Bronchitis
What is "bronchitis"?
Bronchitis is an inflammation of the bronchi. We talk about appendicitis as being an inflammation of the appendix, tonsillitis of the tonsils; well, when you inflame the bronchi, you have bronchitis. Bronchitis can be generated by viruses, by bacteria, by fungi, inhaled noxious compounds, air pollution can do it--anything that will inflame and cause the bronchi to swell and show inflammatory process is bronchitis.
What is the difference between acute and chronic bronchitis?
Chronic bronchitis is where the bronchi become inflamed over a long period of time. Some books will say two consecutive months out of two consecutive years. Probably, three consecutive months out of two consecutive years is the best definition of chronic bronchitis but that has to be a chronic cough that's productive, productive of phlegm or mucous which appear to be, for the most part infected. In other words very pussy or nasty-looking stuff. Acute bronchitis is where it comes on suddenly. Usually it will go away within a week or so and there are no residuals left over as a result of having that inflammation. Chronic bronchitis, it goes on and on and on.
What are the symptoms of bronchitis?
The most common symptoms of bronchitis include; cough, there can be fever, chest pain, shortness of breath. Many times patients will be severely debilitated by their acute and chronic bronchitis to the degree that they just can't breath and they'll present themselves to an emergency room.
What are the primary causes of bronchitis?
The primary cause of bronchitis is smoking. I'll do everything I can to attack the habit of smoking. Of course, viruses are in there, too, and bacteria and fungi, noxious compounds. But when you realize that there are people who will take a pack of cigarettes, 20 cigarettes--8 puffs per cigarette, 20 times a day--and blow down into their lungs some very, very noxious material, you can understand how the airways will become inflamed after a while, and especially after years and years of this. So probably the leading issue with us pulmonologists and bronchitis is, of course, smoking. But then there are the things that we can't control, such as viruses, which cause a significant problem.
How is bronchitis diagnosed?
Chronic bronchitis is diagnosed as a temporal thing, in other words, three consecutive months out of two consecutive years you're coughing up material. Acute bronchitis is diagnosed mainly by the history and physical findings listening to the lungs, hearing wheezing, etcetera. It is different from pneumonia, which we can talk about at another point. But chronic bronchitis is usually the patient saying they have a sudden onset of cough that produces phlegm; nasty looking, pussy looking maybe yellow or green material. Sometimes they cough so hard that they may have a little bit of blood mixed into their phlegm that they cough up.
How is bronchitis usually treated?
Bronchitis again, if it's a virus, the treatment is to just apply systematic relief with decongestants, cough suppressants. Things that will liquefy the material that's being manufactured down in the lung, so that it's easy to bring it up. The cough suppressants many times are actually compounds that will liquefy mucus and help you bring it up. But if it is obviously bacterial, such as there is lots of pus, lots of fever then, antibiotics.
What are the risks of acute bronchitis?
The risks of acute bronchitis also include extending down into the actual meat of the lung and developing pneumonia. But if acute bronchitis occurs over and over and over again, it can become then chronic bronchitis. At that point, the lung starts to remodel itself in ways that are detrimental, ultimately, to the way air flows in and out of the lung. So the long-term attacks, frequent attacks over and over again that turn into chronic bronchitis, allow for significant problems, as it relates to the lungs.
Should I take antibiotics for bronchitis?
You should take antibiotics for bronchitis under your physician's instruction. However, there are many patients of mine that have long-term lung problems, orchronic obstructive pulmonary disease, and I teasingly tell them that the next time they get an attack of acute bronchitis, it's going to be 1 o'clock at night on a Friday night. It's impossible for them to find their physician, so I will not uncommonly tell the patients that I see frequently who I understand and they understand their own lung that I'll give them a prescription, undated, for antibiotics that are broad spectrum and that we know have worked before for them so that they can get on that attack of bronchitis right away. We tell patients commonly that if their mucus or their sputum changes in color, consistency or amount, in other words, it was white and it becomes yellow, or it was yellow and it becomes white, or they used to have a lot of it and now they have a little of it, or if its consistency used to be very thin and now it's thick, that they need to get treatment right away. But these are the patients who have had long-standing chronic obstructive pulmonary disease and we understand them well. The answer to your question is should I get treatment for my bronchitis, usually not, most commonly virus. But, many times, we know that these people will develop frequent bacterial complications, and so, yes, we would treat it.
What is the difference between bronchitis and pneumonia?
The difference between bronchitis and pneumonia is one of position within the lung where the inflammatory process has now moved past the bronchi, down into the meat of the lung and has now infected the lung substance itself, not the conducting tubules. In that case then, you have pneumonia and these are for the most part, on the average, a little more difficult and a little more dangerous than is bronchitis.
