CONDITIONS

Bronchitis

What Is Bronchitis

The bronchi are the two main airwaves that branch down from the trachea (this is the airway that starts in the back of the throat and extends to the chest). The respiratory disease called bronchitis occurs when the walls of the bronchial tubes, or bronchi, become inflamed, causing more mucus to be produced. This makes the airwaves narrower and you breathe less air and oxygen into your lungs. Bronchitis sufferers frequently cough up thickened and discolored mucus. Bronchitis can also cause wheezing when you breathe, chest pain or discomfort, a low-grade fever, and shortness of breath.

There are two main types of bronchitis:

  • Acute.  This lasts from one to three weeks and is accompanied by the hacking cough we love to hate. There is also phlegm, which is often attributed to an upper respiratory infection. In most cases acute bronchitis is viral in origin; though sometimes it is the result of bacteria
  • Chronic. The bronchitis lasts at least three months for two years in a row. Asthma sufferers are susceptible to chronic asthmatic bronchitis.  This occurs when the lining of the bronchial tubes are inflamed

Other types of bronchitis are:

  • Infectious. This typically occurs in the winter, a result of the influenza virus.  Even after the virus has passed, the irritation of the bronchi may continue causing symptoms.  This type of bronchitis may also be due to bacteria, particularly if it follows an upper respiratory infection.  You can have both a viral and bacterial-based bronchitis simultaneously.
  • Irritative.  This is the result of exposure to mineral or vegetable dusts or fumes from strong acids, ammonia, organic solvents, or chlorine

 

What Causes Bronchitis

Acute bronchitis is typically caused by a lung infection, 90% of which are viral.  It can also be caused by exposure to substances that irritate the lungs such as tobacco smoke, dust, fumes, and air pollution. Repeated attacks of acute bronchitis weaken the bronchial airwaves, which can lead to chronic bronchitis. In rare cases the bacterium that causes whooping cough, Bordetella pertussis, also causes acute bronchitis.

In 1999, it was reported that 9.9 million Americans were diagnosed with chronic bronchitis. Heavy, long-term cigarette smoking causes chronic bronchitis most frequently. The bronchial tubes become irritated and produced excess mucus. Other causes of chronic bronchitis include air pollution, dust and/or toxic gases in the workplace or environment. Being exposed to an explosion or big fire can also aggravate or result in this condition. Chronic bronchitis sufferers go through periods when their symptoms are worse than usual. At these times they may have also have acute viral or bacterial bronchitis

When you have chronic bronchitis, these things happen:

  • Excess mucus is constantly produced
  • The lungs become scarred
  • Air flow is often hampered
  • Lining of the airways becomes thicker
  •  An irritating cough develops. You can get to the point of coughing up an ounce or more of yellow mucus daily!

Many people ignore the signs of chronic bronchitis until It becomes advanced, because they don’t consider it life-threatening. But the longer you wait for treatment, the more you damage your lungs and the more you are at risk of these conditions:

  • Emphysema.  Indeed, when you have both chronic bronchitis and emphysema it is called Chronic Obstructive Pulmonary Disease (COPD). Chronic Asthmatic Bronchitis also falls under the umbrella of COPD. This is serious business as COPD affects approximately 11 million Americans and is the fourth leading cause of death in the U.S.
  • Heart failure
  • Other respiratory problems

Risk Factors For Bronchitis

Here are factors that heighten your susceptibility:

  • Smoking or exposure to second hand smoke
  • Gastroesophogeal reflux disease (GERD)
  • Exposure to irritants on the job such as ammonia, chlorine, minerals or dust
  • Chronic medical conditions such as COPD, cystic fibrosis, allergies or asthma
  • Weakened immune system. This causes the body to be more susceptible to infections that cause bronchitis
  •  Upper respiratory infections such as a cold, sinusitis and the flu can spread to the lungs
  • Viral infections such as the one causing bronchitis can be caught via the air when someone coughs near you

Diagnosing Bronchitis

To make a diagnosis of bronchitis your doctor will ask about:

•    Your medical history
•    How long you’ve had your cough, how often you cough, what you’re coughing up…
•    If you smoke and/or are around smokers
•    Whether you have been exposed to air pollution, fumes, or vapors
•    Whether you’ve recently had a cold or flu

To diagnose acute bronchitis the doctor will perform a physical examination, listening with a stethoscope for wheezing and/or other abnormal sounds.  Often a sample of sputum from a cough may be examined. Whether the sample is clear or yellow or green can help determine whether the bronchitis is the result of a viral or bacterial infection.  There is usually no need for further testing unless the doctor suspects a secondary infection or chronic bronchitis.

To diagnose chronic bronchitis, a chest X -ray will likely be performed to rule out another lung disease, such as lung cancer. Pulmonary function tests can measure how well your lungs are working.  The level of oxygen in your blood might be checked with a small sensor, known as a pulse oximeter, which is clipped on your finger or toe.

A  doctor will check for:

•    A  daily, mucus producing cough lasting three months for two years in a row
•    Exacerbations. There are episodes where symptoms get much worse very quickly. These episodes are called exacerbations, and can be triggered by upper- or lower-airway infections such as a cold. They can also be triggered by medical conditions such as heart attacks

Sometimes it can be difficult to determine if you have acute bronchitis or pneumonia. It’s likely acute bronchitis if:

•    You have a dry cough that does not initially produce mucus. After a few days the mucus may be clear, yellow, green  and possibly tinged with blood
•    If there is fever, it is mild
•    X-rays are normal
•    Symptoms dissipate in two to three weeks

It’s likely pneumonia if:

•    The cough often brings up mucus that may be rusty or green or tinged with blood
•    Fever is often higher than 101 degrees F
•    The heart rate is faster than 100 beats a minute and the breath is more than 24 breaths a minute
•    X-rays are not normal
•    There are shaking, teeth-chattering chills
•    Symptoms may last longer than two to three weeks

Since bronchitis weakens the immune system it can lead to pneumonia if medical attention is not sought.

Symptoms of Bronchitis

Here are symptoms of acute bronchitis. Several of these symptoms mirror those of pneumonia, which is why a doctor’s diagnosis is essential:

•    Chronic cough, which may continue beyond 10 days, and contain clear or colored mucus
•    Low-grade fever – high-grade fever could be symptom of pneumonia
•    Shortness of breath
•    Wheezing
•    Chest tightness or chest pain
•    Sore throat caused by persistent cough

Suffering from any of the following symptoms should result in an immediate visit to a doctor:

•    High fever – 100.4
•    Deep hacking cough
•    Cough lasts over 10 days
•    Difficulty breathing
•    Chest pain

Here are symptoms of chronic bronchitis:

•    Cough and mucus production that occur daily and last three months, although the intensity of the cough and amount of mucus varies
•    Smoker’s cough is most common symptom. The cough is worst upon waking and the mucus is discolored. As the day goes on there is less music.
•    Shortness of breath increases gradually as chronic bronchitis worsens. Initially it occurs with activity and coughing commences. Shortness of breath when the sufferer is at rest occurs with the onset of emphysema
•    Frequent wheezing
•    Sore throat
•    Muscle aches
•    Chest pain with severe coughing

When symptoms worsen quickly they are referred to as exacerbations—and are particularly important to pay attention to. Seek medical attention if you have symptoms that are worsening quickly.

Prognosis

Acute bronchitis usually clears up within a few weeks with no lasting health implications. If there is a secondary infection, it can take longer to heal

Unlike acute bronchitis, chronic bronchitis can cause symptoms for prolonged periods of time.  In many cases, adhering to the protocols recommended by your physician can help you control the illness. This involves giving up smoking as heavy, long-term smoking is the number one cause of chronic bronchitis. Indeed, approximately half of smokers with chronic bronchitis will stop coughing after just one month of smoking cessation.  It’s also important to avoid other triggers for bronchial irritation, like airborne dust, chemicals, and other environmental irritants. The improvement level depends on the duration of the injury (how obstructed the airflow is) and compliance with therapy.

However, when the sufferer experiences repeated exacerbations – repeated bouts of being highly symptomatic, thus repeated bronchial irritation – his or her immune system is compromised and the illness can become debilitating.  Poorly managed or untreated chronic bronchitis can lead to permanent damage of lung function

Living With Bronchitis

Here are strategies that can help you deal with acute bronchitis:

•    Stop smoking.  At least reduce your intake for the duration of the acute bronchitis
•    Avoid alcohol. It’s a diuretic that can cause extra fluid and dehydration. Since the lungs need to be rehydrated with extra fluid, this is not a good idea for acute bronchitis sufferers
•    Avoid caffeine. Also a diuretic. See above
•    Moist air.  This can help break up congestion In your lungs, allowing you to cough it out
•    Drink fluids.  Aim for 8 glasses of water a day or freshly squeezed juices
•    Rest.  This allows your body to summon the energy to deal with the infection
•    Supplements.  Vitamin A, vitamin C and Vitamin E have anxiodant properties that boost the immune system and quicken healing

Here are strategies to help you deal with chronic bronchitis:

•    Abstain from smoking. At the very least don’t smoke during the duration of a flare-up.  Though stop totally if you can
•    Medications.  Corticosteroids may be prescribed for the inflammation as well as a painkiller for the pain
•    Drink fluids.   Aim for 8 glasses of water a day or freshly squeezed juices. This helps rehydrate the lungs
•    Humidifier.  This helps moisten the airways in your lungs so you breathe easier
•    Bronchodilator.  This is an aerosol oral inhaler that helps widen the bronchi.  Whether over the counter or prescription , make sure you use it properly
•    Avoid alcohol.    It’s a diuretic that can cause extra fluid and dehydration.
•    Avoid caffeine.  It’s also a diuretic
•    Supplements.  Vitamin A, vitamin C and Vitamin E have anxiodant properties that boost the immune system and quicken healing

Prevention

There are several steps you can take to prevent bronchitis:

•    Don’t smoke and avoid second hand smoke
•    Get vaccinated. Acute bronchitis is often the result of the flu, so getting an annual vaccine is a helpful tool. There are also vaccines that help prevent certain types of pneumonia
•    Wash your hands frequently. This helps reduce your risk of catching a viral infection. Get in the habit of using hand sanitizers
•    Wear a surgical mask. If you have COPD, a mask might be helpful to wear at work or in crowds
•    Avoid exposure to lung irritants such as dust, fumes, vapor or air pollution
•    If you have chronic bronchitis, avoid exposure to people with colds and flu

Common Treatment

For acute bronchitis, self care should be sufficient:

•    Rest
•    Avoid smoke and fumes
•    Drink plenty of fluids
•    Consider getting a Bronchodilator inhaler

For chronic bronchitis, treatment is aimed at reducing symptoms and improving lung function as there is no cure:

•    Do not take over-the-counter cough syrup.  The coughing is helpful in ridding the lungs of excess mucus. If your coughing fits are severe your doctor can prescribe a cough-suppressant
•    Quit smoking and avoid second hand smoke. Also avoid fumes
•    Drink plenty of fluids
•    Bronchodilator inhaler
•    Corticosteroids such as prednisone may be prescribed
•    If you have an underlying lung problem, antibiotics may be prescribed
•    Your doctor may advise pulmonary rehabilitation. This combines education and graded physical exercise. The former often involves smoking cessation technique. The latter includes breathing techniques. For example, breathe in through the nose so the air is moistened, cleansed and warmed by the sinuses. Air is then expelled through the mouth – in some instances with pursed lips to optimize the lung’s functioning

Complementary and Alternative Treatment

These natural remedies are in addition to the traditional ones described above:

  • Foods that may reduce bronchitis symptoms include honey, lemon, ginger, bay leaf and almonds
  • Breathe steam. Methods include taking a very hot shower; pouring steaming water into a bowl, leaning over it, and draping a towel over your head. Add a few drops of eucalyptus or pine oil into the water to soften the mucus in obstructed airways. Pine oil helps “bring up” phlegm from the bronchial tubes.
  • Mucus-thinning foods include chile peppers, hot, spicy salsa or dishes prepared with cayenne pepper. These foods also help you cough more productively.
  • Drink mullein tea.  Mullein is a traditional folk remedy for respiratory ailments, with phlegm loosening properties.
  • Supplements.  These include Arcozon, which has potent antibacterial and immune-stimulating properties, and R-lipoic acid.
  • Oregano Oil. Put a few drops under your tongue once a day to ease severe cough

When To Contact A Doctor

Contact a doctor if  you:

•    Have a cough on most days, or have a cough that keeps returning or your cough lasts over three weeks
•    Are coughing up blood
•    Have thick, yellow-green mucus, especially if it has a bad smell
•    Have a chronic illness, like heart or lung disease
•    Have a high fever or shaking chills
•    Have a low grade fever three or more days
•    Are experiencing wheezing or shortness of breath

Questions For A Doctor

Pre-appointment, write down a list of things you want him or her to know as well as questions you’d like to have answered. For instance:

•    Tell your doctor if you have recently had a cold or the flu, another medical condition, are coughing up mucus, and/or have ever had pneumonia
•    Give the doctor a list of the medications, vitamins and supplements you take
•    Tell the doctor if you are exposed to irritants at your job
•    Let your doctor know if you have seen another physician in the past for your cough. Bring the reports with you if possible, including results of a chest X-ray, sputum culture and pulmonary function test
•    Let your doctor know if you smoke, how many cigarettes a day you smoke, how many years you have been smoking

Ask questions, such as:

•    What can help my breathing and keep me from coughing up a lung?
•    Can medicine help chronic bronchitis?
•    What is the best course of action?
•    What about oxygen therapy?  If your chronic bronchitis is very bad and medicine doesn’t help, your doctor might prescribe this to get more oxygen in your body
•    What else can I do to help my lungs?
•    Are there websites or printed material you recommend I read?

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