Bronchitis occurs when an irritant or infection causes inflammation and swelling of the lining of the bronchial tubes. These tubes, the bronchi, are the major air passages that lead from the trachea (the windpipe) into the lungs. The bronchi are lined with cilia, or tiny hairs, that sweep foreign matter out of the respiratory tract. When the bronchi are inflamed, the cilia don’t function properly, and coughing—the chief symptom of bronchitis—becomes the body’s main way of coping with the irritants and mucus that build up and threaten to clog the bronchi.
Bronchitis can be either acute or chronic. About 5 percent of Americans suffer from chronic bronchitis, which is characterized by a deep mucus-producing cough that over time becomes constant and lasts for months. Most people who get chronic bronchitis are smokers.
Bronchitis signs and symptoms
- Persistent coughing that may be initially dry and hacking, but usually becomes productive, bringing up sputum that is green, yellow, or gray.
- Shortness of breath and wheezing.
- Fever (occasionally), usually below 101°F.
- Chest pain and discomfort behind the breastbone.
What causes bronchitis?
Most cases of acute bronchitis are caused by viruses, including some of the viruses that cause the common cold. Occasionally, however, bacteria cause the condition. Chemical fumes, dust, smoke, or other irritating air pollutants may also cause or aggravate bronchitis. In addition, smoking, asthma, cold weather, and congestive heart failure may increase the risk of an attack.
What if you do nothing?
Attacks of acute bronchitis are common but usually not a major health threat. Symptoms generally clear in about seven to ten days, but if you are a smoker or have a chronic lung disease such as asthma or emphysema, you should seek medical advice earlier.
Home remedies for bronchitis
- Relieve the discomfort. Take nonprescription NSAIDs—aspirin, ibuprofen, or naproxen—or acetaminophen to reduce fever and pain.
- Don’t stop a wet cough. If you have a wet productive cough (coughing up phlegm), do not try to suppress it with nonprescription cough suppressants unless advised to do so by your physician.
- For a dry coughthat interferes with sleep or everyday activities, you can try taking an over-the-counter cough suppressant containing the active ingredient dextromethorphan (usually designated by “DM” at the end of the medicine’s name). But don’t expect too much: There’s actually no good evidence that OTC cough preparations work any better than a placebo. Menthol (such as Vicks Vapo-Rub) or honey are just as likely to help, if not more so, and without the potential side effects. Note that OTC cough syrups should never be given to children younger than 2.
- Drink plenty of fluids. This will liquefy the mucus and loosen phlegm, making it easier to expel them when coughing. Drink sufficient water or other nonalcoholic fluids throughout the day; if your urine is virtually colorless, you are drinking the right amount.
- Humidify the air. Take hot steamy showers or use a humidifier or vaporizer in your bedroom to keep your bronchial tubes moist. However, home humidifiers can harbor fungi and other potential allergens, so be sure to keep the system scrupulously clean and in good working order. Change the water daily, and replace filters as often as directed.
How to prevent bronchitis
- Get the flu shot every year, since bronchitis can be a complication of the flu.
- Don’t share glasses, utensils, or towels with someone who has bronchitis, a cold, or the flu.
- Wash your hands often, especially in cold and flu season.
- Don’t smoke. Avoid secondhand smoke as well.
- Take it easy. If you are at risk for bronchitis, avoid strenuous outdoor work and outdoor exercise on poor air-quality days.
- Steer clear of respiratory irritants. Try to avoid paints, dust, smoke, chemical vapors, or other irritants. If these are unavoidable at your workplace, be sure to use a mask or other protective gear.
- Filter the air. If you live in an area with high pollution levels and your bronchitis has become chronic, consider installing a home air cleaning unit (or "air purifying" unit) to filter the air. Like humidifiers, home air cleaners can provide an ideal environment for fungi that have the potential to worsen your symptoms, so it’s important to keep the system clean and to replace filters as often as directed.
When to call your doctor
Contact your doctor if symptoms don’t begin to ease up within 72 hours or if episodes of acute bronchitis recur. Also contact your physician if you develop bronchitis and you also have a lung ailment or congestive heart failure. If you cough up blood during an attack of bronchitis, or if you have a fever above 102°F, contact your physician.
What your doctor will do
Your doctor will take a complete medical history and then examine you. Blood tests and chest X-rays may also be taken. He or she may prescribe a stronger cough syrup or, if the cough is chronic and unexplained, the anti-seizure medication gabapentin (Neurontin), which is sometimes prescribed off-label as a cough suppressant.
In most cases the underlying infection is caused by a virus, but if you’re diagnosed with a bacterial infection (about 10 percent of the cases), a course of antibiotics may be prescribed.
Also see Coughing: 8 Things to Know.