bronchitis caused by an underlying condition that needs to be treated.

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