Bronchitis

Sometimes referred to as: post-infectious cough, chest cold, respiratory infection

Interview between:

  • Andrew Cunningham, MD

  • Nora Lansen, MD

Bronchitis is a general description referring to inflammation of the airways of the lungs. The term is commonly used to describe both viral and bacterial lung infections, but  viral bronchitis is notably different than bacterial bronchitis, and the two require distinct treatments. The same is true for acute (short-term) bronchitis and chronic (long-term, recurrent) bronchitis–they are different entities, requiring different treatment approaches.

Cases Per Year (US)

acute bronchitis: 16 million; chronic bronchitis: 9 million

General Frequency

Most children and adults experience 3-5 viral infections (including sore throat) per year.

Risk

Acute bronchitis almost always stems from infection with a virus such as influenza, parainfluenza, respiratory syncytial virus, or rhinovirus. Chronic bronchitis usually develops over time as a result of exposure to inhaled irritants.

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Symptoms and Causes

What are the usual symptoms of bronchitis? 

Bronchitis almost always includes a cough. The cough can be wet or dry, produce mucus or not, and there may be associated symptoms, such as wheezing and chest tightness. Viral bronchitis is often preceded by upper respiratory symptoms like congestion, runny nose, and sore throat.

How long does bronchitis last?

A viral infection that triggers bronchial inflammation often feels like it lasts forever. In fact, the average duration of a viral-induced cough is an impressive 18 days! That’s almost three weeks of coughing, and it can indeed feel overwhelming. 

But the duration alone does not substantiate a need for antibiotics. It’s important to keep in mind that antibiotics are only effective against bacterial infections, not viral ones. 

For viral bronchitis, the key to healing is time. Supportive care (e.g., rest, hydration, over-the-counter medicines and supplements) can help to alleviate symptoms while the virus clears. 

What causes acute bronchitis?

Acute bronchitis–bronchial inflammation lasting anywhere from a couple of days to a couple of weeks–generally results from infection with a virus that settles in the respiratory system. 

Inflammation occurs as part of the body’s immune response to infection, and when the airways of the lungs (“bronchi”) become inflamed, the result is bronchitis. A cough, although irritating, is one of the ways that the body works to clear the infection. 

Very occasionally (5-10% of the time), bronchitis is caused by bacteria rather than a virus. The symptoms are similar. A variety of considerations (such as severity of symptoms, duration, and concomitant chronic illnesses) are taken into account when a healthcare provider is distinguishing between viral and bacterial bronchitis.

Why do some people end up with bronchitis every time they get a cold?

Although we do not have a clear understanding of the process, certain individuals seem to have one or two areas of the body that are more sensitive to inflammation than the rest. 

For example, some people seem to have bronchitis every time they get sick. For others, it may be a sore throat or sinus issues. And for still others it can be gastrointestinal distress frequently when they’re ill. There might be a genetic component, as these things often run in families, but scientific research has not yet supported an obvious connection.

Is bronchitis contagious?

Acute bronchitis is contagious, while chronic bronchitis generally is not. 

Chronic bronchitis is a long-term inflammation of the airways that is usually caused by exposure to inhalants. Acute bronchitis is most often caused by a virus, which can be picked up in the air (through respiratory droplets from the cough or sneeze of an infected person), or by touching something that the infected person has touched. 

Handwashing is the most effective way to minimize risk. The flu vaccine is also critical in combating the very contagious flu virus, which commonly results in bronchitis. 

What’s the difference between bronchitis and pneumonia?

Bronchitis and pneumonia have very similar symptoms, and are sometimes clinically indistinguishable. From an anatomical perspective, the two conditions affect different parts of the lungs–bronchitis settles in the breathing tubes (bronchi), while pneumonia affects small air sacs in the lungs called alveoli.

Although pneumonia can sometimes be mild, it usually causes a more severe version of lung symptoms than bronchitis does. Like bronchitis, pneumonia can cause cough, shortness of breath, chest pain, wheezing, and fever. In severe cases, pneumonia can cause respiratory distress and death.

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Treatment

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Prevention

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Andrew Cunningham, MD and Nora Lansen, MD are both members of the Galileo Clinical Team. Connect with one of our physicians about Bronchitis or any of the many other conditions we treat.

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