Acute bronchitis is form of bronchitis, usually due to viral infection, that develops suddenly but often clears up within a few days. Bacterial infection of the airways may be a complication. Smokers, babies, the elderly, and people with lung disease are particularly susceptible.
Symptoms include wheezing, shortness of breath, and a cough producing yellow or green sputum. There may also be pain behind the sternum (breastbone) and fever. Symptoms may be relieved by drinking plenty of fluids and inhaling steam or using a humidifier. Most cases clear up without further treatment, but acute bronchitis may be serious in people who already have lung damage.
Bronchitis is an infection of the main airways of the lungs (bronchi), which causes them to become irritated and inflamed. The main symptom is a cough which may bring up yellow-grey mucus. Bronchitis may also cause a sore throat, wheezing and a blocked nose.
The symptoms of bronchitis.
The main symptom of bronchitis is a hacking cough. It is likely that your cough will bring up thick yellow-grey mucus, although this does not always happen.
- a tight feeling in your chest
- sore throat
- slight fever and chills
- blocked nose and sinuses
- aches and pains
Although unpleasant, these symptoms are usually not severe and you may not need to see your family doctor or GP. However, the symptoms of bronchitis can be similar to those of pneumonia (an infection that causes inflammation in your lungs), so it is important to look out for any changes in your symptoms.
When to see your GP or family doctor
Most cases of bronchitis can be treated easily at home. You only need to see your GP if your symptoms are severe or unusual for example,
- if: your cough is severe or lasts longer than three weeks
- you have a constant fever for more than three days
- you cough up mucus streaked with blood
- you have an underlying heart or lung condition, such as asthma or heart failure
In most cases bronchitis will clear up by itself within a few weeks without the need for treatment. This type of bronchitis is known as acute bronchitis. While you are waiting for it to pass, you should drink lots of fluid and get plenty of rest. In some cases the symptoms of bronchitis can last much longer. If symptoms last for at least three months, this is known as chronic bronchitis. There is no cure for chronic bronchitis but there are several medications to help relieve symptoms. It is also important to avoid smoking and smoky environments, as this can make your symptoms worse.
Most cases of bronchitis do not require treatment from a GP and the symptoms can be easily managed at home.There is no cure for chronic bronchitis but healthy living will help. In particular, you should stop smoking if you smoke.
Managing symptoms at home
If you have bronchitis:
- Get plenty of rest.
- Drink lots of fluids. This helps prevent dehydration and thins the mucus in your lungs, making it easier to cough up.
- Treat headaches, fever, and aches and pains with paracetamol or ibuprofen (ibuprofen is not recommended if you have asthma).
- There is little evidence that cough medicines work (read more about treating coughs) and the Medicines and Healthcare products Regulatory Agency (MHRA) has recommended that over-the-counter (OTC) cough medicines should not be given to children under the age of six.
- As an alternative to an OTC cough medicine, try making your own mixture of honey and lemon, which can help soothe a sore throat and ease your cough.
- Stop smoking
Although treatment from a GP is rarely necessary, there may be times when you should see your GP or family doctor.Doctors do not routinely prescribe antibiotic treatment as bronchitis is nearly always caused by a virus. Antibiotics have no effect on viruses, and prescribing them when they are unnecessary can, over time, make bacteria more resistant to antibiotic treatment. Your GP will only prescribe antibiotics if you have an increased risk of developing complications, such as pneumonia. Antibiotics may be recommended for:
- premature babies
- elderly people over the age of 80
- people with a history of lung, heart, kidney or liver disease
- people with a weakened immune system, which could be the result of an underlying condition or a side effect of a treatment such as steroid medication
- people with cystic fibrosis
If you are prescribed antibiotics for bronchitis, it is likely to be a five-day course of amoxicillin, oxytetracycline or doxycycline. Possible side effects of these medicines include nausea, vomiting and diarrhoea, but they are uncommon.
Why do I have bronchitis?
The bronchi are the main airways in your lungs, which branch off on either side of your windpipe (trachea). They lead to smaller and smaller airways inside your lungs, known as bronchioles. The walls of the bronchi produce mucus to trap dust and other particles that could otherwise cause irritation. Most cases of acute bronchitis develop when an infection causes the bronchi to become irritated and inflamed, which causes them to produce more mucus than usual. Your body tries to shift this extra mucus through coughing. Smoking is the most common cause of chronic bronchitis. Over time, tobacco smoke can cause permanent damage to the bronchi, causing them to become inflamed.
Causes of bronchitis
The bronchitis infection can be caused by either a virus or bacteria, although viral bronchitis is much more common.
In most cases, bronchitis is caused by the same viruses that cause the common cold or influenza (flu). The virus is contained in the millions of tiny droplets that come out of the nose and mouth when someone coughs or sneezes. These droplets typically spread about 1m (3ft). They hang suspended in the air for a while, then land on surfaces where the virus can survive for up to 24 hours. Anyone who touches these surfaces can spread the virus further by touching something else. Everyday items at home and in public places, such as door handles and keyboards, may have traces of the virus on them. People usually become infected by picking up the virus on their hands from contaminated objects and then placing their hands near their mouth or nose. It is also possible to breathe in the virus if it is suspended in airborne droplets.
Breathing in irritant substances
Bronchitis can also be triggered by breathing in irritant substances, such as smog, chemicals in household products or tobacco smoke. Smoking is the main cause of chronic (long-term) bronchitis, and it can affect people who inhale second-hand smoke as well as smokers themselves. You may also be at risk of bronchitis if you are often exposed to materials that can damage your lungs, such as grain dust, textiles (fabric fibres), ammonia, strong acids or chlorine. This is sometimes referred to as occupational bronchitis, and usually eases once you are no longer exposed to the irritant substance.
Pneumonia is the most common complication of bronchitis. It happens when the infection spreads further into the lungs, causing air sacs inside the lungs to fill up with fluid. One in 20 cases of bronchitis leads to pneumonia. People more vulnerable to the effects of infection, such as the very young or people with a pre-existing health condition, may need to be admitted to hospital as a precaution if they develop pneumonia.
Around one person in 20 with bronchitis goes on to develop a secondary infection inside one or both of their lungs. Specifically, the infection takes hold in tiny air sacs known as alveoli. This type of infection is called pneumonia. People at an increased risk of developing pneumonia include:
- elderly people
- people who smoke
- people with other health conditions such as heart, liver or kidney disease
- people with a weakened immune system
Symptoms of pneumonia include:
- difficulty breathing – your breathing may be rapid and shallow and you may feel breathless, even when you are resting
- rapid heartbeat
- feeling generally unwell
- sweating and shivering
- loss of appetite
- pain in your chest
Mild pneumonia can usually be treated with antibiotics at home. More severe cases may require admission to hospital where, if necessary, a breathing machine (ventilator) can assist you with your breathing and antibiotics can be given directly into one of your blood vessels through a drip.
Who is affected by acute bronchitis?
Acute bronchitis is one of the most common types of lung infection and one of the top five reasons for GP visits. Acute bronchitis can affect people of all ages but it is most common in younger children under the age of five. It is more common in winter and often develops following a cold, sore throat or flu. It is estimated that there are around 2 million people in the UK affected by chronic bronchitis. Most of these are adults over the age of 50.