What is bronchitis?
Bronchitis is the inflammation of bronchial tubes within the lungs. It mostly presents with coughing and can be either acute or chronic bronchitis. Bronchitis is associated with many risk factors such as smoking, asthma, or allergies.
Acute bronchitis is one of the most common diseases in the world, affecting about 5% of adults and 6% of children worldwide, at least once a year. Also known as a chest cold, it is mostly due to viral pathogens. It is a short term inflammation that may last up to ten days but the associated cough may last for around 3 weeks.
Etiology of Acute Bronchitis
Acute bronchitis is rarely ever caused by a bacterial pathogen. However, some bacterial agents may cause acute bronchitis, such as:
- Mycoplasma pneumoniae
- Chlamydophila pneumoniae
- Bordetella pertussis
- Streptococcus pneumoniae
- Haemophilus influenzae
The most common causative agents are viruses, namely respiratory syncytial virus, rhinovirus, and influenza virus.
Symptoms of Acute Bronchitis
Acute bronchitis lasts for a few days to weeks. It usually starts with a dry cough which affects sleep. This cough progresses to a wet cough in a few days and is usually accompanied by fever, fatigue, and malaise.
Acute Bronchitis presents with wet or dry cough that may be purulent. The viral etiologies also result in an upper respiratory tract infection which causes headaches, sore throat, and nasal congestion. Along with these symptoms, wheezing and shortness of breath may also be present.
Diagnosis of Acute bronchitis
Auscultation during the physical exam will reveal wheezing, rhonchi, and prolonged expiration. These findings along with the presence of wet or dry cough may lead to suspicion of acute bronchitis.
Chest XRAY may be performed if patients present with fever. This is done to exclude pneumonia, which is a serious respiratory pathology.
CBC count and differential count may be requested to check for WBC and CRP levels. WBC levels increase in response to infection and CRP levels increase in response to inflammation. And an increase in both may point towards acute bronchitis.
Sputum samples and culture may be taken to isolate the pathogen, especially Streptococcus species.
Treatment of Acute bronchitis
Acute bronchitis is mostly self-limited. It will resolve on its own and medication may be given for pain management. Many studies have been conducted to evaluate the benefits of antibiotic use in the treatment of acute bronchitis. The results of these studies concluded mostly that not only did the antibiotics provide no great benefit, they actually cause more side effects.
Inappropriate use of antibiotics treatment may lead to the development of antibiotic-resistant bacteria. This is already an issue in the infectious diseases field, and great care needs to be taken to prevent this.
Smokers are recommended to quit smoking completely or at least during the infection period, to allow for better healing.
A productive cough lasting for more than three months is defined as chronic bronchitis. It is a respiratory disease with characteristic overproduction of mucus. If it presents with decreased airflow, it can be defined as chronic obstructive pulmonary disease, COPD.
Chronic bronchitis used to be in the definition of COPD and was considered to be a feature of COPD. However, recent studies prove it to be a disease of its own, that can also be associated with COPD.
Cause of Chronic Bronchitis
Cigarette smoking is the most common cause of chronic bronchitis. Recent studies also found cannabis smoking to be a strong cause of chronic bronchitis.
Inhalation of air pollutants or irritating fumes associated with occupational hazards is also associated with the development of chronic bronchitis. Bronchitis caused by these hazards is referred to as occupational or industrial bronchitis.
Symptoms of Chronic bronchitis
As mentioned above, chronic bronchitis develops as a result of the overproduction of mucus. This overproduction is due to enlarged glands as a result of long term mucosal irritation. These glands and the goblets cells found in the mucosa secrete mucin which thickens mucus secretions.
However, these secretions can be cleared by coughing which leads to the removal of mucus. It starts with clear mucus and overtime becomes yellowish or green in color. After a certain time period, coughing can no longer clear the secretions resulting in obstruction and exacerbation of bronchitis.
Diagnosis of chronic bronchitis
Chronic bronchitis is diagnosed in the same way as acute bronchitis, mentioned above.
Treatment of chronic bronchitis
Chronic bronchitis in many cases can become a life long condition. However, symptomatic treatment can help improve the patient’s conditions.
- Lifestyle modifications: Patients are often asked to change their lifestyle to prevent exacerbations of chronic bronchitis. They may be asked to quit smoking, which has been proven to be beneficial in treating chronic bronchitis.
- MEdications: Obstruction caused by the accumulation of mucus can make breathing difficult. For this purpose, bronchodilators may be useful as they open up the airwards. These are generally prescribed as an inhaler.
- Vaccinations: Pneumococcal and flu vaccines may prevent complications associated with chronic bronchitis.
- Oxygen therapy: This treatment option is used when a patient has low oxygen levels in their blood. This also aims to help patients breathe easier and better.
- Pulmonary rehabilitation: This aims to improve the general condition of patients through an exercise program, disease management training, nutritional counseling, and psychological counseling
Smoking is widely known to be bad for our health and the health of those around us. Quitting smoking may help in the long run by preventing diseases like bronchitis, and several types of cancer. Also, inappropriate antibiotic use is extremely dangerous as it results in antibiotic-resistant bacteria. Treating diseases caused by these pathogens is extremely difficult and continuing on inappropriate antibiotic use may result in mass mortality.
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