Bronchitis

What is bronchitis?

• Bronchitis is a condition where there is swelling and irritation in your air passages (called the bronchi). You may have:
• Acute Bronchitis: When the bronchitis is at its' worst, and is happening now or
• Chronic Bronchitis: When the bronchitis has been occurring for a long time.
• People with acute bronchitis usually have a cough with sputum (secretions or phlegm), and sometimes have pain when they take a deep breath.
• You may develop acute bronchitis from:
  • Smoking cigarettes
  • Environmental irritants, such as pollution, chemicals and hair spray
  • If you are elderly, or have an altered immune system from chemotherapy, long-term steroid use, or have chronic diseases
• Acute bronchitis may be from bacteria, but is more commonly due to a virus. Even though you may have greenish-or yellowish sputum, bronchitis is usually an inflammation of your air passages, and there may be no bacteria present.
• You may be treated with antibiotics if there are bacteria present in a sputum sample, or if your healthcare provider is concerned that bacteria has caused an infection.
• If your bronchitis is due to a virus, your symptoms may take 2 or more weeks to resolve, but antibiotics won't help. Treatment of a virus includes cough medications, drinking lots of fluids, and avoiding irritants.
• Chronic bronchitis may have been caused by long-term exposure to smoking cigarettes, air pollution, or other irritants. People with chronic bronchitis have trouble breathing because thick mucus may clog their air passages. They will also have inflammation in their air passages, with similar symptoms.
• Chronic bronchitis is diagnosed based on symptoms of a productive cough, on most mornings, for 3 or more months, for 2 years in a row.
• Because this is a long-term disease, those with chronic bronchitis may go through periods when they feel well, and then go through periods when they feel ill.
• Severe outbreaks of cough, shortness of breath and congestion (called exacerbations), may last for 3 months at a time, and occur a few times a year. As the disease progresses, the periods when you will be less short of breath will lessen.

Symptoms:

• You may notice that you are wheezing, or have shortness of breath with both types of bronchitis.
• You may have fever, chills, or a headache if you have an acute bronchitis.
• You may have pain in your muscles, or pain in your lungs when you take a deep breath with both types of bronchitis, especially if you are coughing really hard, for long periods of time.
• You may be overly tired, or very weak (fatigued). It may be hard for you to do any kind of your normal activities with both types of bronchitis.
• You may have sudden onset of coughing spells, or a long-term (chronic) cough. You may or may not be able to bring up any secretions (sputum), or you may bring up greenish-yellow sputum. People with chronic bronchitis tend to bring up a lot of sputum early on in the morning.
• You may experience shortness of breath, either at rest or while performing any type of activity. This may include walking to the door, or climbing stairs.
• You may have trouble lying flat in bed, and you may have to sleep on 2 or more pillows. Your shortness of breath may cause you to wake up in the middle of the night.

Things You Can Do:

• Make sure you tell your doctor, as well as all healthcare providers, about any other medications you are taking (including over-the-counter, vitamins, or herbal remedies).
• Remind your doctor or healthcare provider if you have a history of diabetes, liver, kidney, or heart disease. If you have a family history of heart disease, stroke, high blood cholesterol, or high blood pressure, in a first or second-degree relative, you may be at risk for certain problems. Notify your healthcare provider if you have any of these diseases in your family.
• If you are still smoking, you should quit. If you do not smoke, avoid smoke-filled rooms. Smoking first or second-hand can further damage lung tissue. Discuss with your healthcare provider techniques that can help you quit.
• Avoid people who are sick. Wash your hands often, with soap and water, for at least 15 seconds at a time. Use tissues when you sneeze or cough.
• Do not share eating or drinking utensils with anyone.
• If you are over the age of 65 years, or have an altered immune system due to chemotherapy, chronic disease or steroid use, the Centers for Disease Control (CDC) recommends that you receive a flu vaccine every year, and a pneumonia vaccine every 5 years. Discuss this with your healthcare provider if this is right for you.
• People with lung problems need to circulate air from the bottom of their lungs and out of your lungs (oxygenation), to prevent infection and pneumonia. Using an incentive spirometer for 15 minutes a day, twice a day, can help promote oxygenation.
• Controlling secretions through coughing and deep breathing will help you to breathe easier. Remember, if you are dehydrated, your secretions will be thicker, and harder to bring up. Make sure to drink 2 to 3 liters of fluids (non-alcoholic, non-caffeinated) per day, to remain well hydrated.
• Taking warm showers or baths, and using a vaporizer, may help to thin out your secretions.
• Try to exercise, as tolerated, to promote air exchange (oxygenation), and to maintain your optimal level of functioning. Walking, swimming, or light aerobic activity may also help you to lose weight, and feel better. Make sure to exercise, under the supervision of your healthcare provider, and discuss with your healthcare provider how you can create a specific exercise program to suit your needs.
• Try to avoid "environmental allergens" (such as smoke, pollution, and common causes of seasonal allergies), as well as things that may cause allergies in your home (hair sprays, mold, dust mites, and pets). These may trigger an episode of shortness of breath, and make your symptoms worse.
• Keep a diary of your any abnormal symptoms, such as excessive fatigue, shortness of breath or chest pain, if these are occurring regularly. Write down the foods that you have eaten, the exercise or activity you were undergoing when the symptoms occurred, and how you felt before they occurred. This diary may be valuable in identifying certain "triggers" of your symptoms.
• Questions to ask yourself, may include:
  • Did my symptoms occur gradually, or did this episode come on all of a sudden? Was I feeling anxious? Did I perform any kind of activity, or was I resting?
  • Did I eat any different kinds of foods? Was I around any pets? Did I travel recently? Did I do anything differently than I normally do?
• With severe breathing problems, sleeping at night with your head of the bed elevated may make it easier to breathe. You may do this by sleeping on 2 or 3 extra pillows. This will help lung expansion (spreading out), as well as promote the drainage of secretions.
• Use relaxation techniques to decrease the amount of anxiety you have. If you feel anxious, place yourself in a quiet environment, and close your eyes. Take slow, steady, deep breaths, and try to concentrate on things that have relaxed you in the past.
• You should restrict the amount of alcohol you take in, or avoid it all together. Alcohol may adversely interact with many medications.
• If you are ordered a medication to treat this disorder, do not stop taking any medication unless your healthcare provider tells you to. Take the medication exactly as directed. Do not share your pills with anyone.
• If you miss a dose of your medication, discuss with your healthcare provider what you should do.
• If you experience symptoms or side effects, especially if severe, be sure to discuss them with your health care team. They can prescribe medications and/or offer other suggestions that are effective in managing such problems.
• Keep all your appointments for your treatments.

Medications for Treatment of Bronchitis:

• Depending on your lung function, and your overall health status, your doctor may recommend that certain drugs be used to help your lungs function more effectively, and decrease symptoms. Some of the common drugs that are used to treat lung problems may include:
  • Antibiotics - If your doctor or healthcare provider suspects that you have a lung infection, he or she may order antibiotic pills or intravenous (IV). Commonly prescribed antibiotics for lung infections include azithromycin (Zithromax^®), and levofloxacin (Levaquin^®). If you are prescribed antibiotics, take the full prescription. Do not stop taking pills once you feel better
  • Anticholinergic agents - these drugs are given to persons with chronic bronchitis, emphysema, and chronic obstructive lung disease (COLD). Anticholinergic agents work in a complex manner by relaxing the lung muscles, which will help you to breathe easier. A commonly prescribed drug is ipatropium bromide (Atrovent^®).
  • Bronchodilators - These drugs work by opening (or dilating) the lung passages, and offering relief of symptoms, including shortness of breath. These drugs, typically given by inhalation (aerosol), but are also available in pill form.
  • Beta-adrenergic receptor agonists (Beta-agonists) - Beta-agonists can be considered bronchodilators, as these drugs relax airway smooth muscle, and block the release of substances that cause bronchoconstriction, or narrowing of your lungs, if you are having a lung "spasm." Drugs such as albuterol (Proventil^®), or terbutaline (Brethine^®), are commonly used.
  • Corticosteroids: Steroids work by decreasing inflammation and swelling, which may be present with certain lung disorders. People may benefit from steroids, either inhaled, by pill form, or in the vein (IV).
  • Beclomethasone (Beclovent^®), an inhaled steroid, is useful in the treatment of chronic asthma and bronchitis. Inhaled steroids act directly on the lung tissue, so there are fewer long-term side effects, compared with a pill or IV form.
  • People who have an outbreak of severe shortness of breath and airway inflammation may be ordered a steroid pill, such as prednisone, for a short period of time. This is usually given with inhaled steroids.
  • Patients with severe asthma or bronchitis may require IV administration of another steroid, methylprednisolone (Solumedrol^®).
  • Cough Medications/Decongestants - may help you to be more comfortable if you are coughing a lot. Guaifenesin is an active ingredient in many cough medications, may be given alone, but is often combined with other drugs, such as codeine, to help your cough. Guaifenesin may also be combined with pseudoephedrine (Sudafed^®) as a decongestant, or any one of many medications, depending on your symptoms. Another common medication you may receive is Hydrocodone Bitartrate-Homatropine Methylbromide (Hycodan^®). This is a narcotic antitussive (anti-cough medication), which will help relieve your cough.
  • Diuretics - may be known as "water pills" as they work to prevent or treat lung congestion by making you urinate out extra fluid. Some examples of this medication may include furosemide (Lasix^®), and Hydrochlorthiazide. You may receive this medication alone or in combination with other medications.
  • Narcotics - Such as Morphine Sulfate may be useful, in certain cases of shortness of breath, to relieve your body's need to breathe. Morphine is called an Opiate. Opiates tell your breathing center in your main brain stem not to breathe so hard. This might make you more comfortable. If you are taking morphine, though, make sure you discuss with your healthcare provider common side effects, such as constipation, drowsiness, nausea and vomiting, and how to control these side effects.
  • Oxygen therapy - If you are experiencing shortness of breath at rest, or on exertion, your healthcare provider may see if oxygen therapy is right for you. This will help reduce your work breathing. You may take oxygen when your symptoms are at their worst. For example, some people are only on oxygen at nighttime, and not during the day. Some take oxygen when they are performing activities, but not all the time.
• Your healthcare provider will discuss with you which treatments are helpful to you.
• Do not stop any medications abruptly, as serious side effects may occur

When to Call Your Doctor or Health Care Provider:

• Fever of 100.5° F (38° C), chills, sore throat (possible signs of infection if you are receiving chemotherapy).
• If you cough up blood
• Shortness of breath, chest pain or discomfort; swelling of your lips or throat should be evaluated immediately
• Feeling your heart beat rapidly, or experience palpitations
• Any new rashes on your skin
• Any unusual swelling in your feet and legs
• Weight gain of greater than 3 to 5 pounds in 1 week.
• If your symptoms worsen or do not improve in 3 days of therapy

Note: We strongly encourage you to talk with your health care professional about your specific medical condition and treatments. The information contained in this website is meant to be helpful and educational, but is not a substitute for medical advice.