What Is Bronchitis? Symptoms, Causes and Treatment Methods

Bronchitis is inflammation of the airways leading to the lungs. The bronchial tubes, which form the bronchioles in the lungs, are an important component of gas exchange. Smoking, chemicals, toxins, smoke and other environmental factors can cause irritation and mucus production in the bronchi. The irritated bronchial lining may swell and begin producing more mucus, and inflammation may develop. The typical symptom is a cough and sputum, which may change color. Bronchitis can start suddenly and be short-lived. Conversely, it may progress slowly and show a persistent, chronic pattern. It can often be affected by other respiratory tract diseases and may occur simultaneously with them. With home care recommendations and medication treatment, the acute form can be brought under control. However, since the chronic form does not show improvement, it requires only symptom-directed interventions.

What Is Bronchitis?

Bronchitis is inflammation of the trachea (windpipe) and bronchi, either complete or partial. Air breathed in through the nose passes through the trachea and reaches the bronchi. Air distributed from the bronchial tubes, which branch into bronchioles, fills the lungs. After oxygen and carbon dioxide exchange in the blood vessels of the lungs, the air passing through the same pathways is exhaled. The normal inner surface of the bronchial tubes is lined with a mucous membrane. This membrane acts as a barrier against particles, microorganisms and irritants and helps protect the airways. However, depending on various causes, the mucosa in the bronchi may become irritated and inflamed, and excessive mucus production may occur. Therefore, among its most specific symptoms may be a cough with mucus and a feeling of chest congestion.

Chemical, physical or infectious factors can cause inflammation in the bronchial tubes. Inflammation and irritation may proceed in an acute or chronic manner. Inflammation that begins suddenly and rapidly and is short-lived is called acute bronchitis. Bronchial inflammation that develops more slowly and over a long period is the chronic form. Chronic bronchitis can cause permanent damage due to long-term inflammation of the mucosa. Treatment for acute and chronic bronchitis can generally be carried out with a focus on symptoms. However, recovery can be achieved by eliminating some risk factors (3).

What Are the Symptoms of Bronchitis?

Symptoms of acute and chronic bronchitis usually show similar features, but these may also vary from person to person. The acute type tends to last less than 3 weeks. Commonly, symptoms of acute bronchitis may include:

Dry or productive (mucus) cough,

Cloudy or clear, yellow, green or brown sputum,

Sore throat,

Fever and chills,

Nasal congestion,

Shortness of breath,

Wheezing,

Headache,

Chest pain or tightness,

Fatigue and weakness.

Symptoms may appear with varying severity in individuals. Usually these symptoms resolve on their own within a week, while the cough may persist for several weeks. The chronic type may be associated with a persistent cough lasting longer than 8 weeks. In addition, symptoms of chronic bronchitis may include:

Tachycardia (heart palpitations),

Feeling of discomfort in the chest,

Feeling of exhaustion may be present.

In some cases, acute infections may occur in addition to chronic bronchitis. If additional symptoms such as high fever, bloody cough, worsening shortness of breath, pale skin, bluish nails and lips, or difficulty concentrating occur, individuals should definitely contact a relevant healthcare facility. In infants, symptoms of bronchitis may include fever, shortness of breath and restlessness (2, 4, 5, 6).

How Does Bronchitis Develop?

Acute and chronic bronchitis can be triggered by different risk factors. Physical and chemical substances, biological agents, etc., which can cause irritation, may lead to inflammation of the mucosa. Acute bronchitis cases can usually be caused by viruses. Many different virus types, such as influenza (flu), the common cold, RSV or COVID-19, can cause the acute type. These viruses, which affect the upper respiratory tract, are contagious and can cause inflammation in the bronchial mucosa. When infected individuals talk, sneeze or cough, droplets are spread into the air. Viruses can enter the respiratory tract when airborne droplets that spread and remain suspended are inhaled. In addition, microorganisms can be transmitted when hands are brought to the mouth, eyes and nose after touching contaminated objects. Furthermore, bacteria such as Streptococcus are also microorganisms that can contribute to the development of acute bronchitis.

The most common cause of the chronic bronchitis picture is smoking and exposure to smoke. Therefore, it may develop in parallel with health problems such as COPD, asthma, cystic fibrosis and emphysema, etc. The long-term form may also develop as a result of exposure to air pollution, certain dust particles, smoke or chemical gases. Long-term exposure to risk factors may trigger persistent inflammation in the bronchial tubes. In the chronic type, thickening of the mucosa can cause narrowing of the airways and trigger excessive mucus production. This damage, which results from repeated irritation of the mucosa, can promote bacterial proliferation. This condition may lead to recurrent bronchitis (2, 3, 7).

How Is Bronchitis Diagnosed?

There is no specific test for diagnosing bronchitis. Therefore, multiple diagnostic methods may be applied and other respiratory diseases may be ruled out. In particular, flu, asthma, COPD and pneumonia may show a profile similar to bronchitis symptoms, and making an accurate diagnosis is important. During diagnosis, evaluation of family history, medical history, medication use, and work and environmental conditions may be necessary. A physical examination may be needed to assess the presence and severity of symptoms. During the physical examination, a stethoscope is used to listen to the lungs and breathing. Other diagnostic methods may be preferred to determine whether there is inflammation in the blood or respiratory tract, and whether there are other health problems affecting the lungs. These diagnostic methods may include:

Swab sample: A soft-tipped swab may be taken from the nose or throat to detect respiratory diseases such as flu, COVID-19, etc., and microorganisms.

Sputum tests: Sputum samples collected from individuals by coughing may be examined for pathogens such as viruses and bacteria. Sputum may also be tested for allergic bronchitis.

Blood tests: Blood samples may be taken as an indicator of general health status and whether there is an infection in the body.

Chest X-ray: A chest X-ray may be recommended for diagnosing other diseases that may cause coughing. In particular, serious health problems associated with smoking can be ruled out with this method.

Lung function test: It may often be preferred in the diagnosis of chronic bronchitis and emphysema. The lungs' capacity to hold and expel air can be measured with a device called a spirometer.

Individuals with a family history of hereditary diseases and respiratory diseases should inform their doctor (8, 9).

How Is Bronchitis Treated?

Bronchitis treatment is aimed at controlling symptoms and treating other underlying causes. In particular, cases caused by viruses cannot be treated with antibiotics or similar medications. Instead, treatment methods that help accelerate the healing process and support alleviation of symptoms may be preferred. In general, the options for treating bronchitis are as follows:

Antiviral medications: These are medications that may be prescribed to relieve symptoms in cases of inflammation caused by viruses.

Antibiotics: These are medications preferred for eliminating infection in cases caused by bacteria. Such medications are not prescribed for bronchitis caused by viruses.

Anti-inflammatory medications: Corticosteroids and other medications may be recommended to reduce inflammation.

Bronchodilators: Medications that help open the airways may be prescribed for individuals with severe symptoms.

Antitussive medications: These are medications that can be used with or without a prescription to relieve or improve persistent cough.

Asthma-COPD treatment: Since chronic bronchitis may develop along with health problems such as COPD and asthma, additional medications and respiratory therapies may be preferred.

Bronchitis treatment in children may include medications for fever, cough, headache and shortness of breath. In addition, home care recommendations such as steam humidifiers, warm and plenty of fluid intake, honey use, etc. are available, but honey consumption should be avoided for bronchitis treatment in infants under 1 year of age. Bronchitis treatment in infants may include some prescription medications and inhalers (8, 10).

Frequently Asked Questions

Bronchitis usually presents with symptoms such as dry or productive cough, chest pain, weakness, mild fever, wheezing and shortness of breath. In acute bronchitis these symptoms are short-lived, while in chronic bronchitis they continue long-term. Acute bronchitis usually resolves on its own within 1 to 3 weeks; however, the cough may last longer. Chronic bronchitis, on the other hand, is persistent and requires long-term treatment and follow-up. Antibiotics are not used for viral bronchitis; cough syrups, expectorants and pain relievers/fever reducers are preferred to relieve symptoms. In bacterial bronchitis, the doctor may prescribe antibiotics if deemed necessary. In chronic bronchitis, bronchodilators, inhaled steroids and lifestyle changes are important in treatment. Yes, especially in smokers, people with allergies or individuals with chronic lung disease, bronchitis may recur frequently. This condition increases the risk of developing chronic bronchitis. Chronic bronchitis is a subtype of COPD (Chronic Obstructive Pulmonary Disease). Not every chronic bronchitis patient has COPD, but chronic bronchitis is frequently seen in individuals with COPD. Although the two have similar symptoms, COPD encompasses a broader group of diseases.