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Clinical Specialties
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Bronchitis

DEFINITION

Bronchitis is the medical term for inflammation of the tubes that connect the mouth and nose with the lungs, the bronchi. The bronchi are the large airways that allow air to pass from the mouth or nose to the lungs where the exchange of oxygen and byproducts takes place. There are two types of bronchitis: acute and chronic. Acute bronchitis is usually caused by a cold or other upper respiratory infection that moves down into the bronchi. Acute bronchitis can be caused by either bacteria or viruses and will generally resolve in a few days on its own. Chronic bronchitis is generally due to smoking over time which causes a long-standing irritation of the airways and produce mucus, irritation and cough which is similar to acute bronchitis but not caused by viruses or bacteria. Chronic bronchitis will often recur or stick around for a longer period of time. Chronic bronchitis is one type of chronic obstructive pulmonary disease (COPD) with the other type being emphysema. Risk factors for both types of bronchitis include: smoking, upper respiratory illness, poorly functioning immune system (due to HIV or medications that weaken the immune system), gastroesophageal reflux disease (GERD), and lung irritants (like grains, textiles or fumes at the workplace). An acute episode of bronchitis can lead to complications such as pneumonia. Having acute bronchitis repeatedly can mean more serious problems such as chronic bronchitis (as mentioned above), asthma, lung disorders or immune system problems.

SYMPTOMS
Cough that produces thick yellow or green sputum, difficulty breathing, wheezing, fatigue, fever or chills, chest discomfort

DIAGNOSIS
Your doctor will begin by talking to your about your symptoms and habits and then proceed with a physical exam. Your doctor will pay special attention to your throat and lungs. Your doctor may have you get a picture of your lungs (chest x-ray) to make sure that you don’t have pneumonia or other problems with your lungs. Your doctor may ask you to save a specimen of the sputum your cough up to give to the lab to determine what type of bacteria is causing your bronchitis. If your doctor suspects chronic bronchitis or other problems, he or she may recommend seeing a lung doctor (pulmonologist) and having different pulmonary function tests done. Pulmonary function tests can involve blowing hard into a small tube to measure the function of the lungs (spirometry). More complex pulmonary testing can measure the speed with which you breathe in and blow out as well as the maximum capacity of the lungs.

TREATMENT
The treatment of bronchitis depends on if you have acute or chronic bronchitis. In either case, the goal of treatment is to ease breathing and decrease symptoms. For acute bronchitis, it is important to rest and increase your fluid intake. You may find it beneficial to use a humidifier to increase the ease of breathing. Your doctor may recommend medications available over the counter like acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) or cough syrups. Cough suppressants may actually be more harmful than helpful as your body is trying to cough up the secretions to get rid of them and help clear the bacteria out of the airways. If your doctor thinks that you have bacteria causing your bronchitis, he or she may prescribe antibiotics to help treat the infection. If you have chronic bronchitis, your doctor may want you to take other medications or undergo other therapies for that condition. You should discuss all your treatment options with your doctor or pulmonologist.

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