Bronchitis: A Respiratory Condition
Authored by Dr.Sai Praveen Haranath
Introduction
Bronchitis is inflammation of the mucous membrane lining the tubes that carry air to the lungs both ways, in and out. These tubes are known as bronchi and ‘itis’ refers to inflammation which leads to swelling of the lining of the tube. Narrowing of bronchi takes place and results in mucus build up. People suffering from bronchitis often cough up thickened mucous. Bronchitis normally develops from a cold or other respiratory infection. Bronchitis may be acute or chronic, the former is more common and easier to treat and improves within a few days while, the latter is a serious condition and can lead to Chronic Obstructive Pulmonary Disease (COPD). When bronchitis recurs frequently most often due to smoking, the bronchial lining becomes very irritable and inflamed and needs immediate medical attention. Bronchitis is contagious only when the causative agent is either a virus or a bacterium. Types: There are mainly two types of Bronchitis: 1. Acute Bronchitis: It is experienced for a short duration (less than 3 weeks). 2. Chronic Bronchitis: It affects an individual for a longer period of time (3 months over 2 years continuously). Repeated attacks of Acute Bronchitis can lead to Chronic Bronchitis. Causes Causes for Acute and Chronic Bronchitis include: Acute Bronchitis
Chronic Bronchitis
• Virtually all instances of acute Bronchitis are known to be caused by infections, in which 90 percent of cases are due to viruses such as Influenza, para-influenza, rhinovirus, corona virus and adenovirus. • Bacteria is the cause in rare cases of acute Bronchitis.
• Cigarette smoking irritates the mucous lining leading to production of excess mucus, which is one of the principal causes of chronic Bronchitis. • Several occupations such as coal mining, grain handling and metal moulding are said to be the culprit in causing chronic Bronchitis.
Symptoms Common symptoms for both types of Bronchitis include: • Chest discomfort • Cough (with clear/ yellow-green sputum) • Fatigue • Shortness of breath • Wheezing For acute Bronchitis: Dry coughing may last for several weeks even after infection is gone. For chronic Bronchitis: Productive cough is seen at least for a period of 3 months in a year. Diagnosis When history and physical examination of a patient is not sufficient to diagnose Bronchitis, the following tests are taken into consideration: • Sputum cytology • Throat cultures • Influenza test • Chest X-rays • Blood gas • Bronchoscopy • Pulmonary Function Test (PFT)
Who are at Risk? Risk factors for Bronchitis include: • Cigarette smoking • Low immunity • Exposure to irritants • Gastric reflux Complications: • Pneumonia • Sinusitis • Pertussis ( whooping cough) • Chronic Obstructive Pulmonary Disease (COPD) • Tuberculosis • Other lung infections Treatment
Bronchodilators: These medications dilate the tube for free passage of air in wheezing. Salmeterol (long acting beta-2 adrenergic receptor agonist) and Ipratropium Bromide (Anti-cholinergic) are two bronchodilators. For shortness of breath another short acting bronchodilator like salbutamol can also be used. • Cough medicines: To lower cough, certain medications like Guaifenesin can be used, but take them only on doctor’s advice. • Mucolytics: These agents lower the viscosity of mucus making it easier to cough out from the body. • NSAIDs (nonsteroidal anti-inflammatory drugs): These agents help decrease inflammation and relieve discomfort. • Antibiotics: These are recommended only when an infection is confirmed to be caused by a bacterium. Using antibiotics in viral infections may lead to development of antibiotic-resistant bacteria. • Oxygen supplementation: It is used in chronic bronchitis patients when their blood oxygen levels fall below normal. Non-drug therapy: • Drink plenty of fluids • Breathe humidified air. • Alcohol and caffeine containing beverages should be avoided as these agents may interact with medications used in the treatment. • Stay indoors to avoid air pollution. • Stop smoking to avoid irritation to the mucous membrane. •
Prevention Avoid smoking and second hand smoke (being exposed to the smoke from the smoker). • Stay away from an infected person and ask them to cover their cough and sneezes with a kerchief or a cloth. • Cover your nose and mouth with a mask during travelling in dusty places. • Wash your hands with an antibacterial soap. • Stay vaccinated against infections. • Avoid being in the presence of large groups or a crowd particularly in the winter season. •