BRONCHITIS

The disease comes in two forms: 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 may be responsible for the hacking cough and phlegm production that sometime accompany an upper respiratory infection. In most cases, the infection is viral in origin, but sometimes it’s caused by bacteria. If you are otherwise in good health, the mucus membrane should return to normal after you’ve recovered from the initial lung infection, which usually lasts for several days.
• Chronic bronchitis is a serious long-term disorder that often requires regular medical treatment. If you are a smoker and come down with acute bronchitis, it will be much harder for you to recover. Every cigarette damages the tiny hair-like structures in your lungs, called cilia, that are responsible for brushing out debris, irritants, and excess mucus.

For either acute bronchitis or chronic bronchitis, signs and symptoms may include:

• Cough
• Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color — rarely, it may be streaked with blood
• Fatigue
• Shortness of breath
• Slight fever and chills
• Chest discomfort

If a fever is present (temperature above 100.4 degrees Fahrenheit), and there are signs that your general well being is affected, such as loss of appetite, shortness of breath, and generalized achiness, see your doctor right away. Pneumonia may be the cause of your symptoms. Pneumonia usually requires the use of antibiotics.

DIAGNOSIS

During the first few days of illness, it can be difficult to distinguish the signs and symptoms of bronchitis from those of a common cold. During the physical exam, your doctor will use a stethoscope to listen closely to your lungs as you breathe.

In some cases, your doctor may suggest:

• Chest X-ray. A chest X-ray can help determine if you have pneumonia or another condition that may explain your cough. This is especially important if you ever were or currently are a smoker.
• Sputum tests. Sputum is the mucus that you cough up from your lungs. It can be tested to see if you have whooping cough (pertussis) or other illnesses that could be helped by antibiotics. Sputum can also be tested for signs of allergies.
• Pulmonary function test. During a pulmonary function test, you blow into a device called a spirometer, which measures how much air your lungs can hold and how quickly you can get air out of your lungs. This test checks for signs of asthma or emphysema.

RECOMMENDED MEDICATIONS

Conventional treatment for acute bronchitis may consist of simple measures such as getting plenty of rest, drinking lots of fluids, avoiding smoke and fumes, and possibly getting a prescription for an inhaled bronchodilator and/or cough syrup. In some cases of chronic bronchitis, oral steroids to reduce inflammation and/or supplemental oxygen may be necessary.

Most cases of acute bronchitis resolve without medical treatment in two weeks.

Medications

In some circumstances, your doctor may prescribe medications, including:

• Antibiotics. Bronchitis usually results from a viral infection, so antibiotics aren’t effective. However, your doctor might prescribe an antibiotic if he or she suspects that you have a bacterial infection.
• Cough medicine. It’s best not to suppress a cough that brings up mucus, because coughing helps remove irritants from your lungs and air passages. If your cough keeps you from sleeping, you might try cough suppressants at bedtime.
• Other medications. If you have allergies, asthma or chronic obstructive pulmonary disease (COPD), your doctor may recommend an inhaler and other medications to reduce inflammation and open narrowed passages in your lungs.

Therapies

If you have chronic bronchitis, you may benefit from pulmonary rehabilitation — a breathing exercise program in which a respiratory therapist teaches you how to breathe more easily and increase your ability to exercise.