Bronchitis - Symptoms, Causes, Risk factors, Treatment and Prevention

Bronchitis definition

Bronchitis is a lung condition characterized by inflammation of the bronchial tubes (bronchi- the passageways that carry air to the lungs), which swell, making it more difficult for air to move through and making it more challenging to breathe. 

Bronchitis can be treated by a pulmonologist who specialises in diagnosing and treating respiratory conditions, including the lungs, airways, and blood vessels.

Bronchitis meaning

Charles Bedham coined the term "bronchitis" which means "inflammation of the bronchial membrane" in 1808 from the word:

• Bronchia, which means "the bronchial tubes"
• Itis, which means "inflammation" 

Bronchitis medical term breakdown: broncho + itis

Bronchitis prevalence

Bronchitis prevalence in India

In India, the prevalence of chronic bronchitis (CB) among adults over 35 is 3.49%. According to findings from a study on respiratory symptoms, asthma, and chronic bronchitis this rate is lower for women at 2.7% and higher for men at 4.29%.

Bronchitis prevalence worldwide

Globally, acute bronchitis is one of the top five reasons people seek medical attention. Approximately 5% of adults are affected, while around 6% of children experience at least one episode each year. In the general population, the prevalence of chronic bronchitis ranges from 3.4% to 22.0%, but in individuals with COPD, it can exceed 74.1%.

Types of bronchitis

There are different types of bronchitis with different causes, symptoms and treatments which are mentioned below

• Acute bronchitis
• Chronic bronchitis

The primary distinction between acute and chronic bronchitis lies in the duration of the symptoms, including:

Acute bronchitis

Acute bronchitis is a respiratory condition characterised by inflammation and swelling of the bronchi (breathing tubes), leading to increased mucus production and other changes. It is a short-term condition that usually resolves on its own within a few days or weeks, and lung function returns to normal.

Chronic bronchitis

Chronic bronchitis is characterised by inflammation and swelling of the bronchi, a kind of chronic obstructive pulmonary disease (COPD) condition referred to as productive cough that lasts for at least 3 months or more, occurring within a span of 2 years which is more serious than acute.

Bronchitis symptoms

Signs and symptoms of bronchitis impact the quality of life. Bronchitis occurs when the bronchi are irritated and inflamed by an infection. This causes them to produce more mucus than normal, and the body produces coughing to eliminate the excess mucus. Based on the types, some of the common symptoms of bronchitis in adults are listed below: 

Acute bronchitis symptoms

Acute bronchitis often comes after having a cold or flu-like illness. It can last from three to four days Up to three weeks to four weeks and is contagious in nature. Some of the acute bronchitis symptoms in adults are listed below:

• Chest discomfort 
• Cough that produces mucus may be clear or yellow-green (acute bronchitis green phlegm)
• Low-grade fever 
• Wheezing, fatigue 
• Breathlessness or shortness of breath that gets worse during activity

Even after acute bronchitis has cleared, individuals may have a dry, nagging cough lasting 1 to 4 weeks.

Chronic bronchitis symptoms

As mentioned above, chronic bronchitis can last up to three months or even two years and typically worsens as the disease progresses; at first, they exhibit no symptoms or mild symptoms. Some of the chronic bronchitis symptoms in adults include:

• Regular cough or coughing produces a lot of mucus
• Wheezing 
• Loud or whistling sounds produced during breathing 
• Shortness of breath, particularly during exercise 
• Chest tightness 

Colds and flu are common respiratory diseases in individuals with chronic bronchitis, and severe bronchitis symptoms may include ankle, foot, or leg edema, lower muscle weakness, and weight loss. 

Symptoms of bronchitis in children include a runny or stuffy nose, sore throat, malaise, or a general feeling of being unwell, a feeling of chest congestion or tightness, a cough that may be dry or produce mucus and may be accompanied by gagging or vomiting and a low-grade fever.

Bronchitis causes

Bronchitis disease causes inflammation of bronchial passages by a virus, bacterium and irritant particles. Although smoking is a significant risk factor, nonsmokers can also develop bronchitis. Some of the common causes of bronchitis in adults are listed below:

Acute bronchitis causes

Acute bronchitis in adults is often linked to viruses that cause infections in both the lower and upper respiratory tracts, as well as exposure to lung irritants and bacterial infections. The following are the viruses, bacterial infections, and lung irritants that cause acute bronchitis, including:

Viruses that cause lower respiratory tract infections include:

• Influenza A and B (most common cause of acute bronchitis)
• Parainfluenza
• Respiratory syncytial virus
• Human metapneumovirus

Viruses that cause infections of the upper respiratory tract include

• Rhinovirus
• Coronavirus
• Adenovirus

Bacterial infections cause a significantly lower percentage of acute bronchitis 

• Chlamydia pneumoniae is mainly observed in young adults
• Bordetella pertussis
• Mycoplasma pneumoniae

Lung irritants such as 

• Tobacco smoke
• Air pollution
• Vapours
• Dust and fumes

Chronic bronchitis causes

Chronic bronchitis in adults is often linked to prolonged exposure to irritants that damage the lungs and airways, however, other factors can also contribute, including:

• The primary leading cause is cigarette smoke, and inhaling tobacco smoke from other sources, such as pipes and cigars, can also cause chronic bronchitis.

• Exposure to other inhaled irritants, including air pollution, second-hand smoke, and chemical fumes or dust from the environment or workplace, can lead to chronic bronchitis.

• Rarely alpha-1 antitrypsin deficiency is a genetic condition that can cause chronic bronchitis. In this condition, the body cannot produce sufficient protein to protect the lungs from damage.

Bronchitis risk factors

Understanding the bronchitis risk factors can help prevent and maintain respiratory health. Some of the risk factors are listed below:

Acute bronchitis risk factors

• Smoking: Cigarette smoking or inhaling second-hand smoke (inhaling smoke that is exhaled by smokers) can break down the body's defence against infection. People who smoke are at a higher risk of developing acute bronchitis and experiencing a longer duration that could lead to chronic bronchitis.

• Weakened immune system: Having a weakened immune system makes it more difficult for the body to fight infections, raising the risk of bronchitis. Even a common cold or illness can strain the immune system.

• Gastroesophageal Reflux Disease (GERD): GERD may increase the risk of acute bronchitis by causing the stomach acids to backflow into the bronchial tree or from windpipe to air sacs.

• Chronic respiratory conditions: Chronic conditions like asthma, COPD, and bronchiectasis increase the risk of acute bronchitis in many ways due to continuous inflammation and damage of airways, mucos production, and decreased lung function making them more susceptible to infections and inflammation, which can trigger bronchitis.

Chronic bronchitis risk factors

• Older age: A study shows that the majority of people with chronic bronchitis start experiencing symptoms when they are at least 40 years old. As age increases, lung function decrease, which means the lungs become less effective at taking in air, even if they do not smoke or are not exposed to any lung irritants.

• Family history of lung disease: A family history of chronic obstructive pulmonary disease (COPD) also increases the risk of developing chronic bronchitis. If someone in the family has lung problems, they might be at high risk, especially if they are smokers.

• Female smoker: Women are more prone to the lung-damaging effects of cigarettes than men; they are likely to experience COPD and decreased lung function at an earlier age and or with lower levels of exposure.
  

Bronchitis Complications

Complications of bronchitis can arise when the condition is left untreated. These complications can differ in severity depending on whether the bronchitis is acute or chronic, which are mentioned below:

Complications of acute bronchitis 

• Pneumonia: Pneumonia is the most frequent complication of acute bronchitis occurring when the infection spreads further into the lungs, causing air sacs to fill with fluid. 
• Spontaneous pneumothorax: Lung diseases such as acute bronchitis can increase the risk of developing spontaneous pneumothorax, also known as a collapsed lung. This condition occurs when air builds up in the pleural space which connects lungs and chest wall which is a very rare condition and a complication of bronchitis in elderly people. 
• Chronic bronchitis: Repeated episodes of acute bronchitis led to chronic bronchitis especially in smokers and individuals with other lung conditions. 

Complications of chronic bronchitis

• Respiratory failure: Respiratory failure in chronic bronchitis occurs because of prolonged airway obstruction or by impaired gas exchange. Chronic inflammation and mucus buildup reduces oxygen intake and CO2 elimination which causes strain on the lungs leads to respiratory failure
• Cor pulmonale: Chronic bronchitis can lead to cor pulmonale, a heart disease characterised by an enlarged right ventricle. This causes the right side of the heart to fail, hindering the heart's ability to pump blood to the lungs due to prolonged hypoxia because of chronic inflammation and increased pressure in the pulmonary arteries.
• COPD: Chronic bronchitis is a form of COPD, and its progression can cause worsening lung function.
  

Bronchitis diagnosis

Bronchitis diagnosis is based on clinical assessment, which includes medical history and physical examinations. The evaluation focuses on symptoms such as cough, its duration, and mucus production. The following are tests that can be advised by general physician or pulmonologist that can be done alone or in combination to diagnose bronchitis:

• Medical history
• Physical examination
• Acute bronchitis physical exam findings
• Chronic bronchitis physical exam findings
• Other diagnostic tests for bronchitis
• Chest X-ray
• Arterial blood gas
• Pulse oximetry
• Blood test for bronchitis or a CBC for bronchitis
• Cultures of sputum or bronchitis sputum test
• Nasal swab
• Pulmonary function test
• Bronchoscopy
• Fractional exhaled nitric oxide (FeNO) test
  

Bronchitis treatment

Bronchitis treatment may varies depending on the types, symptoms and causes. Treatment options for bronchitis are listed below:

Conservative treatment

• Acute bronchitis treatment
• Acute bronchitis treatment at home
• Over the counter medicine for acute bronchitis
• Analgesic and antipyretic

• Chronic bronchitis treatment
• Antibiotics
• Bronchodilators 
• Corticosteroids 
• Mucolytics
• Antitussives
• Oxygen therapy
• Pulmonary rehabilitation
• Vaccines

Surgical treatment

• Bronchial rheoplasty
• Lung transplantation
  

Bronchitis prevention

Bronchitis prevention in acute and chronic conditions is different because of its causes and risk factors. Some of the preventive measures for acute and chronic bronchitis include: 

Acute bronchitis prevention   

Prevention of acute bronchitis can be achieved by staying healthy and keeping others healthy by taking the following actions: 

• Regular hand washing: Wash hands with soap or water, especially after coughing, sneezing, and being in public places. 
• Getting vaccinated: Get flu vaccines every year and pneumonia vaccines based on age helps in prevention.
• Covering mouth and nose: Cover your mouth and nose during sneezing and coughing to avoid spreading.
• Avoid sharing items: Avoid sharing pillows, towels, and glasses can prevent transmission from infections. 

Chronic bronchitis prevention 

Prevention on chronic bronchitis mainly focuses on reducing the risk factors that lead to disease development and progression. Some preventive methods listed below:

• Quitting smoking: If you’re a smoker, quitting smoking is the most crucial step in chronic bronchitis prevention because smoking is the leading cause of it.
• Avoiding second-hand smoke: Experts recommend avoiding second-hand smoke as it is a leading risk factor for developing respiratory infections. 
• Avoiding lung irritants: Avoid exposure to air pollution, chemical fumes and dust by wearing a mask can decrease the risk of chronic bronchitis.
• Exercising regularly: Exercise regularly to enhance breathing by improving lung function.
  

Difference between Bronchitis and  Pneumonia

Bronchitis vs Pneumonia

Bronchitis and pneumonia, both are lung conditions that cause coughing and make it hard to breathe, but they affect different parts of the respiratory system and have different causes and severity which are mentioned below.

Difference between chronic bronchitis and emphysema

Chronic bronchitis vs Emphysema

Chronic bronchitis and emphysema are lung conditions classified under the term chronic obstructive pulmonary disease (COPD). Although the two disorders have similar symptoms, like wheezing and shortness of breath, they are distinct conditions. A few differences are listed below:

Difference between asthma and bronchitis

Bronchitis vs Asthma

Bronchitis and asthma are respiratory conditions that share similar symptoms, and the airways get blocked in bronchitis and asthma. Although they have similar symptoms, they have different triggers and other difference listed below: