Bronchitis

Acute bronchitis can be contagious and is often the result of a respiratory infection caused by viruses. Depending on the cause of the respiratory disease, bronchitis treatment can also vary: Acute bronchitis is caused by a viral respiratory infection and usually heals on its own; in other cases, your doctor will prescribe medication to treat the bronchitis. If you have an active smoking habit, stopping smoking is the most important therapeutic measure for chronic bronchitis.

What is bronchitis?

Bronchitis occurs when the mucous membranes of the bronchial tubes become inflamed. The bronchi resemble the branches of a tree, which become thinner and thinner from the trunk. The smallest branches at the end of the bronchi are called bronchioles; they carry breathing air into the lung tissue with its millions of tiny air sacs (alveoli). The lungs and bronchi belong to the lower respiratory tract, while the nasal cavity and throat form the upper respiratory tract.

In Switzerland, around 10,000 patients are treated in hospital for acute bronchitis every year, especially in the winter months. In addition, there are numerous patients who suffer from chronic bronchitis or other respiratory diseases.

Whether bronchitis is called chronic or acute depends, among other things, on how often the symptoms of bronchitis occur in the patient and how long they last.

Acute bronchitis

Acute bronchitis typically begins in winter – with a cough that may be accompanied by fever and a sore throat. In patients who are otherwise healthy, acute bronchitis usually lasts no longer than seven days to three weeks. The patient’s own immune system can often successfully fight the respiratory disease during this time without the need to take medication for bronchitis. Women and men are affected about equally often, and acute bronchitis also occurs frequently in children and adolescents.

Chronic bronchitis

Bronchitis is chronic if it occurs so often in two consecutive years that it causes a cough with sputum on most days for at least three months in each of these years. Such a cough is called a “productive” cough. Unlike acute bronchitis, which is usually caused by viruses, chronic bronchitis is mainly caused by smoking. Chronic bronchitis mainly affects older men.

Causes: How does bronchitis develop?

Bronchitis can be caused by various triggers. These are usually pathogens such as viruses and bacteria. They cause the bronchitis to be contagious (infectious). However, there are also non-infectious causes of bronchitis.

Causes of infectious bronchitis

• Viruses are the most common cause of acute bronchitis. These pathogens include rhinoviruses, which also cause colds and flus, but also herpes viruses, influenza viruses, respiratory syncytial viruses (RSV) and metapneumoviruses. They all cause the bronchitis they produce to be contagious.
• Bacteria can also trigger acute bronchitis. They are often not the sole cause, but affect the mucous membrane of the bronchi after it has already been attacked by viruses. Such an inflammation is called a “bacterial superinfection”. Various types of bacteria can cause infectious bronchitis, including mycoplasma, chlamydia, streptococci and staphylococci.
• In rare cases, fungi are also a possible cause of bronchitis, especially in people with a weakened immune system.

Causes of non-infectious bronchitis

• Irritants such as ammonia, sulphur dioxide and various acids and gases can damage the bronchial mucosa and trigger inflammation when inhaled.
• Allergens, for example dust or pollen, can cause acute allergic bronchitis in people with allergies. If the allergic reactions also include asthma, this is referred to as asthmatic bronchitis.
• Tobacco smoke is the most common trigger for chronic bronchitis.
• Dust, polluted air and chemicals (for example in the workplace) can also cause chronic bronchitis.

Symptoms: How does bronchitis manifest itself?

A dry cough is often the first sign of acute bronchitis. Such a cough without sputum is called an “unproductive” or dry cough. Bronchitis causes the mucous membranes of the bronchial tubes to swell and become inflamed. After a few days, the inflammation often causes the bronchial tubes to produce mucus, which produces a “productive” cough with sputum. Anyone who has a cough with bronchitis often experiences pain and a sore feeling in the chest. Breathing can also be painful if you suffer from acute bronchitis. Other symptoms may (but do not necessarily have to) occur:

• Mild fever
• Common cold
• Sore throat, reddened throat
• Pain in the limbs
• Swollen lymph nodes in the neck area
• Rattling or whistling breath
• Shortness of breath

Even though bronchitis often passes on its own like a cold, uncomplicated bronchitis can worsen. There is then a risk that it will develop into complicated bronchitis with a severe course. Therefore, do not hesitate to seek medical help if your bronchitis symptoms worsen or if you have the feeling that your bronchitis is not getting better after a few days. If bronchitis occurs in babies or small children, you should always seek medical advice at an early stage.

Diagnosis: How can bronchitis be diagnosed?

In order to diagnose bronchitis, your doctor will first ask about your symptoms (or those of your child) and then begin the examination. Listening to the chest cavity with a stethoscope reveals whether the lungs and bronchi are impaired. Oxygen saturation is also determined. It may be necessary to determine the bronchitis pathogens or to determine inflammation values. This is possible with the help of a blood test.

In some cases, coughed up mucus is also examined in the laboratory and can provide information about the cause of bronchitis. An X-ray examination may be necessary – because a detailed examination can rule out other respiratory diseases, some of which manifest themselves in a similar way to bronchitis:

• Bronchiolitis causes respiratory distress, especially in infants and young children. The disease affects the bronchioles, the finest branches of the bronchi. Bronchiolitis is usually caused by viruses, especially respiratory syncytial viruses (RSV).
• Bronchiectasis are permanent protrusions of the bronchi and bronchioles. Thick mucus forms in them, which is difficult to cough up.
• Pneumonia (lung inflammation) can have various causes – one of them is chronic bronchitis, in which the inflammation of the bronchial tubes develops into so-called bronchopneumonia.
• COPD is short for chronic obstructive pulmonary disease. It often occurs in smokers and causes permanent damage to the lungs.
• Pulmonary emphysema is the term for the destruction of certain tissue parts, often in connection with COPD. Here too, tobacco smoke is the most common cause.

Prognosis: How does bronchitis progress?

Acute bronchitis often begins with a cold – with an inflammation of the upper respiratory tract. From here, the infection can spread to the lower respiratory tract and affect the bronchi. Acute bronchitis is usually contagious (infectious).

The time between the infectious bronchitis pathogens entering the body and the onset of the first bronchitis symptoms is often short: if viruses are the trigger, the incubation period for bronchitis is only one day. Bacteria, on the other hand, take several days to infect the mucous membranes of the bronchial tubes. They usually originate from the mouth and throat; if they infect the bronchial mucosa, which has already been damaged by viruses, they can cause renewed inflammation.

The course of acute bronchitis typically peaks after a few days and then gradually subsides. However, the cough can last for up to three weeks. The acute bronchitis is then usually cured.

The course of chronic bronchitis, on the other hand, extends over months or years. Shortness of breath, especially during physical exertion, and a persistent cough can become frequent or even constant companions of those affected.

Treatment: How is bronchitis treated?

Medication is not always the first choice for acute bronchitis. This applies in particular to antibiotics, which are unsuitable for treating the most common cause of bronchitis: Viruses cannot be combated with antibiotics. However, an adequate intake of fluids is important for bronchitis treatment – so drink as much as possible. Cough medicines, inhalations and decongestant nasal drops can also provide relief until your bronchitis symptoms have subsided.

Whether you may need additional medication is a decision that you should put in the hands of your doctor. You may be prescribed a cortisone preparation or a bronchodilator. Or, if bacteria have attacked her bronchial tubes, an antibiotic that is effective against these pathogens.

If you suffer from chronic bronchitis, you are probably already being treated by a doctor; otherwise you should not hesitate to do so. And if you are a smoker, you will know that the most effective therapy is to protect your lungs and bronchial tubes from tobacco smoke. That means quitting smoking.