Bronchitis - Acute and Chronic

Bronchitis is a respiratory disease characterized by an inflammation of the lining of your bronchial tubes. These tubes are large and delicate  that carry air in the tiny branches and smaller cells of the lungs after this air has passed through the mouth, nasal passages, and trachea and then back out from the lungs. Breathing is more difficult  when the bronchi become swollen due to irritants or infections. Bronchitis sufferers also tend to have much more mucus and phlegm. People with asthma may also have asthmatic bronchitis, inflammation of the lining of the bronchial tubes.

The two main types of bronchitis are Acute (lasting from one to three weeks) and Chronic (lasting at least 3 months of the year for two years in a row).
    
                                                                           




ACUTE BRONCHITIS

Acute bronchitis is a type of bronchitis that is short-lived, usually lasts about two weeks. However, coughing may still be experienced for a few weeks even if the infection is gone. Most people recover with no permanent damage to the bronchial tree. Lung irritants or infections may cause acute bronchitis. Infections can be viral or bacterial in origin, but viral origin account in most cases. Influenza, Respiratory Syncytial Virus (RSV), and Rhinoviruses are among the viruses that causes acute bronchitis, while Mycoplasma and Pneumococcus bacterial agents also causes to develop acute bronchitis.

Cause

• Acute bronchitis is generally caused by infections or lung irritants. In most cases, it is viral in origin while others are from bacterial infection. A short-term, high-level exposure to chemical irritants or substances like inhaling or exposing to cigarette smoke (including secondhand smoke), dust, inhaling solvents, or industrial air pollution may lead to acute bronchitis.

CHRONIC BRONCHITIS

Chronic bronchitis is an ongoing, serious long-term condition characterized by an inflammation of the lining of the bronchial tube secondary to constant irritation. This condition often requires regular medical attention. A productive cough  that produces a slimy mucus is usually present for 3 months during two consecutive years. Chronic bronchitis is one of the conditions included in chronic obstructive pulmonary disease (COPD) that the majority of people diagnosed with the disease is 45 years of age or older. Patients with chronic bronchitis are often called "blue bloaters".

Cause

• The most common cause of chronic bronchitis is heavy, long-term cigarette smoking.

SIGN and SYMPTOMS of Acute Bronchitis or Chronic Bronchitis

• Persistent cough which may last up to 20 days. A cough may produce a clear, slimy mucus (sputum). A green or yellowish mucus may indicate bacterial infection. In most cases, the infection is viral in origin. Coughing lingers for several weeks after the inflammation of bronchial tube resolves
• Wheezing is a high-pitched whistling sound made while you breath. The sound is most obvious when you breath out (exhale)
• Slight fever may include sore throat, stuffy or runny nose, vomiting, and headaches
• Chills and malaise
• Chest discomfort
• Shortness of breath (Dyspnea) especially with physical exertion.

RISK FACTORS

• Acute bronchitis are at higher risk for older adults, infants, and young children may be because of low resistance
• Cigarette smoking, second-hand cigarette smoke, and having an existing lung disease greatly increases the risk for bronchitis.
• Repeated exposure or contact with dust, chemical fumes, and vapors from certain  occupations
• Air pollution, infections, and allergies can worsen the symptoms of chronic bronchitis
• History and repeated bouts of acute bronchitis
• Women are more than twice as likely as men to be diagnosed with chronic bronchitis.
• It occurs more often in people who are older than 45 although anyone can have the disease. Also, many adults who develop chronic bronchitis are smokers.

DIAGNOSIS

Medical History

• Presence of symptom - How long been coughing, presence of mucus, breathing problems, chest discomfort, sleeping or work problem, wheezing sound, and fever
• Smoking - Daily consumption  and period of time been smoking
• Ask for another medical condition
• Type of job that constantly irritate the lungs
• Drugs and supplements currently using
• Records of vaccination against pneumonia or annual flu shot

Physical Examination

• A stethoscope is used to hear wheezes, and a prolonged exhalation which are signs of airflow obstruction

Test

• Pulmonary function test - A spirometer is used to measure the amount of air inspired and expired by the lungs
• Blood test (CBC)
• Chest X-ray help rule out other lung problems (pneumonia and bronchial obstructions).
• CT scans of the chest
• Measurement of arterial blood gas
• Sputum Culture

MANAGEMENT

Early diagnosis and treatment, combined with avoidable risk factors such as quit smoking and avoiding secondhand smoke, provide a favorable prognosis. The main goals of treatment are to relieve symptoms and make breathing easier.

Get enough rest, drink plenty of fluids, and aspirin or acetaminophen for fever if you have acute bronchitis. The antibiotic may not work if you have a viral infection. 

Bronchodilator

• This medicine relaxes the smooth muscles that encircle the bronchi, which allows the inner airways to expand making it easier to breathe. It is usually inhaled using an inhaler, but is also available in pill form.

Theophylline

• This medicine relaxes and open the airways to help you breathe better
• Indicated for shortness of breath, wheezing and chest discomfort for patients with chronic bronchitis and for other COPD. They are available in tablet, capsule, solution or in syrup.

Steroids Medication

• Works to reduce the inflammation which in turn decreases the bronchial swelling and secretions, making improve air flow. You can take steroids either with an inhaler or in pill form.

Antibiotics

• As a whole, antibiotics cannot help chronic bronchitis while others prescribed antibiotics during acute exacerbation of chronic bronchitis. May be prescribed if it is from a bacterial infection, but not from a viral origin.

Supplemental Oxygen Therapy

• This will help to get more oxygen supply needed to breathe better. Usually prescribed for severe chronic bronchitis and if the medicine doesn't show improvements. A small finger oximeter for monitoring blood oxygen levels at rest and with activity is helpful.

Exercise

• A regular strengthening exercise help improve strength and general body endurance. Begin with light exercise and slowly progress over time. An exercise frequency of at least 3 times a week is usually recommended. Start with slow walking  and progress the duration and speed later. Consult your doctor or a physical therapist for the appropriate exercise program.

Breathing Techniques

1. Pursed-lip breathing

• This technique will also help to feel better from shortness of breathing. This is done by taking a deep breath (inhale) and then breath out slowly (exhale) through the mouth with pucker lips. Stay relaxed and exhale normally. No holding of breath.

2. Diaphragmatic breathing

• This technique uses the primary muscle of respiration, the diaphragm. To do this, lie down on your back with both knees flexed and supported. Place the hands on the abdomen and notice the marked expansion of the abdomen rather than the chest when breathing.

Over-the-counter (OTC) cough suppressants

• Drugs like Dextromethorphan  and Guaifenesin may be helpful in reducing cough symptoms.

Alternative Remedies

• It is advisable to consult a health care professional before using any of these products.

Medical Complications

• Dyspnea is a medical term to describe shortness of breath
• Respiratory failure will happen if there is not enough oxygen that passes from the lungs into the blood
• Pneumonia is an infection that causes inflammation of the air sacs in one or both lungs.
• Cor pulmonale is an abnormal enlargement and weakness of right heart ventricle due to lung disease
• Pneumothorax is an abnormal collection of air or gas in the pleural cavity of the lung causing lung collapse
• Polycythemia is an abnormally increased concentration of red blood cells needed to carry oxygen),
• COPD (Chronic Obstructive Pulmonary Disease) is a lung disease characterized by chronic obstruction of lung airflow that affect normal breathing and is not fully reversible. These diseases include the emphysema and the chronic bronchitis. Tobacco smoking is the most common cause of COPD.
• High mortality rate 

Preventive Measures:

• Do not smoke and avoid second-hand smoke
• Vaccination - Flu shot every year and pneumococcal vaccination every 5 or 6 years
• Wear an appropriate mask to high-risk areas to limit exposure to chemical fumes, dust, second-hand smoke, and pollution
• Wash your hands to limit viral and bacterial infections
• Maintain a physically active lifestyle and eat a balance diet