What is bronchitis?

Bronchitis is an infection in the lungs that causes the lungs to become inflamed. Some people call it a chest cold. It can be a miserable, but minor, acute illness that follows the common cold - or a more serious chronic condition called chronic obstructive pulmonary disease (COPD). A cough, phlegm and feeling tired are typical symptoms of bronchitis. These are also symptoms of other illnesses, so getting the right diagnosis is important.

Bronchitis: Inside your lungs

When the bronchial tubes that carry air deep into your lungs become inflamed, the inner lining swells and becomes thicker, narrowing the breathing passages. These irritated membranes also secrete extra mucus, which coats and sometimes clogs the small airways. Coughing spells are the body's way of trying to clear out these secretions for easier breathing.

Symptoms of bronchitis

The main symptom of bronchitis is a frequent cough that produces mucus. Other symptoms that may occur are:

• Mild fever
• Fatigue
• Wheezing sounds when breathing
• Tightness or dull pain in the chest
• Shortness of breath

Acute bronchitis: How long does it last?

Acute bronchitis often develops three to four days after a cold or the flu. It may start with a dry cough, then after a few days the coughing spells may bring up mucus. Most people get over acute bronchitis in two to three weeks, although the cough can sometimes hang on for four weeks or more. If you're in otherwise good health, your lungs will return to normal after you've recovered from the initial infection.

Repeated bouts: Chronic bronchitis

Doctors suspect this illness when you have a cough with phlegm on most days for at least three months in a year, for two years in a row. Chronic bronchitis is a serious condition that makes your lungs a breeding ground for bacterial infections and may require ongoing medical treatment. It's one form of chronic obstructive pulmonary disease (COPD), a lung disease that makes it hard to breathe. The smoker's cough is a sign of bronchitis and COPD.

Bronchitis or something else?

The symptoms of bronchitis are often similar to those of other conditions, such as asthma, pneumonia, allergies, the common cold, flu, sinusitis and even gastrooesophageal reflux disease (GORD) and lung cancer. Seek medical advice to get an accurate diagnosis. Serious illnesses like pneumonia require prompt treatment.

When to seek medical help

Seek medical advice if you:

• Feel short of breath or wheeze
• Cough up blood
• Have a persisting fever greater than 38C (101F)
• Have a cough lasting more than four weeks

Causes of acute bronchitis

This form of bronchitis is more common in winter and most cases are caused by a viral or bacterial infection. Irritants - like tobacco smoke, smog, chemicals in household cleaners - even fumes or dust in the environment - can also cause acute bronchitis.

Causes of chronic bronchitis

Smoking is by far the most common cause of chronic bronchitis. Exposure at work to dust and toxic materials is a much less common cause. Air pollution can make symptoms worse for people with chronic bronchitis.

Smokers and bronchitis

A smoker who gets acute bronchitis will have a much harder time recovering. Even one puff on a cigarette can cause temporary damage to the tiny hair-like structures (cilia) in the airways that brush out debris, irritants and excess mucus. Further smoking continues the damage and increases the chances of chronic bronchitis, which can lead to increased risk of lung infection and permanent lung damage. The bottom line: it's time to quit.

How is acute bronchitis diagnosed?

Doctors usually diagnose acute bronchitis by reviewing how your symptoms have developed over time and through a physical examination. Using a stethoscope, your doctor will listen for any abnormal sounds produced within your lungs when you breathe.

How is chronic bronchitis diagnosed?

Your doctor may recommend lung function testing. This can be done at your doctor's surgery or at a hospital clinic after doing a medical history and physical examination. Lung function tests like spirometry measure how well the lungs are working. A chest X-ray may also be done.

Treatment: Acute bronchitis

The only treatment generally needed for acute bronchitis is symptom relief: Drink lots of fluids, get plenty of rest and avoid smoke and fumes. A non-prescription pain killer such as paracetamol or ibuprofen may help with body aches. An expectorant may help to loosen mucus so it can be more easily coughed up. Your doctor may recommend an inhaled bronchodilator medicine to open your airways and help you breathe more easily.

Treatment: Chronic bronchitis

If you have chronic bronchitis related to smoking, the most important thing to do is to stop smoking to prevent further damage to your lungs. Unless your doctor advises against it, get a pneumococcal vaccination and an annual flu vaccination. Treatment may include bronchodilators and steroids (inhaled or by mouth).

Chronic bronchitis and COPD

Chronic bronchitis and emphysema are the two main forms of chronic obstructive pulmonary disease (COPD). Doctors may prescribe bronchodilators, which are medications that help open constricted airways. Oxygen therapy helps some people breathe better. Pulmonary rehabilitation can improve your quality of life. Quitting smoking is a must to stop further lung damage.

How to avoid bronchitis

It's no surprise that the best way to decrease your risk is not to smoke and not to allow others to smoke in your home. Other ways include: avoiding colds and staying away from things that irritate your nose, throat and lungs, such as dust or pets. Also, if you catch a cold, get plenty of rest and take any medicine as directed.

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