Acute bronchitis is one of the most common infections of the upper/large airways (trachea and bronchi) in the lungs. It is usually caused by a viral infection, which damages the lining of the airways and leads. This causes a cough that persists for several days or weeks, possibly with sputum (coughed-up mucus or phlegm).

It is a self-limiting condition; this means it is temporary, and will clear up by itself without the need for medical intervention.

It is distinct from chronic bronchitis, which is a much more persistent cough caused by long-term inflammation of the bronchi.

Cause


Bronchitis is usually caused by infection by a virus, such as respiratory syncytial virus, rhinovirus or influenza. Only about 5-10% of bronchitis cases are caused by bacterial infection.

Patients who smoke or have other respiratory diseases are at greater risk of developing secondary bacterial infections during or following the viral infection.

Symptoms


The symptoms of acute bronchitis are usually cough and possibly mild fever. It may accompany or follow a cold or flu, or it can appear on its own.

Bronchitis usually begins with a dry cough, which changes after a few days to a wet or productive cough. You may experience a few days of fever, fatigue, headache, shortness of breath, wheezing and general malaise. There may be some gastrointestinal symptoms as well. The coughing can continue for up to three weeks, after the other symptoms have faded.

If there is a change in sputum colour, it can mean a secondary bacterial infection has developed. Pneumonia is likely if the cough is accompanied by high fevers and the sputum is purulent (contains pus). This can be diagnosed with a chest X-ray and treated with antibiotics.

(Mildly purulent sputum can mean the lining of the airways is damaged and tiny pieces of it are being coughed up. This does not require antibiotics.)

Diagnosis


Acute bronchitis is usually mild and does not require any medical intervention. Most doctors will consider a persistent dry or wet cough as sufficient evidence of bronchitis. A physical examination will reveal wheezing or shortness of breath. Usually no further investigations are required.

However, if you develop high fevers, strongly discoloured sputum or are short of breath, and are concerned that you have a secondary bacterial infection, you should return to your doctor to see if antibiotics are needed. You should also see a doctor if you start coughing up blood-tinged mucus.

If an alternative diagnosis, such as pneumonia, COPD (chronic obstructive pulmonary disease), asthma or acid-reflux associated cough is suspected, more tests should be performed, as these conditions require special treatment. These tests might include a chest X-ray or analysis of sputum or blood samples.

If the cough lasts more than a month, your doctor may refer you to an otorhinolaryngologist (ear, nose and throat doctor).

Treatment


Patients are advised to be patient and wait for bronchitis to resolve itself, which it will do after a few weeks. Some relief can be gained from symptomatic treatment with paracetamol and anti-inflammatories. Cough mixtures can help to suppress the coughing if it is disturbing your sleep. Smoking will make bronchitis worse; smokers are advised to quit, to help the bronchi heal faster.

Antibiotics will have no effect on acute bronchitis, and should not be prescribed unless microscopic examination of the sputum shows that there is also a bacterial infection. Treating non-bacterial illnesses with antibiotics encourages the development of antibiotic-resistant bacteria.

Unfortunately, antibiotics are widely overprescribed by doctors. Although not advised, this practice is probably due to pressure from the patient for medication, as well as fear on the doctor’s side that he or she may be overlooking a bacterial infection.

If you are asthmatic or have COPD you might need to increase your medication during an attack of acute bronchitis.

Supplements and immune boosts



    • Zinc is essential for your immune system. If you are not getting enough dietary zinc, consider taking a zinc supplement, which can not only help boost immunity in zinc deficient individuals, but is good for boosting a number of other health functions.

    • Vitamin A helps form and maintain healthy skin, teeth, skeletal and soft tissue, mucus membranes, and skin.