Acute Bronchitis

Acute bronchitis – also commonly called a chest cold – is a short-term inflammation of the bronchial tubes which carry air to and from the lungs. Its principal symptom is coughing. This is often accompanied by: 1 2

• Wheezing
• Shortness of breath
• Fatigue
• Coughing up mucus (phlegm) or sputum (a mixture of saliva and phlegm)

A common condition, it often develops following upper respiratory tract infections, such as the common cold or the flu. It is usually caused by viruses, but in rare cases, it can be caused by a bacterial infection. It is generally considered to be non-serious and in most cases will clear up in around two weeks, though the characteristic cough may linger for longer. However, there is a risk that the causal infection will spread further into the lungs and develop into pneumonia – a more serious condition.

The most common symptom of acute bronchitis is a cough, which is typically described as dry and hacking in nature in its initial stages. As the condition develops and phlegm builds up in the lungs, coughing up phlegm or sputum will likely occur. This may be yellow, green or clear in color.

Other signs and symptoms of acute bronchitis may include: 1 3

• Sore throat
• Fever
• Chest congestion
• Shortness of breath
• Wheezing
• Chills
• Fatigue
• Unexplained weight loss

The duration of the main condition is usually between 10 and 14 days. However, the cough alone often lasts longer, around two to three weeks or possibly more. The exact reason for this is not fully understood, but may be due to ongoing healing processes in airways.

Good to know: Coughing up a small amount blood, or having bloody sputum, is a possible symptom of bronchitis, as it can result from prolonged coughing causing tiny tears in the throat lining. However, if a person coughs up blood or has bloody sputum, this is more likely to be a sign of a more serious chest infection, such as pneumonia.

Always seek a medical opinion if blood is present, so that the cause can be identified and treated. A differential diagnosis can be made with the aid of various tests, including a chest X-ray. 2 Feeling unwell? Get a free symptom assessment with the Ada app.

The condition may be misdiagnosed as, or can develop into, pneumonia ‒ an infection of the lungs. The two conditions share many of the same symptoms, including having a productive cough, i.e. a cough which produces green or yellow sputum, chest pain and a fever.

Signs that acute bronchitis may actually be ‒ or may have developed into ‒ pneumonia include: 4

• A very high fever; of 38 C or above
• Sharp chest pain
• Coughing up blood or bloody sputum
• Persistent chills
• Shoulder and neck pain
• Symptoms generally worsening

Read more about pneumonia » and pneumonia in children »

Seek medical attention promptly if pneumonia is suspected. Tests, including a chest X-ray and sputum analysis, will usually be carried out to confirm the diagnosis, so that the correct treatment approach can be devised.

If the condition is recurring, it may be diagnosed as chronic bronchitis, a constant irritation of the bronchial tubes in the lungs. 1 This form of bronchitis is often associated with smoking, but can also be made more likely by exposure to irritants in the air, such as pollution, fumes or vapours from industrial cleaning products.

For bronchitis to be diagnosed as chronic, it must persist for a duration of at least three months of the year, for two years in a row. 1 For more information, see this resource on chronic bronchitis.

The condition is most commonly caused by a viral infection – often involving the same viruses that cause upper respiratory tract infections such as the common cold and flu.

When a person acquires such a virus, the mucous membrane lining of the airways can be affected, and when that happens the symptoms of acute bronchitis can result. Processes which take place as a result of the infection include: 5 6

• Hyperemia; increased blood flow to the mucus membrane, resulting in inflammation of the airways which conduct air to the lungs
• Edema; otherwise known as fluid buildup, which also contributes to inflammation of the airways
• Increased phlegm production; which occurs in the airways, as a result of the swelling and inflammation caused by the infection

These changes to normal bronchial tube function result in a buildup of phlegm in the airways, causing coughing and other symptoms.

Acute bronchitis can be contracted through exposure to droplets released after an infected person coughs or sneezes. Viruses spread in these droplets are able to survive on a surface for as long as 24 hours. 1 It can also be caused by bacterial infections, but this is far less common.

Certain factors make developing the condition more likely. These include: 7

• Smoking tobacco products
• Environmental factors, such as exposure to inner-city pollution or irritant chemicals, for example chemical cleaning compounds
• Having a compromised immune system, which reduces the body’s ability to fight off causal infections; this can be due to a short-term condition such as the common cold, or a chronic condition, such as human immunodeficiency virus (HIV)
• Recurrent irritation to the throat, experienced as a result of stomach acid reflux from gastroesophageal reflux disease

Good to know: These factors can also cause chronic bronchitis, depending on the length of a person’s exposure to them.

In its early stages, it may be difficult to distinguish the condition from a common cold. However, in the majority of cases, a doctor will be able to diagnose a person accurately after performing a physical examination and inquiring about what symptoms are being experienced.

If there are difficulties making the diagnosis, or if the condition persists for a longer period than expected, a series of further tests may be called for. These tests may include: 8

• Pulmonary function test; a group of tests that measure how well the lungs work, used to check for signs of asthma or chronic obstructive pulmonary disease (COPD)
• Sputum tests; sputum, or mucus, can be tested to identify underlying causes
• Chest X-ray; an X-ray may be useful in determining the cause of a cough and ruling out the possibility of pneumonia, or other lung problems

Good to know: If a person is affected by pneumonia, the alveoli (air sacs) which pass oxygen to the blood become filled with fluid. This will show up as a white area on a chest X-ray. 9

In many cases, the condition will require no treatment and will clear up of its own accord in two to three weeks. If it is particularly severe, if it lasts for longer than 10 to 14 days, or if a bacterial cause is suspected, however, treatment methods are available. These include:

• Cough medicine; if a cough is particularly severe and affects sleep, a cough medicine may be prescribed by a doctor, or they may recommend an over-the-counter (OTC) form of cough medicine. However there is little evidence that cough medicines are effective.
• Pain relievers such as ibuprofen and acetaminophen (paracetamol) can be taken to suppress fever, aches and pains associated with the condition.
• Antibiotic medications; these may be prescribed, if sputum tests reveal that the causal infection is bacterial; however, these will not be effective against viral infections or cases where the condition is due to non-infectious causes.
• Other medications; people with allergies, asthma or chronic obstructive pulmonary disease may be prescribed a range of other medications to help alleviate the symptoms of the condition.

To manage the symptoms of acute bronchitis at home, it may also be helpful to: 1

• Rest; this is vital in order to help the immune system regain its strength.
• Hydrate; drinking plenty of water prevents dehydration, and may help to thin out the sputum in the chest, making it easier to cough up.
• Consume hot drinks and throat lozenges; some people find that drinks such as tea with honey and over-the-counter lozenges can provide some relief from symptoms including coughing and sore throat.
• Inhale steam; steam from a hot shower or through a towel over a bowl of hot water may help dislodge sputum and relieve symptoms.

Good to know: To avoid burns and scalds, make sure that children are supervised all the time when inhaling steam, and do not come into contact with any water which is hotter than they would normally bathe in.

Some people find certain herbal remedies helpful; however, there is currently no strong medical evidence supporting their use. These include: 10 11 13

• Apple cider vinegar (ACV), some people believe this can help thin mucus and reduce congestion. ACV is best taken by drinking a solution with warm water.
• Turmeric, a plant and spice which contains the compound curcumin, which may have antiviral and antibacterial properties.
• Ginger, which may have anti-inflammatory properties, and can be eaten raw, brewed as a tea or taken as supplements.
• Essential oils, which can be added to hot compresses or bath water. Popular oils to use for acute bronchitis are frankincense, oregano, eucalyptus, tea tree and lemon. Never ingest an essential oil.

Good to know: Some herbal remedies and supplements cannot be taken with underlying conditions or certain prescription medications. If, in addition to their chest cold, a person has a chronic (ongoing) condition and/or regularly takes any medications, they should consult their doctor before using any natural products.

Although it is not always possible to completely avoid the viruses and bacteria that cause acute bronchitis, there are several ways to reduce the risk of contracting acute bronchitis. These include:

• Washing hands as frequently and thoroughly as possible, using soap and water or an alcohol-based hand sanitizer
• Getting plenty of rest
• Avoiding excessively touching the eyes or mouth, particularly around people who have a respiratory infection
• Avoiding sharing items such as drinking glasses or utensils, or towels
• Making efforts to keep healthy with regular exercise and a balanced diet
• Getting vaccinated against pneumonia, flu and whooping cough

Acute bronchitis can develop in children of any age. Premature babies and children with asthma or allergies are especially susceptible. The symptoms of acute bronchitis in children, as well as the treatment methods, are generally the same as in adult cases. However, complications may present differently in children. Parents should seek immediate medical attention if any of the following symptoms occur:

• Breathing becomes difficult and wheezing occurs
• A child struggles to talk or eat
• A child experiences a fever of 38 degrees or higher, neck stiffness or headaches
• The lips or nails turn grey or blue
• A child is dizzy, confused, faints or finds waking up more difficult than usual
• Signs of dehydration, such as cracked lips, crying without tears or a dry mouth occur
• A fever disappears and then returns
• A child’s cough lasts for longer than three weeks
• Symptoms generally worsen

Breathing difficulties are especially likely to be apparent in younger children. There may be signs that the child is having trouble breathing, including flaring of the nostrils and clenching of the muscles in the ribs. If you are concerned that you or a loved one may be developing acute bronchitis, get a free symptom assessment with the Ada app.

Q: Is acute bronchitis contagious?
A: Yes. It is, in most cases, caused by influenza or other similar virus types. These viruses can be spread from person to person via droplets expelled when an infected person sneezes, coughs or talks. To avoid developing acute bronchitis, people should try to wash their hands regularly, avoid close contact with people with an infection and get an annual flu shot.

Q: Are there any home remedies for acute bronchitis?
A: Yes, there are a number of home remedies that may help to alleviate the symptoms of bronchitis. For more information, see Treatment: : Home remedies for bronchitis.

Q: Can antibiotics be used to treat acute bronchitis?
A: Most cases of bronchitis are the result of a viral infection, and therefore antibiotics will be unhelpful. In persistent or severe cases of bronchitis, a bacterial infection may be suspected, in which case antibiotics could be prescribed after confirming the diagnosis. Unnecessary use of antibiotics can be harmful and lead to antibiotic resistance, so antibiotics should only be prescribed when necessary.

Q: What is the difference between acute bronchitis and a chest cold?
A: There is no difference – they are different terms for the same condition. Acute bronchitis is, however, different to a common cold and is characterized by more severe symptoms and the buildup of sputum.

Q: Can acute bronchitis turn into pneumonia?
A: Yes, approximately one in 20 cases of bronchitis will develop into pneumonia, according to the U.K.’s National Health Service. 1 This is the most common complication of bronchitis, and results from the causal infection advancing further into the lungs. Pneumonia can be diagnosed using various tests, including a chest X-ray.

Q: Can acute bronchitis be a symptom of cancer?
A: If a person experiences recurrent chest infections, such as bronchitis or pneumonia, this may indicate the presence of a serious underlying cause, such as lung cancer. 14 If cancer is suspected, diagnostic tests such as a chest X-ray, biopsy and CT scan will be carried out. 15

Q: What is acute bronchitis with bronchospasm?
A: A bronchospasm occurs when the airways (bronchi) temporarily narrow, reducing the airflow to the lungs. This limits the amount of air coming in and out of the lungs, resulting in symptoms such as wheezing, coughing and shortness of breath. Medications can be prescribed to help widen the airways. Bronchospasm is more likely to be a complication of chronic, rather than acute, bronchitis.

[^12: “Quick Access Patient Information on Conditions, Herbs & Supplements.” Integrative Medicine Communications. 2000. Accessed: 07 October 2018.