Bronchitis-Its definition, causes, symptoms, diagnosis, treatment and prevention

(Syed Shamsher Ali Gilani-Senior Advocate , Lahore)

Definition
Bronchitis is a condition in which the bronchial tubes become inflamed. These tubes carry air to lungs.
According to Babylon dictionary bronchitis is inflammation of one or more bronchi
Bronchitis, in other words, is an inflammation or swelling of the bronchial tubes (bronchi), the air passages between the nose and lungs. More specifically, bronchitis is referred to a condition when the lining of the bronchial tubes becomes inflamed or infected. People with bronchitis breathe less air and oxygen into their lungs; they also have heavy mucus or phlegm forming in their airways.
Bronchitis-An introduction
Bronchitis is a pernicious disease. In the region of Indo-Pak sub-continent, it usually get its exposure during the climate especially in autumn and winter seasons. As the irritated membrane swells and grows thicker, it narrows or shuts off the tiny airways in the lungs, resulting in coughing spells that may be accompanied by phlegm and breathlessness. More specifically bronchitis occurs when the trachea (windpipe) and the large and small bronchial tubes (airways) within the lungs become inflamed because of infection or irritation from other causes such as dust. Following facts are noteworthy to elucidate in order to understand bronchitis:-
• The thin mucous lining of these airways can become irritated and swollen.
• The cells that make up this lining may leak fluids in response to the inflammation.
• Coughing is a reflex that works to clear secretions from the lungs. Often the discomfort of a severe cough leads a person to seek medical treatment.
• Both adults and children can get bronchitis. Symptoms are similar for both.
• Infants usually get bronchiolitis (inflammation of the bronchioles, the smallest air passages of the lungs), which involves the smaller airways and causes symptoms similar to asthma.
• Asthmatic bronchitis occurs when asthma and bronchitis coexist. Asthma is a chronic inflammatory airway condition that leads to tightening of the muscles around the airways and swelling, both of which cause the airways to narrow. The combination of inflammation of the inner lining of the airways and mucus production can lead to severe wheezing and shortness of breath.
• Breathe when inhaled, small, bristly hairs near the openings of nostrils filter out dust, pollen, and other airborne particles. Bits that slip through become attached to the mucus membrane, which has tiny, hair-like structures called cilia on its surface. But sometimes germs get through the cilia and other defense systems in the respiratory tract and can cause illness.
Kinds of bronchitis

The disease comes in two forms: acute bronchitis (lasting from one to three weeks) and chronic bronchitis (lasting at least 3 months or more).

Acute Bronchitis

Infections or lung irritants cause acute bronchitis. The same viruses that cause colds and the flu are the most common cause of acute bronchitis. These viruses are spread through the air when people cough. They also are spread through physical contact (for example, on hands that have not been washed). Sometimes bacteria can cause acute bronchitis. Bacteria causing throat infection can resultantly cause bronchitis.

Acute bronchitis lasts from one to three weeks. However, coughing may last for several weeks even after the infection is gone.

Acute bronchitis is a shorter illness that commonly follows a cold or viral infection, such as the flu. It consists of a cough with mucus, chest discomfort or soreness, fever and sometimes shortness of breath.

An acute medical condition comes on quickly and can cause severe symptoms, but, as mentioned above, it lasts only a short time (no longer than a few weeks). Acute bronchitis is most often caused by one of a number of viruses that can infect the respiratory tract and attack the bronchial tubes.

Several factors increase the risk for acute bronchitis. Examples include exposure to tobacco smoke, dust, fumes, vapors, and air pollution. Avoiding these lung irritants as much as possible can help lower your risk for acute bronchitis.

Chronic Bronchitis

Due to repeated attacks of acute bronchitis, which weaken and irritate bronchial airways over time, can result in chronic bronchitis. Chronic bronchitis is an ongoing, serious condition. It occurs if the lining of the bronchial tubes is constantly irritated and inflamed, causing a long-term cough with mucus. Smoking is the main cause of chronic bronchitis.

Viruses or bacteria can easily infect the irritated bronchial tubes. If this happens, the condition worsens and lasts longer. As a result, people who have chronic bronchitis have periods when symptoms get much worse than usual.

Chronic bronchitis is a serious, ongoing illness characterized by a persistent, mucus-producing cough that lasts longer than three months. People with chronic

bronchitis have varying degrees of breathing difficulties and symptoms may get better and worse during different parts of the year. If chronic bronchitis occurs with emphysema, it may become chronic obstructive pulmonary disease (COPD).

Causes of bronchitis
Acute bronchitis is generally caused by lung infections, 90% of which are viral in origin.
Industrial pollution is another culprit. Chronic bronchitis is found in higher-than-normal rates among coal miners, grain handlers, metal molders, and other people who are continually exposed to dust and fumes. But the chief cause is heavy, long-term cigarette smoking, which irritates the bronchial tubes and causes them to produce excess mucus. The symptoms of chronic bronchitis are also worsened by high concentrations of sulfur dioxide and other pollutants in the atmosphere.
Here are some major factors that increase the risk of bronchitis, which can be included in causes:
Cigarette smoke. People who smoke or who live with a smoker are at higher risk of both acute bronchitis and chronic bronchitis.
Low resistance. This may result from another acute illness, such as a cold, or from a chronic condition that compromises the immune system. Older adults, infants and young children have greater vulnerability to infection.
Exposure to irritants on the job. Risk of developing bronchitis is greater for the people who work around certain lung irritants, such as grains or textiles, or are exposed to chemical fumes.
Gastric reflux. Repeated bouts of severe heartburn can irritate throat and make the affected person more prone to developing bronchitis.
(Note to elaborate Gastric reflux: Gastric reflux gastric reflux disease, or acid reflux disease in which due to damage in Mucous membrane stomach acid comes up from stomach in to the esophagus /a tube connecting the mouth and the stomach)
Chronic bronchitis is a serious, long-term medical condition. Early diagnosis and treatment, combined with quitting smoking and avoiding secondhand smoke, can improve quality of life. The chance of complete recovery is low for people who have severe chronic bronchitis.
Signs and symptoms of bronchitis
For either acute bronchitis or chronic bronchitis, signs and symptoms may include:
• Cough
• Throat infection in case of acute bronchitis
• Production of mucus (sputum), which can be clear, white, yellowish-gray or green in color — rarely, it may be streaked with blood
• Fatigue
• Shortness of breath or difficulty in taking full strength breath
• Slight fever and chills
• Chest discomfort

In acute bronchitis patient has a nagging cough that lingers on for several weeks after the inflammation resolves. Chronic bronchitis is defined as a productive cough that lasts at least three months, with recurring bouts occurring for at least two consecutive years.
In case of chronic bronchitis, patient usually has to undergo with periods when signs and symptoms are worsen. At those times, patient has to keep acute bronchitis on top of chronic bronchitis.
Tests and diagnosis of bronchitis
During the first few days of illness, it is very difficult to distinguish the signs and symptoms of bronchitis from those of a common cold. During the physical examination, a physician uses a stethoscope to listen the morbid sounds of lungs during deep breathe.
Following are the major tests to diagnose the ailment:
• Chest X-ray. A chest X-ray can help determine whether patient has mucus in the region of lungs or not. Pneumonia or another disease can be ascertained by examining the chest
X-ray.
• Sputum tests. Sputum is the mucus that patient coughs up from lungs. It can be tested to see if patient has whooping cough or other illnesses that could be helped by antibiotics. Sputum can also be tested for signs of allergies. Sputum culture test explores the name of exact bacteria due to which cough and fever occurred.
• Pulmonary function test. During a pulmonary function test, through a device called a Spiro-meter, which measures that how much air lungs can hold and how quickly patient can get air out of lungs. This test checks for signs of asthma or emphysema.

Treatment, medication and therapies in bronchitis
Most of the cases of acute bronchitis resolve without medical treatment in two weeks.


Medication
However, a physician may prescribe following medicines in bronchitis caused by viral infections or infection due to bacteria:
Antibiotics. Bronchitis usually results from a viral infection, so antibiotics aren't effective. However, physician prescribes antibiotics just to avoid further complications such as bronchial pneumonia. Prescription for the use of antibiotic for upper resparatory infections in acute bronchitis, due to bacterial infection, has shown good results.
Cough medicine. It's best not to suppress a cough that brings up mucus, because coughing helps to remove irritants from lungs and air passages. Usually physicians prescribe cough expectorants which help to remove chest congestion by expectorating mucus and phlegm from lungs.
Other medications. In case of cough due to allergy or asthma or in chronic obstructive pulmonary disease (COPD), physicians recommend an inhaler and other medications to reduce inflammation and open narrowed passages in the lungs.
Therapies
In case of chronic bronchitis, pulmonary rehabilitation — a breathing exercise program in which a respiratory therapist teaches that how to breathe more easily and increase the ability to exercise.
Lifestyle and home remedies
In order to avoid the onset of bronchitis following lifestyle and home remedies are recommended by the specialist physicians:
a) Use a humidifier. Warm, moist air helps relieve coughs and loosens mucus in airways. But be sure to clean the humidifier according to the manufacturer's recommendations to avoid the growth of bacteria and fungi in the water container.

b) Avoid lung irritants. Don't smoke. Wear a mask when the air is polluted or if one is exposed to irritants, such as paint or household cleaners with strong fumes.

c) Consider a face mask outside. If cold air aggravates cough and causes shortness of breath, put on a cold-air face mask before going outside.

Prevention
It is well known maxim that prevention is better than cure. Therefore, physicians have recommended following tips to reduce the risk of bronchitis:
• Avoid cigarette smoke. Cigarette smoke increases the risk of chronic bronchitis.
• Get vaccinated. Many cases of acute bronchitis result from influenza, a virus. Getting a yearly flu vaccine can help to protect from getting the flu. Similarly vaccination as a prophylactic measure of protection against some types of pneumonia is strongly recommended by the physicians.
• Washing hands. To reduce the risk of catching a viral infection, it is recommended to wash the hands frequently and get in the habit of using hand sanitizers.
• Wear a surgical mask. In case of chronic obstructive pulmonary disease (COPD), one must wear a face mask while at work or exposing to dusty atmosphere and in crowds.


 

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Syed Shamsher Ali Gilani-Senior Advocate
About the Author: Syed Shamsher Ali Gilani-Senior Advocate Read More Articles by Syed Shamsher Ali Gilani-Senior Advocate : 5 Articles with 24851 views Syed Shamsher Ali Gilani
M.Sc (Applied. Psy) M.A (Pol.Sc, Hist, Eng), LL.M, Diploma in Labor Laws-D.LL,
Diploma in Intellectual Property Laws-
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