What is bronchitis and how is it treated?
Bronchitis is a disease of the respiratory tract in which the bronchi are inflamed. Bronchitis can be acute and chronic.
Short information about bronchitis
Acute: ~5% of people a year
Chronic: ~5% of people
In most events of acute bronchitis it is caused by an infection, for example, a viral or bacterial one, but most often only symptomatic treatment with antihistamines, cough medicines, and mucolytics are required and antibiotics are not needed.
Chronic bronchitis develops as a complication of the acute form if it is insufficiently, untimely treated, or not treated at all. Or, it can develop as a result of prolonged action of non-infectious irritating factors such as dust, cigarette smoke, gases, etc. In some cases, the disease causes an obstruction of the bronchi due to edema of the mucosa, this bronchitis is called obstructive. The therapy of the disease is contingent on the causative agent, the type of course, and form of the disease.
There are 2 forms of bronchitis:
- Acute bronchitis is an acute inflammation of the bronchi mucosa. It is manifested in an elevation in the volume of bronchial secretion with cough and mucus occurrence.
- Chronic bronchitis is a diffuse progressive lesion of the bronchi with the reorganization of the secretory apparatus of the mucosa with the onset of the inflammatory process. It is manifested in abundant production of sputum, impaired cleansing and protective function of the bronchi.
Acute and chronic forms substantially differ from each other in causes, the manner of development of a disease, and therapy.
Causes of bronchitis development
In most cases, the cause of acute bronchitis is viruses, for instance, flu, common cold, and bacteria. Less commonly it is caused by fungi, allergens, or exposure to toxic substances or tobacco smoking. The most typical route of infection is by airborne droplets, that is, breathing in of infected droplets of saliva upon contact with a sick individual (during a conversation, when they cough, sneeze, etc.). The disease usually develops as a complication of a common cold or flu as the infection passes from the upper respiratory ways to the lower.
The course of chronic bronchitis
Viruses or chemical, physical effects damage the epithelial cells of the bronchial mucosa and cause their death, which creates favorable conditions for bacteria development (usually pneumococcus and hemophilic bacillus) in the bronchial tissue. Bacteria usually join a viral infection of the respiratory tract from day 2-3 of the illness. This determines the further course of the resulting inflammation. Regularly, the inflammation fades, and the damaged mucous membrane recovers within a few weeks. But in some individuals, the pathological process does not undergo a reverse development and acquires a chronic character.
In mild cases, changes of the bronchi structure are limited only by the mucous membrane, in severe cases, all layers of the bronchial wall are affected. The mucous membrane becomes swelled, overfilled with blood, with the presence of mucus on the surface. In severe form, hemorrhages in the mucous are often observed. Mucus can become reddish due to the damaged blood vessels. In rare cases, complete obstruction with mucus of the lumen of the small bronchi and bronchioles is noted.
Acute bronchitis usually lasts about 14 days. Like other respiratory tract diseases, bronchitis can come along with a common cold or flu, or arise as a complication but can start on its own, without a visible preliminary reason. The disease usually begins with an unproductive (dry) cough, which can be severe, especially at night, and thereby deprive the individual of normal sleep and rest. After a few days, an unproductive (dry) cough turns into a productive (wet) cough, which may be followed by a slight fever, fatigue, headaches (symptoms of intoxication). Fever, malaise, fatigue, and apathy can pass in just a few days, but a cough can last a few weeks. However, if relief does not occur, this indicates the attachment of a bacterial infection. In some people, coughing can last up to several months, since healing of inflammation of the bronchial pathways is a slow process.
If the cough lasts more than a month, you should consult a specialist pulmonologist and find out if the irritation of the respiratory tract and cough has any other reason than inflammation. In some patients with bronchitis, prolonged irritation of the bronchial pathways that lasts for several months can lead to asthma.
It is crucial to consult a doctor if the patient coughs up blood in order to exclude such serious diseases as tuberculosis or lung cancer.
Treatment of acute bronchitis
In the majority of cases, acute bronchitis is caused by a viral rather than bacterial infection, and the acute stage usually goes away without antibiotics within a week. Antibiotics such as Zithromax can be used in the treatment of bronchitis of a bacterial nature, and sometimes as an adjuvant in cases of suspected possible complications or concomitant diseases. Currently, uncomplicated acute bronchitis is more regarded as an inflammatory rather than an infectious process, and therefore anti-inflammatory therapy seems more relevant than antimicrobial. However, a randomized, placebo-controlled study in Spain showed insignificant differences in the effectiveness of anti-inflammatory therapy compared with placebo and antibiotic therapy.
There are effective non-drug methods for treating cough, including acute bronchitis, which are useful both in the use of a medication prescribed by a doctor and when they are not used.
- The patient needs to rest and drink as much as possible. A sufficient amount of caffeine-free drinks, such as water or juices or herbal tea (up to 2 to 4 liters of liquid per day) is required. In cold climates, traditionally, warm drinking is recommended for cough treatment: tea with raspberries, honey, linden blossom, and so on.
- Since inflammation of the bronchial pathways, as a rule, is accompanied by inflammation of the pharynx, soft, non-acute, non-irritating throat food is recommended during bronchitis.
- As a warming antitussive, rubbing with warm camphor oil is used.
- Since the condition of a patient with bronchitis can worsen in dry air, measures must be taken to increase the humidity of the air in the room. To do this, you can use indoor air humidifiers, or constantly hang wet towels or sheets in the patient's room. This is important in cold climates, when the interior is heated in the fall and winter and the air in them is very dry.
- In cold climates, it is also substantial to pay attention to body temperature and clothing. With bronchitis, a violation of the body's thermoregulation can be observed and, as a rule, sweating increases, and unusually strong sweating can occur even with a little physical effort. An individual with bronchitis must be dressed according to the weather so as not to overcool. In the case of sweating, it is necessary to take a shower and change wet clothes to dry ones.
- In order not to worsen the condition and to promote the speedy healing of inflamed bronchial pathways, smokers are strongly advised to sharply reduce the number of cigarettes, and especially do not smoke in the room where they themselves live or work.
- A cough can easily become chronic, so it should be quickly and effectively cured. Analysis of the study shows that herbal remedies help very well remove stuck mucus when coughing. For analysis, 34 studies were conducted in which 7,083 patients participated. Scientists used only studies related to cough medicine. Results show that compared to placebo, herbal preparations significantly reduce the frequency and severity of cough symptoms. Particularly effective were cough suppressants containing Pelargonium root extract. Therefore, researchers recommend that they take appropriate medications for the first symptoms of a sore throat.
During the recovery period, when you feel well and close to normal temperature, but still have a cough and sleep is still often disturbed, it is recommended that you do not try to stay in bed for a long time, but rather take short walks in the fresh air, in the warm season - through the forest or park or near the sea. This will help cough up sputum and improve the general condition and ultimately help to more quickly normalize the patient’s sleep and restore their strength.
The disease is regarded as chronic if cough with mucus production is present at least 3 months a year for two years or more. Chronic bronchitis is the most common chronic condition of the respiratory tract.
The main causes of chronic bronchitis are:
- Prolonged irritation of the bronchi by harmful factors (dust, various chemicals), tobacco smoking;
- Recurrent respiratory tract infections;
- Prolonged exposure to dry and cold air;
- Less commonly, chronic bronchitis is caused by some genetic abnormalities.
Chronic bronchitis can be secondary to inflammatory diseases of the lungs and upper respiratory tract.
It is treated mainly with the elimination of the factors that cause bronchi inflammation. Besides, herbal medications for the easier mucus outflow are used. Anti-inflammatory and bronchodilating medications can be also used, for instance, corticosteroids.