Bronchitis is a respiratory condition in which the mucus membrane of the bronchial tubes becomes inflamed. This can be due to variety of causes eg cigarette smoke, air pollution, viruses, bacteria, chemicals (eg chlorine gas inhalation). The disease comes in two forms: acute (lasting from one to three weeks) and chronic (lasting at least 3 months of a year for two years continuously). One has to be careful about making the diagnosis of “bronchitis” as many other conditions can cause similar symptoms.
Acute bronchitis is usually caused by an infection, usually viruses and sometimes bacteria. Rarely, it can be caused by smoke inhalation, toxic gas release or even extreme air pollution. The patient presents with acute cough, sometimes accompanied by wheezing and fever. Cases not due to microorganisms are usually easily diagnosed by history taking alone. The microorganisms causing acute bronchitis are almost always air borne.
Most patients with acute bronchitis present to their general practitioner with a very short history of cough with low grade fever and sometimes wheezing. Symptomatic treatment is usually given, especially if the patient is not ill and the history is short (less than 5 days). This is because most of these cases are due to viruses. If the history exceeds a week, antibiotics may be prescribed. If the symptoms are prolonged (more than 3 months) or recurrent, it is important to perform investigations to rule out other causes. One very common cause of “recurrent bronchitis” is asthma.
Chronic bronchitis is a serious long-term disorder that often requires regular medical treatment. It forms a part of the spectrum of COPD (chronic obstructive pulmonary disease). Most of COPD all over the world is due to chronic smoking. Cigarette smoke irritates the airways and causes mucus to be produced excessively. The airways also become narrowed as a result of the chronic inflammation.
Patients with chronic bronchitis have a chronic cough, productive of sputum. Some also complain of wheeze or shortness of breath on exertion. Diagnosis of chronic bronchitis is through accurate history taking and clinical examination. The doctor usually orders a chest Xray and a spirometry to confirm the diagnosis and to rule out other illnesses. Quitting smoking is probably the most important measure to take for the patient with chronic bronchitis.