Common Conditions

Bronchitis

What is Bronchitis?

Bronchitis is an inflammation of the air passages that extend from windpipe into the lungs. This may be caused by a virus, bacteria, smoking or the inhalation of chemical pollutants or dust. When the cells of the bronchial-lining tissue are irritated beyond a certain point, the tiny hairs (cilia) within them, which normally trap and eliminate pollutants stop functioning. As a result, they become clogged by debris and the irritation increases. In response, secretion of mucus is increased resulting in cough and if severe enough shortness of breath.

Bronchitis comes in two forms: acute (less than 6 weeks) or chronic (recurring frequently for more than two years):

Acute Bronchitis:

Image of CXR pneumonia

Chest x-ray of a patient with pneumonia of the right lung

This is responsible for the hacking cough and phlegm production that accompany an upper respiratory tract infection. In most cases, it is viral in origin, sometimes it is caused by bacteria. The mucosal area will return to normal after several days unless there is an underlying lung problem. The presence of fever, chills, muscle ache and chest pain suggest a more serious infection like pneumonia. Chest x-ray should be ordered.

 

Chronic Bronchitis

Chronic bronchitis is defined as excessive mucus secretion in the bronchi presenting with a chronic or recurrent mucus-producing cough that lasts three or more months and recurs year after year. Chronic bronchitis may result from a series of attacks of acute bronchitis, or it may evolve gradually because of heavy smoking or inhalation of polluted air. When the mucus producing layer of the bronchial lining has thickened, narrowing the airways to the point where breathing becomes increasingly more difficult. When the cilia cannot sweep the air clean of foreign irritants, the air passages become more vulnerable to infection. This results in further tissue damage. Unlike acute bronchitis, chronic bronchitis is an ongoing, serious disease.

Diagnosis

Symptoms

  • Persistent cough
  • Productive cough
  • Shortness of breath
  • Wheezing
  • Fever

Investigations

  • Chest x-ray
  • Blood test example blood count
  • Sputum test
  • Lung Function test

The doctor will decide on above tests if indicated and necessary.

Treatment

  • Plenty of rest
  • Adequate fluid intake
  • Avoid smoke and fumes
  • Stop smoking in chronic bronchitis
  • Cough syrup
  • Bronchodilator
  • Inhaled or oral steroid if severe
  • Oxygen therapy if severe
  • Antibiotic if indicated

If you have chronic bronchitis, it is advisable to stop smoking and have an annual flu vaccination.

[Article Ref: Singapore Respiratory Specialists (SRS)]